What is Proprioception?

By: Casey Sobotincic, OTA & PTA Diploma Program Humber College Institute of Technology and Advanced Learning

All  posts are reviewed by a supervising Occupational Therapist.  Hand Skills for Children is appreciative of the time and research, placement students commit to in writing posts for our blog.

Proprioception is a topic that you come across when speaking with an Occupational Therapist.  Widely considered our “sixth sense”, proprioception is vastly important for how we interact with our environment.  Simply put, proprioception is our sense of position and where our body is in space.  Proprioception can also convey to ourselves the heaviness of our limbs and the force of our movement.  It’s a subconscious, internal function that allows us to know where our limbs are even if we’re not looking at them with our eyes.  This ability is best explained with an example.

When driving a car, is it necessary to stare at your feet to make sure you’re pressing the gas pedal?  Can you focus on looking at the road, or must you stare at your hands to make sure they are grabbing the wheel and turning it?  Of course not.  In fact, you can probably do all these things while eating a snack or checking your blind spot.  We often take for granted our proprioceptive abilities.  Because of this sense, we are able to move our bodies freely and impulsively without having to use our visual sense to coordinate our movements.  There are several fascinating neurological mechanisms that make this possible.

Proprioception is largely attributed to proprioceptors within our muscles and joints.  Two organs that play a large role are muscles spindles and the Golgi tendon organ.  Muscles spindles are sensitive to stretching and velocity within muscle tissue.  When a muscle lengthens, a signal is fired that travels along the central nervous system and tells the brain that there has been a change in shape within the muscle.  The Golgi tendon organ is found where muscles attach to bone and it senses tension within the muscle.  It then sends this relevant information  to the brain.  Equipped with this information, the cerebellum can rightly infer where our muscles are taking our limbs.  Moreover, our skin and joints contains small receptors that can detect limb movement.  Amazing, proprioceptors can still tell us where our body is even when it is still.  That is why you know your hand is by your side even when your not moving it.

Because the concept of proprioception can be difficult to understand, it can be helpful to explain what proprioception is not.  Proprioception is not synonymous with the vestibular system, or the sense of balance, although it plays a contributing role.  You may hear reference to kinaesthesia, which is more the sense of body movement and an aspect of behavioural development.  Finally, proprioception is not immune to disease or injury.  Our proprioceptive sense can be severely damaged, and if need be, restored with therapy.

Proprioceptive input can be a very regulating sense.  That is, it can having a calming, as well as alerting, effect.  Therefore, proprioceptive activities are often used to help kids reach a calm-alert state that allows them to focus and perform better.   Studies show that 20 minutes of proprioceptive input can help calm an over-responsive child or alert an under-responsive child, depending on their own unique circumstances.  Some children may display behaviours that suggest they are seeking proprioceptive input in an effort to self-regulate their response to stimuli.

A child may be seeking proprioceptive input if they:

  • Bite or chew on inedible objects (ex. Their sleeve)
  • Enjoy roughhousing
  • Throw themselves heavily on the floor
  • Sit on hands or with knees tucked under themselves
  • Hyperextend or compress joints
  • Write with excessive pressure and hold objects very hard
  • Hit body parts together or against things

The following are some proprioceptive activities that may work for your child.  It should be noted that each child is different.  What may calm one child may over excite another who is overresponsive to proprioceptive input.  Therefore, it is important to establish what specific activities work as an appropriate strategy for your child’s specific circumstance.  Following an Occupational Therapy Sensory Assessment, your Occupational Therapist will be able to provide guidance as to the type of proprioceptive input that your child would benefit from most to address their needs.  Some suggested activities may include:

  • Jumping on a trampoline
  • Wearing weighted vests, backpacks, lap weights
  • Tight hugs
  • Chewing very crunchy or chewy foods
  • Squeezing stress balls
  • Playing tug of war
  • Being wrapped up in a blanket
  • Being “sandwiched” or steamrolled
  • Swimming









Sesame Street: Inclusivity and Diversity

Truly inspiring, Julia, a Muppet diagnosed with Autism is now on Sesame Street – please see link from the Globe & Mail:

Julia on Sesame Street

Sensory Activities

By: Larissa Jones, University of Guelph-Humber Placement Student

All  posts are reviewed by a supervising Occupational Therapist

. Hand Skills for Children is appreciative of the time and research placement students commit to in writing posts for our blog.

