4. Sensory Discrimination for Skilfulness

Check out the list of references we mentioned in this episode below. There is also a handout if visuals help you learn.

Happy Days!

• Bundy, A.C & Lane, S. 2020. Sensory Integration Theory and Practice. 3rd Ed. F.A. Davis Company.

• Kandel, E. Schwartz, J. Jessell, T. Siegelbaum, S. Hudspeth, A. 2021. Principles of Neural Science. 6th Edition. The McGraw-Hill Companies Inc.

• Ayres, A. , Jean, & Robbins, J. (2005). Sensory Integration and the Child. Western Psychological Services.

Reflection Worksheet (CPD Resource):

TRANSCRIPT:

[00:00:00] 

Michelle: Hello. Hi, Cory. Hi, Trace. Hello. Hey guys, great to be with you again. Yeah, awesome. Welcome everybody. Joining Cory and my mentoring session with Tracy. We hope you're enjoying listening to us as we meander in and out pediatric OT theory and practice where we really, are on a journey to learn as much as we can about this huge, really broad.

subject. So we are just trying to wrap our heads around it with what we already know and the new bits and really integrate it, as much as we can. Yeah. So we, uh, It's a meandering journey. What you're listening to us is, uh, not a lecture. There's lots of places and we're giving you lots of resources where you can go and listen to that, um, or attend lectures.

This is us having been on a, reading textbooks and been on lectures and now we're trying to [00:01:00] integrate it into our own thinking. So, you're seeing the gritty behind the scenes work, you're listening to us. We apologise it's not neat and tidy, but

Cory: that's how things go.

Michelle: Yeah. So Cory, episode four.

What are we revisiting today?

Cory: Well, we were talking about posture, and then that led us to posture. Praxis. A backbeat, to all of these topics was sensory discrimination. Um, and so we like alluded it to it a few times, um, and it kind of came up a few times. And so we all thought, well, we better start talking about this.

So that you guys can understand how this underpins. The subjects that we're actually talking about and the function that we're seeing, in front of us. So I guess if you, oh man, sensory discrimination, it's so big. But if you want really detailed, information about the structure and the functions [00:02:00] of each of the senses, how that process comes together, just pure neurologically, there's lots of places you can go.

I don't know. Tracy. has told us about principles of neuroscience, which is, I don't know, how thick do you think 15 centimeters thick? it's a beautiful, beautiful textbook. It's huge. and some of the other textbooks that we've mentioned in the other podcasts, like sensory integration theory and practice might give you more of an overview, or if you just want to dip your toes in the water, even just, sensory integration in the child, like the.

parent based one, can be a good way just to sort of like get a sense of this concept of how each of the senses takes, I guess, information from the environment and translates that into electrical signals to the brain. that we won't specifically dive into that process today, just because we want to get to some real juicy meaty bits, but I mean, I feel like I struggled when I first graduated and I first started learning about these concepts.

knowing the difference between sensory [00:03:00] modulation and sensory discrimination. And we haven't talked about sensory modulation yet, but we definitely will. But this might, I'm hoping, I'm really hoping that this might help some people listening start to figure out the differences and that journey, because it does take time to know the differences between these concepts.

And so, hopefully this episode will help. Everyone start to do that and pull that together. but I mean, how do you pull, put sensory discrimination together, Michelle? Like what do you think of when you think of sensory discrimination?

Michelle: I think about it as the detail. It's the noticing of a particular input.

So whether it's sight, hearing, touch, and it's knowing the exact features of that. So the location of it and the detail of it. So for touch, for example, I can discern whether it's light or hard and I know what body part it is. So it's really the fine tuning of it.

Cory: Yeah.

Michelle: Cause I mean,

Cory: I always went to start to [00:04:00] go, I don't know when I'm trying to explain it to a parent, it's not just me registering, registering that I got touched somewhere on my body.

It's my nervous system actually knowing what was that. Was that something sticky? Was it something rough? Was it hard? Was it, sharp? Like, all the qualities of the input and actually figuring out what it actually is. But Tracy, you, I'm sure can help us refine this even more than what we've got it now.

