Body Safety and the Connection Between Proprioception and Regulation

Seven-year-old Maya crashes into walls, pushes against furniture, and seems to seek out every opportunity to squeeze herself into tight spaces. Her parents describe her as "always on the go" and struggling with meltdowns. Her teacher sees defiance and attention-seeking behaviour. But what if Maya's body is seeking something much more fundamental, the safety that comes from knowing where she is in space?

The Context

In our fast-paced world of sensory overload, children's nervous systems are working overtime to make sense of their environment. As occupational therapists, we're increasingly recognising that what we've traditionally called "sensory seeking" or "challenging behaviour" may actually be sophisticated attempts by the nervous system to achieve regulation and safety.

Research has highlighted and extended our understanding of how proprioception works hand-in-hand with nervous system regulation. Supporting the fundamental neurological foundation that allows children to feel safe enough to learn, connect, and thrive.

The Neuroscience

The relationship between proprioception and regulation becomes clearer from the lens of Stephen Porges' Polyvagal Theory. Our nervous systems are constantly using "neuroception" to unconsciously scan for safety or danger cues from our environment and other people. Should our sensitive sensory systems detect a threat via a loud or unexpected noise, light touch, a sudden movement in the periphery of one’s visual field, physiological responses that shape behaviour may be triggered before we have even had a conscious thought or decision about how to act in a certain situation.

According to Porges’ theory, we humans have three distinct neural pathways that activate in a hierarchical sequence: social engagement, fight-or-flight mobilisation, and shutdown or immobilisation (our primitive survival system). The social engagement state is one where learning, connection, and therapeutic progress become possible. This occurs only on the foundation of the felt sense of safety or body trust.

Research by Blanche and colleagues reveals that children with ASD have distinct proprioceptive processing patterns, particularly in feedback-related motor planning and regulation behaviours like tiptoeing, pushing, crashing, climbing and running. These ‘regulation behaviours’ are an attempt to recruit the deep muscle activation of proprioception needed to feel safe and regulated.

The tactile system develops first in utero at just eight weeks gestational age, forming the foundational layer (with vestibular and proprioception) of our sensory hierarchy. Touch and proprioceptive input directly shape social communication development, occurring long before verbal language emerges. When this foundation is disrupted, it creates a cascade effect that impacts everything from motor skills to emotional regulation to social connection.

Therapy Nuggets

Understanding this neurological foundation transforms how we approach intervention:

Read the Nervous System, Not Just the Behaviour: Learn to recognise the signs of different autonomic states through facial expressions, mobilisation, and overall presentation. When a child is crashing into walls or seeking deep pressure, they may be in a mobilised fight-or-flight state, using proprioceptive input to shift toward safety and social engagement.

Prioritise Safety Before Skills: Create predictable, attuned interactions that signal safety to the child's nervous system before attempting complex therapeutic tasks. Your own regulated nervous system, authentic facial expressions, and attuned responses are a therapeutic tool.

Target Feedback-Dependent Tasks: invite participation in activities that require children to use proprioceptive feedback during tasks e.g. obstacle courses, ball activities. This builds the neurological capacity for self-regulation.

Use Deep Pressure: Research supports that deep pressure input affects arousal levels and can improve attention by supporting the parasympathetic nervous system to balance out the sympathetic NS and achieve regulation.

Fulfilling ones Proprioceptive Needs: View behaviours like pushing, crashing, or seeking tight spaces as information and to highlight that their body needs support. 

Design Sensory Friendly Environments: Consider how lighting, sound, spatial arrangements, and interaction patterns either support or challenge the nervous system's need for safety and predictability.

Individualise Based on Specific Patterns: Use comprehensive assessment tools rather than isolated testing to identify each child's unique proprioceptive needs, focusing on the specific areas where they need support e.g. discrimination difficulties or using proprioception to regulate, or both.

Reflections

As you consider this deeper understanding of proprioception and regulation, reflect on these questions:

How might viewing "challenging behaviours" through a nervous system lens change your assessment and intervention approaches?

When you observe a child seeking proprioceptive input, what questions could you ask about their current physiological state?

Consider a child on your caseload who shows proprioceptive challenges.

Are the seeking or not detecting?

How might their nervous system be communicating needs for safety and regulation?

What environmental or relational factors might be triggering defensive responses, and how could you modify these to support their social engagement system?

Think about your own nervous system regulation during therapy sessions. How does your physiological state influence the therapeutic relationship? What practices help you maintain the regulated, safe presence that supports children's nervous systems?

How might you help families recognise and respond to their child's proprioceptive communication, moving beyond managing behaviours toward supporting the underlying neurological needs driving those behaviours?

Finally, consider the broader implications: If proprioception is truly foundational to nervous system regulation, how might this understanding influence our goals, our advocacy and our therapy planning for the children and families we serve?

Learn more about Sensory Integration and Trauma Informed Occupational Therapy in our SenseUp Hub. 

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References:

Blanche, E. I., et al. (2012). "Proprioceptive processing difficulties among children with autism spectrum disorders and developmental disabilities." American Journal of Occupational Therapy, 66(5), 621-624

Cascio, C. J., et al. (2016). "Somatosensory processing in neurodevelopmental disorders." Journal of Neurodevelopmental Disorders, 8, 93-103.

Case-Smith, J., et al. (2015). "Research in autism spectrum disorders and sensory integration: Making sense of the evidence." American Journal of Occupational Therapy, 69(2), 1-12.

Porges, S. W. (2011). "The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation." Norton Professional Books.

Schaaf, R. C., & Lane, A. E. (2015). "Toward a best-practice protocol for assessment of sensory features in ASD." Journal of Autism and Developmental Disorders, 45(5), 1380-1395.