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THE AFFECTS OF REFLEXES AND
SENSORY SYSTEMS ON GROSS
MOTOR SKILLS.
Presented by:
Amanda Pickett, DAPE Teacher,
Sartell-St. Stephen Schools
Michelle Schluender, PT, DPT
Benton Stearns Education District
OUR SENSES
Near Senses
� Taste
� Smell
� Vision
� Hearing
� Touch/Tactile
� Proprioception
� Vestibular
Far Senses
A CHILD’S VIEW OF SENSORY PROCESSING
� http://www.youtube.com/watch?v=D1G5ssZlVUw
�Sensory overresponsitivity� Too excited or over aroused to participate and engage in a
productive manner
SENSORY
� Sensory underresponsitivity◦ Too lethargic or unaware of internal and/or external
sensory stimuli to participate in a meaningful manner
VISUAL:
� Vision provides knowledge of the surrounding
world and therefore informs us about our
movement and position in space. It is one of the
key components for postural stability.
� Poor visual- spatial processing: Shield eyes to
screen or squints, has difficulty with eye gaze
from the board to paper, omits words or numbers
when reading or copying, orients drawings poorly
on the page (writes uphill or downhill), confusing
right and left, and has a poor sense of
directionality .
VISUAL SYSTEM EXERCISES &
CLASSROOM TOOLS
� Eye Tracking/Crossing Midline
� Eye Tracking with a Flashlight
� Launch Board
� Flip and Catch Ball
� Wand catch
� Tetherball
� Hit a Balloon or Scarf
� Toss Bean Bags or Rings
� Mazes, Puzzles, Word Searches, Coloring
� Visual timer
� Visual schedule
AUDITORY:
� How we process sound and filter sounds/ information through our ears for interpretation as a base for communication or when learning a new skill.
� Auditory Defensiveness: Hypersensitivity to noises and sounds not usually bothersome to other people. Sounds from vacuum cleaners, radios, or certain voices can range from annoying to painful. Student’s may cover their ears, become agitated, or display behaviors when becoming auditory defensive.
� A child with poor auditory- processing may: Be unable to pay attention to one voice or sound without being distracted by other sounds, seem unaware of sounds- may look around to locate where the sounds came from, misses verbal directions, and has trouble attending to, understanding, or remembering what he/she reads or hears.
AUDITORY SYSTEM CLASSROOM TOOLS
� Headphones
� Talking Phones
� Music
� Game: How many sounds can you hear, eyes
closed?
� I-pod Touch with music
� Awareness of Seating in the classroom- keep
towards the front of the room.
TACTILE (TOUCH):
� Awareness of where and how a person has been touched or can involve more discriminative touch as a base for the development of a skill.
� The child with poor tactile discrimination may: seem out of touch with his/her hands, be unable to identify body parts, be unable to perform certain motor tasks without visual cues (such as zipping, buttoning), puts on gloves or socks in unusual way, is a messy dresser (shoes untied, waistband twisted).
TACTILE (TOUCH):
� Hypersensitivity (Tactile Defensiveness): Responds to light or unexpected touch as if it were uncomfortable or threatening.
� The child may object to having tags in the back of shirts, avoid wearing certain clothes, dislike having hair washed/brushed, or brushing teeth, avoid touching certain fabrics, surfaces, carpet, overreact when getting glue or paint on fingers.
� Hyposensitivity (Under-Responsiveness to Touch):Doesn’t seem to respond to touch or has an unusually high tolerance for typically aversive stimuli (pain, temperature).
TACTILE (TOUCH):
� For tactile stimulation the child may: need to
touch certain surfaces and textures (like the wall
when walking in the halls), seek certain messy
experiences, enjoy vibration or movement that
provides strong sensory feedback, rubs skin
excessively.