So, I mean, what do you think in terms of, are we on the right track?

Tracy: So you guys are spot on around sensory discrimination. It's the precise detail that's processed. But here's the OT question, you guys. Sensory processing for the purpose of what? Why does our brain need detail? And our brain needs detail so that it can organize our [00:05:00] system for skillfulness.

So if you pick up detail in the, any sensory system and we'll, maybe we'll talk about some, some examples, that'll kind of bring that to life, but you know, the, the one that comes to mind and is the most typically used to describe this is related to the touch system. And so if you have some coins in your pocket and you're trying to Find the coin that fits into the parking meter.

I guess we don't do that anymore because we use credit cards or Venmo or something. But in the old days, we used coins and put them in the parking meter. So you had to reach in your pocket and get that just right coin. And you can tell the difference by feeling the quality of the size or the edge. Maybe one has more of a rough edge and one is smooth.

Or maybe one has a hole [00:06:00] in it and you can feel that. Or maybe you can feel the weight. So all of that discernment of quality of touch or weight, is processed to tell you information. And that information goes from your touch receptors in your fingers in this instance. into your, higher level cortices, and it tells you information that is visual, that's maybe even linked to language or cognition or memory, because you know the coin because you learned it.

Mm hmm. And so the connection there is that your smarter, higher level brain is able to turn that into what we call representational information. And that representational information then helps you connect to praxis so that you say, Oh, I don't want that coin. Put that one aside. I want [00:07:00] that one. And it helps you isolate and pull the one you want right to your fingertips.

Does that make sense?

Cory: It just like clearly popped into my head around. Okay. So obviously when you feel this certain coin, you've got this language attached to this feeling and this perception of like, I was even thinking like a fruit, you know, if I picture the word fruit in my mind. orange. If I picture the word orange in my mind, then I get this, I can exactly in my hand, I can feel the rough texture of the skin and how you could, how hard it is to like peel it.

Or when you get in the inside, it's kind of squishy, like

Michelle: how,

Cory: how

Michelle: closely they're linked. Well, I did the opposite. So when Tracy was describing the coins, They were popping up. I saw a 50 cent, a dollar. So I had to have a visual image that was prompted by the touch detail, I guess.

Cory: I thought about the 50 cent piece too.

Michelle: It's ours.

Tracy: Yeah, that's it. So when you combine somatosensory tactile [00:08:00] input in particular with visual information, The neurological word we call that is haptic processing. So haptic detail guides so much of our skill all day long and it allows you to become really efficient and automatic and you don't have to think really hard about things like think about how you zip your coat.

You don't even really have to look at it because you can. feel it and you know when the zipper is engaged or when it's not engaged. And you know how to bilaterally shift your hands from the holding to the finessing to the zipping parts, right? So all those little skillful things, those daily living skills that as occupational therapists, we're really interested in those.

But when we're working with children that have problems with coordination, Very often what happens is their ability to pick up on that detail and [00:09:00] operate on that detail is really weak. Dr. Ayers made this very clear link between sensory discrimination and the functions of skillfulness that really live in this big umbrella that we call praxis.

But skillfulness is Sometimes automatic. Sometimes it's really practiced. Sometimes it's so effortful. Like you have to work really hard to develop that level of skillfulness. If you're trying to learn how to play the guitar, right? How can you ever play the guitar if you can't feel how your fingers have to go to each of those frets and each of those, those chord shapes, strings and for the chord changes and how do you configure your hand and that takes a precise detail awareness in your hand, but then it takes and then that guides the motor control [00:10:00] and then you add the finesse of the rhythm and the musicality.

And that all integrates together, but it's all sitting back on this base of sensory discrimination.

Cory: that, like really accurate feedback around how much pressure I'm even just thinking of, like the clearest example in the guitar, if I don't push, if I can't even figure out how hard I need to push, I won't be able to get a clear sound from the string.

So, like, if I don't have the discrimination around how hard to push, like, if I can't tell if I'm pushing hard or soft, then I can't change the plan to make it work. Like, I'll just get a funky chord sound, or like, as in I'll get lots of reverb from the string, because it's just not actually pushed down against the fret.

