Explore The Sense Of Touch

The sense of touch (or tactile sensory perception) is one of our most important senses. It begins to develop very early during pregnancy and becomes quite active long before a baby is born. Like the other senses that play an important role in sensory integration, it usually goes about doing its job without us noticing very much. Yet it is very important for allowing us to perform many skills and to feel comfortable and at ease in many situations.

Babies learn a lot about the world through the sense of touch. When they go through the stage of picking up and putting everything in their mouths they are using their sense of touch to find out about shape, size, and texture. This is how they first learn about the difference between things like round and square, big and little, rough and smooth, etc. If the sense of touch is not very specific, that is, it doesn’t provide clear, consistent information, then it may be more difficult to understand these types of differences visually or cognitively. The hands, feet, and mouth are the most sensitive areas of our bodies because they have many more cells which detect and respond to touch. We depend on information from our touch system to help us perform many skills.

Touch as Feedback

Think about how hard it is to do anything with gloves on. Your muscles still work the same way, but you have reduced “feedback” from your sense of touch. Think now of all the intricate tasks done by using your sense of touch, without looking — finding a dime in the bottom of a pocket, buttoning a button on the back of a shirt, cracking a sunflower seed and removing the seed with your tongue — all day long, one after the other, we rely on our sense of touch to perform everyday tasks without giving it a second thought. How would you do these things if your sense of touch did not help very much? How much longer would it take you to do things if you had to stop and look at everything, or if you had to think about everything, you were going to do with your hands. This happens to many children who are not able to rely on their sense of touch. It can be frustrating and confusing.

Try These Touch Activities

If a child has poor or inconsistent touch perception, one aim of therapy is to help this function to work more efficiently. We might use many different therapeutic activities to work on this. Here are some things you can do at home to help a child whose sense of touch is less than optimal, or who might benefit from enhanced touch feedback:

  • Play hide and find games with objects hidden in dried beans or rice. Choose objects with which your child is familiar, and see if he can identify objects by touch alone. If your child is not verbal, have her match simple shapes (Example: place a coin, a block and a ball on the table. Say, “When you find one of these, show it to me.”
  • Play games where you ask the child to describe an object being felt without looking at it. You can keep the ideas simple, such as “round” “cold” or “wet” or more complex, such as a “long, smooth, pointed object.”
  • Have objects with different textures available for play and help your child discriminate between soft and hard, rough and scratchy, bumpy and smooth, etc. Talk about these differences and see if your child can distinguish them through touch.
  • Have your child identify shapes (or letters and numbers if your child is at this level) that are drawn on their back or on their hands. You can play this game in the bathtub and draw through soap foam or shaving cream so they can see the shape after they have tried to guess.
  • Have your child draw simple lines, shapes, letters or numbers with their fingers in substances such as sand, play-doh, soap foam, pudding, etc. The extra sensation may help them get the idea of the shape or letter.
  • Think about ways to involve novel tactile experiences during play and daily activities. For example, crawling through tunnels, climbing over cushions or rolling in blankets/cloths of various textures; adding shaving cream to a small pool “slip and slide”; making fun cooking activities that involve forming dough with the hands; adding cloths, sponges, loofas and scrubs to bath time; getting “buried” in the sand at the beach, etc.

These are just a few ideas. Try to think about your own sense of touch and incorporate tactile discrimination games and tactile activities into your child’s play in a fun and non-stressful way.

Explore The Sense of Touch© is part of a series of “Parent Pages” on the topic of sensory integration written by Zoe Mailloux, OTD, OTR/L, FAOTA. May be reprinted for educational purposes with full title and copyright information included.

Visual Perception – What Do We See Through The Mind’s Eye?

Of the sensory systems that we discuss when we talk about sensory integration, visual perception (along with auditory perception) is one of the most familiar and commonly understood. Visual perception refers to the meaning that our brains give to the information that we see. For example, if you look at the following design it may appear only as a series of lines with no real meaning:

IVY - Upside Down

The lines spell the word “Ivy” upside down. Now the lines have a meaning when you look at them. An optometrist checks our eyes to ensure they are working well to see the world around us. Visual perception allows us to make sense out of what we see. Good visual perception is obviously needed to read, write, use scissors and draw. We also need visual perception to keep from bumping into things, to direct a ball toward a goalpost on a soccer field and to follow a map to a desired destination. There are many functions related to visual perception. Figure-ground perception refers to the ability to see something that is part of a bigger or confusing picture. For example, finding a roll of tape in a drawer or identifying your child while he is climbing on the play equipment at the park requires figure-ground perception. Mental imaging is another aspect of visual perception. We use this skill to figure out how to arrange furniture in a room (sometimes we need a few attempts!) or planning to put paper in a printer so the letterhead comes out correctly. Eye-hand coordination is also a part of visual perception. We need this skill to coordinate the actions we use to serve a tennis ball, to tie our shoes (at least when we are first learning) and to pull a lever at the right time on a pinball machine. It is easy to see how problems in visual perception can create many hardships in the classroom, on the playground and at home.

