**1. Introduction**

It is important to learn about the 7 senses. We all are familiar with the five senses and the other 2 senses are the Vestibular sense of balance, movement and Proprioception body position sense. By integrating, or combining all the information we get from our senses, we can 'make sense' of the world around us and successfully move through and interact in our world [1].

Proprioception is a continuous loop of feedback between sensory receptors throughout your body and your nervous system. Proprioception, also called kinesthesia, is the body's ability to sense its location, movements, and actions. Children who are clumsy, uncoordinated, and sensory seeking are often experiencing proprioceptive dysfunction. The following are common signs of proprioceptive dysfunction:


#### *Proprioception*

These children often self-regulate by engaging in behaviors that provide proprioceptive input such as toe walking, crashing, running or flapping. Heavy work or tasks that involve heavy resistance and input to the muscles and joints is essential to regulating proprioception [2].

For good control of the muscle and voluntary movement proprioception is required. In pediatric conditions like CP, autism, Downs syndrome and development disorders it is always associated with proprioceptive deficits and hence the

*Proprioception Impairment and Treatment Approaches in Pediatrics*

**CNS The spinal level** The proprioception detects changes in the length and tension of the mucle and provides a stream of information to the cerebellum.

This contributes to postural control and a sense of gravity.

The proprioception information is integrated with the tactile system through

**Cerebellum** This information integrates with vestibular information.

dorsal column medial lemniscal pathway.

Proprioception always integrates with tactile and vestibular system [10]. Sherrington has the first studies on these topics in 1906, he has been established that muscle spindles are a major source of proprioceptive feedback to the central nervous system and appear to mediate the conscious perception of movement and

**1 Month** The newborn will interpret some of his body sensations and respond with built in reflex

Proprioception provides ability to move. if there is any deficit in proprioception, our body movements would become slower, difficult and require more effort to

movement control is affected [9].

*DOI: http://dx.doi.org/10.5772/intechopen.96382*

Processing of proprioception occurs:

limb position for the proprioceptive information [11].

• Eyes and neck motor functions

• Arms & hands movements • Airplane position

• Recognizes the moving and loved to be moved

By 5 years the child becomes mature sensorimotor being.

movement respond to • Gravity and movement • Muscle and joint • sensation • Sound • Smell & taste • Touch

• Grasping • Raising up

• Locomotion • Spatial perception • Finger and eyes • Motor planning • Babbling

• Play • Standing up • Words **2 Years** • Localization of touch • Moving • Mapping the body • Climbing • Self-hound

perform a movement.

**Somatosensory Cortex**

**The development steps:**

**2&3 Months**

**4 to 6 Months**

**6 to 8 Months**

**9 to 1 Months**

**3rd to 7th Year**

**79**

Children that have difficulty sensing or processing proprioception often try to self-regulate by engaging in activities and/or behaviors that provide intense or frequent proprioceptive input [3].

**Sensory Processing/Sensory Integration** is when our different sensory systems work together to process different sensations from our body and/or environment. So, we are able to identify and give meaning to the different sensations we experience to accomplish daily activities and move in a coordinated manner. **Sensory Processing Disorder** is the inability to receive and efficiently use sensory information. Difficulty in processing sensory information interferes in our daily activities and impacts our functional ability to perform different tasks [4].

Benefits of sensory integration therapy may include: [5]


Assessment and intervention should explicitly focus on links among selfregulation, social participation, skills and perceived competence to address parents' expectations [6].

Interventions are proposed that relate to children's participation in contexts in which they live, learn, and play as well as the support of parents in the occupation of parenting [7].

Parents usually understand their child better than anyone else. They play an important role during the intervention and throughout their life time. I hope this chapter would enhance then to understand and give a clear picture of the child who have difficulty with proprioception dysfunction. The concept of this chapter comes from a body of work developed by A. Jean Ayres, PhD, OTR. This theory has been further developed and refined by the research of Dr. Ayres, and other occupational and physical therapists.

## **2. Proprioception impairment and treatment approaches in pediatrics**

#### **2.1 Proprioception**

Proprioception refers to the sense of relative position and movement of the limbs and body.The mechanoreceptors embedded in the joint muscle, tendon and skin provides the proprioceptive information [8].

*Proprioception Impairment and Treatment Approaches in Pediatrics DOI: http://dx.doi.org/10.5772/intechopen.96382*

For good control of the muscle and voluntary movement proprioception is required. In pediatric conditions like CP, autism, Downs syndrome and development disorders it is always associated with proprioceptive deficits and hence the movement control is affected [9].

Proprioception provides ability to move. if there is any deficit in proprioception, our body movements would become slower, difficult and require more effort to perform a movement.

Processing of proprioception occurs:

These children often self-regulate by engaging in behaviors that provide proprioceptive input such as toe walking, crashing, running or flapping. Heavy work or tasks that involve heavy resistance and input to the muscles and joints is essential to

Children that have difficulty sensing or processing proprioception often try to self-regulate by engaging in activities and/or behaviors that provide intense or

**Sensory Processing/Sensory Integration** is when our different sensory systems work together to process different sensations from our body and/or environment. So, we are able to identify and give meaning to the different sensations we experience to accomplish daily activities and move in a coordinated manner. **Sensory Processing Disorder** is the inability to receive and efficiently use sensory information. Difficulty in processing sensory information interferes in our daily activities

and impacts our functional ability to perform different tasks [4]. Benefits of sensory integration therapy may include: [5]

• Improved function in school, home and community

• Active involvement and exploration of environments

• Efficient organization of sensory information

skin provides the proprioceptive information [8].

• Improved independence with activities of daily living (ADL)

• Maximized functional ability to perform daily and recreational activities

Assessment and intervention should explicitly focus on links among selfregulation, social participation, skills and perceived competence to address parents'

Interventions are proposed that relate to children's participation in contexts in which they live, learn, and play as well as the support of parents in the occupation

Parents usually understand their child better than anyone else. They play an important role during the intervention and throughout their life time. I hope this chapter would enhance then to understand and give a clear picture of the child who have difficulty with proprioception dysfunction. The concept of this chapter comes from a body of work developed by A. Jean Ayres, PhD, OTR. This theory has been further developed and refined by the research of Dr. Ayres, and other occupational

**2. Proprioception impairment and treatment approaches in pediatrics**

Proprioception refers to the sense of relative position and movement of the limbs and body.The mechanoreceptors embedded in the joint muscle, tendon and

regulating proprioception [2].

*Proprioception*

frequent proprioceptive input [3].

• Modulation of sensory systems

• Enhanced motor planning ability

• Self-regulations

expectations [6].

of parenting [7].

and physical therapists.

**2.1 Proprioception**

**78**


Proprioception always integrates with tactile and vestibular system [10]. Sherrington has the first studies on these topics in 1906, he has been established that muscle spindles are a major source of proprioceptive feedback to the central nervous system and appear to mediate the conscious perception of movement and limb position for the proprioceptive information [11].

#### **The development steps:**


The important age of development of sensory integration after birth is from 1st month to 7 years. Sensory stimulation, motor activity and exposure to environment during the early childhood have a great influence on the neurons and major role in the development of sensory and motor processes [12, 13].
