Body scheme, body scheme, body scheme! I’ve said it a million times, and I’ll say it again. As an OT, I feel as though this is one of the most important concepts a child needs to develop. We have established that our tiny humans have no dysfunction in any sensory areas (that we know of!) at this stage. You know he can see and hear, is touching things, tasting things and smelling, so now we can start using his ability to process that information and develop his body scheme. If there are some problems with his sensory organs, if your baby has problems hearing, seeing or even serious skin conditions preventing him from interpreting tactile sensation or touch, this is going to impact on his development in other ways, and I can address that with you on a more personal and individual level. Feel free to email me through my contact page if this is the case. So what is a body scheme? Let me start off by doing a little exercise with you all. Close your eyes. Picture your house. Picture where the rooms are in relation to one another. Picture where each piece of furniture is. Imagine walking through the house with your eyes closed. Most of us do this for night time feedings already, and have that coffee-table-dodge manoeuvre down. Your body scheme is your brains’ ability to visually map out and know the ins and outs of your body, down to the tips of your pinky fingers and toes. It allows us to walk up stairs without having to carefully watch each and every step we take. It’s also why when walking into an unexpected hole or down a step we forgot existed, we have to do a complete once over of what just happened. Of course, we need the sensory feedback from the environment (the feel of the ground under your feet, wall against your arm) to make sure we move around as accident free as possible, but imagine having to watch your feet press the pedals of your car when you drive? Or when you run? This is why our brains have developed that ability to know where your body is in relation to other body parts, so that movement can be coordinated and accurately timed. It ties in with the proprioceptive and vestibular sensory input I mentioned in one of my other posts. We aren’t born with this map of our body. It has to develop. It does start to develop in the womb as we tumble around and kick, receiving both vestibular and proprioceptive input. But there is only so much development that can happen in here, the rest happens in the big world outside of the womb. This is why as babies, we struggle to coordinate movements and our movements have almost no accuracy or control. But once it does develop, it helps us to control our arms and legs so that we can reach for that toy, shake it around, and put it back down where we need to. This kind of development works in a similar fashion to how our strength develops – from the core outward. Our hands and feet are the last to develop, but yet the most important. You will notice a baby be able to accurately place his arm in the direction of the toy he wants, but not yet be able to open his hand to take it and close it once in his hand. That comes with time and practice and as our body scheme improves, so do our movements and milestones. This is an important skill, not only for babies to develop milestones, but for children too. They need to develop refined skills like cutting and writing, balancing on a beam, putting clothes on, climbing a ladder, kicking a ball, riding a bicycle – all things that need to be done through knowing where my body is and what my body parts are doing. It is common for children with a poorly developed body scheme to be very clumsy, and compensate for this with their visual abilities. This is exceptionally tiring for anyone to do, let alone a small, active child, who might start to avoid gross motor play or fine motor activities because they are so draining, and because he has identified that others are much better than he is, or perhaps he has even injured himself from being quite clumsy. So we want to make sure this is a skill he develops well. We want confident, busy little bees who can dominate on the playground and in the classroom. How do we get there? We start now, and we don’t ever stop! As I mentioned before, vestibular and proprioceptive input are quite essential in the development of body scheme, so please read the post “Super Seven Senses” if you haven’t already! We need to use all of his senses together in order to advance the development of his body. Remember to watch for signs of overstimulation! Here are some nice activities to do with your baby to incorporate his senses and help him identify and map out his body: Baby Massage. Nothing complicated, nothing fancy, just a little massage here or there with some cream or baby oil. Try not to provide pressure on the stomach, focus on the limbs, chest and back, and pay attention to tiny hands and feet. You want to try massage with movements in one direction because this is easier for the brain to process then an up-down or circular motion. And the movement should be from the core outwards (shoulder to hand, hip to foot). Try not to lift your hand in between a stroke of an arm or leg, go from the shoulder, and slide down to the hand and fingers, then only lift your hand up and start at the shoulder again. You can vary the pressure and speed, but a nice deep (yet gentle) pressure is best, and slower is better to help calm baby down. Pick a nice quiet time to do this. No toys or noises or stimulatory things happening. After a bath is usually a perfect time or when baby is about to go down from a nap, since you are going to be calming him down with the massage. Try to use a natural oil or cream that isn’t strongly fragranced, which will only stimulate him. I use the Johnson’s Bedtime Bath Oil. Joint traction and compression. Ah, fancy words. Don’t be fooled, they aren’t as complicated as they sound, and you are probably already doing these. Any time there is pressure through a joint, this is joint compression. Weight bearing with arms straight during tummy time provides joint compression through the elbow, wrist and shoulder. Standing with legs straight provides joint compression through the ankle, knee and hip. Kicking against something is also really nice for joint compression. So we want lots of play time on the tummy and in standing. The kicking activity mats are really nice too. Joint traction is the opposite of this – it is the bones and joints pulling apart when resistance is applied. I often do this when I massage my little girl, as I rub her arms and legs, I gently pull them as