In my last post, we explored the tactile system, why it is important and some ways to help develop it. I talked about how we try to develop the tactile system from an early age by exposing children to a wide variety of experiences. However, we know that not all children successfully integrate tactile input. I briefly touched on some of the difficulties children can have with this sensory system. I want to dedicate an entire post to one of the most common sensory challenges I encounter as an OT – tactile sensitivities. You may hear this referred to as ‘tactile defensiveness’. My goal is to give some general information and tips, but this information should not fully replace a consult with your child’s OT for specific recommendations.

What is tactile defensiveness?

Tactile defensiveness is the tendency to react negatively and emotionally to touch input. Now, most of us would react negatively to certain touch input like a spider crawling across our skin- or unexpected touch, like when a stranger came up to me and rubbed my pregnant belly in public. (Um, WHAT!?). A child with tactile defensiveness would react this way to so many more sensations. He will be overly sensitive to input that some of us may not even notice. These reactions will impact him across his day throughout many important daily routines.

What does tactile defensiveness look like?

Remember that the term tactile does not just refer to our hands – tactile input refers to input taken in from our skin. Therefore, many daily routines can be impacted if a child has tactile defensiveness.

Difficulty with hygiene routines

  • For children with tactile sensitivities, the hygiene routines can be so incredibly challenging. Every aspect of these routines have challenging tactile components. Think about it – bathing, hair brushing, toothbrushing, nail care. Try to put yourself in their shoes – can you try to imagine what it would be like if the water from the shower or when washing your hands physically hurt? Would you look forward to your shower or completely dread it? Can you imagine the stress this puts on families getting a child ready for school in the morning? The child may have had a really hard morning getting through these routines even before he showed up at school.

Difficulty with certain clothing

  • Tactile sensitivities can affect a child’s ability to think and learn. Can you imagine if your clothes physically hurt to wear, but you still had to pay attention in class? It’s hard to imagine, but I think about what I would feel like if I tried to wear a pair of jeans that are just a bit too small – that tight pressure would be so uncomfortable. Try paying attention at a continuing ed course when that uncomfortable sensation is nagging at you. Children with tactile sensitivities may feel this way all the time. It is really hard to think and learn when your clothes are uncomfortable and you just can’t find relief. They may never want to wear socks, long sleeve shirts or pants, hats or gloves. This can really be a problem if you live in Chicago like I do where there are months that the air is so cold it hurts your face.

Difficulty with play/recreation/social relationships

  • Playing tag on the playground brings a whole other level of stress – not only is the touch stressful, but it is unexpected! Unexpected touch is the worst for children with tactile sensitivities. It is a totally different ballgame if the child is in control. Think about typically fun recreational activities too – the beach, water park – so many threatening sensory experiences at those places as well which could impact the child’s ability to participate.

What can you do?

OK, so now I’ve told you all about what tactile defensiveness may look like, you are probably wondering what to do about it! Here are some tips!  I divided them into general tips that can be used with any tactile difficulty, and then tips for specific daily routines that are commonly affected by tactile sensitivities.  

General Tips: 

Reframe your thoughts

  • Tactile defensiveness, just like all sensory processing challenges, are real. Children who have these challenges will not grow out of it. It can be very easy to jump to conclusions when we see children with sensory processing difficulties in the community. Have you ever silently judged a parent whose child is running around in the winter without a hat or gloves on? Or the child who comes to school with his hair uncombed? Or the child who only ever brings a specific kind of chicken nuggets for lunch? I’m sure I have at some point before I was an OT, which I am not proud of. Tactile defensiveness can impact all areas of daily life and it can be incredibly difficult for families to manage. This is why it is so important to take a step back and reframe our thoughts around this issue.

Heavy Work/Deep Pressure Input

  • I did a post previously about the proprioceptive system that you can find here. I talked a lot about deep pressure input and heavy work. It is generally calming for the nervous system. You can use this to help children with tactile sensitivities. It can help the nervous system be better able to handle potentially uncomfortable tactile information. 

Never force a child into an uncomfortable tactile experience

  • As much as we want to help a child overcome his sensitivities, it is never helpful to force an experience. Gradually expose the child to experiences using adaptations at first will be much more effective. The child needs to feel like he or she is in control.

Tips for specific routines: 

For the child who has difficulty with hairwashing/brushing

  • try giving a scalp massage first. The tactile receptors for the head and neck are different from the rest of the body, and sometimes tactile defensiveness around the head can be more significant

For the child who has difficulty touching new textures:

  • use a utensil to explore first (example: offer a paintbrush instead of finger painting)

For the child who has difficulty bathing:

  • try keeping the water level in the tub low
  • let the child pour the water over his head. Give him as much control as possible over the experience
  • Fun bath toys may also help the child focus on something other than the sensation of the water
  • If the child doesn’t like water on his face or in his eyes, try using goggles, one of those bath visors, or allowing him to lay all the way down in the tub so water doesn’t have to be poured over his head

For the child who has difficulty wearing certain clothes:

  • try sensory sensitive clothing – you may need to play around with this to find the right fit for your child.  Target now offers a sensory friendly clothing line with no tags and flat seams. You can also try Smart Knit clothing line. 

One final tip…Seek out Occupational Therapy!

As I mentioned before, children will not just grow out of their sensory issues. Occupational therapists can help evaluate the underlying issues and develop a targeted treatment plan to address them.

In summary, a child with tactile sensitivities can have a hard time navigating important daily routines, but we have an opportunity to guide and support them in becoming more confident to explore the world around them. If you have any tips, I’d love to hear them!

Reference: Sensory Integration and the Child by Jean Ayres

This post is for informational purposes only.  The information provided is general in nature. Please contact your occupational therapist for specific questions regarding your child/student.

Katie McKenna, MS, OTR/L

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