As a Kinesiology placement student, I have researched exercises and activities in order to further develop my knowledge of sensory diets. I have discovered a wide variety of activities that an Occupational Therapist might suggest or include in a sensory diet, based on a child’s specific needs. Although I feel more educated, I was extremely overwhelmed by the number of studies, websites and articles that had differing opinions and ideas regarding what a sensory diet entails. However, one key aspect  that I learned, is the importance of a very individualized sensory diet, in order for a child to sincerely benefit from this type of regime.


Although every child is unique, here are a few ideas that an Occupational Therapist might include in a child’s sensory diet at the conclusion of an observation session:


  1. Proprioception– Proprioception can be referred to as the body’s ability to sense movement through receptors in the joints, tendons, and muscles. This information is sent to the brain to provide a child with body awareness.  Proprioception typically refers to an individual understanding and identifying where their body is in space. These receptors fire actively when a person is engaged in heavy or resistive activities. Some examples of these types of activities include:
  • Push a grocery cart, stroller or heavy box
  • Go to a playground for at least 30 minutes
  • Jump on a mini trampoline, try some simple yoga exercises
  • Animal walks- bear crawl or crab walk
  • Heavy blankets at night
  • Classroom chores- erasing chalkboard or wash the dry erase board
  • Tie a theraband around a chair’s front legs so the child can kick it with their legs
  • Pinch, roll or pull a ball of theraputty
  • Carry a weighted back pack (no more than 10% of their body weight)

  1. Vestibular– The vestibular sense refers to the body’s ability to sense balance and movement via an organ made up of semi-circular tubes near the inner- ear. The vestibular sense responds to a change in your head position. It also contributes to balance and equilibrium. When this system is not functioning properly, a child may feel over stimulated or under stimulated by the sense of movement. Vestibular movement may be calming, soothing or even overwhelming for some children. In this case, it is important to consult with an Occupational Therapist in order to help identify what type of activities to use with your child and how to effectively grade them. This may be the reason your child is constantly in need to move or is fearful of movement. In the circumstance that they might be fearful, progressions and modifications would be implemented to help support the child’s needs. Some examples of these types of activities include:


  • Jumping rope or walking along an “imaginary” balance beam
  • Summersaults or gymnastics-type moves
  • Dancing, marching, twirling
  • Playing on a scooter board
  • Spin on an office chair
  • Swaying in a hammock or riding a rocking horse


Every child has an individual sensory profile and some children may even present with a mixed sensory profile.  In order to establish a sensory diet routine, that would be effective for your child, it is best to have an assessment by an Occupational Therapist.  Based on your child’s profile, the Therapist will be able to provide recommendations that will meet your child’s specific needs at home, at school or in new surroundings.



What is a Sensory Diet?

The term “diet” can be stereotyped as dietary restrictions, a definitive nutrition program or a tool to impede weight gain. However, a “Sensory Diet” does not fall into any of these categories.

A sensory diet is a carefully designed, personalized activity plan that provides the sensory input a person needs to stay focused and organized throughout the day. Take a minute and think about how many times you eat in a day. Maybe it’s three, four, five or six times during the day. Just like regular eating times, children who have sensory processing difficulties need blocks of time throughout the day to focus their nervous system.  A sensory diet can help children, who are over aroused or even under aroused, feel more attentive, more alert and better able to cope in their environment.

Professional intervention, in terms of an individualized sensory diet, can help your child handle daily transitions with less stress, reduce unwanted behaviours and regulate their daily emotions.  When children are hungry, we feed them food. When children feel wiggly, lethargic or anxious, we “feed” them a sensory diet! Stay tuned for an upcoming blog and you will learn more about the exercises, activities, toys and equipment that will provide a “just right diet” to meet your child’s sensory needs.


By: Larissa Jones, University of Guelph-Humber Placement Student

 More information at: “What is a sensory diet.” Sensory Diet. Kid Sense Child Development Corporation Pty Ltd, 2016. Web.

All student posts are reviewed by a supervising Occupational Therapist at Hand Skills for Children.  Hand Skills for Children is appreciative of the time and research placement students commit to in writing posts for our blog.  

Establishing Hand Preference

If your child is showing preference using one hand in activities like drawing, reaching for a ball, or using a spoon- they are on their way to establishing whether they are right handed or left handed!

The hand that a child uses to perform most of their daily activities is the child’s preferred hand. If a child has not established a dominant hand yet, you may see them switching between both left and right hands for one-handed tasks, such as using scissors while holding paper. It is never to early to start with some fun fine motor play to motivate your child to establish a dominant hand, and there are many activities that could support this!

