1 Health Sciences Module: Occupational Therapy Pathways to Prosperity Network

OCCUPATIONAL THERAPY

Essential Question: Do Humans Have a Sixth Sense?

Learning Targets:

Students will:

● Objectively summarize informational text to describe how information is sensed and

perceived by the human brain.

● Synthesize information to explain how human senses combine to create the “6th sense”

of proprioception.

Lesson Overview

As children, we all learn about the five senses; yet humans actually have seven senses! Vision

and touch (the somatosensory sense) combine with the vestibular (balance) and kinesthetic to

produce our ability to know where we are in space, even with our eyes closed! This ability is

known as proprioception. Often, people with brain injuries have a disrupted proprioceptive

ability due to damage to any of the four senses involved. In this lesson, students will explore

how our senses combine to create our 6th sense, proprioception. This understanding is used to

further the narrative of the emergency victim and to explore the Occupational Therapist career

track.

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Lesson Agenda

Opening (5 min) Emergency Scenario: Recovery

Work Time A Proprioceptive Experience (10 min)

Common Text Proprioception (15 min)

Expert Texts: The Somatosensory Systems (25 min)

World Café (20 min)

Closure (5 min) Occupational Therapist Characteristics

Materials:

□ Young Allied Health Professional student packet

□ <Because of Occupational Therapy> and/or <The Many Faces of Occupational

Therapy> video (to project)

□ Document projector

□ <Expert Texts and Activities> for the Somatosensory, Kinesthetic, Vestibular, and

Visual senses (copy for each person in expert group)

□ Colored pencils (per expert group)

□ Paper (one sheet per expert group)

□ Somatosensory Activity (enough for each student to experience the activity)

□ Toothpicks

□ Blindfolds

□ Corks

□ Metric rulers

FACILITATION NOTES

The Narrative Arc. The more each <Emergency Scenario> can be presented as if telling a

story, the more engaged the audience will be. Work to avoid a stale reading and lean towards

bringing the information to life as in a conversation or a “reveal” of the next chapter. Think of

creative ways to make the story your own.

Media. Preview the videos <Because of Occupational Therapy>

(https://www.youtube.com/watch?v=Ud5Fp279g4Y) and <The Many Faces of Occupational

Therapy> (https://www.youtube.com/watch?v=VmAGzESjZaI). Both show how the field of

Occupational Therapy can extend beyond the hospital and the positive effects it has in some

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people’s every day lives. Each video is about three minutes in length; you can choose to show

one or both.

World Cafe. The following link models the world cafe protocol. If you are not familiar with the

protocol, take a moment to watch https://www.youtube.com/watch?v=7ODLvTBvKow. This

video is geared towards students and can also be shown to explain the World Cafe protocol to

students. An alternative to World Café is to allot time for students to rotate through each station

(reading/activity).

IN ADVANCE

□ Prepare to show the video <Because of Occupational Therapy> or <The Many Faces

of Occupational Therapy>.

□ Preview the proprioceptive experience (adapted activity included during the work time) at

http://www.exploratorium.edu/snacks/proprioception/.

EXTENSION

Brain Games. The National Geographic Channel airs a show called “Brain Games” that

explores the different functions of the brain. The episode, “Super Senses,” presents games and

experiments that demonstrate the brain has more than just 5 senses. If you have a cable

subscription, you can find the full episode and show portions of it at

http://channel.nationalgeographic.com/brain-games/videos/super-senses1/. Without a cable

subscription, you can still show the following clips of games/experiments that highlight the

brain’s different senses: http://channel.nationalgeographic.com/brain-games/videos/the-

weirdness-of-boxes/, http://channel.nationalgeographic.com/brain-games/videos/altered-states/.

You can show these videos and have students participate in the game/experiment to help

emphasize that the brain has different senses that can work together to form “super” senses.

Vocabulary

Content Tier II

proprioception, somatosensory, vestibular,

kinesthetic, rehabilitation, occupational

therapy

awareness, senses

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Opening (5 min)

Emergency Scenario: Recovery

1. Project the video <Because of Occupational Therapy>

(https://www.youtube.com/watch?v=Ud5Fp279g4Y) or <The Many Faces of

Occupational Therapy> (https://www.youtube.com/watch?v=VmAGzESjZaI).