Tracy: That's right, and the same would happen with a zipper, right? You can't get the zipper to zip if you don't get the right amount of pressure, and if you don't get the right amount of pinch, and the right amount of force, and the timing. So all of those praxis [00:11:00] functions are dependent on this sensory discrimination.

Cory: I was thinking about, so in terms of the pressure, so if I'm putting the zip into the, like, zipper catch at the bottom, and I don't have the right. pressure. I was just thinking about the sensations that like, I'll might need, I need for that job. I'm thinking about proprioception and tactile.

Tracy: and then if you don't have. integration at the deepest level of somatosensation, tactile proprioception, and vestibular, then when you go to zip, you will fall down because you can't maintain your core stability while you're moving your extremities with a lot of detail and precision and carefulness.

And so, Dr. Ayers just got it right in terms of integration, right? And we've said this every episode, I think, But, it's really beautiful and it's a [00:12:00] precise system. You know, we see it in, As little kids start to develop, they start to play around with the feeling, the tactile discrimination, and the grading, and the timing.

So they try, they play around with It's pushing something hard and pushing something soft and then pushing it just right.

Michelle: And then

Tracy: they get that nuance between the too hard, the too soft and the just right. so much of our experience and our skill is through playing around with that, playing around with the feeling of it.

Michelle: Yeah. Wow. The thing that I just. Scott, which I haven't really thought about before. I've thought about that each of the senses being able to be, precise in discerning or identifying the qualities, but how you would just explain that then, Tracy, the background is an orchestra that I, that Cory, for example, with the guitar, yes, she's going to feel whether she's got the [00:13:00] pressure right.

But at the start, she will, should hear that she's got the pressure on the tone. I'm not a musician, so I don't know what. pitch, tone, whatever. The sound won't be right, which will cue her in. Change what you're doing. Oh, oh yeah, your pressure's not quite right. So that while, it's tactile input, it's on the Augusta for the rest of the sensors to help add precision to that one, system.

Tracy: That's exactly right. And so the sensory discrimination system, it works through precise mapping of the detail, but then it works through integration of the polysensory systems coming together and auditory and visual helping you. So when you're, putting your finger on the fret and on the chord and you know from the sound and the look and the feel all together that help you to know did I get it right or not and if you got it wrong error [00:14:00] Gives a signal that needs to be corrected and you correct the detail and that's exactly the Refinement that happens that leads to higher level skillfulness so sensory motor embodied through Practice is what leads to skill.

Cory: Yeah, so in that process of like error detection Adjustment try again Correct like oh got it, right That, is that the neural plasticity, like, that's the pathways forming around that new skill?

Michelle: exactly right. And vice versa, that if I don't have precision in enough senses, then I won't get that.

If my auditory system, isn't able to discriminate, ooh, that pitch was a smidge off. and my tactile system isn't saying, Oh, you're not quite right on, then I won't correct. I won't pick up the detail of you haven't got that quite right. So I'll keep [00:15:00] repeating in error that activity

Cory: I'm thinking about, cause you talked about typical development, Tracy, and I'm just thinking we don't come wired.

It's like ready to be skilled, like we're ready to be skillful, but we're not yet skillful. Right. So I'm just trying to think, well, then how do we discern, like, is it when somebody's not detecting the error and not adjusting that we go, huh? Like, that's not typical. I'm trying to think what, how do you discern then what typical is, typical learning from, that's not coming together like as it should typically, and how do then we support that to come together?

That's what my brain goes to.

Michelle: Yeah. I think we see it. And I think, you know, I think you've talked about it in posture, Cory, you were spot on with your posture in terms of talking about the quality of it and that you, we often hear parents say, Oh yeah, I hit that. They hit the milestones. Yes. They did all of that.

But they're presenting, with not enough quality [00:16:00] of skill at full.

Cory: I'm just kind of, I was just in my head trying to think like how, if you have a really little child, like, you're going, you know, is it more in the error detection? Will they not detect the errors?

