Going back to basics, Tummy Time! (Sensory Processing)

This last couple of weeks I’ve been learning quite a bit about sensory processing in relation to early trauma in children. I’ve been able to understand much more about it, and have been very lucky to attend a training day with Sarah Lloyd, an OT who has done a lot of work around sensory processing in childhood trauma and neglect, (see link at the end of post to find her book) As an OT myself I am particularly interested in this topic, and how I can use my existing and newly learnt knowledge to help my little girl achieve her best. I really wish I knew more about sensory processing in children before now, so hopefully this post will help others who are keen to know more too.

So, we were talking with our social worker about our little girl and mentioned that she falls over a lot. This was initially several times a walk, but has actually reduced quite a bit now. We just thought it was because our little girl is very tall, with long limbs, so maybe she’s just still growing into her body and woking out what to do and co-ordinate herself. We never really considered it could be more than that, and thought that she didn’t really exhibit any sensory impairment, so didn’t think about sensory processing. Our social worker recommended that we read Sarah Lloyd’s book (see link below), so I did, and it totally changed my thoughts about sensory processing. I was also very fortunate to attend a training day delivered by Sarah, which really helped me to further understand the topic and to learn about why the techniques taught work. Some parents came and shared how some simple activities and games designed to improve sensory processing had changed their children’s lives. That was really powerful and encouraging.

So, what is sensory processing you ask?, well in it’s basic form it’s all about sensory integration and how early movement and sensory experiences affect brain development. When children have missed out on the normal early movement experiences (e.g. trauma/neglect), they become out of tune with their own bodies, and have little body awareness. They can’t recognise how they’re feeling inside – e.g. they don’t know if they’re hot/cold, hungry or full up. Because body awareness is a foundation for learning, social and emotional development, a lack of it will lead to difficulties in all areas of life as the child grows up. The child also struggles to recognise, understand and control their emotions. Improving sensory processing works on the theory that the systems are not broken, instead they’re under-used, and need lots of practice/use to become functional. This means that missed physical developmental gaps can be filled, and this is what we as adoptive parents can be doing with our children.

From reading the book & attending the training I have worked out that my little girl probably has underdeveloped vestibular and proprioceptive systems. Now I’m not diagnosing this, I’m not qualified to do this, but Sarah advises that you can’t do any harm practicing normal developmental movement patterns, and none of the exercises/activities are technical or more than what any child does in their everyday lives, so should not overstimulate or damage. She does say that if you suspect your child to have a sensory processing disorder, then specialist assessment and treatment/management is required.

The vestibular system helps us balance and not fall over. it gives us gravitational stability and core strength/stability. It is the earliest developing system, which develops in utero (before birth). It is fully formed by mid pregnancy. When the baby is moving in the uterus, this is massively priming the system in preparation for after birth. It’s important to understand that drugs/alcohol will have a depressing affect on this system, so the baby will be born already neurologically compromised. The vestibular system provides our stable base, which for us is the head, neck and shoulder girdle. Without good control of these, we struggle to perform activities very well. Its these that babies develop first.  Under-active vestibular systems present as low muscle tone, being fearful of movement and poor balance/co-ordination. Subtly my little girl has all of these. She didn’t learn to scoot or jump with two feet for ages, she was cautious/fearful in the play-park, and fell over a lot. She walks down steps with 2 feet on each step at a time. She seemed to have poor core muscle control and strength.

The Proprioceptive system is all about knowing/sensing where your body part is in space, and being able to move it in a smooth/co-ordinated way, sometimes without having to look at it. (e.g. walking without always having to look at your feet to know where they are). This may explain why my little girl appears to fall over ‘thin air’. if she is distracted (and being hyper-vigilent she tends to be very aware of her environment, but not always of herself), she diverts her attention from looking at her feet to something else and is no longer compensating for the lack proprioceptive feedback . If you don’t know where your body is in space, the best way to orientate yourself is by connecting with the environment around you, e.g.touching/feeling/ banging/crashing into things. Some children with underdeveloped proprioceptive systems struggle to get adequate sensory feedback from their environment, so they have to move around a lot to achieve this, and know where their body part is and what its doing. They tend to be very fidgety, and can use excessive force (being heavy handed) without really being aware of what they’re doing.

So, what can we do to build up these systems? The main point I took away from the teaching session was that the best way to develop the vestibular and proprioceptive systems is to strengthen the base (head, neck, should girdle) This can be done by the child laying down on their tummy, and being encouraged to lift their head up.  Lots of activities can be done in this position (e.g. reading, watching tv, drawing) Once the child can manage this, they could try to move onto commando crawling. Other more ‘heavy’ activities such as carrying heavy items, pushing against things, wall squats can help to calm the central nervous system when it becomes over-stiumulated or over-aroused. They help to stimulate the proprioceptive system, and help to ‘ground’ the body.

Since learning more about sensory processing we have already been practicing laying on our tummies, and it’ll be fun to come up with some ways to make it fun and challenging at the same time.We started going to the play session at the gym. I’ll try to think about how we can use what there is there to work on her ‘stable base’. It’s prompted me to remember that even though my little girl did not appear to have sensory processing impairment, her background makes it highly likely that she does have it to some extent. Its my job to make sure that she gets the opportunities to fill in some of those early gaps as it will all help to set her up better to manage her world when she’s bigger.

Sarah’s Lloyd’s book: “Improving Sensory Processing In Traumatised Children”