Thursday, February 21, 2013

Sensory Week - The Tactile (Touch) System

From the moment your child is born, they crave "touch."  

Dr. Ashley Montagu writes "touch is a message system between the caregiver and the infant - both for quieting and for alerting and arousing."

The tactile system, as with the proprioceptive system, are combined in what is called The Somatosensory System. Our tactile sense is input from the skin receptors to the brain about touch, pressure, temperature, pain, and movement of the hairs on the skin.

The tactile system lays the foundation for all other systems. It is the first means of communication and interaction on both an emotional and sensorimotor level.  Development of our touch system begins with the lips (hands to mouth can even be seen in utero!) and ends with feet and legs. Oral touch is the first area of sophistication followed by tactile exploration  of the body. All areas of the body are sensitive to touch by three and one half months. Enjoy this video by Sonia Rochel on you tube and then view her website as she takes an amazing approach on touch during bathing and gives great information on massage. 

Some more information on touch and development:
  • A child's tactile system guides their visual system
  • Children learn by active touch
  • Many reflexes are based in the somatosensory system, especially the tactile system
  • Our skin is the largest organ in the body
  • Touch has an impact on motor control and muscle tone
  • Providing skin to skin, bonding and good handling, all assist to decrease stress and deal with the release of stress related hormones in development
As stated by Shelly J. Lane, Ph.D., in The Sensory Integration and Praxis Test Course 1, 
  • "Maternal touch aides in the immune response"
  • Touch aids in cognitive development "related to the ability to interact with the environment, explore and feel safe"
So Mama's and Dad's love, snuggle, do skin to skin and give your developing babe a sense of security and love from the day they are born, all through the tactile sensory system! Interesting study by Dr. Harry Harlow on the importance of love and touch.

When a child has deficits in their tactile system, they may have tactile hypo-sensitivity (under-responsiveness to touch) or tactile hyper-responsivity (over-responsive to touch, also known as tactile defensiveness). They also may have difficulties perceiving and discriminating touch. 

When a child presents with Tactile Defensiveness, they react negatively and emotionally to unexpected, touch sensations. Examples of Tactile Defensiveness include:
  • Avoid being touched, even "freak out" at the thought of being touched
  • Enjoys deep pressure hugs over the light touch of a kiss that he will wipe off!
  • Does not like tags in his/her shirt
  • Avoids play in the sand
  • Does not like to pet the dog 
  • Needs to wash hands immediately after messy play or avoids messy play all together (examples, play in rice, mud, dirt, finger painting, etc)
  • Fights about wearing a winter hat and gloves
  • Wears long sleeves and pants in the summer or short sleeves and shorts in the winter
  • Becomes upset during self-care tasks (nails being cut, hair washed/brushed or a haircut)
  • Avoids certain textures of clothing
  • May have oral defensive to certain textures - for example will only eat soft foods or foods of a certain temperature
  • In school, a child may dislike standing in the middle of the line because children rub against or touch her
  • They may have limited peer and social interaction
What can you do?
  • Remember that light touch is more noxious than firm, deep pressure touch
  • Allow your child to initiate hugs and kisses - give a nice, firm hug when you do give your child a hug
  • Initially, avoid situations that are irritating to your child. Don't make him kiss everyone at Christmas, allow your student's to stand at the front or end of the line at school, allow them to wear clothes that they are comfortable in, cut the tags out of shirts
  • Review heavy work activities described in The Proprioceptive System blog as they may assist to organize and calm your child 
  • Work to add in tactile experiences to your day. Have your child help you with cooking or baking, play with safe, non-toxic foam in the bath tub
  • Discuss The Wilbarger Deep Pressure Protocol with your therapist - The Wilbarger Deep Pressure protocol is a sensory-integration intervention program developed by Patricia and Julia Leigh Wilbarger and aids in decreasing tactile defensiveness
When a child exhibits hypo-sensitivity or under-responsiveness to touch/tactile discrimination challenges they may:
  • Seem unaware of touch unless very strong and intense
  • Enjoy walking around barefoot
  • Have no idea that their face is still dirty after lunch or that they have a runny nose
  • Show an increased pain tolerance
  • Use too much force during play

What to do?
  • Touch, touch, touch! Target the system
  • For children that are unaware their face is still dirty, prior to their tactile system becoming more mature, bring in the visual system and use a mirror to show them the food still on their face. The visual system will assist to bring awareness to the tactile system
  • Play dress-up with make-up or clown make-up increasing awareness to the face - again, use a mirror bringing in the visual system as well
  • Play in a bin with rice/beans. We have one of these at home and my son loves to hide puzzle pieces and various objects in the rice also targeting discrimination
  • Cooking - a great way to incorporate the tactile system into a functional, fun activity for the whole family. Make  pretzels, knead dough/gluten free dough (also good for strengthening)
  • Make obstacle courses that incorporate an array of tactile stations - crawl on a rug, go through a tunnel, find an object in a bin of balls or rice, snuggle between couch cushions with various textured stuffed animals
Let's again go back to that handwriting task, discussed in both the vestibular and proprioceptive posts. When children have difficulties with tactile processing and are attempting to perform a task such as handwriting, these may be their challenges:

  • How and where do I hold the pencil? 
  • Learning to discriminate shapes through touch and carry that over to the paper - If a child is not exploring their environment and learning through touch, then moving these concepts to paper may be extremely difficult
Modulation - Over-responsive
  • A child may have tactile sensitivity to the desk or paper they are writing on
  • Their shirt sleeves may be annoying them as they are writing
  • Organizing all of these distractions, again, takes away from the task of writing, which is most likely very challenging as well.

If you feel that your child/student is demonstrating challenges related to the tactile system or in any other areas of sensory processing, it is important to discuss this with your Doctor or Naturopathic Doctor and consult with an occupational therapist in your area. Feel free to also contact Michelle with any questions or concerns via the Contact Michelle link at the side of the blog or by commenting on this post.

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