One of the first lessons in kindergarten – the five senses- the sense of vision, hearing, smell, taste and touch. But did we ever go past that lesson, to see if there is more than just these five?
Yes, I hear you- The sixth sense. If someone were to compliment you saying “you have a good sixth sense” it means you seem to be more intuitive than others in general. You basically get things others don’t get as easily. But this sixth sense is actually just a phrase! The movie Sixth Sense by M Night Shyamalan just takes this phrase to another level altogether. I have no intention here to get into the theories around the phrase – ‘sixth sense’. Instead, I am going to introduce you to the idea that our body has 3 more senses that we were not taught, after that first kindergarten lesson!
Why talk about senses in a blog here? Well, sensory processing is a huge piece in the autism puzzle. To help a child with autism, it is important to understand:
–how the child receives the above sensory information
–what those sensations mean to the child
–how the child reacts or behaves to these stimuli
The 5 senses we all know are environmental in nature- the ones that help us receive external stimuli (namely, what we see around us, what we hear, what we smell, what we taste, or the feeling when we touch something).
The 3 others are more internal to our body.It was only few years back I got to know about the vestibular and proprioceptive senses which are commonly discussed amongst Occupational therapists and the likes. I hope that you find the information on the same and my observations on it helpful. The eight sense – the interoceptive sense which I just came to know about also has a serious effect on how we function but is hardly talked about. However, research is on and I am excited to learn more as it affects self-regulation, another piece to fix in the autism puzzle. More on that in the later blogs.
This is the sense that allows us to maintain our balance during movements. There are parts in our inner ear which is responsible for this sense. The vestibular input or stimuli comes from any movement but mainly from the movement of our head. Often, we hear of people experiencing spinning, dizziness, or going off-balance or in some cases vertigo. This mostly happens when the inner ear is affected by ear-infections, stress or lack of sleep.
For children with ASD, who have impaired vestibular sense can either cause them to seek more and more vestibular input or avoid the vestibular input. While many infants need some rocking to fall asleep, I recall how my son needed to be rocked gently to sleep as a baby and continued to seek movement to sleep until almost 3 years. He would also swing for a good amount of time and while in the swing, spin himself clockwise and then anticlockwise. This looked very pointless to me and I wish I had known better then. These movements energise the child’s body and bring it to alert state. We all grew up with games in our childhood that actually had “in-built” vestibular inputs. One that I can remember was holding crossed hands, and spinning till we were thrown off balance! We did it in more social settings but our sensory seeking kids tend to do some of these activities by themselves. The child who constantly rocks back and forth while doing a task, the child who paces back and forth while waiting are examples of children who are seeking this vestibular input to increase their alertness. The vestibular inputs can get our kids to be less restless and more focussed. However, one also needs to understand that too much spinning or too much bouncing or too much rocking could eventually lead to a “sensory shut-off” causing nausea or melt-downs and could take many hours to recover. A fun example to identify with this is the extreme case of vestibular stimulation- the roller-coaster ride while for many it results in sheer excitement, for others it may result in headaches or nausea or many hours to get back to feeling normal.
Occupational therapy involving vestibular inputs also stimulates this sense and children tend to focus better after the sessions. During our stay in South Africa, we continued to find opportunities in places like Tree Top adventures, Bounce and Kids Gym where our son could explore climbing, navigate obstacles through a mix of stable and unstable surfaces with the additional challenge of heights. These opportunities gave better results than in a therapy room as we found that he was motivated when amongst kids his age doing what they do, feeling happy about what they do, and feeling safe enough to explore and stimulate their senses. With time I understood that impaired senses can also develop with time provided the child
- Gets more exposure to using the sense
- Feels safe and secure while doing the activities
- Feels motivated to do activities
This is the sense that allows us to know where our different body parts are relative to each other- in other words this sense is all about body awareness, posture, self-regulation and alertness. If you were asked to put your ring finger on your nose, you can do it even with your eyes closed: it’s the senses in the muscles of your hand and joints in your fingers that does this for you. This sense comes in play when we sit in front of our computer to work; we tend to automatically align ourselves and our chair to the table we are sitting at. This is the sense that makes you aware of where your body parts are and also helps you judge force and pressure. A very common activity we use this sense in is writing with a sketch pen, pencil or pen. We all know what pressure to apply within a few minutes of writing but this is not the case with kids who have poor proprioceptive sense. They wrap their fingers and hold the pencil so tight that their fingers tire out quickly while writing. The child who engages with his friends in pretend play and becomes rough or hurts his friend is often unable to understand how he landed up hurting his friend when he had absolutely no intention to do so. Also children love crashing to the floors, who want to run around silly may be found to have poor proprioceptive sense and will benefit if proprioceptive input is given to them.
The occupational therapy activities are also geared to engage this sense. We realised early on that just 30-40 min of OT twice a week, where in the therapist works on various challenges just for a few minutes each, may not be the best solution for our son. The proprioceptive sense is stimulated and developed through regular exercising, lifting weights, push ups and pull ups, giving deep pressure, jumping in the trampoline and other such rigorous activities that stimulate the receptors in the skin, joints and muscles. A child who needs to do an academic task, slumps in his seat, wants to rest the head on the table and seems to be sensory-seeking. This child could really benefit with some star jumps, pushing heavy furniture or deep pressure applied on his body. We found that a lot of our son’s initially sensory seeking behaviours like crashing to the floors between 3-5 years disappeared eventually. We attribute this to our persistence to engage him in weekly exercise sessions and daily animal crawl routines. More on this in my blog ‘The Core Issue’.
It is also important to know that the vestibular sense and proprioceptive sense work in conjunction in some of the activities. One such example is when we walk up and down the stairs or walk on hanging bridges. Here both the senses come into play. I have noticed that if my son were walking down a flight of stairs in an unfamiliar territory, he would want to hold the railings, slow down and his gaze is strictly on the steps. At 9 years we know this effort should not be as distinguishable but it is. He is also very anxious over hanging bridges but due to increased exposure the levels of anxiety have decreased.
Having said that, there are many of us who would never get onto unstable hanging bridges or into those crazy rides we see in the carnivals or fairs. We all have our fears and its either to do with how we perceive danger or we may just not be the adventurous types. That is not as much a concern especially if we know how to handle and react to these situations. In my observation, children on the spectrum seem to be unable to make sense of these sensory inputs, sometimes due to the lack of exposure to them and sometimes due to the other concerns they have. So, the behaviours and emotional responses that stems from these sensory processing issues can hinder their day-to-day activities and interactions with the world. As humans we are gifted with our ability to sense and make sense of the various sensations in and around us. We feel alive because of this. I firmly believe that every parent with children on the autism spectrum or with children having SPD (sensory processing disorder) should consider doing a bit of homework on these two senses and understand how it affects their child’s behaviours and interactions, in particular.