Making Sense of our Internal Regulators

Baby pushing strollerSometimes when I take a look around I feel like an old lady with these young therapists cropping up! But, I tell you us older folks need young therapists to show us new tricks, to remind us of forgotten tricks and to help keep our spirit young.  I met Kaitlyn Vokaty (Occupational Therapist) about 6 months ago at a local clinic, Fingerprints Therapy, in Naperville, Illinois where I see 4 kids for ongoing therapy.  We currently have a co-treat session with one of our kids.  Recently, she brought in the Guess Who game and said I thought this would be good for asking questions.  Yes! Great idea for speech and language!  Kaitlyn is one of those naturals that just “gets it” and digs right in.    Many of our kids need us to think about the senses discussed below in order to work on speech and language.  Any who…Here is Kaitlyn and an informative post regarding proprioception and vestibular input!

Some of the most common questions that parents ask me pertain to our internal senses, the vestibular sense and proprioception. Questions I often hear include, “How is swinging calming?” “How does the vestibular system work? and “What is proprioception?” Every client of mine benefits from some form of vestibular and proprioceptive input – children who struggle with attention and focus, children who have sensitivity to clothing or food, and children who are under responsive to the senses, to name a few examples. I have a feeling there are many more parents or clinicians out there wondering why occupational therapists incorporate swings, scooter boards, and heavy work activities into our sessions and how these activities improve our children’s function in everyday life.

As you know, we have 5 senses: taste, smell, hearing, vision, and touch. Nobody talks about the other two very crucial senses to our functioning, the vestibular sense and proprioception. These senses begin forming before birth and continue to develop with the other five senses as we grow. When children’s senses are not regulated, it is very difficult for them to properly use their senses – listening to directions, paying attention in class, completing an activity with background noise, wearing clothing without feeling the texture of it on their skin all day, or tasting and enjoying food. Occupational therapists aim to regulate our clients’ sensory systems in order to help them feel comfortable in their own skin, with others, and with their environments.

vestibularMany of my clients come in with tactile sensitivity (sensitive to clothing or human touch), or the opposite in which kids do not sense tactile input accurately, oral sensitivity (sensitive to food taste or texture), and auditory sensitivity (sensitive to sounds), olfactory sensitivity (smell), and visual sensitivity. You would think that I should target that specific sense that is having difficulties in order to solve the problem. While we still have specific interventions for balancing each sense individually, such as feeding therapy, the amazing thing is that we can help regulate the five senses by organizing our internal regulators.

The vestibular system tells us where our head is in space, the speed of our movement, and in what direction we are moving. It is a major organizer of sensory input. It functions like a traffic cop, telling each sensation where and when it should go or stop. It organizes the data received from the senses. The vestibular sense is important for the development of balance, coordination, eye control, attention, and some aspects of language development. It is composed of small receptors in the inner ear. When you swing and move, these receptors send nerve messages to your brain. Your brain then tells your body how to stay balanced. So much is happening in our ears every second of the day! When choosing vestibular activities, we think about how we can challenge that system in ways that it is not used to and in doing so we help regulate the vestibular system. That’s why we choose activities that will change your child’s head position, such as prone in a swing. All vestibular input is calming and regulating.

Proprioception tells us where our body is in space. We have proprioceptors in our muscles, joints, and skin. They allow us to know where our joints are positioned as well as the amount of force against our body and the effort our muscles need to apply for any action. It is needed for body awareness (resource for body awareness). So, we incorporate activities that involve lifting, pushing, pulling, and weight bearing to provide input to our clients’ proprioceptors, which is calming and organizing for their systems.

proprioceptionThink about behaviors you see in your kids or clients that may be inappropriate. Do they spin through the house? Crash into the couch? Chew pencils? In many cases, your kids are not just doing this for fun! They are communicating with you that they are seeking sensory input to organize their internal regulators. Spinning – they are seeking vestibular input. Crashing, chewing, jumping – they are seeking proprioceptive input. Instead of saying no to them, respond to their needs by providing them with a structured sensory task. They will love that they can still do the things that they are craving, and you will love it because it is a structured task and nobody is getting hurt! Think about when your child demonstrates similar inappropriate behavior and what triggers him or her to do sensory seeking type things. Is it during transitions? In the morning? Is it before bath time? Before dinner? It will be beneficial to plan sensory breaks before those trigger moments.

  • If your child is running through the grocery store knocking down food, have him or her push the grocery cart for proprioceptive input.
  • If your child is chewing pencils, provide him or her with something else to chew: gummy bears, gum, chewable toys, candy necklaces, or Bubba straws (chewing provides proprioceptive input!)
  • If they will not go to bed no matter what you do, have your child do animal walks (resource for animal walks) to get that deep calming pressure , carry a heavy ball upstairs, bury them in pillows. Then as they get into bed, give them a big bear hug for even more deep input.
  • If your children are having a hard time sitting in their seat completing homework and cannot focus, don’t push and instead let them have a wiggle break. Tell them to do jumping jacks, bear crawls, frog jumps: all of these movements organize the vestibular system and proprioception and will help your child attend to the homework.
  • Think about how much sensory input parks have to offer. If your child is crashing and spinning at home, bring him or her to the park to climb monkey bars, climb up slides, slide down slides, and swing.

Think about how you used to comfort your infants when they were crying. You would swaddle them tight and rock them in the rocking chair – vestibular input and proprioception. Your toddler or teenager still needs just that for calming and regulation, just in different forms now. The internet is full of more ideas for providing vestibular and proprioceptive input. Here are a couple sites I have referred to:

Thank you for reading my post about our internal regulators. Comment below to share how you incorporate vestibular input and proprioceptive input into your children’s or clients’ daily routines! And, feel free to ask questions too!

Sources:
Kranowitz, C.S. (2003). The out-of-sync child has fun. New York: The Berkley Publishing Group.
Szklut, S.E. (2007). The art of clinical reasoning: Enhancing sensory integration perspectives for assessment and intervention.

Thank you Kaitlyn for joining us this week! We look forward to another guest post from you down the road!  If you enjoyed this post and found it helpful please consider sharing with others.  For next week we will be continuing the Toys and Tips series with another one of my favorites! Consider signing up to receive the posts via email so you don’t miss one!

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  1. Jennie Reed

    Please ask Kaitlyn to review her comment, “All vestibular input is calming and organising”. This is true for the proprioceptive system however for some children the vestibular system can be easily put into over drive. Therapists would be aware of this but some parents may not. We can also use stop/start vestibular movements, which are alerting for the nervous system.

    • Kaitlyn

      Hi Jennie! Thank you for reading my post and commenting. I agree with your comments.
      The intent of this post was to generally explain how regulating the vestibular sense and proprioception is key for sensory modulation. To clarify my statement, vestibular input can be used in therapy to both calm and organize the sensory system, depending on the client’s sensory needs. All children’s sensory systems are different; therefore, as you stated, vestibular input can also be alerting to the system through start/stop movements and the speed of movement that is applied.
      When engaging in activities that provide vestibular input, be observant of your children’s reactions. Stop swinging if your child asks to stop and be cautious of dizziness.

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