TACTILE SYSTEM EXERCISES
� Deep Pressure
� Body Paint
� Plastic Pool with balls
� Disappearing kid- sensory table
� Tenderfoot – walk on different textures
� Sticker games- place stickers on body parts
� Cocoon Crawl
� Squish- play-doh or clay
� Palm Paint
� Goop
TACTILE SYSTEM
CLASSROOM TOOLS
� Koosh Balls
� Lotion
� Modeling Clay
� Hand Held Massager
� Silly Putty or Theraputty
� Crunch Paper Together to Throw in Trash
� Identifying Different Textures
� Read and Touch Me Books
� Shaving Cream
� Water or Sensory Table
ORAL ACTIVITIES:
� Sucking (on hard candy or finger) is calming
� Chewing ( on candy or an eraser) helps the child
to concentrate and organize his thoughts )
� Crunching (on pretzels or a pencil) is alerting.
� Children seeking oral motor input may:
Constantly be putting things in their mouth
(toys, fingers, ), chews on their shirt or pencils…
ORAL EXERCISES AND ACTIVITIES
� Blowing and Sucking Activities
� Chewing Gum
� Straws
� Cotton Ball Races
� Drinking from a Water Bottle
� Kazoos or Whistles
PROPRIOCEPTION (DEEP PRESSURE)
o The awareness of ourselves gained through muscles and joints and through other receptors within our own bodies.
o A child with proprioceptive dysfunction (doesn’t receive feedback through their muscles and joints like a typical student) may exhibit difficulties with; body awareness, motor planning, motor control, and postural stability.
o The child with low muscle tone may have a loose and floppy body, tend to slump in the chair, constantly lean her head on hand or arm, sit on the floor with her legs in a “W”.
PROPRIOCEPTION (DEEP PRESSURE)
� Characteristics may include: difficulty positioning body to put on a jacket, or when trying to dress self, holds pencils tightly, produces messy work – with large erasure holes, poor posture, slumps in a chair, sits on the edge of the chair to keep one foot on the floor for extra stability, fixate joint to decrease excessive movement during activity- example toe walk to fixate ankles or lock shoulders when running.
� 3 P’s – Plop, Pop, Prop
� To gain feedback (deep pressure) the child may: stomp his feet on the ground while walking, crash on the floor or into walls, rub his hands on tables, prefers clothing to be tightly fastened, kicks heels against the floor or chair.
PROPRIOCEPTIVE SYSTEM EXERCISE
� Pushing and pulling
� Lifting and carrying
� Jumping, hopping, skipping
� Moon shoes
� Hop jump or jump rope
� Weights
� Alternatives to desks
� Foot massage
� Rockerbaord
� Trampoline
� Climbing
PROPRIOCEPTIVE SYSTEM
CLASSROOM TOOLS
� Carrying Books for the Class to the Library
� Carrying a Weighted 3 Ring Binder during Transition
Times
� Weighted Lap Pad
� Chair Push-ups
� Sharpening Pencils with a Manual Sharpener
� Arrange Desk in the Classroom
� Wash Desk and/or Chalkboard/Dry Erase Board
� Place Chairs on Desk of Day or Take Down at Beginning of
the Day
� Pull a Weighted Rolling Back Pack
� Animal Walks
� Yoga
� Wrist Weights
� Weighted Pencils
VESTIBULAR (MOVEMENT):
� System with receptors in the inner ear. It helps
us respond to head position to help with balance
and coordination. We get input from our eyes,
muscles, and joints to keep us oriented to gravity
and to how we maintain balance and move our
bodies.
� Vestibular Dysfunctionmay cause difficulty with
movement, balance, and posture: move in an
uncoordinated way, easily loose balance when
standing on both feet when eyes are closed.
VESTIBULAR (MOVEMENT):
� Hypersensitive (Intolerance for movement):
Increased alertness/arousal, motion
sickness/nausea so they dislike playground
activities such as swinging, spinning, and sliding.
� Hyposensitive (Increased tolerance for
movement): need to keep moving, as much as
possible, in order to maintain attention/function,
craves intense movement experiences, and does
not get dizzy after twirling in circles or spinning
rapidly. Decreased postural tone, poor co-
contraction, and poor rotational patterns.
VESTIBULAR SYSTEM
� Flight- student may say, “I need to use the
bathroom” or “it is time to go yet.”