2. Ask: What is the major difference between an occupational therapist and a physical

therapist?

o Invite the young professionals to turn and talk with a colleague. o Call on a volunteer to answer the question. Listen for: Physical therapists work

to help people rehabilitate issues with the musculoskeletal system to gain better

function and mobility. Occupational therapists work to help people accommodate

for their difficulties in order to live as normal and independent a life as possible. o Distribute the <Emergency Scenario: Recovery>. o Share the scenario.

Work Time

Say: As Occupational Therapists, you understand a lot about how a brain injury may affect

people’s “sixth sense”—the awareness of their body in space, or proprioception. Issues with

proprioception can be seen in a person’s posture and balance.

Even with our eyes closed, we have a sense of body position—where our arms and legs are, for

example, and that we are moving them. Muscles, tendons, joints, and the inner ear contain

proprioceptors, also known as stretch receptors, which relay positional information to our brains.

Our brains then analyze this information and provide us with a sense of body orientation and

movement.

A Proprioceptive Experience (10 min)

1. Invite the young professionals to find a colleague.

2. Tell them that they will take turns timing and recording the following activities:

Balancing on one leg with your eyes open.

Switching legs.

Closing your eyes or using a blindfold and repeating the process.

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3. Ask: What differences did you notice in the length of time you were able to balance

on one leg?

Common Text Proprioception (15 min)

1. Distribute the <Common Text: Proprioception>.

2. Tell the young professionals to read the text through one time and attempt to read

for the big picture.

3. When the young professionals finish the first reading of the text, direct them to read

through the text a second time, this time annotating the text by circling vocabulary

words and underlining their definitions.

4. Model this form of annotation.

o Project the document using a document projector.

o Read up to the vocabulary phrase, somatosensory sense, and circle it.

o Ask yourself aloud, “What is the definition of the somatosensory sense?”

o Reread the sentence and underline the word touch.

o Restate that the somatosensory sense is the sense of touch.

5. When the young professionals have read the text a second time and annotated it for

new vocabulary, ask them to think-write-pair share a one sentence summary of the

text.

6. Provide 30 seconds for the young professionals to think.

7. Tell them to write their one sentence summary for another 30 seconds.

8. Invite the young professionals to turn to a colleague and share out their summary.

Expert Texts: The Somatosensory System (25 min)

1. Invite the young occupational health workers to count off by 4.

o Ask the 1’s to sit together, the 2’s to sit together, and so on.

o Provide each group their <Expert Texts and Activities for the

Somatosensory, Kinesthetic, Vestibular, and Visual Senses>.

o Each group will have only one text.

2. Tell the young professionals that they will collaborate to:

o Read the text.

o Annotate the text (marking new vocabulary and information).

o Perform the activity that models the sense.

o Write a clear one-sentence summary of the information.

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World Café (20 min)

1. Direct each group to select a “leader.” The leader’s role is to record the major points

of the conversation that takes place at the table and to then summarize the

conversation, using the recorded notes.

2. Provide about 10 minutes for teams to discuss the information in the text. They

should catch notes with colored pencils on a piece of paper that can be left behind so

that each leader of the groups in the World Café protocol will have speaking notes.

3. Distribute the <Proprioception Note-catcher>.

4. Direct the young professionals to add to their note-catchers as they learn about each

sense involved in this crucial ability to know where your body is in space.

5. Project: https://www.youtube.com/watch?v=7ODLvTBvKow. This short video

explains the world café protocol.

o Ask: Who here can explain the protocol?

o Listen for: That for the first rotation, the leader stays put and the rest of the

group rotates to the next table. The leader (the one who didn’t move)

presents a summary of the conversation recorded from the former group to

the new group.

o After the first round, invite each table to select a new leader. Again, the new

leader’s role is to record the major points of the conversation that takes place

at the table and to then summarize the conversation using the recorded

notes.

o The group discusses the topic at hand until time is called. Then the newly

elected leader remains at the table while the remaining group members rotate

to the next table.

o Repeat the process, ideally until all participants have had a chance to lead.

o After the final round, the last group of leaders will present to the whole group

rather than reporting out to a new rotation.

