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Under-reactive Proprioceptive System by Michelle Liptak

About Alexis

My daughter Alexis was diagnosed with an under-reactive proprioceptive system at the age of four. She is a beautiful child from the inside out but I realized early on that she would never be a graceful ballerina. In preschool, it became apparent that she is unusually clumsy and heavy-handed. While she is typically sweet-natured she would squeeze her little brother and others while hugging. Coloring and learning to write were tough because she would constantly break the writing instruments. Delicate and gentle aren't her thing.

Every parent wants their child to be happy and healthy and while it was heartbreaking to learn that Alexis wasn't developing typically, I know that she has a lot to offer the world and I feel blessed to have her in our lives. We hope that she will use her sensory differences as a tool to gain greater empathy for others who are a little different.

Alexis found it difficult to color due to an under-reactive proprioceptive system.

What is the proprioceptive system?

The proprioceptive system can be defined as our bodies ability to sense where it is in relation to it’s surroundings. It is responsible for helping us move our bodies through space efficiently. Our bodies proprioceptive system receives input through its muscles, joints and ligaments to help create body awareness.

Feedback from receptors in the muscles, joints, and ligaments provide a person with a subconscious awareness of body position.

What are some signs and characteristics of children with under-reactive proprioceptive systems?

A poorly functioning proprioceptive system makes it difficult to know where different parts of our body are without looking. People with this disorder may appear clumsy or heavy handed. This can affect self-awareness, emotional security, and the individual's ability to feel safe and secure in their surroundings. Children who have under-reactive proprioceptive systems will be more likely to use more force than necessary inadvertently breaking things like pencils, run into objects, walls or people, prefer tight clothing, stomp while walking, hug too tightly and chew on inappropriate objects.

Oops...
When children such as my daughter Alexis exhibit the above symptoms, they are considered proprioceptive sensory seekers.

Accommodating children with under-reactive proprioceptive systems

Occupational Therapists work with children so that they can experience and recognize the type of input their body needs to organize itself. Better internal organization allows children to be as calm, focused and attentive to the tasks at hand as they are capable of.

Alexis’s OT coached her on how she can utilize her body as well as tools in her everyday environment outside of therapy.

The goal of occupational therapy isn’t necessarily to reorganize the nervous system, that may not be possible for everyone, but it can be a positive consequence. The primary objective is to help individuals gain confidence and tools to better integrate activities of daily living into their lives, allowing them to more efficiently integrate information from their sensory systems. In OT, communication with parents children, parents and teachers and other caregivers is essential to increase success across all environments.

Alexis’s OT prescribed a sensory diet to help her get the input that her body needs to organize itself.
Sensory Systems

During a sensory diet, sensory input may need to be increased or reduced depending on whether the child is under-reactive, as in the case of Alexis, or over-reactive. Most of these activities can be carried out as home as well as at school. These activities can be carried out whenever necessary for the child to help attend and can take anywhere from a few minutes to a few seconds. The times of day when the activities are carried out should coincide with the child’s schedule.

Examples of Heavy Work (Proprioceptive Input):

  • Using a weighted pen
  • Writing while lying on the floor
  • Weight bearing on elbows
  • Squishy balls
  • Wall pushups
  • Carrying heavy objects like a backpack: Carry backpack from car to classroom, adding extra weight to their bag i.e. water bottles, books, etc.
  • Have the child push their hands together with as much force as possible 10-20 times
  • Chair push-ups
  • Weighted blankets on legs
  • Weighted wrist bands
  • Weighted vest
  • Cleaning the board
  • 5 to 15 minutes on the trampoline at recess
  • Stomping
  • Swing on hanging bars or play structures
  • Wheelbarrow walks
  • Hopping, jumping jacks
  • Hopscotch
Examples of "Heavy Work"

Services and agencies

When Alexis was with her peers I noticed some differences and she's lucky enough to have a god mother who is an occupational therapist. She noted my concerns and was able to provide testing for me and guide me in the right direction so that I could find services nearby.

This website is written by an OT Mom who shares ideas that can be implemented at home or in an educational setting: http://www.ot-mom-learning-activities.com/sensory-integration-activities.html

Ideas for Implementing Sensory Integration Activities into an IEP: http://www.brighthubeducation.com/special-ed-law/117766-integrating-sensory-goals-into-an-iep/

Information about heavy work activities: https://gotoforot.com/2015/12/10/heavy-work-activities-whats-that/

This website is dedicated to informing the public about all things related to sensory processing disorders: http://www.sensory-processing-disorder.com/proprioceptive-dysfunction.html

We have found the therapists at Kid Abilities in Santa Monica to be an excellent resource and team in helping Alexis learn what her body needs. If you live in the area I highly recommend them. They don’t come cheap though. It’s $180/ per 45 minute session and insurance only reimburses me for $25 of that. We take Alexis for two sessions per week: http://www.kidabilitiesla.com/

Weighted vests like the ones these two are wearing are stylish and adaptive. They tend to cost between $45 and $69 per vest:

In Closing

We now know that it’s not related to a lack of intelligence or motivation, but rooted in the way a person processes their body’s sensory input in relationship to the environment. Through a variety of exercises and coping mechanisms, from performing “heavy work” activities to adjusting one’s lifestyle, Alexis and children like her can better regulate themselves and have a better chance of achieving their highest level of functioning.

We hope that Alexis will use her experiences of knowing how hard it can be to do something simple, such as writing with a pencil without breaking it, to extend empathy toward others who may be having a hard time accomplishing a seemingly simple task.

References

Ayres, A. J., & Robbins, J. (1979). Sensory integration and the child. Los Angeles, Calif: Published by WPS.

Gina Geppert Coleman, M.A., OTR/L. Senior Occupational Therapist at KidAbilities in Santa Monica, Calif.

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