Then you start to become concerned. Like, I guess it just wouldn't improve or wouldn't progress or it's, I guess it would look clunky. Yeah. That's the lagging. Yeah. I don't know, Tracy, what do you think?

Tracy: That's exactly right. When a child produces an error, a lay observer, a parent, is somebody, may notice that it looks a little bit off.

The difference that studying this theory and working on our clinical reasoning, provides for us is exactly being able to attune our eyes to where in that process is the error the clunkiness, the difficulty, the struggle, the lack of ease and smoothness and automaticity. Where is all of that coming from?

And so that's [00:17:00] really part of your journey. you know, as a clinician and using these approaches, You're observing. Where do you see The detail is missing. Is it at the level of error? Does the kid get to the point of let's say that they're trying to put A thread into a needle or they're trying to kick a ball into a goal So those are the same skill, right?

It's a precise skill, there's just one is on a fine, very fine motor level, and one is on a gross motor level. But it's the same skill. Take this thing and put it into that thing. So, as children are working on that precision, If the issue is more around, I don't really understand what part of my finger I would hold it with, and so I'm just using the more, you know, primitive parts of my hand to try to hold on to the little thread, [00:18:00] then if you give them something bigger that they can feel better, they're probably going to learn the process of the feeling for the doing.

Faster than just continuing to be frustrated by what's going on. So, OTs are really good at that kind of grading the shape and size and feel of things. and what we're talking about is why we do that. Why do we do that kind of task analysis? Why do we offer a bigger thread versus a skinnier thread?

And we're doing it. to give the fuel, the sensory discrimination detail and force that as the agent of precision and the agent of skillfulness.

Cory: that sounds amazing. Like that has been really helpful for me, Tracy, just that juicy bit of information you just gave us. But I thought about if you start to grade the size of the bead for the [00:19:00] kid that can't get. The smaller bead and the finer thread, and they still can't figure out how that this piece of string goes into that bead and how do I push it through and pull it out?

how do we figure out where the, I guess the problem lies in that example?

Tracy: So this kind of takes us to the kind of coolest thing, you guys, that is not easy to access in the literature. It's available in the science literature and it is in our OT literature, but it's not easy to pull all this together.

So here we go. Sensory discrimination is the foundation of praxis. Dr. Ayers wrote that. We've talked about it for decades, but the link between those two is how sensory discrimination leads to perception and perception is coupled with action. to give us praxis. [00:20:00] Perception and action together are a dynamic system that are produced by the affordances Of the body interacting with the environment and the things out in the world.

So let's think about like a round object. If a human being comes up to a round object, they know that that cylinder, the roundness, the shape of it, the affordance of roundness is something that can move across space. if you take your hand and you push it onto a round object, that round object will roll.

So if you have the capacity to put your hand into a pushing space and you push, you'll produce the action of rolling. If you come up to that object, And you have the capacity to balance on one foot. You can lift your foot and have your foot be the pusher or kicker, right? So our hands can be pushers [00:21:00] Our hands can be pullers.

Our hands can be pick uppers Our feet can be pushers and tappers and kickers and lifters Those are actions that our body can create And those actions that our body creates those are affordances And those interact with the affordances that are out in space, in the environment. So if you have an object that's pick up able, like a peg, or like a a bead and it has a hole in it.

if you give a big bead with a hole in it to kids and you don't give them something to fill that hole with, they're going to fill it, right? They're going to fill it by looking through it because they're going to interact with the affordance of the hole. They're going to maybe blow through it.

Michelle: They might find things to put

Tracy: if you give them a string and a bead. They might see that those two things can [00:22:00] interact with each other and if they have the capacity Fine motor wise to put those two things together. They will but if you give a bead in a string to a little baby Who doesn't yet have the fine motor skill to do those things?

They won't see it as an option for their action because they don't they can't embody The skill of putting it together. So they just won't they'll play with the string they'll play with the bead but they won't necessarily put them together once they have the skill in them in their own self to put the bead, the thread through the bead, then that becomes an action that they can produce.

And so it becomes a skill that's possible because the affordance draws it out of them.

