When we talk about awareness we think about it on several levels:
In general, how well is the client aware of his body in relation to the environment around him? We look at how the client moves in the environment – bumping into things, not noticing how close or far other people are away, having awareness of what is behind him or to his sides. We look at how the client copes with gravity and other forces such as touch. This type of awareness is learned over time via movement and experience. It is affected by other senses such as vision and hearing as well.
We also look at the client’s awareness of different body parts such as the trunk – we often see poor awareness of the back of the trunk – or arms and legs. We think of awareness of specific muscle groups – does the child use muscles selectively to move with good control.
Again, we have many tools in our therapy tool box. There are many types of sensory stimulation that can help improve awareness. Compression is powerful and if we have fitted the client with a trunk garment to improve trunk alignment, this will have a positive effect on the client’s awareness and all of a sudden they improve both awareness of body parts but also how they relate to their environment. We see that they do not bump into things and people and they negotiate challenges such as changes in surface much better.
We frequently use vibration to improve specific awareness – try it on yourself and see how the area “wakes up”. Another tool to both assess and treat awareness is EMG Biofeedback, which I will discuss when look at the next step.