6. When the young professionals have completed the rotations, ask: How do you think

these four senses combine to create our sixth sense of proprioception?

o Invite the young professionals to turn and talk with a colleague.

o Use equity sticks to call on the young professionals to provide an answer.

Listen for: Proprioception requires information from the eyes, muscles,

joints, and the vestibular organs.

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Closure (5 min)

Occupational Therapist Characteristics

1. Distribute the <Who Are You?> questionnaire.

2. Explain that they will rate each characteristic on a scale from 1-4, with 1 meaning the

characteristic does not apply to them at all and 4 meaning it describes them perfectly.

3. After students have had the chance to rate themselves on the characteristics, explain

that if they answered with mostly 3’s and 4’s, then the career of Occupational Therapist

might be career of interest based on the lens of Self and Society.

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Name: Date:

OCCUPATIONAL THERAPY: Do Humans Have a Sixth Sense?

Today’s Learning Objectives:

I can:

Summarize informational text to describe how information is sensed and perceived by

the human brain.

Explain how human senses combine to create the “6th sense” of proprioception.

Lead and participate in collaborative discussions with peers.

As children, we all learn about the five senses; yet humans actually have seven senses! Vision

and touch (the somatosensory sense) combine with the vestibular (balance) and kinesthetic to

produce our ability to know where we are in space, even with our eyes closed! This ability is

known as proprioception. Often, people with brain injuries have a disrupted proprioceptive ability

due to damage to any of the four senses involved. In this lesson, I will explore how our senses

combine to create our 6th sense, proprioception. This understanding is used to further the

narrative of the emergency victim and to explore the Occupational Therapist career track.

Today’s Activities:

Emergency Scenario: Recovery

A Proprioceptive Experience; Common Text Proprioception

Expert Texts: The Somatosensory Systems

Occupational Therapist Characteristics

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Emergency Scenario: Recovery

You work as an occupational therapy assistant and chose to go through a 2-year training

program so that you could work and help people right away. Working in a hospital, you are in

the position to help people adapt to and rehabilitate their bodies after injury. You help people

develop, recover, or maintain daily living and work skills. Your goal is not only to help clients

improve basic motor, cognitive, and emotional functions in order to return to their roles in life,

but also to compensate for loss of function. You provide skilled treatment that helps individuals

achieve independence in all facets of their lives.

The 14-year-old boy who you are now assessing is experiencing compromised function with

balance, as a result of his contusion and associated Traumatic Brain Injury (TBI). He has not

experienced any further swelling, or edema, of the brain tissues, thankfully. You are going to

work with his family to think about how to make changes in their household during his recovery

period. People with TBI must avoid digital screens and sometimes even miss school or work for

2-6 weeks. You are also going to teach him how to dress himself with one hand, as his left

forearm is broken. Luckily, he is right handed and does not need assistance using his non-

dominant hand.

You truly love your work and find that you are very good with patients. You are warm, patient,

and listen well. You also love the creative problem-solving aspect of the career. You have

decided to return to school to finish your training to become an Occupational Therapist.

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Common Text: Proprioception

Did you know that humans actually have seven senses? We all learned the basic five in primary

school: vision, smell, taste, hearing, and touch, or the somatosensory sense. But wait! We

have two more senses! We also have a vestibular sense that keeps us balanced and a

kinesthetic sense that helps us know the location of our bodies in space.

The somatosensory cortex primarily receives data from the sense of touch. The primary area

for the perception of the sense of touch is the postcentral gyrus of the cerebral cortex.

Information from the somatosensory cortex is also combined with the vestibular (balance),

kinesthetic (movement), and visual senses in the somatosensory association area of the parietal

lobe of the cerebral cortex to give us a unique sixth sense—proprioception, which is your

awareness of your body’s position in space. The purpose of proprioception is to use these

combined sensations to coordinate muscle movement, including the constant adjustments

needed to maintain an upright posture.

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Proprioception Note-catcher

Write your notes from conversations during the World Café to describe each sensory system.