Cory: Okay. So I've, I, my brain is, I think, been a little bit like blown because this is so cool. I'm just thinking about, so I have to have this, the capacity in my body to actually do. the [00:23:00] action. So like the little baby doesn't have the actual fine motor capacity to do, put the thread through.

Right. But then is there also like a, I'm just thinking at, at a developmental point, babies start to put things in. Things, right? So I'm just like, how is it because they're, I don't know, cognitive, postural, like all the development to that point has then allowed them to go, Oh, now this is something. So I can perceive that this is something that can fit inside that thing, or I can take it.

Michelle: does this

Cory: sort of come together?

Michelle: dance. Well, I'm putting it together as a dance between the two that they will either cognitively or sensor, sensory motor, motorically, something develops that allows them to hang on to something that's fine, like a bead.

And then they have to have the cognitive ability to do something with it that it might. just accidentally happen the first time and then they repeat it and [00:24:00] they add on to it and do things in different ways. Cognitively, they file that, they have a memory of the repertoire that they can do with that.

And then as they move on to, the next level of development. So for example, with a ball, they might catch it, roll it, kick it. And then when they get to 10, they might. balance it when their balance is fine tuned enough that as they go through the stages They keep layering on well

Cory: in my head.

I just thought well, that's so complicated because then if you don't have Well, like if you have these all these elements, I have to have the capacity in my body and the cognition So say if you've come into the world with poor cognition Then I'm just trying to also fit in the perception piece around this, right?

So there's I have to perceive it then I have to have The capacity of my body and then I have to have the cognition. So like at any point any of these pieces could be potentially undoing this whole process. Is that right?

Tracy: That's exactly right. And it's a dynamic system, right? So cognition. [00:25:00] really

results from the embodied experience. But once you embody the experience and you have the ability to say, Oh, this is a thing that goes inside of the thing. Now you have that as a schema. So affordance action turns into schemas. And once you have some schemas, like I'm capable of putting in, or I'm capable of pushing, or I'm capable of kicking, then you forever get to own that.

Like that's a part of you now. Like riding a bike, you can't unlearn riding a bike. Yeah, unless something degrades, or you fall off and bonk your head, right? So then you can lose the skill through degeneration, or through injury, or through a degradation of memory. you can be a good tennis player.

And if you practice and practice and practice, you will always be a decent tennis player, but you won't maintain the expertise and high level of skill unless you keep practicing.

Michelle: So

Tracy: you can have a degrading of skill. if you don't use it, you lose it [00:26:00] kind of that philosophy, but the basic scheme is you don't really lose those.

they are episodic in nature. They kind of in your memory. And so, that's a complicated process to talk through, but what we're really thinking about here is how sensory discrimination is a part of the perceptual affordance dance that happens that builds the embodied cognitive language experience and capacity.

So praxis is a capacity, language is a capacity. Cognition is a capacity and all of them draw from this rich sensory discrimination perceptual fund that gives you all the possibilities. And what happens with affordances that are so interesting. if I give, you an object that you've never seen before, you will explore it for its bits and parts, and then you'll sort of turn it [00:27:00] into something that creates some sort of meaningful repetitive quality, and then that becomes that for you.

So if you've never seen scene, you know a stretchy thing like a slinky before. You would, you would sort of notice that it squeezes together and stretches apart, that you can really stretch it, that if you put one part higher than another maybe it flops around. So we give children toys like this that don't have really obvious,

It's a non cause and effect. Yeah, it's an explore it. Explore this. What, what is this? What could this be? And, and when you watch children play with those kinds of toys, you can start to get a sense of what is their perceptual, what did they do with it? You know, do they just smash it really hard? Do they pick it up and toss it?

Do they act on it from an old schema? Or can they generalize and generate new [00:28:00] schemas? and then, how does that look in terms of the smoothness and accuracy and timing? And so as you dance across that flow from perception into motor execution, you start to be able to discern where does the problem come from more likely.

Is it more around that distinction? execution of motor function, or is it more in they just don't have any idea how to generate meaning out of this object? So children, who line things up for instance, right? they get that this thing and this thing and this thing, I'm going to put them next to each other and I'm going to create this perceptual set for myself, but they don't really move beyond perception into, well, what are those things that you're lining up?

