Sensory Processing Disorder & the Tactile System Sensory Processing Disorder (SPD) occurs when the body has difficulty taking in and/or interpreting sensory input. All the senses contribute to each individual’s sensory profile, but not everyone is impacted by sensory input from various stimuli in the same way. For example, one person may be bothered by certain sounds and have auditory sensitivities, whereas another person may instead by impacted by visual sensitivities to light rather than sounds. SPD can make it more difficult for the affected person to participate in day-to-day functions by presenting challenges with engagement in daily routines, behavior management, emotional regulation, and social interactions with friends and family.
The tactile system can be impacted by a variety of diagnoses, including SPD, hypotonia, autism, cerebral palsy, down syndrome or a genetic disorder. An individual may experience sensitivity to touch in a variety of ways, and it can range from mild to severe. Each of these is explained in detail below.
Sensory-Seekers: An individual may crave sensory input when their nervous system does not efficiently send signals to the brain that sensory input is being obtained. This will result in the body continuing to seek out additional sensory stimuli even when its needs have been met. Children who are constantly craving movement, pressure or touch, or those children who under-register feelings of pain or temperature would fall into this category.
Sensory-Avoiders: When a person’s nervous system over-reacts to sensory input via touch, the brain will send signals to the rest of the body to avoid or withdraw from uncomfortable sensations as a way to protect itself. The brain may also become overwhelmed by taking in too much sensory stimuli at once – the sights, sounds and smells of a particular event may be too much for the brain to handle all at once. The reaction to experiencing the offending stimuli can be unpredictable and will often result in a “fight or flight” response. Children who avoid exposure to various sensory stimuli or become fearful of unexpected touches or unfamiliar textures and sensations would be classified in this group.
Mixed Profile: Children who have sensory modulation difficulties will vacillate between a sensory-seeking profile and a sensory-avoider profile. This occurs when the brain has difficulty processing and interpreting sensory input. An activity that seems to bring the child joy and excitement one day – or one minute – may cause him/her great distress the next. A child who is unpredictable, easily frustrated and quick to meltdown may have a mixed sensory profile.
When situations that are tactilely challenging for a child arise (and they often do on a daily basis), it impacts the lives of both the child and their loved ones. Parents and caregivers often feel like they are walking on eggshells trying to avoid any sensory stimuli that may cause the child to become overwhelmed, defensive or dysregulated. Though tactile sensitivity certainly presents challenges, there are strategies that can be used to help prepare your child for situations in which uncomfortable sensory input is unavoidable. Family can work with the therapeutic team on coming up with ways to desensitize or increase their child’s awareness through a variety of tactile activities.
Give advanced warning: If your child does not like the feeling of water on his/her head in the bath or shower, it might be helpful to prepare him/her for the experience ahead of time. You can let your child know what’s coming up next by creating a visual schedule with pictures of his/her routine activities. When your child sees the activity line-up for the day, s/he will know exactly where bath time will fall into the routine and have a chance to mentally prepare for this challenging task.
Provide sensory-friendly activities: Does your child love arts and crafts but hate the mess? There are art supplies that can be used to provide a creative outlet! Stamps, sponge-tip paint markers and squeezable bottles of glue or glitter paint can all be used for relatively mess-free projects. Perhaps your child doesn’t mind the mess but you would like to keep it contained – that’s understandable! You could offer your child a dedicated sensory bin or table where s/he can play with beans, sand, water, shaving cream and more without the worry of finding the aftermath all over your home. Additionally, if you are seeking a fun family activity, some movie theaters offer special showings of films marketed as “sensory-friendly screenings,” with reduced volume, increased lighting and the freedom to get up from your seat to move around when needed.
Offer clothing that is tactile-friendly: Children may be curious and eager to explore the world around them, but they may fear the feeling of new items on their skin or hands. By making a pair of familiar, comfortable gloves available, your child may feel supported enough to challenge themselves to trying new sensory experiences. Having gloves as a barrier between a sensory item and your child’s skin can sometimes be enough physical support to navigate different substances. Additionally, if your child is particular about clothing and bothered by itchy tags, you can find tagless clothing at several stores and websites. Some common brands that offer tagless apparel options include Hanes, Carter’s and Cat and Jack; you can also find other options at specialty sites, such as Fun and Function, Lucky and Me and Independence Day Clothing.
Follow your child’s lead: Your child likely will not be shy about letting you know when s/he is uncomfortable. When this happens, you can follow their cues and help them create boundaries to avoid these situations and foster independence. Provide your child with acceptable ways to tell others that a touch is not welcome, either with language or with a physical cue or gesture (such as shaking his/her head to say “no” in response to an attempted hug). Provide step-by-step instructions for your child so that s/he can perform an action on his/her own (“Wet the paper towel. Now wipe your chin with it.”). If your child does not like the feeling of certain towels following a bath or shower, you can have them feel various washcloths in your home or at the store to see which type s/he is most comfortable using.
Let your child do the heavy-lifting: Your child might need a lot of gross motor activities to help provide the sensory regulation s/he is seeking. While you may not have room for a trampoline or swing at home, there are other activities that can get your child moving. Vacuuming, helping to carry in grocery bags or collecting clothes and carrying the laundry basket are some chores that can allow children to have the extra movement or weight that they need to stabilize their bodies. Riding a bike or scooter, playing in the snow and climbing playground equipment are some other gross motor play activities your child might enjoy.
Try brushing therapy: Children who are very sensitive to touch can benefit from using the Wilbarger Brushing Protocol. Using a soft, plastic sensory brush, you can run the brush over the child’s skin with firm, even pressure for two- to three-minutes. Per this protocol, you start by brushing the arms and work down to the feet, avoiding the face, chest and stomach since these are especially sensitive areas. Use of this protocol can help decrease tactile defensiveness and anxiety and improve self-regulation. An occupational therapist would be able to provide specific guidance and suggestions on implementing this program with your child.
Address safety issues: Some children are not reactive to stimuli that should cause feelings of pain or a sense of danger. Talking with your child about these situations and giving him/her the words to express these feelings can help. For example, if your child falls and scrapes his/her knee, you can model appropriate language for this situation: “Ouch! I scraped my knee. That really hurt! I need mom or dad to look at it now.” You might also point out when a sibling, other child or character from your child’s favorite television show responds appropriately to pain or danger.
It is important to keep in mind that not all children will need to use all of these strategies. What works for one child might not work for another. The only way to find out if an idea is helpful is to try it out and see what is most effective at regulating your child and making him/her feel comfortable in his/her surroundings. Once you find something that works, you can use your tried and true methods to increase your child’s chance for success in a variety of situations throughout the day!