Therapists concerned with sensory integration usually think of visual perception as an “end product” of good tactile, proprioceptive and vestibular sensory processing. In other words, these basic systems must work well for a higher-level system, like visual perception to develop. This is why a child’s therapist may select therapeutic activities that do not, at first, seem obviously related to the concerns at home or school. For example, a child who has trouble learning to write may have problems with his vestibular sense which makes it difficult to coordinate his eye movements when his head is moving. He may have poor proprioception which makes it difficult to judge how hard to push on the pencil or how to position himself correctly in the chair. Poor tactile perception may interfere with his ability to hold a pencil properly. Therefore, therapists often work first on these foundational skills to help higher-level skills, like visual perception, come along more easily.

What You Can Do To Help

The following are some ideas that can be used to help the visual perception systems develop and function optimally:

  • Encourage your child to build things-with blocks, couch cushions, cardboard or plastic boxes- or any other found materials. You can help your child to develop visual perception by both making structures for your child to copy and also to have your child make his own creations (ones that you might try to copy to add to the fun).
  • Make puzzles, mazes and other visual games that are at the right developmental level for your child available and easy to access. You may need to start with simple ones if this is an area in which your child might need some help.
  • Books and games such as “Where’s Waldo” and “I Spy” can be helpful for developing figure-ground perception. You can also ask your child to “spot” signs, cars or other landmarks while on walks or driving in the car.
  • Parents often know how important it is to read to their children and to provide visually appealing toys and designs in their rooms. Finding ways to help your child interact with these important visual elements such as stopping to point to objects in a book or to trace designs on the wall will make the visual experiences more meaningful and long-lasting. Active participation always trumps passive input!
  • Practice “drawing” shapes and objects in various tactile media, such as sand, finger paint, shaving cream, etc. The touch and visual systems develop closely with one another and feeling the shape, size, and texture of something will reinforce the visual concept as well.
  • Similarly, matching shapes or objects felt in the hands with pictures of objects will further reinforce the co-development of tactile and visual perception.
  • Simple and fun eye-hand coordination games such as tossing, catching and batting with balls or other objects will support depth perception and smooth eye movements in conjunction with visual perception and motor skills.
  • With increased access to computer and handheld games, some children will spend a lot of time watching screens. While many of these games and apps can be engrossing for a child, those that involve some problem solving and physical interaction (such as the on-screen games that involve activities like bowling or tennis) will be most supportive of your child’s overall development.
  • Be aware of too much visual stimulation-too many visual distractions in a bedroom or study area can be distracting for a child who is sensitive to visual stimuli or who has trouble discriminating one thing from another visually. If your child seems especially sensitive to sunlight, to certain colors or contrasts of colors, or to particular shapes, consider ways you can reduce the irritation by removing these sensory features of a situation. Helping your child to understand that he may be more sensitive than others to these experiences may also help him to cope more effectively.

Visual Perception – What Do We See Through The Mind’s Eye?© is part of a series of “Parent Pages” on the topic of sensory integration written by Zoe Mailloux, OTD, OTR/L, FAOTA. May be reprinted for educational purposes with full title and copyright information included.

Discover Proprioception: A “Hidden” Sense

Most children learn that we have five senses: sight, sound, taste, touch, and smell.

However, there are other very important senses not included on this list.

Awareness of our body position or “proprioception” is one of these. Because we do not usually teach children about this sense or think about how much we all use it, most people are not aware of it. This creates an additional challenge when the sense is not working well. If we’re not even aware of it, it’s hard to understand problems related to it. Just as our eyes and ears send information about what we see and hear to the brain, parts of our muscles and joints sense the position of our body and send these messages to the brain as well. We depend on this information to know exactly where our body parts are and to plan our movements. When our proprioceptive sense works well, we make continual, automatic adjustments in our positions. This sense helps us to stay and to move into optimal positions for everyday activities such as sitting in a chair to do paperwork; holding utensils such as a pen or a fork in the right way; judging how to maneuver through an aisle so that we don’t run into or knock down things; knowing how far to stand away from people so we’re not too close or too far; planning how much pressure to exert so we don’t break a pencil lead or a toy; and changing actions that were not successful, such as the throw of a ball that was off target or a dive that turned into a belly flop.

Since proprioception helps us with such basic functions, a problem in this system can cause a great deal of trouble. Often, an individual has to pay attention to things that should happen automatically. He may also have to use vision to compensate and “figure out” how to make adjustments. This can take a lot of energy. A child with these difficulties may feel clumsy, frustrated and even fearful in some situations.

