Tell me if you’ve heard of a scenario like this. It’s the perfect example of a child who lacks proprioceptive skills.
Students are in a line. One student bumps into the other. A little bit of drama ensues, maybe it’s shoving, maybe it’s “hey, he pushed me!” The teacher approaches the pusher, who says, “It was an accident!” and then gets punished for lying too. Sound familiar?
I mean, c’mon! I can’t tell you how many clients I’ve had who have been punished for lack of proprioception.
As a kid, I was called “non-athletic” and put in adaptive PE. Combined with being in the gifted program, it was a nightmare socially. Nerdy smart and I suck at sports? If that’s not a combination for bullying, I don’t know what is. I’ll give the adults in my life a pass since it was the 1970s. But the fact is, I had low muscle tone and poor proprioception and proprioceptive skills.
My whole life I have been clumsy. Even as a middle-aged woman, I constantly have bruises because I walk into things. Things in my house that have been in the same place for decades, like doors.
How does our body know what to do in a dark room? How can we navigate our way around, especially if nothing is in our way to make us stumble and fall? Our body is using proprioception. And since I don’t have great proprioceptive skills, this is why I walk into corners, walls, and doors at night.
Our bodies rely on receptors from our joints and muscles to send messages to the brain to keep our balance and sense of where we are going, and our position in space.
Another example, cover your eyes and have someone move your arm around and place it out in front of you. You will know, even with your eyes closed and covered, that your arm is out in front of you. Unless, of course, you lack this skill.
My son struggles to help me with shirts and things pulled over his head. His arms struggle to get to the right spot.
Proprioception Definition
According to WebMD, “your body’s ability to sense movement, action, and location. It’s present in every muscle movement you have.”
It means we do things like move and walk without concentrating on every step; we just do it. Unless we lack proprioceptive skills, which many children and adults do.
The nervous system has sensory receptors that send messages to the brain from muscles, joints, and tendons. Then the brain kind of does the rest; you just move without putting extraneous thought into each step.
About Kinesthesia and Proprioception
(Don’t miss the article about kinesthetic learning).
While proprioception deals with our position and balance, kinesthesia deals with the body’s movement.
Proprioception, or kinesthesia, is the sense that lets us perceive the location, movement, and action of parts of the body. It encompasses a complex of sensations, including the perception of joint position and movement, muscle force, and effort. It’s a complex system that involves sensory information being felt by the body, and then that information is processed in the brain. And then the ability to react or respond appropriately and timely.
Proprioceptive skills are some of those “hidden skills” that we take for granted unless we lack them. But when you dig in, you can see that proprioceptive skills really tax the brain!
Proprioception describes one’s awareness of posture, movement, and changes in equilibrium and the knowledge of the position, weight, and resistance of objects in relation to the body. The information may be there, but can the child process the information?
Kinesthesia, however, refers to the ability to perceive the extent, direction, or weight of movement. It is the processing of this information.
It is behavioral, and when we move, we continually teach our body what happens when we move a certain way.
When there is an issue with proprioception, it can present as instability on uneven surfaces, being uncoordinated, or balance issues.
To control movement, the brain has to integrate proprioceptive information from various receptors in the body. The role of proprioception in daily activities, exercise, and sports has been studied extensively, as we use it all day, every day.
Drunk? Or lacking Proprioception?
As an example, alcohol inhibits our proprioception. That is why, if you are suspected of DUI, police ask you to touch your nose.
You’ve seen the images, right? The person standing on a road, going through a battery of simple tests to see if they’ve been drinking.
And, if a person is inebriated, their proprioceptive skills will diminish.
But you don’t need alcohol to have poor proprioception. All other things being equal, my son would fail the roadside drunk driving test. Stand on one leg? Not in your dreams.
This had led to countless dangerous encounters between disabled people and police. You can find many first-hand accounts on Reddit about this.
Proprioceptive Disorders
Some conditions can lead to disorders with proprioception. Some of them are Traumatic Brain Injury, Autism, Multiple Sclerosis, ALS, injuries to joints, Parkinson’s Disease, Huntington’s Disease, stroke, arthritis, herniated disks, or neuropathy.
TBI and Autism are both eligibility categories for IEPs.
What will that look like for children with difficulties with proprioception? Such as when they are not processing the proprioceptive input correctly.
One of the significant ways is in motor control planning and bodily awareness.
Some examples are:
- climbing or descending stairs
- bumping into others
- slumping
- inability to stand on one foot
I’m not saying every clumsy kid is learning disabled or has autism, but a lack of proprioceptive skills is genuine. I bump into people accidentally all the time. I stand too close to people in the grocery line.
I’m old enough to know and do better, but sometimes I don’t have the cognitive bandwidth to recognize it in the moment.
Signs of Proprioceptive Difficulty
Here are a few other things kids may do if they struggle with proprioception.
- Their inability to realize their strength~too much or too little pushing on a pencil when writing, throwing a ball too hard, or not with enough force.
- Their posture: they may present with difficulty riding a bike, on swings, teeter-totter, stability ball, or possibly ascending and descending stairs.
Let’s not disregard how difficult this can make socialization with other children! If you cannot play the things your peers are playing, you are usually excluded. Children who lack proprioception are often not good at sports, so they cannot build friendships on teams like others do.
In addition, some kids will seek out too many sensory behaviors (roughhousing, pushing), not realizing when enough is enough, or on the other end, become uncomfortable with too much sensory stimulation.
They do not like touch or tight hugs, etc. It is important to note here that many or all of us can have these issues/behaviors in more moderate ways that do not negatively affect our lives.
For our children that do have issues with proprioceptive input, it is affecting their lives; academically, behaviorally, and socially.
They may not be able to stay on task, sit still and concentrate, play with other kids, or may be seen as exhibiting disruptive or unusual behavior when really it is all about how they are processing their environment.
Having said that, let’s talk strategy now! What can be done for these kiddos?!
Strategies to Improve Proprioception
Time to circle back to the word kinesthesia. Kinesthesia is behavioral; movement. Remember we talked about understanding our position in space?
These strategies may help children with proprioceptive difficulties.
- A tried and true strategy is the use of weights.
- weighted blankets
- weighted vests or lap pads
- Fun exercises to go with the weighted items to give the child the sense of where their body is in space.
- Exercising teaches the body to do certain things and builds muscle tone and coordination.
- Climbing is an excellent activity as it involves pulling and moving, and activating many muscles in the body.
- Joint compressions (ask your child’s PT about this)
- Body brushing (see options below)
- steamrolling with a therapy ball
- yoga (see, this is why I hate yoga, I’ve never been good at it, now I know why)
- tight hugs (appropriate people and spaces only, of course)
- For those seeking proprioceptive input, it is recommended to incorporate crunchy foods
- blowing bubbles
- Vibrating toothbrushes or spoons
Those that are avoiding too much input should be weaned into more acceptance slowly with some of these aforementioned strategies.
Proprioception Accommodations
Finally, let’s look at accommodations at school for our kiddos with proprioception. For special education students, accommodations could be added to their IEPs; non special education students may be eligible for Section 504 accommodations.
That could look like
- a separate setting for testing
- visual schedule
- help with organization and planning
- accommodations for concentration
- removal of distractions
- handwriting
- use of sensory equipment
- assistance with transitions
- determining whether push-in or pull-out (or a combination of both) will meet the child’s needs
Also, an OT could be beneficial with the implementation of anything listed above. They often help with proprioception and interoception.
The critical thing to remember is there is help out there.
Some behaviors that can be looked at as unusual, annoying, or strange; may result from proprioceptive difficulties, and the proper strategies can bring happiness and quality of life to a child.
