Proprioceptive Sense

To continue on with the last few days theme, I am going to concentrate on the Proprioceptive Sense, as documented in The Out-of-sync Child, by Carol Stock Kranowitz.

"Proprioception tells us about our own movement and body position"

It informs us about where we are in space, how our body parts relate to one another, how much and how quickly our muscles stretch, how fast we are moving through space, how our timing is, and how much force our muscles put forth.

"We get the most and best proprioception when we actively stretch and tighten our muscles in resistive motions, against the pull of gravity" (doing a push-up or doing heavy work like hoisting a loaded laundry basket)

Muscle sensations come through the proprioceptive system, which works closely with the tactile and vesitbular senses (discussed in previous blogs). Proprioception helps integrate touch and movement sensations. Due to the relationship, there are two kinds of processing: Tactile-proprioceptive (judging the weight of a glass of milk or holding a pencil efficiently to write) and Vestibular-proprioceptive (to help throw and catch a ball or climb stairs).

"Another very important function is to help modulate our arousal level".

Proprioceptive experiences calm and organize us. It's these kind of activities that help settle children before they sit to listen to a story. Oftentimes, this is the purpose when someone tells you to stand and stretch for a minute before continuing a lecture or seminar.

Proprioceptive Dysfunction

Proprioceptive dysfunction is the inefficient processing of sensations perceived through the muscles and skin, as well as the joints. (it is almost always accompanied with tactile and/or vestibular problems).

The difficulty in processing the sensations about position and movement of body parts can cause the child to have difficulty using this information for adaptive behavior. Oftentimes, this kind of child is labeled the 'klutz'. Exerting too much or not enough pressure while handling objects is a problem for these children. (breaking pencil points or poor grip on objects or trouble holding two objects of different weights)

To compensate, these children oftentimes needs to use their eyes to see what the body is doing. They need the aid of vision to do things that can normally done by feel. (zipping a jacket, getting out of bed in the dark, orienting body to get dressed)

Overresponsive - avoids stretching and contracting muscles; lacks the 'internal eyes' to see what body parts are doing; shun playground activities; typically picky eaters

Underresponsive- lacks the inner drive to move and play; usually clumsy with toys and materials, may not know they are sitting in an uncomfortable position; may not be able to orient body to get dressed

Seeking - bumper and crasher, active mover; craves passive movement to muscles; may bite, kick, hit and behave in an aggressive manor; oftentimes engaging in self-stimulation, such as biting their own skin or banging head against wall.

Proprioceptive Sense and John

As far as I can tell from the checklists, John again, is a sensory seeker. Many categories here had checkboxes that were not age appropriate for John, as I could not answer one way or another. He is too young to tell if he has low self esteem, lacks self confidence saying "I can't do that", has messy school work, , etc. There are times in his speech that I can tell he 'knows' he can't say the hard E sound. (as in bee, Mommy, please). He is now imitating almost everything we say and if we ask him to say a word with the hard e sound, he all of the sudden won't imitate. So, there might be something there, but again, he seems to young to tell for sure.

The Vestibular Sense

Using Carol Stock Kranowitz' book, The Out-of-Sync Child as a reference, I am going to concentrate on the Vestibular Sense today.

The Vestibular System

The vestibular system sends sensory messages to our brain about balance and movement, generating muscle tone so we can move smoothly and efficiently. The receptors for vestibular sensations are hair cells in the inner ear, stimulated by gravity. It is what responds when we feel ourselves "falling"-- the response being self-protective reflexes.

Vestibular Dysfunction

Vestibular dysfunction is the inefficient processing in the brain of sensations received through the inner ear. Posture and coordination can be off. Eye movements are influenced by the vestibular system, so visual problems can occur --- inadequate gaze stability, inability to focus on moving objects, reading problems due to coordination issues with left-to-right eye movement, etc. It can contribute to difficulty processing language. Certain movements that should produce a calming effect do not for the out of sync child, causing them to be unable to calm themselves down. Difficulty moving smoothly interferes with behavior and attention.

Overresponsivity - children respond negatively to movement; causes emotional outbursts or overexcitement; can't organize sensory stimuli due to overload; some may be intolerent to any movement at all;

Gravitational Insecurity - no sense of stability; primal fear of falling - abnormal distress and anxiety about falling

Underresponsivity - this child doesn't seem to notice changes in movement; these children typically were called "easy babies"; loved curling up for long naps; later lacks any motivation to want to move; does not usually seek movement; needs extra movement just to get going, but then once started, has difficulty stopping; oblivious to the sense of falling

Seeking more - can't get enough of movement; increased tolerance for movement; enjoys vigorous activity; loves being upside-down, loves to climb - -uses everything for a ladder; loves swinging for exceptionally long times; loves twirling in circle --oftentimes seeming like they don't get dizzy; darts from one activity to another; short attention span even for things they enjoy; constantly on the go, but moves without caution or good motor coordination


Muscle Tone is the degree of tension normally present when our muscles are in the resting state. A child with a vestibular dysfunction may have low muscle tone. (this is not strength of muscles, but the state at which the muscles are at rest). Their muscles lack the energy needed to be ready to move. It takes a little bit of extra effort to just get them started.

