PROPRIOCEPTIVE UNDER RESPONDERS
Behaviors that you will see when a child is under responsive includes:
- Constant movement
- Can't sit still
- Impulsive
- Quick movement with disregard to safety
- Poor attention to task
- Seeks rough play
- Toe walking or walking with heavy feet
Try these strategies:
1. WEIGHT BEARING -Picking up a child who needs to move to limit their movement is counterproductive. Let them walk and move. You can also get weight through the arms by doing a wheelbarrow walk.
2. RESISTANCE ACTIVITIES & HEAVY LIFTING-Carry, push, pull, lift, throw, jump, climb
3. CARDIOVASCULAR ACTIVITIES-Get them to move. Play chase, play hide and seek, play soccer, have races, ride a bike. There are so many ways to help kids get their heart beating.
4. DEEP PRESSURE ACTIVITIES-Massage, Traction/Compression to extremities. Have the child hold himself suspended from a bar on the playground or do a handstand. Experience yoga with children.
5. PRACTICE TIMING and TARGETING-Here are some suggestions: Stopping a ball with one foot, catching a tossed ball, targeting a ball to a basket or goal, playing bean bag toss, throwing laundry into a basket.
6. SOCIAL AWARENESS -Teach spatial boundaries. Often, kids are unaware of how close they are to others. There is a free social story titled “Stay in Your Bubble Social Story” by Ariel Vestri that you can find online. It is about when it is and isn’t ok to give friends a hug. Please know, that when we identify an issue such as a child “hugging” too much or inappropriately, it is a behavior that should be telling us more. The social story alone will NOT be useful. Because you are not addressing the primary need which is a sensory need. The child needs to be able to get this input in other ways. The child is seeking proprioceptive “deep pressure” input. If you fill this bucket appropriately and use it in conjunction with a social story it will be more effective.
7. DAILY ACTIVITIES-Use weighted utensils at meals, blowing off food, sucking from a straw, how to turn to get seated in a chair, putting extremities into clothing, stepping on/off a step stool (toileting/handwashing), getting into clothes, dig in the garden, shove drawers closed, vacuum, mow grass, push grocery cart.
Challenging behaviors that may be present with children who are Proprioceptive Seekers/Cravers: Please be aware that these children are trying to "fill their buckets". If you take something away, you need to replace it with something that helps them get what they need, or you may find yourself battling a worse behavior.
8. HEAD BANGING-Consider the possibility that there could be other medical issues. Head banging could be due to pain (most children don't have the words to say, "I have a headache." I also see so many children with eczema that looks to be so itchy and painful that I can't imagine living in the child's skin. Address medical issues first. Then try to fill the bucket by offering proprioceptive input through the head. (Gentle but firm head compression can be offered manually or with helping the child do a handstand.)
9. MATSTERBATING-This is simply a child trying to offer pressure to a body part and it feels good. Some ways to help reduce this is to offer more pressure to that part of the body with compression garments, lap pads, and offering ways to keep the hands busy and out of the pants. If you take something away, you must give something to replace it.
10. HITTING SELF OR OTHERS, PUSHING OR PULLING ON OTHERS-This is an area where we need to really pay attention to the function of the pushing/pulling. If a child is doing this because they are filling a sensory need, then we need to address it in that way. Consider what happens when a child throws a tantrum. The adult will often grab their arm and pull them back to stand. They are using a behavior to fill a sensory need- I need to be pulled upon. When they don’t get it by traction, they can get it by compression when they push others.
This same input happens when a child hits themselves or others. Figure out the reason for the behavior. Not all hitting is sensory. Sometimes, I want to hit someone when they are ugly to me or take something I was working on. If the behavior is persistent and is a safety issue for themselves or others, it needs attention. Kids who bang their head on the floor when you take a toy away and sit right back up and smile at you when you give it back are demonstrating behavior. This has worked for them in the past and they are continuing to use it as a part of their mechanism to get needs/wants met. Parents often do not want to watch the child head bang, so a lot of attention is given to it or the item the child wants is given back to them to stop the head banging. This only reinforces the behavior…
-Here is a suggestion:
Decide what your limits are…if you DO NOT want the child to have something and it is a limit breaker, then DO NOT give in when the behavior occurs…
1. Say, “We can do SOMETHING else” or “You can have this instead>>Distraction often works.
2. If the behavior continues, bring them to a place where the head banging is not harmful. A bedroom on the bed or the sofa are nice soft places.
3. Do not give in.
4. Know this, the behavior has been working and when it stops working, they will get confused. They will think... well, this worked just fine yesterday, maybe she doesn’t hear me and I need to be louder or do it longer. At some point I will get what I want because this works. You will need to hold firm through the behavior. Try not to verbally address the child in this crisis because each word you say will stimulate more anger.
11. SCRATCHING / PINCHING-When I have clients that scratch/pinch, I try to offer activities they can do with their fingers/hands that mimic the same thing they are doing to their bodies or the bodies of others. Peeling stickers off a sticker sheet, put objects into thera-putty and have the find them by prying the putty apart with their fingers, pull small Velcro items off a board.
12. TEETH GRINDING -Bruxism, or tooth grinding, may occur for a variety of reasons, some of which include poor temporal mandibular joint formation or alignment, ear infection, gum infection, tooth disease, tooth eruption, sinus infection, pain anywhere in the body, muscle weakness or abnormally increased muscle tone. Dental intervention may be necessary. Debra Beckman has good strategies for this and can be found on her website. “An Oral Motor Perspective on Bruxism.
13. PICA BEHAVIORS-Pica is when a child is eating things that have no nutritive value such as hair, dirt, paint chips, rocks, carpet fibers, feathers. Iron-deficiency anemia and malnutrition are two of the most common causes of pica, followed by pregnancy. In these individuals, pica is a sign that the body is trying to correct a significant nutrient deficiency. Treating this deficiency with medication or vitamins often resolves the problems. If you address this only in a behavioral way, you will not be getting to the source of the problem. Fill this bucket with offering the correct intensity and frequency of input. Find toys/items that are safe for chewing and that do not break down. Be vigilant of the toys that they can chew and swallow and be mindful of areas where this is a significant problem (like on a gravel or tire shred playground) Ingestion of items such as this will require surgery. Offer more intense oral input.
