The Tactile System
We have been learning about the importance of our sensory systems and how they can help us in a therapeutic way. Many of the children we see at The Children’s Therapy Center, Inc. have issues with how they perceive and/or process sensation. We have already covered the Proprioceptive and Vestibular systems, which are so important to understand, and now we will deal with the largest sensory system of the body, the Tactile Sense. It is the largest because the receptors are all over the body in the skin. The tactile system keeps us safe by telling our brain if something is too sharp, too hot, or otherwise dangerous. It is the sense that lets us reach into our pocketful of change and choose a quarter without looking. The tactile system helps us know that the ground is safe for walking and that a duckling is so soft. These experiences are stored in our brain and are part of what help children learn about their world and how to interact with it.
The tactile system will help a child feel comfortable and secure in the world, able to understand it and make choices accordingly. Children learn through touch at first and later are able to judge using their other senses such as sight. For example, you can look at a puddle and know what it feels like to be wet without needing to touch it because of past experiences you have had playing with water. But, if the information the skin receives is not interpreted correctly, imagine how different the world would be, maybe even frightening. Or, in the case of our kids who do not seem to sense their environment enough, how many danger signals they may miss.
Occupational therapists often refer to kids who are hyper- or hyposensitive. Some children even show signs of both, overly sensitive to some stimuli and under sensitive to others. Our hypersensitive kids often do not like tags in their clothing, seams in their socks, may prefer long sleeves and pants to cover their skin like armor or not like clothing at all, stripping every chance they get. They choose the same clothes every day because they know it will feel good. They may hate haircuts and behave as if they are getting hurt and react similarly during nail trimming and baths. Certain areas may be more sensitive such as the head and face, wrists, back, etc. These children are often found at the end of a line or standing just outside the circle so they can be more assured no one will poke them or even brush up against them. It is hard to imagine what it would be like, but these children are often hypervigilant and on edge trying to protect themselves from what they perceive as harmful. The “alarms” in their brain are going off way too soon and too easily.
A hyposensitive child does not perceive harmful sensation well or has a delayed response. They may love to touch everything and do! These are the kids that seem like nothing fazes them, falling down or crashing into something then jumping right back into what they were doing without complaint. They often have bruises and scrapes but no memory of how they got there. They do not learn as well from these experiences because they simply do not sense the pain to the appropriate degree. So, a hyposensitive child may make poor decisions based on the incorrect judgment that they are safe from harm. These kids need a lot of supervision.
In therapy, we offer children many safe sensory experiences. We use various tactilely interesting toys and activities to promote exploration without fear or discomfort. If a child is hypersensitive to wet textures, for example, play with shaving cream may be on the agenda for the session. For kids that do not want to even touch something like this, they may just be expected to play in the same room with it. Or, he can use a tool such as a paintbrush or run a car through it. Our kids who love touch have great fun with shaving cream, spreading it all over and even on themselves. Each time a child has a positive (or negative) experience tactilely, the memory is stored in the brain. Your child’s occupational therapist guides your child in a safe environment to explore that which she will not explore on her own.
If appropriate, your child’s OT may teach you how to perform the Wilbarger Protocol of deep pressure stimulation with a surgical scrub brush followed by joint compressions. I will not teach this method here primarily because it should be done in person to insure success. If not done correctly with guidance from someone trained in the technique, the child may have a negative experience. What I will say is that this is one of the most powerful techniques that, over time, can help the individual’s nervous system learn to correctly interpret sensation and cause an appropriate response. If, as a parent or caretaker, you do nothing else your therapist asks of you, do this. It involves daily input of sensation to your child’s arms, legs and back and should take very little time. You will help teach your child’s brain to recognize and accept a certain amount of stimulation. A hypersensitive child may seem to be more easygoing and less edgy. Our hyposensitive kiddos need to seek out less sensation and may start feeling pain when they did not seem to before. Again, I cannot stress enough the importance of doing this technique with the supervision of a trained therapist. They will help you learn the appropriate amount of pressure to apply and the best way to work with your child. The children often love this technique and will remind parents that it’s time for more.
The tactile system tells us so much about our world and helps keep us safe and secure. Without a proper working system, we may misinterpret sensations as dangerous, or we may miss true danger signals. But the important takeaway is the knowledge that working together in therapy, we can help our children learn to interact with and enjoy their world the way they should.
Nancy E.A. Weiss, MOT, OTR/L