Do you have a child that doesn’t like wearing clothes? Does your child not like to be touched and hugged? Or does your child constantly pull at their tags?
Occupational Therapy often works with children with tactile sensitivity. If you have a child who is tactile defensive, you may see the impacts on their daily life including sensory seeking behaviors, a distinct sensory defensiveness, or negative reactions to sensory processing activities.
In this article, we are going to talk about the tactile sense, tactile defensiveness, activities to help your child, and how an Occupational Therapist can help.
What is the function of the tactile sense?
Before we talk about tactile sensitivity, let’s talk about what is the tactile sense and why it the tactile sense important.
What is the Tactile Sense?
Tactile sense or the sense of touch is the “sensory system that receives sensations of
- Temperature, and
Primarily through receptors in the skin and hair.” (Kranowitz, 2005).
Why is the Tactile Sense Important?
The tactile sense has two main functions: protection and discrimination.
Our touch receptors on our skin and hair allow us to protect ourselves. This sensory system allows us to sense movement, temperature, and pain. For example, if your hand is on a hot oven stove, then your touch receptors kick in and tell your body to remove your hand from the hot source.
Touch receptors also allow us to discriminate between different objects. For example, without looking at an object, your touch receptors send signals to your brain about what the object might be depending on the size, toughness, shape, etc., and tell you what part of the body is being touched.
Good development of tactile perception allows an individual to both protect themselves and discriminate between different objects. This sensory discrimination is very important to everyday functioning.
In saying this, touch plays a major role in our interaction with our environment. Touch as a sensory input allows us to develop gross motor skills like body awareness and motor planning, develop language, academic learning, and social skills.
What is Tactile Defensiveness a Symptom of?
Tactile defensiveness is a result of poor sensory integration. Significant impact on daily life and/or responses to other senses may point towards potentially Sensory Processing Disorder.
This means, instead of having a well-integrated sensory system to know the difference between different touch stimuli, the brain has difficulty recognizing and organizing the information received. They may produce negative responses and behaviors as a response to that touch.
What is Tactile Defensiveness?
Tactile defensiveness is the “over-responsiveness to touch” (Kranowitz, 2005). The child may react negatively towards the input. Sometimes, it is not just being touched, but the anticipation of being touched.
For example, your child might respond negatively by pushing you away or screaming if they know you are about to help them with dressing or brushing their hair.
Because they are experiencing a disorganized nervous system, children who are tactile defensive can respond in a fight or flight response. This tactile sensitivity can be exhausting for both the family and the children themselves.
Tactile Defensiveness Symptoms
A child who is tactile defensive or who has tactile sensitivity may exhibit some of the following behaviors:
- Respond negatively to light-touch senses
- Does not like being touched on the face
- Difficulty with toothbrushing
- Does not having hair washed or cut
- May overresponsive to minor scrapes
- Rub parts of the body that have been touched
- Can be a picky eater and avoids certain textures
- Does not like wearing certain clothing
- Sensitive to new clothing or tags and labels
- Avoids messy play (e.g. sand, shaving cream, paint etc.)
But My Child Loves Big Hugs
Contrary to popular belief, children who are tactile defensive can still enjoy touch. However, they prefer deep pressure rather than light touch.
Deep pressure includes big hugs and squeezes. Whereas, a light touch is gentle brushes across the skin and kisses.
How can I help my child who is sensitive to touch?
There are various strategies to help your child who may be hypersensitive to touch stimuli. Here are some basic strategies that you should incorporate.
Before you touch them, give them a warning
This allows their body’s nervous system to prepare for the input. Initially, they may still have some negative responses in reaction to the anticipation of the touch. However, it is better than sudden or unexpected touches.
Get them to do it themselves
When you allow the child to do the task, it allows them to control the level of input they can tolerate. For example, if you are getting them to wash their body, give the child the cloth and soap so they can clean themselves, rather than you doing it for them.
They may not be able to clean themselves fully using this method but it can allow them to have more control over the situation. Therefore, they may have less dramatic reactions to the task.
For younger children, you may get them to do as much as possible by themselves first. And then you give them a short countdown (e.g. 20 seconds) so you can help them with the rest of the task. For example, “I’m going to help you wash for 20 seconds and then we are finished”.