Are they, Trucks or crayons or cars or dinosaurs or what are they and can they be more meaningful than [00:29:00] just the perceptual quality that they can be in a line? So a child who's doing that, you would really be able to work at that level of perceptual affordance different than if the kid was lining it up in order to make sure that they were all exactly even because they were working on the precision of That's really a different thing.

And so it's really in observing what is it that they're doing and then using your clinical reasoning to think it through and to understand the process well enough. We don't have tests for this stuff. You know, we, we have tests for sensory discrimination. We have tests for playfulness.

We have tests for motor accuracy. We have tests for motor execution, but we don't really have. And we, we do have the, the SIFT and the EASY and the world of air sensory integration that help us get a sense of the [00:30:00] process of praxis, but we don't have great tests for all these parts. So it really comes down to clinical observation and clinical reasoning and interpretation.

Michelle: Oh, wow, Trace. So now I wonder, can we talk about sensory discrimination right down into the sense. So at the receptor level, the pathway heading up to the cortex. I'm thinking about the tactile system. We won't go into detail of that. And then you've said the word perception. It's kind of, I wonder, can we unpack that a bit?

So we've got the neural pathway for the, sensory system. So obviously they're all different. and then perception, I guess I've just That's cognition, is it? Like, what is that?

Tracy: Yeah, so it's kind of the step between. The pure sensory, reception and then you, that [00:31:00] the information is going to land in cortical areas.

Various cortical areas. And because it's cortical, on some level, somebody in the world may say, of course it's cognition. But there are those steps that happen where. the cognition sort of boils out of the embodiment of it and out of the integration. Cognition in and of itself kind of comes from perceptual embodiment and from experience and from putting the pieces together.

in an integrated way together. So cognition is going to be the summation function that starts to be the representational holding tank of that information.

So, and partly that's just because that link between sensation, perception, cognition is pretty controversial depending on who you read and it gets very detailed in terms of top down and bottom up processing and all of the [00:32:00] different theories of it. But for our purposes.

Michelle: at a neuroscience level, not an OT, yeah, yeah,

Tracy: yeah, more in a neuroscience and sort of psychological theory level.

But for our purposes in looking at children, what we see is that they, they have to be able to get this sensory detail and To interact with those sensory details in a meaningful way in order for the skillfulness to even be able to be a possibility. And what we see, we see that break down for children that have sensory integrative processing problems.

So that they, aren't, able to make use of that detail. Now where the problem comes from is not well understood, whether it's at the level of the periphery, in the receptors themselves, in the surround processing facilitation that happens, or if it's more in the [00:33:00] level of integration up higher. It's probably at multiple levels and different for different children.

So if we have kids that have Known peripheral processing problems. We know that that's where it's coming from, but it isn't just living at the peripheral level because you'll see it in the more in the higher level processing and in the cognition. So, but what we really are interested in is When a child is trying to learn how to be an effective beat doer in the world, right?

And they want to know how to kick or use their little hands to put coins in the bank, or button their shirts, or pick up a fork and get the food into their mouth, or move the food from the front of their mouth to the side of their mouth so they can chew it, or hear the difference between a pea and a bee or a black bear?

Is there a [00:34:00] bleh in the bear word? Like, is it Blair, because I said black, black Blair, or is it bear? So, how do they discern how to create precision in their listening, in their speaking? in their doing. That's what we are really interested in. And when children struggle with this, it's often because the sensory detail isn't meaningful enough to them, so we have to enhance that.

Michelle: Yeah.

Tracy: Or their nervous system is telling them that detail isn't important because you're working so hard to just keep yourself up against gravity that we don't care about detail.

Michelle: second priority.

Tracy: issues, modulation problems, anxiety, postural problems, can make sensory discrimination sort of irrelevant.

Like, yeah, I don't care about where the hole is. Because I'm going to fall down if I try to put the thread through the hole. And so all of what we look at when we're [00:35:00] doing deep clinical reasoning is we try to figure out where do we start and do we treat that postural problem first or the discrimination problem first?