Bilateral Coordination is a term used to describe using both sides of the body to work together. A well-regulated vestibular system helps to integrate sensory information from both sides of the body. Children by age 3 or 4 should be able to cross the mid-line, which means reaching with one hand to the other side of the body (crossing the center of one's body) -- think 'cherry-pickers' from grade school PE class (arms outstretched-twisting and bending to touch our right hand to our left foot and then back to center, reverse) or shaking hands with someone (your right hand with their right hand, crossing over your center of your body).
It's also what contributes to the ability to jump with both feet from a ledge to the ground, as opposed to just stepping off with one foot.---- or using both hands to clap.

The Vestibular Sense and John

For John, I checked 2 of the 4 listed for underresponsive in movement
and 4 of 7 in sensory seeking. I had a lot checked and a lot of question marks in the "sensory slumper with sensory-based postural disorder affecting movement of head, balance, muscle tone, and bilateral coordination".

John had lots of scattered skills throughout this section, but nothing that is definitive for me, although my gut tells me he is the sensory seeker for movement.

For example, he moves all the time and is almost always in constant movement, which would tells me that he is a sensory seeker. However, he doesn't vigorously shake his head, doesn't rock back and forth, doesn't like trampolines more than other kids (he will jump for 2 seconds and then he is done, as with everything else he does), etc. Many of the questions in the checklist were not age appropriate for me to know yet with John (like seeks out thrill rides at amusement parks).

He appears at times to be uncoordinated, but can clap, cross the mid-line, open doorknobs, is already potty trained (poor bladder control is one checkbox), and loves structured activities (hard time with structure was another check box) -- he actually loves the structure.

So, to sum it up, there seems to be an issue here for John, but I can't pin point it myself. I'll have to see what the OT evaluation shows.

The Tactile Sense

The tactile sense is the sense of touch. Tactile dysfunction is the inefficient processing in the central nervous system of sensations perceived through the skin.

In today's blog, I will be using Carol Stock Kranowitz' book, The Out-of-Sync Child, as my main source of reference for this information. I will be concentrating on the tactile sense today, but there are other senses that need to be and will be discussed in later blogs.

Tactile Sense at Work

A normal tactile sense lets us know when something feels nice and when something feels wrong. We can sense danger through touch (self preservation), as well as enjoy touch. Touch lets us know when someone is "too close" to us or if something is "too hot" for us. Normal tactile sense allows us to discriminate what kind of touch we are feeling.

Tactile Dysfunction

Children can be tactile defensive (overresponsive) - they respond negatively to unexpected, light touch senstations; uncomfortable with touch; will over respond with a fight, flight, fright or freeze response

Children can be tactile underersponisive -they disregard touch --soothing or painful; may not be able to self-protect because he can't 'sense' anything touching him

Children can be tactile sensory seeking - they crave deep pressure, more skin contact than most, touch & feel everything in sight, handle things that other children understand are 'no-nos'; they just have to touch it; intense & impulsive; loves messy play, crams mouth with food; gets too close to other people - can touch to the point of annoyance

The tactile sense affects everyday skills, such as body awareness, motor planning, visual discrimination, language, academic learning, emotional security, and social skills.

"The child with poor tactile awareness in his mouth, lips, tongue, and jaw may have a sensory-based motor problem called oral apraxia, which affects his ability to produce and sequence sounds necessary for speech". quoted from The Out-of-Sync Child by Carol Stock Kranowitz.

How Tactile Dysfunction affects John

I see John with a Sensory Seeking Tactile dysfunction. In this section of the Kranowitz' book, there is a checklist. In the Sensory Seeking category for Tactile dysfunction, I checked 12 of the 15 options. In the other categories, I checked 0 of 17 boxes for over responsive to being touched, 0 of 17 for over responsive to active touch, 4 of 14 for Under responsive and then 12 of 15 for sensory seeking. (the ones I didn't check in that category were 1. twirls hair in fingers 2. seeks really cold or really hot bath water 3. prefers steaming hot, icy cold, or spicy food )