Dr Chris Moore
Tips for Sensory Needs - Tactile
What is the Tactile sense?
The Tactile system is our sense of touch, governed by receptors all over our skin. It gives us an enormous amount of information about our environment and is a fundamental part of relationships; first by communicating with parents/caregivers and later through social bonds with friends and partners. Unlike some of our other senses, it is always on – even if we stay perfectly still, we are touching the ground with our feet, touching the chair with our legs or in contact with the air around us.
Carol Stock Kranowitz, author of “The Out-of-Sync Child”, talks about how the Tactile system has a defensive basis, alerting us to stimuli and enabling us to make a judgement about whether it is comfortable or harmful. We develop the capacity to discriminate between different kinds of touch and subsequently remember and interpret them when they happen again. The Tactile system connects to a myriad of developmental domains, including feeding, dressing, perception, language and gross/fine motor skills.
What are the implications for a child who is over-responsive to Tactile stimuli?
These children can be very sensitive to physical contact. They find light touch, such as someone brushing against them, very alerting or even painful. Some may walk on their tiptoes in order to receive less stimulation. These children can avoid messy play, contact sports and close proximity to peers. They can also be sensitive to clothing and the texture of food.
How can we help children in school who are over-responsive to Tactile stimuli?
· Provide a designated space or separate chair for activities on the carpet or for practical demonstrations in one area of the classroom, ensuring that they have enough space to avoid sudden and very alerting touch from nearby peers. They may benefit from standing at the back of line for transitions. Consider letting them begin tidying up and leaving activities or classrooms slightly earlier, so that they can avoid large groups or crowded corridors.
· Opportunities for messy play will need to be gradual and controlled using a visual timer or countdown strip. The child may initially need to interact with the stimulus using gloves or manipulate it with a spade or paintbrush. Work up to touching the substance or texture with one finger, then two fingers and eventually brief exposure with the whole hand.
· A similar approach should be considered for food textures, with gradual smelling and touching before it is placed in the mouth. Consistent routines should be considered, so that the child agrees to try a new texture at the same time and in the same place; allowing them to feel relaxed for ordinary meal times with preferred food.
· Proprioception will be important in providing calming sensory input. This may involve deep pressure to the head and limbs, letting the child be wrapped up in heavy blankets or massaging their body with large soft materials. Scheduling time for chair and wall push-ups, jogging on the spot and pushing/pulling/lifting weighted objects should also be considered.
· There will need to be flexibility with school uniforms, such as cutting off clothing labels and allowing the child to wear seamless materials. Skin-fit fabrics may be preferable to loose clothing and could be worn underneath their uniform. Wearing clothing which is slightly smaller than the child’s normal size may provide calming deep pressure and limit the movement of the material against their body.
· These children may need to be encouraged to engage in activities which allow for social interaction, but do not involve direct tactile contact with peers. These might include running, gymnastics, tennis, throwing and catching a ball, hopscotch, going on nature walks or treasure hunts, etc.
What are the implications for a child who is under-responsive to Tactile stimuli?
These children can engage in excessive touching and manipulation of objects. They may frequently bump into furniture or other children, due to reduced spatial awareness. Some can show a lack of reaction to touch or be unaware of cuts and bruises. When using a pencil or other utensils, they can find it hard to apply an appropriate grip and level of pressure.
How can we help children in school who are under-responsive to Tactile stimuli?
· For children who crave touch, we may need to provide designated fidget objects for them to manipulate when watching or listening to teaching. Discreet methods of stimulation can also be considered, such as placing a strip of velcro in their book or under their desk and access to resistance bands on the legs of their chair or desk.
· Consider opportunities for increasing their tactile awareness as part of a sensory diet over the course of the day – this may involve scheduling time for messy play with water, paint, lotions and shaving foam. They could also explore and differentiate between different textures through the use of feely books or hiding objects in an opaque box or a tray of dry rice or sand.
· When attempting to gain the attention of some of these children, a slight touch to the arm or shoulder may be insufficient due to their under-sensitivity. The use of their name or a visual cue will be more successful in providing instructions or directions. Similarly, they may require explicit visual feedback through picture schedule or standing in front of a mirror when getting dressed.
· Provide practice with letter and number formation on a range of surfaces and textures, such as chalk on the ground, finger painting, drawing on carpet or sandpaper, etc. They may benefit from the page being raised or provided on a slanted board when writing with a pencil. Experiment with pencil grips and consider weighted cutlery if there are difficulties with feeding.
· We may need to teach them about appropriate forms of touch. Photographs can help to demonstrate desirable physical proximity during specific activities. Concrete resources such as carpet squares or coloured tape on the floor can be used to show appropriate sitting or standing amongst peers. Social Stories can also provide guidance on rules about touching and where/when it is appropriate.
· Sports involving tactile contact may need a clear structure. Games such as tug-of-war, passing a baton during a relay race, wheelbarrow races or capture-the-flag allow for controlled contact which is frequently modelled. The child may be more settled for non-contact activities if there is initial proprioceptive input, such as deep pressure to the shoulders or back.