Pawprint, May 2014

Therapist's Corner
Deanna Maciole
'Steamrolling' Through Proprioceptive Input
Deanna Macioce, MS, OTR/L

As teachers, parents, and therapists, we learn more and more each day about sensory processing, especially in our everyday life.  We see how the world around us is always feeding our sensory systems, and how it effects our interactions with the environment and others. In turn, we begin to get a better understanding of what it means for our children, especially those who have Sensory Processing Disorder (SPD). We all love a good bear hug or that great deep pressure massage, right?  Well, that is not true for everyone however, we have found that providing activities that elicit proprioceptive input offers a realm of benefits.

Proprioception plays a major role in overall self-regulation for children who demonstrate difficulty with tactile input, focus, attention, and body awareness.  Understanding proprioception and the effect that it has on the body is sometimes very complex since it also affects the tactile and vestibular systems.   Having a functional proprioceptive system helps improve body awareness, postural control and stability, and motor planning.  

So often we hear about trying to find ways to address proprioception with heavy work activities. With success, these activities will help our children motor plan with greater ease, understand where their bodies are in space, attend better, and demonstrate improved postural control.   These activities help with organizing and calming a child's sensory system. There are numerous activities that help provide proprioception, especially in our day-to-day routines.   Carrying a backpack, climbing at the playground, loading and unloading groceries, as well as participating in yard work, just to name a few.

Within the therapy setting, there are many pieces of equipment out there to assist with the various needs of children who demonstrate sensory processing concerns, but one that is very successful and versatile at providing the proprioceptive input so often desired is the Southpaw Steamroller.  The Steamroller is a great addition to any obstacle course, providing the necessary deep-pressure input for a calming effect. It also is an ideal place to have your child hang out to complete an activity such as a puzzle, reading a book, or doing a maze for continuous input. The Steamroller allows you to be creative because is easy to attach to a theme, such as making pancakes or going through a car wash.  Set out cars on one end and have a child go in and out of the Steamroller multiple times to take the cars through the car wash. In addition to providing deep pressure, it is an excellent way to address improving shoulder strength and stability, as well as motor planning.  As a child negotiates his or her way into the machine, they pull themselves out with their arms giving them just enough support to work on shoulder strength.  

Whether you have direct access to the Steamroller or not, take the time to focus on proprioceptive input for our children this month with new ways to use the Steamroller or finding ways to provide it in those activities already happening naturally at home.


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Southpaw Products
  Portable Itinerant Frame
Portable Itinerant Frame
Using the lightest, strongest material available, our Itinerant (ITN) Frame will fit in almost any area giving "on the go" therapists the first real portable suspension system on the market. Comes complete with a built-in safety rotational device.

Linear Glider
Linear Glider
Southpaw's Linear Gliders are another therapist-proven piece of equipment. The Gliders accommodate clients from pre-schoolers to adults in a variety of positions. Your creative possibilities are endless with this piece of equipment. It is ideally used to provide vestibular input, increase balance, address weight-shifting abilities and increase bilateral coordination.

Sling Swing
Sling Swings
Southpaw's Sling Swing, a single-point suspended hammock, provides full and even support and will not gather or bunch with weight of the client. Made of soft nylon knit fabric, the Sling Swing works like a net, without any tangle problems.
Available in two sizes, the Sling Swing can accommodate a full range of client weights.

Professional Spotlight
Zoe Mailloux
Tactile Defensiveness: Some People Are More Sensitive©
Zoe Mailloux, OTD, OTR/L, FAOTA

In addition to the important role of our touch (or tactile) system previously discussed under tactile perception, another critical aspect of this sense is its protective function. Our tactile sense alerts us when something is sharp, hot, cold, or in some other way may present a danger. We learn to "notice" those things which may represent harm or danger and respond by moving away from them. For some individuals, however, the aspect of the touch system which distinguishes between potentially harmful and harmless "messages" does not work normally. Occasionally we see children who have an underactive sense of touch. These children do not seem to feel pain as much as others and often seem unaware of tactile sensations that should be noticeable. More common, however, is a condition of inconsistent responsiveness or hypersensitivity to touch. Dr. A. Jean Ayres was the first to describe this condition as "tactile defensiveness." An individual with hypersensitivity to touch or tactile defensiveness appears to overreact to sensation that most people might not particularly notice, or at least are not bothered by. Common signs of tactile defensiveness include: sensitivity to certain types of clothes or fabrics; preference or aversion to foods which seems most related to the texture of the food (e.g. avoidance of smooth and creamy foods or irritation in response to crunchy or lumpy foods); avoidance of touching substances such as finger paint or mud, or of getting one's hands messy; avoidance of walking barefoot on particular surfaces such as sand or grass; a greater than normal resistance to having teeth brushed, hair combed or face washed; and/or a tendency to prefer to touch rather than be touched, especially when the touch is unexpected. Because we do not usually think much about our sense of touch or realize that some people are more "sensitive" than others, many of these behaviors are often attributed to personality, emotional make - up, or behavioral tendencies. However, enough cases of tactile defensiveness have been documented for us to be confident that this is truly a neurologically-based condition which can create a great deal of discomfort and even turmoil for the individuals who experience it and their families. Our sense of touch is closely tied to our emotions. Perceiving frequent discomfort through this sensory system is likely to make an individual demonstrate emotionally potent reactions. Thus, children who experience this condition are often described as irritable, withdrawn, weepy, angry, etc. It's difficult to pay attention if a person is thinking about how his clothes feel, or how much it bothered him when someone brushed against his skin while he was standing in line. Individuals who have this condition can cope with it better at some times than they are able at other times. Stresses such as fatigue, illness, anxiety and even hunger often make the defensive reactions more severe. Therapy aimed at reducing tactile defensiveness attempts to gradually elicit more regulated reactions to various tactile sensations. The goal is to normalize the way the nervous system registers and interprets touch information and to develop productive coping strategies for understanding and living with increased sensitivity.

What You Can Do To Help

The following are ways you may be able to help your child or other members of your family who seem to display tactile defensiveness:

 * Light, ticklish touch is usually the most irritating. When you touch your child, attempt to use firm and constant pressure , versus light touch. You may be able to help your child avoid the irritation of light touch by asking the teacher if your child can stand at the front or back of lines or at the end of a reading circle at school rather than in the middle.
 * Firm, consistent - pressure tends to override tactile irritation. This is why we naturally rub something that hurts and it is probably how hugging developed.
 * Firm massage, pressure (as in wrapping: the arms or legs with a stretchy material such as an ace bandage) and gently "sandwiching" the child between cushions may be helpful.
 * Pay attention to which types of clothing, play substances or social situations (e.g. walking through a crowded mall) seem to elicit negative reactions from your child. Until the problem is alleviated, try to avoid irritating situations (e.g. let your child wear all cotton clothes if that is what she prefers).
 * Avoid power struggles over this unless safety or some other critical issue is involved. It is easy to think that the child with tactile defensiveness is trying to manipulate you or purposefully make your life difficult. Believe him when he tries to tell you something hurts. There is a good chance that it does.
Note: any sudden or significant change in behavior should always be checked. Children with issues around sleep, digestion, allergies and other medically based conditions might show increased irritability, including tactile sensitivity. Be sure that other possible conditions are considered and fully evaluated before assuming that these behaviors are sensory in nature.

 TACTILE DEFENSIVENESS: SOME PEOPLE ARE MORE SENSITIVE © 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.

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