� Fright- it is too hard, fear , tears, whinning
� Fight- hit, bite, yell
� We CANNOT work a student through the high
arousal stage
VESTIBULAR SYSTEM EXERCISES
� Spinning
� Rolling
� Swinging
� Rocking
� Sit and Move
� Hippity Hop Ball
� Scooter Board
� Jump Rope
� Hop Scotch
� Rocking Chair
� Therapy Ball
� Drive Thru Menus… woodchopper, pendulum swing, paint
your rainbow, pop up spelling, jumping beans, ants in my
pants
VESTIBULAR SYSTEM
CLASSROOM TOOLS
� T- Stool
� Therapy Ball
� Sit and Move
� Tilt Board
� Drive Thru Menus… woodchopper, pendulum
swing, paint your rainbow, pop up spelling,
jumping beans, ants in my pants
� Hop Scotch
� Rocking Chair
� Yoga Activities
� Brain Gym
THE LEARNING TRIANGLE
� DNA
� Reflexive Patterns
� Learning
� Visual
� Auditory
� Tactile
� Vestibular
� Proprioceptive
� Performance
� Motor Skills
� Motor Patterns
� Motor Responses
KINESTHETIC AWARENESS
� The unconscious understanding of our brain
about our position in space or “body awareness.”
This information comes from the muscles, joints,
eyes, tactile, and vestibular systems.
� Movement Sense- some children need to see what
they are doing
� Example: Finger to nose on the BOT-2
� Example: lift the leg forward when standing on
one foot or try to hold leg with a hand
� Information our
brain is gathering
through the
different systems
and sensations all
of the time.
�Movement skills
that are used to
demonstrate what
we have learned
internally.
�Examples: speak,
gesture, write to
communicate our
thoughts and
ideas.
Learning Performance
REFLEXIVE SYSTEM – CLUMSY CHILD
�Reflexes are God given movements that are
stored in each of us. All movements are
reflexive and are modified by influences of
the brain. Those “brain influences” are what
we call sensory systems: vestibular,
proprioceptive, tactile, visual, and auditory.
�Children with poorly integrated reflexes may
have issues with falling often, difficulty with
catching a ball, difficulty with riding a bike,
and difficulty with writing.
�Reflexes that persist: blink, gag, yawn and
cough for safety reasons.
REFLEXES
� ATNR – asymmetric tonic neck reflex
� STNR – symmetrical tonic neck reflex
� Labyrinthine – prone flexion or supine extension
ATNR
� Normal in infants up to 4-6 months of age and is integrated as the baby is learning to roll.
� Important to help infant reach for toy/object they are looking at and to assist with rolling
� Fencing Posture
� When the child’s head is turned to the right, muscle receptors (proprioceptors) in the neck stimulate extension of the right arm and leg and flexion of the left arm and leg. Occurs in either direction. The response is usually stronger in the arms than the legs.
� Flexed side provides stability, extended side allows for mobility.
ATNR
� Children that do not integrate the ATNR reflex
may:
� When sitting at their desk writing and turns her
head to see the board or respond to the teacher, her
writing arm will flex or extend slightly, causing her
to loose her place on the page. With experience the
student will anchor her hand in place with a tight
grip and/or pushing hard on the paper which can
cause the paper to tear and the students arm to tire
quickly.
� Difficulty catching a ball because the student may be
afraid and turn his/her head away from the ball
causing one elbow to flex and the other extend
STNR
� Normal in infants 6-11 months of age and is integrated as the baby is learning to crawl.
� If the infant extends the neck lifting his head and looking up, his arms will extend and his legs and hips will flex.
� If the infant flexes his neck putting his chin close to his chest, his arms will flex and his legs will extent.
� This reflex contributes to the infants ability to develop a crawling position- rocking back and forth – then eventually integrates and the child is able to crawl with a combination of flexion and extension of the opposite arm and leg
STNR
�Children that do not integrate this reflex
can be seen
� Bunny Hopping
� Falling on their face or elbows as they
are unable to extend their arms when
their neck is flexed
� Sitting posture at their desk will be
flexed legs and extended trunk and
head at the table or a flexed head/arms
and extended legs.