It's quite complex.

Cory: I'm at that point where I have so many questions, but I can't actually figure out what my question is. so maybe for the sake of people listening, we can come back to, this affordance thing. I feel like I need to pull this together.

I don't feel like I've integrated it right for myself. So I'm certainly going to re listen to this episode. I think we can revisit this concept as well, because once I re listen, I'll have all these questions in mind, and it probably will be helpful for all of us to just keep coming at it and just keep trying to put it together.

But, I guess. In terms of, so if you're seeing issues present like lack of skillful precision or not knowing how that that's a thing that I can do with this object or, I guess what's coming to mind for [00:36:00] me is even a kid sitting on a swing and not being able to figure out how to use their body to make the swing Move, right?

And so, I've heard you talk about this before, Tracy. So in terms of the discriminative function of the vestibular system around once my body moves through space and gravity pulls differently at different points in the arc of the swing. So especially at the point where it changes, that it'll give a signal to the vestibular system, which should then discern what that is.

And then you'll see the postural. Yeah, shift at that point to know, okay, I've now changing direction in space. And so now I'm going to shift my weight to make the swing go.

I just threw in a random example about the vestibular system and we haven't even talked about that yet, this episode. So what is actually going on when you seeing change and the shift in that example that I just gave?

Tracy: [00:37:00] Yeah.

So here's, What, what you're describing is exactly how sensory discrimination leads to that sensory motor embodied response, adaptive response. And so that is where capacity grows out of. So much of our basic sensory motor experience grows out of that sensory discrimination signal. So in the vestibular system, there's this signal of am I in more flexion or extension in my head and neck complex as my body moves through space?

And if I am getting a vestibular proprioceptive signal that I'm in a little more flexion, then I'm gonna recruit the flex or surface, and then I'm gonna counter that if I start to go too far by the opposite and engaging my extensors. And that's really what swinging is, right? You're in. That, [00:38:00] that flow between flexion, extension, flexion, extension.

So you're doing that in response to the sensory detail and that discriminative sensory detail is helping organize your motoric response, your adaptive response in your postural motor system to become a swinger. And then you develop the schema of swinging and now you're a swinger. So you have this skill that grows out of swinging.

So that story is going to repeat itself in every single sensory motor domain. and so in the vestibular system, it's going to be related to the adaptive responses of that function. So like postural control or swinginess.

Michelle: Yeah.

Tracy: or bilaterality, or balance, those things all come out of the detail.

And then in the somatosensory system in your little fingers, your touch receptors, your [00:39:00] discernment of the front or the back of your thumb, the pressure that you can get in opposition, all of that comes, that detailed discrimination gives you the ability to be a prehensile person that can pinch things and pick things up and move things and do things, where you squeeze a grape and squish all the juice out of it or you Carefully pick it up so that you don't squeeze the juice out of it.

That precision is all guided by the sensory discrimination system. And it gives you that skillfulness. So in treatment, what we're looking at is really giving that beautiful enhancement that either fuels the sensory discrimination system with more juice, more information, more detail, more intensity, or more frequency, or more specificity, [00:40:00] that gives you then the adaptive connection to, oh, if I feel my fingers, then I can be a careful great picker upper.

But if I can't feel my fingers, then I'm not going to. Really be very skillful at that grape picking up or putting them onto a spoon or using my skillfulness. Yeah, it's all the same story, it just goes across the different systems.

Michelle: And that's where we can use the other systems to, add emphasis to what we're doing so that, Eventually, things happen automatically that we can pick our, put a hand in our pocket and pick our coin and I give no thought to that ever.

Like it just happens, where at the very start what I might need to do is look at it that we might, help the child to notice all the different elements and sizes and shapes. So they're using their vision and we [00:41:00] might talk them through it. So we narrate that so that they get that auditory input to help add the cognitive picture or perception of it.

So that we're layering or giving attention to the tactile system with details from other systems to emphasize that. The saline information. This is, pay attention to this bit. Notice all of those things that will help refine, in the end, the tactile system. Functions. Yeah, yeah. And that eventually it's automated, that we don't need to look at it, that we don't need to hear it.