For example, it may be very scary to walk downstairs if you’re not sure where your feet are. The proprioceptive system is activated through push/pull type activities, jumping, and activities that involve weight and deep pressure. This kind of sensation is often calming and may be helpful to a child who becomes easily disorganized.

Help Your Child Be More Aware Of Body Position

The following are some examples of proprioceptive-type activities. They may be useful in helping children be more aware of body position and become more calm and organized:

  • Have children help with “heavy work” activities like carrying in the groceries, carrying the laundry basket, pulling bags of leaves, taking out garbage cans and pulling weeds.
  • Play “backpacking” by placing bags of beans or rice in a child-size backpack. Pretend to be climbing mountains and jumping off rocks at the park or in the backyard.
  • Make a “sandwich” out of your child between the couch cushions. Gently add pressure as you pretend to put on “pickles”, “cheese”, ”lettuce”, etc.
  • Have the child close his eyes and “feel” where his legs, hands, arms, etc. are. Ask if they are up or down. See if the child can get into different positions without looking, such as rolling into a ball, touching his nose, making a circle with his arms, making an “X” with arms and legs, etc.
  • Some children will especially enjoy the sensation of holding onto a bar and feeling the stretch of hanging and swinging their body from it. A pull-up bar installed in a doorway can be a simple way to offer this activity to a child at home.
  • Give the child extra proprioceptive input when he is learning a new skill. For example, wearing a light-weight cuff when a child is trying to throw a ball may give a little extra feedback about the position of his arm. Other examples include practicing letters, shapes or numbers by making them in clay or another firm mixture; placing your hands on his hips or shoulders and providing gentle pressure when the child is learning a new motor skill such as climbing upstairs or skating; and moving the child through an action and providing gentle resistance to his movements so he can “feel” it more easily.
  • Provide gentle but firm massage if your child enjoys this. Try rubbing arms and legs to help wake him up, applying gentle pressure to his shoulders and head to calm him down, or massage his hands before he tries a difficult fine motor task

These are just a few ideas. Use common sense and don’t apply too much pressure or ask a child to push, carry or pull something that’s too heavy. Experiment and find out what seems to help your child the most.

Discover Proprioception: A “Hidden” Sense© is part of a series of “Parent Pages” on the topic of sensory integration written by Zoe Mailloux, OTD, OTR/L, FAOTA. May be reprinted for educational purposes with full title and copyright information included.

The Vestibular System: Why Is It So Critical?

Of all the sensory systems that we talk about in sensory integration theory and treatment, the one that may be the most basic, yet the hardest to understand is the vestibular sense. This sensory system develops just a few weeks after conception and plays a very important role in a child‘s early development. It was also probably one of the most important senses for our evolutionary ancestors. However, the vestibular sense is not familiar to many people.

Children do not learn about it when they learn about the basic sensory systems and if adults know about this system, they may only be aware that it has something to do with balance. Understanding more about the vestibular system will be helpful to a better understanding of the types of problems children may have as well as the methods we use to address these problems.

As we all know, there are portions of our eyes and ears which “take in” sights and sounds and send that information to our brain. The parts of the vestibular sense which “take in” information to be sent to our brain are located in the inner ear. One part is a set of fluid-filled canals which respond to movement and change of direction. The other part is a sac-like structure which responds to change of head position and gravitational pull. The information about movement and head position that comes in through these structures is sent to many different parts of the brain. This is one of the main reasons we are so concerned about this sensory system–it has so many different functions which are important to our ability to do so many things.

One important function of the vestibular system allows us to coordinate our eye movements with our head movements. This occurs in activities such as copying from a blackboard (looking up and then back down at our work), turning our head to watch a moving object (as in watching a ball move across a soccer field), and even sometimes in looking across a page to read. These functions of the vestibular system probably help to explain why several studies have shown that up to half of all children with learning disorders show signs of vestibular dysfunction.

The vestibular system is also important for helping us to develop and maintain normal muscle tone. Tone is not the same as muscle strength, but it does allow us to hold our body in position and to maintain positions. The vestibular system is especially important in helping us to keep our heads up. Many children with vestibular problems slouch at their desks, hold their heads up with their hands and generally seem to have low endurance.

Balance and equilibrium are also very influenced by the vestibular system. In addition, our ability to coordinate both sides of our body together (as is needed in riding a bicycle or cutting with scissors) also require good vestibular function. Finally, some aspects o flanguage seem closely related to the way in which the vestibular system processes information.

Considering all of these very basic and important functions, it is not difficult to see how a vestibular problem can create a very real yet often invisible problem.

