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Movement and Body Awareness

What is body awareness?

Movement and Body Awareness Proprioception: How the Body Senses Itself
When you close your eyes, how do you know where your feet are? Your arms? Your hands? Proprioception is the internal sense that tells you where your body parts are without your having to look at them. This internal body awareness relies on receptors in your joints, muscles, ligaments, and connective tissue. They pick up information as muscles bend and stretch as well as when your body is still. The joints, muscles, and connective tissue in your buttocks, hips, and legs are compressed (pushed together) as you sit and read this. They are "distracted" (pulled apart) when you hang from a chin-up bar.

Information about body position travels through the spinal cord and into parts of the brain that are not conscious. Because of this, you are seldom aware of where your body parts are unless you actively think about them. As you read this book, your attention is focused on the concepts and information presented. You may be filtering out the sound of your children playing in the other room. Perhaps you're eating a snack. Whatever you are doing, you are probably not thinking about your body position. Yet you are not falling off your chair or the couch because sensory receptors are taking care of that for you.

Life for a child with impaired proprioception is not so easy. He's a "space cadet" because he doesn't know where his body is in space; there's no internal body map to ground him. He's not quite sure where any body part is at any given time unless he looks. Both moving and staying still take some conscious effort. Such kids may be physically clumsy or move slowly to compensate. Without proper proprioceptive input from his trunk and legs, your child might slide off a classroom chair, stumble on stairs, or fall when he runs.

Poor proprioception in the fingers makes it difficult to manage fine motor manipulations needed to write well, button clothing, and make a peanut butter and jelly sandwich without shredding the bread. Without being able to gauge the weight of things (think: compression of the joints), your child drops pencils or uses so much force to pick up things that he hits himself in the face.

Since proprioceptors detect the stretch and pull on muscles and joints, telling the brain just how much tension the muscles need, impaired proprioception robs the body of key information needed to maintain good muscle tone.

Laura, a preschooler Lindsey worked with, was an active, affectionate child at home, but her hugs were way too strong. At mealtimes, she spilled her juice, and her plate flew across the table onto the floor when she attempted to scoop up food with her spoon. She had a complete meltdown at her friend's birthday party when someone put a blindfold over her eyes to play Pin the Tail on the Donkey, and couldn't calm down until her mother hugged and rocked her for a very long time.

Laura wasn't being rough or destructive – it's just that without the knowledge of how to apply the correct amount of force on things, she couldn't fine tune her movements because she was not getting reliable sensory information from inside her body. When blindfolded, Laura had no way to monitor her body and its position in space.

While Laura craved intense proprioceptive experiences, such as crashing into walls, banging toys, tumbling around in a pile of pillows, and general roughhousing to get stronger sensory messages, some children don't seek it out and may try to avoid such input as much as possible. They're the kids slumped over their desks like limp noodles while doing homework or who are usually "too tired" to play outside with the other children.

Common Signs of Body Awareness Problems
All children refine their body awareness as they mature. Compared to other children his age, does your child...

• seem to move awkwardly or stiffly?

• seem to be physically weaker than other children?

• use too little or excessive force on things (for example, has trouble attaching clothing snaps, pop beads, and Legos, writes way too light or too dark with a pencil, breaks toys often)?

• push, hit, bite, or bang into other children although he isn't an aggressive child?

• avoid – or crave – jumping, crashing, pushing, pulling, bouncing, and hanging?

• chew on clothing or objects more than other children do?

• always look at what he is doing (for example, he watches his feet when walking or running)?

Problems with the vestibular systemHow the Body Handles Movement: Vestibular Sensitivities
The vestibular system has many different pathways and different jobs to accomplish. As with other sensory systems, some of these pathways may be working efficiently, while others are not working well at all. The difference between children who are oversensitive and undersensitive to movement can be dramatic. The brain normally processes vestibular and other sensations by facilitating protective responses if they are appropriate ("Watch out!") and inhibiting protective responses ("No need to worry – go for it!") or at least dampening them ("Proceed with caution") if there is no immediate threat. A child will typically assess the situation – Am I in danger? – and act accordingly. Not so for the child with a poorly functioning vestibular system.

Gravitational insecurity. A child with gravitational insecurity has an exaggerated emotional response to antigravity movements way out of proportion with the actual possibility of falling. The pull of gravity most of us trust and take for granted is perceived by this child as a primal threat to survival. Because there is no inner sense of gravity's reliability, just a bit of movement may feel like he's bungee jumping or being tossed into outer space. Research suggests that gravitational insecurity may be caused by poor modulation of input from the otoliths.1 The gravitationally insecure child prefers to stay low to the ground – lying down or seated (often in W-sitting, see page 176 for an illustration) – rigidly fixing his body to prevent any possibility of movement, and avoiding most active physical tasks. This child becomes quite upset when movement is forced on him, especially if it is unexpected.

Max, the little boy afraid to get on the swings, is a classic example. He becomes fearful and anxious whenever his feet aren't firmly planted on the ground. He hates it when other people force him to move, but he pretty much trusts his mom. Other parents and baby-sitters in the playground are envious about how he never runs off like their children do. Instead, Max sticks right by his mom's side, looking for her to fend off all those kids who might bump into him or push him. He waits for her to recognize that he can't handle all the chaos and to safely guide him to the security of the sandbox where he can plop down in a corner, close to the earth.

Movement intolerance. Some children feel uncomfortable with fast movement or spinning. Children with vestibular sensitivity get dizzy or nauseated very quickly on merry-go-rounds or riding in a car. For children who also have visual sensitivity, just watching another child spin can make them sick because an eye reflex stimulates the vestibular system. A child may have both gravitational insecurity and movement intolerance.

Hyposensitivity to movement. When a child has a high threshold for sensory stimulation, she craves more, and more, and more of it to get the input she needs. A child who underresponds to vestibular stimulation may move a lot, but not necessarily in an organized, appropriate manner. She may have low muscle tone and difficulty moving against gravity. She may have difficulty transitioning from one position to another (such as getting up to walk), and problems starting and stopping movement. She may also move impulsively, without regard to safety.

What to look for Common Signs of Movement Problems
There's a wide variation in how much children like movement. Yes, some are happiest curled up for hours with a good book, while others go stir crazy if they sit around too long. To determine if there's a problem, ask yourself whether your child...

• is constantly on the move (can't sit still, fidgets);

• dislikes – or craves – activities that require his feet to leave the ground or challenge his balance;

• seems to have a stiff head, neck, and shoulders – or always holds his head straight;

• hesitates or is afraid of climbing or descending stairs and playground equipment;

• seems overly fearful – or fearless – of movement, heights, or falling;

• gets dizzy very easily – or never gets dizzy;

• becomes easily carsick or falls asleep immediately in a car (or bus, boat, train, airplane).