When a child is taking part in fine motor activities that requires them to use small objects like tongs and use their pincer grasp (the ‘pinching fingers’), they will find comfort and preference in using one hand over the other.

Try a few games with small pieces that you can get your child to manipulate in their hands, motivating them to use their ‘pinching fingers!’ Here are some ideas that are sure to bring both fun and focus to the table!

Tongs and Pom-Poms!

Children love pom-poms! Why? Could it be there bright colours, textures and sizes? Whatever it is… your child is sure to agree to some play when you bring pom-poms to the table! You have creative freedom here and can use texture
d, sparkled or regular pom-poms.

Take the pom-poms and put them in a small bowl or lay them scattered on the table for messy fun! Use child sized plastics tongs (you can find these in any dollar store) and have the child try and pick up as many as he/she can, placing them into another bowl or area of the table!

This activity will engage those ‘pinching fingers’ while making it comfortable to use one hand as tongs are built to use with one hand only. Whatever hand the child seems to use comfortably, get creative and see what other activities you can make using their ‘pinching fingers’ for practice!

Did you know?

90% of the population is right handed, and only 10% are left handed?

While it is certainly a milestone to establish a dominant hand, this would prove difficult if a child has not yet developed bilateral coordination; the ability to use both right and left sides in a coordinated manner to complete a tasks. There are many daily tasks that require our children to use both hands at once such as: buttoning or zippering a jacket, putting on socks and shoes, or riding a bike. This is why it is important to play games that utilize both hands so that your child can feel confident coordinating between the left and the right side when needed.

There are three main bilateral movements that children go through:

  • Symmetrical movements: using both hands to do the same action at the same time (rolling dough)
  • Reciprocal movements: alternating movements between the left and ride side with either the hands or feet (climbing up stairs)
  • Hand preference/ dominant hand: using one hand as the dominant in a task and the other hand as a support system (cutting)


If you would like to learn more about bilateral coordination, movements and tips, here are two great resources!




Since the first step to a dominant hand is using bilateral coordination, I thought I would give you some fun and focused activities to use with your child today! These activities are sure to get your child alternating between their left and right hands. Remember… it is always more fun when the adult joins in the fun and games! J


The Flip-a-roo and Do Race!
In this activity you will have your jacket and your child(ren)’s jackets a few feet away, laying upside down with the hoods pointing towards you.

Make some DIY Play-Doh together!Line up… Get ready… Get set… GO!

You and your child(ren) will run to the jackets, put your arms in the holes at once and flip the jacket over your head, ending with you wearing your jackets. You will zip or button it up, run back and whoever touches the starting point first wins! You can also do this activity with mittens, hats or other articles of clothing that require your child to use both hands coordinately.

*if your child is not yet at the stage where they can use a zipper or buttons, try using buttoning and zippering activities as a starter before moving to this. A good idea for a starter buttoning activity is dressing dolls with clothes that require the child to do up Velcro or buttons!


Make Play-Doh together!

When making Play-Doh, it requires a lot of mixing, stirring and squishing! There are so       many ways that this activity utilizes both the left and the right hand.

  • Ingredients:

2 cups flour,

1 cup salt,
3 tbsp cream of tartar,
2 tbsp oil (vegtable or canola work best)
2 cups boiling water,
food coloring (however many drops you desire!)


  • Steps:

Have you or your child pour all of the dry ingredients into a large bowl.

Have your child stir the dry ingredients with a spoon!

To be safe, add the bowling water to the bowl slowly yourself, stirring until the consistency is right.

Once cooled, get you or your child to squeeze a few drops of food colouring out of the tube, and lay the Play-Doh mixture on top of the table.

Have your child kneed and roll the dough using both hands: pushing, rolling, squeezing and finally rolling in to a big ball!

Store in a tightly sealed container for up to two weeks J



           Tape the Table!

There are so many fun colours of painters’ tape and washi-tape available all over stores   that are guarantee to intrigue children just as much (and may I say sometimes even more) as stickers. Yes- you heard me, as much as stickers! Whether it’s the large_washi-tape-setcolours, designs or sticky texture of the tape that children love; there are so many ways to use tape that motivate children to use both hands!

Get any design of washi-tape or painters tape that your child will like. If you want, you can put paper or plastic over the table, but these tapes usually peel off very easily, too.

Have your child take the roll of tape in one hand, peel the tape off with the other and either get scissors and cut pieces of the tape or rip the pieces of tape off. Next, your child can use their artistic creativity to make designs out of the tape pieces on the tabletop!