What Parents Can Do To Help. The following are some ideas that can be used to help the vestibular system develop and function normally:

  • Movement experiences are very important to the developing child. Be sure to make time for activities like swinging, sliding, riding the merry-go-rounds at the park, etc. Encourage active, child-propelled movements rather than passive movement (e.g. never spin, twirl, or swing a child excessively or for prescribed lengths of time-this is sometimes recommended by individuals who quote, but do not understand, Ayres‘ theories).
  • Experiment to see if your child has an easier time sitting up or doing her paperwork after physical activity (especially swinging or other movement activity). The vestibular system often has a fairly immediate effect on the nervous system, and for some children, these activities can make desk type work much easier.
  • Encourage activities in which the child lies on his stomach and holds his head up. Try playing with Legos in this position, or have him throw objects at a target while lying on his stomach on a swing.
  • Encourage “bilateral” or two sided activities such as jumping rope, swimming, biking, rowing, paddling, etc. Too much swinging or spinning can have negative effects (overactivity, lethargy, changes in heart rate and breathing, etc.) Some children cannot pace themselves very well and have reactions sometime after the activity. Discuss these activities with your therapist and plan appropriately for your child.

THE VESTIBULAR SYSTEM: WHY IS IT SO CRITICAL? is part of a series of “Parent Pages” on the topic of sensory integration written by Zoe Mailloux, OTD, OTR/L, FAOTA.

How Sensory Processing Disorders May Affect Kids

Sensory Processing Disorders may affect kids in multiple ways. In the following post, we explain the 2 additional senses related to body awareness and balance/spatial orientation.

Many are already familiar with the five senses:

Sensory Processing - child legos
  • Taste
  • Sight
  • Touch
  • Smell
  • Sound

Did you know there are two more senses? These two additional senses refer to body awareness (proprioception), and balance/spatial orientation (vestibular sense).

Proprioception

Proprioception is the ability to sense where your body is in space, and the ability to safely maneuver around your physical environment. For example, we can tell when our arm is raised above our head without looking at it because of our sense of proprioception.

Vestibular Sense

Vestibular Sense helps control balance, eye movement, and spatial orientation. It helps you stay stable and upright.

Sensory Processing Disorder

Children with Sensory Processing Disorders have trouble organizing information received from the senses. That is, they can be oversensitive to input, undersensitive to input, or both.

These issues can make it hard for children to succeed in school. For example, a child who is undersensitive to the sound of a school bell may take longer to transition to the next class simply because they were not alerted by the initial sound of the bell. A child who is oversensitive to the sounds of peers laughing or talking loudly during recess may be observed to cover their ears because they are overwhelmed with the auditory input.

There are many other ways sensory-motor difficulties can be observed. The following examples may be suggestive of difficulty with sensory integration.

Undersensitive Children

Children who are undersensitive to sensory processing input may seek out more sensory stimulation, which may look like:

  • Constantly touching people or feeling different textures
  • Personal space issues
  • High pain tolerance
  • Unable to sit still/are fidgety
  • Love jumping, bumping and crashing activities
  • Enjoy deep pressure
  • Crave fast, spinning, and/or intense movement

Some behaviors might look like hyperactivity or Attention-Deficit/Hyperactivity Disorder (ADHD) when many of these behaviors are sensory seeking. It is important to speak with your medical team for more information.

Oversensitive Children

Children who are oversensitive to sensory processing input may avoid sensory stimulation, which may look like:

  • Unable to tolerate loud noises
  • Refuse to wear clothing/find tags and labels irritating/clothes feel too tight
  • Easily distracted by background noises
  • Fearful of playground equipment
  • Clumsy and bump into people
  • Have extreme meltdowns when overwhelmed

Medication and Treatment

There is currently no medication available to treat sensory processing issues.

However, occupational therapists engage children in specific, purposeful physical activities that are designed to regulate their sensory input, so they may participate in their daily activities and navigate their environment more efficiently.

An occupational therapist who is trained in the Ayres Sensory Integration approach identifies the child’s sensory preferences, assists the child in becoming aware of what their body seeks and avoids (self-awareness is key!), and provides meaningful activities that are the “just-right fit” to help regulate their sensory needs so they may go about their days more smoothly.

The sensory system is a realm of the human body that can be overlooked because we do not necessarily constantly and consciously think about it (much like how we take breathing or the beat of our heart for granted).

However, our senses affect how we go about our days and how we interpret our days. Think about it: if we are in an environment with consistent auditory and visual stimulation for hours, we may go home feeling drained and ready to relax.

We may not consciously think about it, but our brains are constantly processing, registering, and putting together the sensory input we provide it. What we surround ourselves with and what we do matters.

Once understood it can be fun learning about how we can modify our environment or activities to set us up for success for the day.