well. Not so hard that her whole body moves, just that the arms and legs are getting a bit of a stretch. We can do the on the spine in both directions during play time – on the tummy, the vertebrae are pulling apart at the front of the bones as they arch their backs upwards. On their backs, when their legs come up, the vertebrae are being stretched at the back of the bones. When on his back, you can lift his feet up and touch his nose to give a nice quick stretch of the spine. Which brings me to the next activity. Playing with hands and feet. Whether baby learns to do this on his own, or you do it with him, it is essential for him to explore with these body parts, and that means putting them in his direct visual field and also into his mouth – an area better developed at interpreting tactile sensory input at this age! It’s nice to do this when baby is naked after a bath, during a bath or even when he is being changed. Make sure he is warm though! Take his hands and bringing them to his feet, crossing the left hand to right foot, and vice versa, as well as left hand to left foot. Let the hand just touch the foot, and if he can grasp it, even better! Now is your turn to play with his hands and feet. Take his feet together and touch his nose and lips with his toes. Hold his feet and clap the soles together. Give his feet lots of tiny kisses. Blow air against them. Let him kick against you, blow out your cheeks and use his feet to slowly push the air out! Do all of these while he watches you! Do the same with his hands (fisted or flat). Pretend to eat his hands, let them touch your face, let them feel the vibration of your cheeks as you talk or hum. Clap his hands together. Bring his hands up to his eyes and cover them, touch his nose and his mouth. Verbalise what he is touching, and try to let his hands do the feeling, so hold the palms or the wrists and let him use the fingers to feel. You can also use wrist and ankle rattles to draw his attention to the hands and feet. Have a look at my post titled “Legs in the air!” as well for helping him interact with his feet. Mirror play. I mentioned in my previous post on Christmas gifts about how useful a mirror is in obtaining feedback and watching yourself move. It is really important for babies to watch themselves in the mirror as often as they can. Not only do they love it, it helps them identify and understand how they are moving and what they look like when moving. Please use a good quality mirror and make sure it isn’t going to harm him in any way at any point in time! Sensory play. Find things around the house with different textures – feathers, silks, wools, cellophane. Use them to touch your baby in the same way you give him a massage, provide a bit of pressure (we don’t want to just tickle him), and make sure movements are in one direction, starting from the core and moving outwards. Obviously be cautious of his face and never fully cover his nose and mouth. Make sure he can see the object you are using, bring his hand to touch it where he can see what it is as well! Describe the feeling to him and talk to him, tell him where feathers come from and what we use silk for! You can also use something like shaving foam, while sitting in front of a mirror, place the foam on the mirror, take his hands and squish it all around, draw patterns with it. You can also use sugar or sand on a tray or in a box, put his hands in and let him feel the texture, take his hands and make patterns in the sand. Trickle the sand over his legs and arms. Make sure to wipe down and clean him after activities like this – we don’t want him putting these things into his mouth when on his hands. When he is able to sit independently, we can use a ball pond and sand pit and when he learns to crawl, we can use tunnels to develop his body scheme as well. Swaddling. Try limiting the swaddle to night time, since play time should involve as much freedom to move as possible. You also want to swaddle with his hands in the middle, not at his sides. It is not comfortable for anyone to sleep like a soldier, please don’t make your baby sleep this way either. Having his hands up and in the middle allows him to put them in his mouth to begin to self soothe and to develop a milestone called hands-to-midline, which is a very essential and important skill. It teaches him that he has two sides to his body and they can work together – coordination. It is also not a functional position to have his arms hanging at the sides of his body, and he will not learn their existence if this is how he constantly lies! A swaddle blanket should have flexibility to stretch so that he can receive proprioceptive input when moving, and so that he is able to wiggle and move without big startling movements that may wake him. Small movements are normal and allow him to get comfortable as well as for his blood to circulate. Knowing your body boundaries is a soothing feeling, which is why massage and swaddle are calming techniques we use for babies. Also remember that eliminating body parts from his field of vision is only going to delay his ability to learn about them – especially when giving him one sensory input in that area – for example standing in an exersaucer, receiving proprioceptive input through the legs but having no vision of them whatsoever during the weight bearing, which is really not helping him to learn that they are there. Once he knows where his feet are and what they do, he won’t need to look at them when standing or walking!
Try not to limit movement by placing him into a Bumbo, bouncer or anything similar. Lying against a surface provides tactile input and allows for learning. But sitting and being unable to actively move body parts is a very limiting thing to do for his development, physically and from a sensory point of view. Reward his free movement by giving him cause-and-effect toys to kick, touch and grab at. Something that moves and makes a noise just encourages him to move and play in a controlled and accurate manner. Please be careful of over-stimulating him. This is the first time he is getting exposed to or feeling some of these things, so give him time to learn and be patient. When he starts to fuss, he has had enough and you can try again later! Happy playing to you all!
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About MeI am a Pediatric Occupational Therapist by profession, but a full-time mom to a beautiful baby girl, born in September 2014. My husband and I live in sunny South Africa. Archives
October 2015
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