Tactile Sense (Touch)

Kinesthetic Sense (Movement)

Vestibular Sense (Balance)

Visual Sense

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Group 1 Expert Text: The Vestibular Sense

The vestibular sense is one of the first to develop in a growing fetus, prenatal baby, and

starts with the movement of a carrying mother’s body. By only 5 months in utero, in the

womb, this system is well-developed and provides a great deal of sense information to a

growing baby’s brain. This system is very important to a child’s early development. Its

role is to relay information to the brain as to where a person is in space, as related to

gravity; whether they are moving or still; and if they are moving, how quickly and in what

direction. The vestibular system gathers that information from a set of fluid-filled canals

and a sac-like structure in the inner ear. These structures respond to movement,

change in direction, change of head position, and gravitational pull due to small

“crystals” suspended in the fluid.

4 functions of the vestibular system are:

1. Coordinating eye and head movements. Without this coordination, it would be

challenging for us to complete everyday activities such as copying from a whiteboard in

a classroom, following a moving object such as a softball through the air; or visually

scanning across a page to read. The vestibular system helps the brain to register and

respond to whether the object looked at is moving or if our own head is moving.

2. Helping to develop and maintain normal muscle tone. Muscle tone is the ability of a

muscle to sustain a contraction. Without a proper functioning vestibular system, it would

be challenging to hold our body in one position.

3. Impacting balance and equilibrium. As you move throughout your environment, so

does the fluid in your inner ear canals. As the fluid in your inner ear moves, your brain is

receiving information on the position of your head in space. Depending on that signal,

the brain then sends a message to your body signaling it to move in a way that will help

you to respond to and compensate for any planned or unplanned movements. Without

efficient vestibular processing, you would appear to be clumsy and have trouble staying

on your feet.

4. And finally, coordinating both sides of the body together for activities, including riding

a bicycle, catching a ball, zipping a coat, or cutting with scissors.

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Group 1 Expert Text: Vestibular Sense Activity

Eagle Pose: Step-by-Step Instructions

1. Stand in with your legs together and arms hanging at your sides. Bend your knees

slightly, lift your left foot up and, balancing on your right foot, cross your left thigh over

the right. Point your left toes toward the floor, press the foot back, and then hook the top

of the foot behind the lower right calf. Balance on the right foot.

2. Stretch your arms straight forward, parallel to the floor, and spread your scapulas wide

across the back of your torso. Cross the arms in front of your torso so that the right arm

is above the left, then bend your elbows. Snug the right elbow into the crook of the left,

and raise the forearms perpendicular to the floor. The backs of your hands should be

facing each other.

3. Press the right hand to the right and the left hand to the left, so that the palms are now

facing each other. The thumb of the right hand should pass in front of the little finger of

the left. Now press the palms together (as much as is possible for you), lift your elbows

up, and stretch the fingers toward the ceiling.

4. Stay for 15 to 30 seconds, then unwind the legs and arms and stand in Tadasana again.

Repeat for the same length of time with the arms and legs reversed.

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Group 2 Expert Text: The Kinesthetic Sense

Kinesthetic receptors detect change in body position.

The kinesthetic sense monitors the position and movements of muscles, bones, and

joints. Through the sense of kinesthesis, you can tell, even with your eyes closed,

where your arms are located. When you play any sport, when you drive a car, when

you move around, etc., you need to know where your limbs are located so you can

move them to the right positions. Receptors, or nerve cells, in the joints and tendons

send the brain information about the angle of your limbs.

For example, a neuron connected to kinesthetic receptors in the elbow fires a

certain number of impulses when the arm is outstretched. If the arm is at a 45-

degree angle, the cell might fire 40 impulses per second. If the arm is at an angle of

60 degrees, the cell might fire 90 impulses per second.

Kinesthetic receptors are primarily stretch receptors located in the muscles, joints

and tendons. To activate a knee-jerk reflex, a doctor taps the tendon below the

kneecap with a rubber hammer. The tap of the hammer momentarily stretches the

patellar tendon, which runs from the patella (kneecap) to the muscles of the lower

leg. When the tendon is tapped, stretch receptors send impulses to the spinal cord,

activating motor neurons in the spine and sending impulses back to the muscle of

the leg, making it twitch. This reflex system helps keep us upright; when we lean,

stretch receptors activate leg muscles to correct the lean and pull us back into a

vertical position.

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Group 2 Expert Text: Kinesthetic Sense Activity

Walk around an object and return to the starting point:

Make sure there are no obstacles or hazards anywhere nearby.