Cory: is it a hexagon? I think it's a ten sided shape. Isn't it? Octo. Octo. I can't remember. Anyway, someone will correct us in the comments. That's right. So is, I was, I was just thinking in that example, Michelle, though, even there, you're in that pulling them in and helping them tune in with your relationship with that child.

You're also spotlighting the whole nervous system [00:42:00] onto the function, right? So like we're enhancing the perception, but then you're also going, we don't, you love that. Hey, here. pay attention, like this is information, this is important, and this is helpful. And then you use it in a skillful way, right, so in the activity that you're doing.

so it's like a combination of things, because we're hitting at all the levels there, we're trying to enhance the actual sensory information, but then we're also pulling in the cognition piece around. Hey, this is useful. Pay attention.

Tracy: Yeah. That's exactly right.

So that affective spotlight and putting effort in and trying it again and doing it a little bit different. All of those are the qualities that bring it into real cognition into into real skill. And so it takes. Our effect in our connection to the child and our kind of motivation with them and our attentional system together and we're working together and we're working [00:43:00] in mastery drive and we're really trying hard to get better at it.

And all of those different qualities are all a part of the treatment. But we're also basing it in sensory discrimination for the purpose of that higher level adaptive response. And that's the formula that comes together in play so beautifully and is enhanced. if you don't know to enhance the sensation, then you can play but you're gonna miss the beat of where does the brain, where's that information that the brain needs to actually Do this with more fluidity, automaticity,

ease skillfulness. And so it's really understanding the whole process and the treatment planning that is rich and exciting and fun. and part of why we were having this conversation in the first place.

Michelle: And it keeps us then relied on somebody else. Like if we don't help facilitate them to do it [00:44:00] for themselves, then they'll need a carer or a friend or a.

Somebody to say, Hey, tune in here or notice that. So it isn't allowing them to be. Independent.

Cory: Wow. So much information. It's been so good. key takeaways, I guess. Yeah. Key points from this episode. for me, I think my key, my straight straightaway, my first thought was, okay, I need to re listen to this episode and this is really complicated and it's exciting.

what about you, Tracy?

Tracy: Well, probably I've said this before. In another episode, but Dr. Ayers got it right yet again, here she is, you know, sensory discrimination as the base of skillfulness and as the base of praxis, there's such richness there, and there's such a truth to that, it rings true still today in the neurosciences.

Even all these 50 years later, and that's critically important for us to be able to trust that [00:45:00] this that's one of the reasons why this treatment is also efficacious and why we know it's an evidence based practice. So I just think that her brilliance. It's really, really is very shiny in terms of sensory discrimination.

Michelle: Wow. Absolutely. My mind has blown. I will certainly be listening to this again and coming at this idea of affordances and perception again, again, the orchestra of the brain, I guess. the thing that stuck out for me is that only when my body perceives itself to be safe in my body or in relationships with you, that I can worry about the detail.

so that I have to tend to first things first before we can really get, a child interested in detailing, finessing, Fine tuning. Fine tuning. This is fine tuning, I guess. It leads into

Tracy: safety,

Michelle: yeah.

Tracy: does.

And that is that on the other side of this coin, if your body can't feel [00:46:00] detail, it's really hard to feel safe. And so sometimes the first step is, what is the container that I'm in? And am I safe? And can I feel it? And do I know that? And so it kind of leads us to how sensory discrimination and sensory modulation are going to be partners, but they're different from each other.

And that kind of came, comes full circle to how we started Cory. So what a fun thing to be able to talk about it with you guys today. And maybe next time. We'll jump into talking about sensory modulation.

Michelle: you just segwayed us right there, Tracy.

Cory: Wow. Thanks, guys. We'll get to talk to you soon. See you. Bye. This podcast is brought to you by Seed Pediatric Services and Developmental FX, produced by Little Image Co. For more information, please go to our show notes on our website, spiritedconversationspodcast. com. Or [00:47:00] catch us at our Seed and Developmental FX Facebook or Insta pages.