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. Lead and participate in collaborative discussions with peers. 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. 1
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 2
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/theweirdness-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 3
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. 4
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. 5
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. 6
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. 7
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 my senses combine to create a 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 8
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 nondominant 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. 9
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. 10
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 11
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. 12
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. 13
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. 14
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. 15
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. 16
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. 17
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. 18
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. 19
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. 20