Along a wall, find a place that has something that you can identify by touch, such as a

light switch or wall trim. Place an object, like a desk, 5-15 feet away from the wall, and

visually or non-visually familiarize yourself to the size of the object as well as the

distance between it and your starting point on the wall.

Starting at the wall, close your eyes and square off at the marker you can touch. Walk

around the object as close as you can without touching it, and return to the exact same

place along the wall that you started.

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Group 3 Expert Text: The Somatosensory Sense

The tactile sense, or sense of touch, is how we interpret the information we get from the

receptors, or nerve cells, on our skin. When we encounter the feel of an object in our

environment, our nervous system receives this information and helps us understand

and tell the difference between pressure, texture, traction, and other tactile qualities of

the object, and it helps us determine exactly what we’re feeling. Our tactile system also

helps us to understand temperature and to feel pain. There is a relationship between

touch and the emotional centers in the brain, helping us make decisions and remember

details about tactile experiences that we find pleasurable and ones that aren’t so

pleasurable.

The tactile system is what lets a child reach way down into his toy box and pull out his

favorite action figure without even looking. It lets you know when the shower is warm

enough (but not too hot) and helps you decide whether you prefer a calm bath or a

strong shower. It’s how you know that you are touching something sharp, smooth,

rough, or bumpy. But touch receptors aren’t only in your hands– in fact, they’re all over

your body! It’s because of these receptors that you feel your foot hit the floor with every

step or you grab your favorite jeans or shirt because they feel good to wear.

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Group 3 Expert Text: The Somatosensory Sense Activity

HOW SENSITIVE IS MY SKIN?

PROCEDURE

1. The subject must wear a blindfold. (The subject may not watch the procedure—this

would give away the answer!)

2. The tester should use a cork with toothpicks stuck into it. You can use one cork and

move two toothpicks different distances apart, or use several corks, each one with two

toothpicks a measured distance apart. The tester should start with toothpicks about 50

millimeters (mm) apart. Make sure that the two points touch the skin at the same time.

Begin with the tip of the index finger.

3. The data recorder asks how many points the subject feels. If the person feels two,

move the points closer together—about 40 mm apart, and check again. Continue the

procedure until you find the smallest distance the points can be separated for the

person to feel two points instead of one. When the person reports “one point” for the

first time, move the two points apart only one or two millimeters at a time and try to

make a very accurate measurement.

4. When the smallest distance is found, record the measurement of the distance in

millimeters between the two points while the experimenter holds them on the subject.

5. Continue this process for the rest of the skin areas: tip of the thumb, forearm, and

forehead.

6. Use fresh toothpicks if another person becomes a subject.

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Group 4 Expert Text: The Visual Sense

Along with proprioception and vestibular function, the visual system plays an important

role in the ability of an individual to control balance and maintain an upright posture. It

has been found that vision is the most significant contributor to balance, playing a

bigger role than either the proprioceptive or vestibular senses. How clearly a person can

see his environment, as well as the size of the visual field, the sensitivity to light and

glare, and poor depth perception all play important roles in providing a feedback loop to

the brain on the body's movement through our environment. Anything that affects any of

these variables can hurt a person’s ability to maintain balance and posture. Monocular

vision (one-eyed vision) has also been shown to negatively impact balance.

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Group 4 Expert Text: The Visual Sense Activity

The Hole in the Hand Illusion

This simple trick plays with your binocular vision to make it appear as if you have a hole

in your hand! Roll a normal piece of 8x11" paper into a tube and place it next to your

hand as shown in the picture below. With one eye, look through the tube; with the other

eye, look at your hand. With a little bit of shifting you should perceive what appears to

be a large hole through your hand. Your mind takes the two distinct views to create one

odd, bizarre view.

The viewer should look through the tube with his left eye and at his right hand with his right eye.

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Exit Ticket: Who Are You?

Rate each statement on a scale from 1-4.

1= does not describe you at all

2= somewhat describes you

3= describes you pretty well

4= is exactly who you are

____ You like working with people.

____ You are a good listener.

____ You love to problem-solve, especially when the problem feels impossible.

____ You are physically strong.

____ You enjoy being a help to others.

____ You are extremely organized.

____ You are a patient person.

____ You have a lot of compassion for people.

____ You are very creative.

____ You can write clear explanations of concepts.