TONIC LABYRINTHINE REFLEXES
� Normal in infants birth to 4 months of age and is
integrated as the baby is learning to bring feet to
mouth or props on elbows in prone.
� Patterns are influenced by the labyrinths of the
vestibular system.
� Prone Flexion: newborns curl into a flexed little
ball when we place them on their stomachs
� Supine Extension: newborns in supine will
extend their arms and legs and arch their trunk.
� Gravity provides stimulus to several systems to
provide organization of muscle patterns to
develop other skills.
TONIC LABYRINTHINE REFLEXES
�Children that do not integrate this reflex
may:
� Struggle with learning new skills
because postural stability, stable head
control and reorganization of muscle
patterns are necessary for the child to
reach and eventually complete other
skills.
REFLEX INTEGRATION EXERCISES
� Superman-
Labyrinthine Reflex
� PopcornLabyrinthine Reflex
� Giraffe Stretch
STNR
� Rocking Horse- ATNR
� Wall Lean- ATNR
REFLEX INTEGRATION EXERCISES
� Exercises can be completed daily – kids do not
get bored with these activities
� Superman and Popcorn should be held for 20
seconds and repeated 3 times. If the student was
unable to hold for 20 seconds, count faster to 20
and then slow down as they are able to hold
longer.
� Giraffe Stretch should be completed 10 times
� Place a poster on the wall for the student to look at.
� Rocking Horse should be completed 10 times with
head turned to each side
MODIFICATIONS
� Superman
� Start with only arms, then only legs
� Help hold arms for 3 seconds, then have them hold
for 3 seconds and then rest
� Wedge
� Popcorn
� Wedge
� Start with knees tucked, then bring arms around
knees
� Provide assistance to get full body flexion
MODIFICATIONS
� Giraffe Stretch
� Hold the cube position
� Provide assistance to hold head upright and rock forward
� Stand behind the student to prevent them from rocking too
far backwards
� Bolster for positioning
� Rocking Horse
� Hold the cube position with head turned
� Provide assistance to hold to the side while rocking forward
� Provide assistance to keep elbow straight
� Place bean bag between chin and shoulder to maintain
position
� Bolster for positioning
MIDLINE CROSSING
� One side of the body is able to move into and
occupy the space of the other side of the body.
� Children need to learn to use each side of the
body independently and the brain must
understand the function of the opposite side of
the body to cross midline effectively.
� Faulty reflex integration will affect the ability of
a child to cross midline.� ATNR STNR LR
MIDLINE CROSSING EXERCISES
� Tornados
� Jumping Rainbows
� Horizontal Waves
� Spider Webs
� Vertical Waves
� Peanut Ball
� Trampoline
MOTOR PLANNING ACTIVITIES OR EXERCISES
REQUIRE THE COMBINATION OF OUR SENSES
AND MOVEMENTS TO PERFORM A SKILL.
� For example, collect several objects of differing size and weight balls to throw into a box from 5 feet away (tennis ball, weighted ball, rock, bean bag). The information from all the systems are recalculated and interpreted when processing the different textures, weights, force needed, motor planning in order to throw each item.
� Visual system- “Did it land past the box?” ( can I step and look at the box at the same time)
� Auditory system-“ Did it hit the inside of the box?”
� Tactile system- “How will this smooth ball travel?”
� Vestibular system- “How far forward should I step as I throw?”
� Proprioceptive system- “How heavy is this ball?”
RECOMMENDED RESOURCES
Ready Bodies Learning Minds - http://www.readybodies.com/
Yoga Kids: Tools for Schools - http://yogakids.com
No Longer a Secret by Doreit S. Bialer and Lucy Jane Miller
The Out-of-Sync Child by Lucy Jane Miller
Starting Sensory Integration Therapy by Bonnie Arnwine
Sensational Kids: Hope and Help for Children with Sensory Processing
Disorder by Lucy Jane Miller and Dorris A. Fuller
Understanding Your Child’s Sensory Signals: A Practical Daily Use
Handbook for Parents and Teachers by Angie Voss
Drive Thru Menus - http://drivethrumenus.net/