Prior to touch activities, do some deep pressure exercises
Deep pressure activities can help regulate and calm the body. Instead of just doing the activity quickly, take some time to do these activities so your child’s body is more ready for the task. In turn, this may make the task go a lot faster as they will not be in constant fight or flight.
For example, before dressing your child, get them to jump around the house, or give them a long big hug. This can help with tactile sensitivity. There are more activities below.
What to do when kids refuse to put on certain clothing?
There may be a few reasons why your child refuses to put on clothes and it is important to know the underlying reason before we offer strategies. Some might be to do with a tactile sensitivity others another reason.
Reason 1: Some children don’t like wearing clothes
Some children, and adults, just don’t like wearing clothes. It can be a preference thing, like people who prefer walking around barefooted rather than with shoes on.
For toddlers, this can be a common occurrence. However, as the child gets older, there are social expectations to wear clothing when going out of the house.
Try loose-fitting clothing
Try loose-fitting clothing and avoid those who have tight clothes, especially with elastic bands. Loose-fitting clothing can help the individual feel less restrictive.
Get the child to choose the pieces of clothing
Some children prefer having a sense of control over what they wear. If your child refuses to put on clothing, give them a choice between 2-3 shirts to choose from.
However, if your child still does not like wearing clothes and if it is impacting your child’s daily life, you may need to look into this a bit deeper.
Reason 2: Child has tactile hypersensitivity
This means your child is overly sensitive to the clothes. As an occupational therapist, I see this all this time.
Try softer fabrics
Consider the type of fabrics that they are already wearing. Instead of getting your child to wear wool (that can be prickly), try soft high-quality cotton. This lowers the tactile stimuli & sensory input experienced by the child.
Remove labels and tags
We’ve probably all had the experience of having an annoying tag on your shirt. Some children are more sensitive to this.
If your child has complained of this, remove the tags. Depending on the tags, there are different ways to remove them for the most effectiveness.
Some children are bothered by the seams on the clothing, especially on socks. There is a variety of seamless clothing and seamless socks for children to wear.
Tactile Sensitivity: Helping a child who doesn’t want to be touched
There may be a range of reasons why your child does not like being touched or have tactile sensitivity. These could include:
Some people have tactile sensitivity simply because they have different personal preferences. Some people’s love language is through touch, whereas, others prefer having a big personal space bubble.
If this is the case, find alternative ways to show your child affection through words or time spent with them, rather than through touch.
Trauma and/or abuse
Individuals who have experienced trauma, abuse, or have attachment difficulties, may have negative responses to touch.
Sensory Processing Disorder
If your child has tactile sensitivity, tactile defensiveness, or general sensory issues the underlying reason might be sensory processing disorder. A large number of children with sensory processing issues don’t even know they have Sensory Processing Disorder.
This is due to a lack of knowledge surrounding sensory processing as a whole and since there is no formal diagnosis in the DSM5.
Autism Spectrum Disorder
Individuals with Autism Spectrum Disorder may experience tactile defensiveness as well.
It is important to find out why your child does not want to be touched. If it is due to past experiences, sensory processing difficulties, or just a personal preference.
If it is a sensory processing difficulty, trial some of the suggested strategies above in “How can I help my child who is sensitive to touch?”.
Activities for Tactile Defensiveness Treatment
Tactile sensitivity is due to disorganization in the central nervous system. It is important to note that Sensory Processing Disorder is a neurological condition and therefore there are no quick fixes.
Depending on what area your child is having the most trouble with, the sensory play might be a good method to work on tactile sensitivity. There are various activities that you can do with them including:
- Heavy Work exercises – These are activities that help regulate and calm the body. The aim of heavy work is to provide ‘deep pressure’ input. These include:
- Jumping from one room to another
- Pushing against the wall
- Wheelbarrow walks
- Eat crunchy food
- Push their toy box or some other furniture pieces
- Hang on the monkey bars
In everyday life consider making the following alterations:
- Instead of using light touch, try providing a bit more pressure when you touch your child. For example, instead of a light touch when tapping them, grab their arm with more pressure. Don’t hurt them but some children with tactile defensiveness are going to respond better to deep pressure touch.
- Encourage them to carry heavy objects around the house
Kranowitz, C. (2005). The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder. New York: Penguin Putnam Inc.