This activity not only requires them to peel, rip or cut tape but also use their ‘pinching fingers’ to hold the pieces of tape and press them on to the table to make their design!


 Welcome to the Tupperware Band!

Sound familiar? Taking Tupperware out of our parents’ cupboards and smacking our hands on them like drums is a fond memory for many of us… why not pass that memory on to your child(ren)?!


You know the drill- gather up bins and bowls of different shapes and sizes and place them upside down on the ground. You and your child can rock away the night making beats with your hands alternating or hitting the ‘drums’ at the same time!


Want to take it a step up? Gather sticks or small items for your child to use both of their hands, grasp and hit the drums with those! Remember… using small items helps develop their pincer grasp!

Not only will these activities allow your child to make a mess, make some noise and play with you- they will be developing and practicing bilateral coordination at the same time! If that is not both fun and focused, I don’t know what is!

by Bryna Stahlbaum, RECE & Undergraduate student at Ryerson University.  

Hand Skills for Children offers placement opportunity for students in related programs in Toronto.

References: Jones, L. & Lederman, S. (2006). Human Hand Function. Oxford University Press: NY, NY. (147-149). ISBN 1 3 978-0-19-517315-4


The benefits of Crawling

slide1Another good article on the benefits of crawling.  We always explain to families that there should be no rush for an infant to transition from crawling to walking.   All the skills infants practice while
crawling will support their mobility on two feet.  The longer a child spends crawling, the greater strength they will have in their hips, tummy, back, neck, and arms.  Moving arms and legs in an opposite but coordinated manner also facilitates walking and later coordination needed to write with a pencil and sports.  Enjoy your infant at this stage as they explore space.  If your child is scooting on their bum or having difficulty transitioning from their belly to four point consult your doctor, an occupational therapist, or physiotherapist.  For some infants all it takes is a little “nudge” from a professional to get your child moving.

To read the article click here: Why Babies Should Not Skip the Crawling Phase

Gross Motor Fun in the Fall Sun

Hand Skills for Children offers placement opportunity for students in related programs in Toronto.   Below is an article on fun fall gross mootor activities  written by one of our students, Bryna Stahlbaum, RECE & Undergraduate student at Ryerson University.  


Fall is here! And if you ask me, there is no better time of the year to get outside and do some fun-filled exercise with your little ones!

Healthy Organic Apples in the Basket

As a Registered Early Childhood Educator, I often have parents ask me what seasonal activities they can do with their children outside of child care, schools, or extracurricular activities. As fall is in its prime with the perfect temperature and beautiful environments to enjoy quality family time, what better than to participate in some fun, active, gross-motor building activities to do with your children before winter rushes in!

Why is gross motor play important?

Gross motor play is highly beneficial both for children with or without special needs. In fact, no matter what stage of development your child is in there is one universal truth for all children: they will need movement in some way or another every single day. It is important that we promote strength building to support children with any movement barriers they may face on a daily basis, for example; getting dressed, walking, carrying bags, balancing…
No matter what physical capabilities children have, in some form or another they will have to implement core strength and coordination to participate in their daily lives. Did you know gross motor play benefits child development in many more ways than just physically? An article from the Indiana Resource Centre for Autism, “The Value of Movement Activities for Young Children” shares their perspective,

“In physical education (motor) programs, the social, communication, emotional, and cognitive skills of children are “exercised” as well as their motor skills. Playing interactive games develops social interaction and communication skills while working on motor development. Problem- solving or cognitive skills such as counting, identifying colors, or learning body parts, are stimulated during games. Participation in motor activities with peers who are accepting influences friendships, and the social and emotional growth of all children.”
Take a look at their article to learn more on the benefits of gross motor play, as well as tips and tricks!



Reflecting on every child’s unique strengths and weaknesses, I understand that not all gross motor games may be suitable for your child’s interests and needs. You know your child best- have fun with it! Get creative and use materials in your natural environment to create a unique experience for your little one(s). From my experience, engaging in an activity that is challenging their needs but focuses on their interests and inherent capabilities (especially with your involvement!) equals success- and fun!


With the stresses and time constraints of everyday life, I have put together some time-friendly, fall-themed gross motor games to get you and your child moving.


Apple Picking with Baskets!

Go on a field trip with your little one(s) to an apple orchard! This is perhaps the most fall-friendly gross motor activity and there is so much you and your family can get out of this experience! Grab some baskets and see if your little one(s) can pick the apple straight from the tree, add them to the basket and carry the basket around. If you are a home-baker, or want to get many more apples than a basket can carry, try using a small wagon!


 Rake, Pile, Jump!
Is your lawn piling up with leaves this season? It can seem daunting to rake all of those leaves on your own after a long day, so why not invite children and make it a game! Give them a child sized rake, let them use their hands and arms to scoop the leaves up, or use any other tools you may have at home and make the biggest pile you can! Next, have your child jump in the leaves and see who makes the biggest SPLASH!

Outdoor Yoga

Yoga is an extremely popular way to wind down and focus every muscle in the body. Traditionally practiced by adults, yoga is now being practiced more and more with children. With the crisp fall air and beautiful scenery there is no more relaxing atmosphere than outdoor yoga. Lie out a mat, or create a relaxing outdoor space with materials from home and go through a few simple yoga moves with your child. Want to make it a little more interesting? Ask your child what stretches they can come up with and join in! If you would like some simple yoga moves to practice with your little one(s), this website is a great resource!

Leaf Bag Race
Combining raking and piling leaves with a relay race, this game will keep you and the kids busy and active! Rake or pile the leaves in a big pile and hold open garbage bags (whichever size you think is best for your child!). Have your little one(s) take big scoops of the leaves and put them in the garbage bags. Tie the garbage bags up and pick a starting position- you get one bag, your little one(s) gets their own bag. Standing and holding the top of the bag with two hands, pull the bags across the yard and see who gets to the other side first! Want to make this more challenging? Add an obstacle course!
Pumpkin/ Gourd Relay Race

Gather fake or real small pumpkins/gourds and find a starting position. Each person gets one pumpkin/gourd! You and your little one(s) will stand holding the pumpkin/gourd on the top of your head and speed walk to the finish line, trying to not drop the pumpkin/gourd! Want to make this more challenging? Draw a line with chalk or create a line with string and try to walk one foot in front of the other for balance!

Go for the Ghost
With Halloween just around the corner, this game will combine creativity and gross motor skills- ending with a H

alloween decoration that can stay up all season! Find a hanging Ghost decoration at the store, or better yet make it an art project with your little one(s)! Out of a bag, paper, tissues or any materials you have in the house; create a Ghost and hang it from a

tree in the yard, or anywhere you see fit. With your child, stand a couple steps back from the ghost and use a ball to take turns throwing at the
Ghost as your target! Each time you hit the Ghost, take a step back and throw further. Want to make this more challenging? Adjust the Ghost higher or lower each time your little one(s) throw!


Bobbing for Apples

A classic fall-friendly game, bobbing for apples can be done in so many ways! Practice your creativity with this game, and ask your child for some ideas, too! All you need are some apples, water, a container and a game-face on as you bob for as many apples as you can in 30 seconds and see who gets the most! Whether you bob with your mouth, a fishing rod, a butterfly net or any other items you have at the house- this game is sure to bring laughter and concentration!


Remember that in any season there are so many opportunities to get outside and get moving! With an almost constant focus on technology every day, there is nothing more refreshing than stepping outside and setting aside some much needed family time!

Challenging behaviours and Autism

This is a really good article that explains the possible ramifications of attempting to eliminate a behavior that may be sensory in nature and alternative approaches to addressing them.  It is a very thorough and well written explanation.

We frequently have parents that come to us with the goal of removing a behavior that may appear distressing, for example, licking or flapping the hands.  As a therapist we are careful to look at why this behavior may be happening and rather than making recommendations to eliminate the behavior, it is sometimes best to redirect it to a more functional or more acceptable response.  Otherwise,  the child runs the risk of replacing the old behaviour with something less acceptable or even one that may cause injury.   Our role as occupational therapists is to help problem solve the rationale behind the behavior based on a sensory-motor assessment in order to be able to guide the parent with available options to reduce or redirect the behaviour.

Parent seeking help with new “stim” behaviour.  article written by Moira Pena


A grade 8 student from an alternative Toronto middle school contacted Hand Skills for Children requesting an interview for her Independent Study Project.  She completed a film about Dyspraxia and interviewed a variety of professionals, including an adult with Dyspraxia.  I don’t love seeing myself on camera but I would say that this student did an excellent job of putting together an informative video on Dyspraxia.  Congratulations Patia!

to view the video please press here:  Gap: Treatment for Dyspraxia

Lizette Alexander OT Reg. Ont

Chewing inedible objects versus Pica

This is an article written by Moira Pena, Occupational Therapy at the Holland Bloorview Kids Rehabilitation Hospital in Toronto.

Chewing clothes and swallowing objects