SPD and Sensory Touch Issues: Tactile Defensiveness

Judy Benz Duncan, Occupational Therapist

When a child’s sensory touch system does not properly process the sensory inputs it receives, there are three typical responses seen.

Children with SPD tactile or “touch” issues may:

·  be slower to respond and may seek out more sensory input

·  they may be unaware to even notice the tactile sensory input where they be injured for example, and not notice, and

·  others are sensitive to touch where they find some types of touch overwhelming and painful, displaying what is generally labeled as “Tactile Defensive.”

This article will be discussing SPD and Tactile Defensiveness. The other challenges with poor sensory modulation of sensory touch are covered in other articles & blogs on TheraPlay4Kids.com

Sensory Touch and Tactile Defensiveness

Our sensory tactile, or touch, system responds to anything that may touch the skin. This includes light touch, discriminative touch, deep touch pressure, temperature, vibration, length of contact time, and pain messages. When a child is tactile defensive, they are very sensitive to touch, often finding certain kinds of touch painful, overwhelming, and often overloading their sensory system.

Light touch sensitivity may include anything that touches the skin lightly, like a strand of hair, the breeze, humidity “wetness,” a loose thread in clothing, a feeling of vibration from “thumping” music, the “heat” felt from sitting too close, crumbs, a tickle, etc.

Discriminative tactile / touch sensitivity may include being oversensitive to things that a child touches. This may interfere with the development of fine motor skills, motor planning, and coordination. This type of tactile defensiveness may be seen with a child who does not like, or who resists, “messy play,” where play items may be sticky, wet, rough, or squishy, or with dry play items like sand and craft materials. Discriminative sensitivity can also impact meal time, with oral tactile issues with food textures and temperatures.

Deep tactile / touch pressure includes firmer touch, hugs, and squeezes. A child may be overwhelmed and respond to deep tactile pressure that is soft or hard (as in a hug), loose or tight (as in clothing or shoe fit), or by the weight of pressure (blankets, pillows). They may “tolerate” a brief encounter, at certain times of the day, or only deep pressure in certain specific areas of their body.

Tracking your child’s responses to what they react to, when this occurs, time they will tolerate, areas of the body they can accept sensory tactile stimulation to is an important step toward developing the plan with your service providers to support your child and to work to reduce the level of tactile defensiveness.

Common Signs and Symptoms of Tactile Defensiveness

Children, as well as adults, with tactile / touch sensitivity may display the following common sensory processing symptoms:

· Avoids hugs, kisses, tickles, massages; may try to “rub away” where they were touched or kissed as if the sensation remains and continues to irritate them

· Difficulty wearing socks and/or shoes

· Dislikes socks, especially the seams and has a preference for the position of sock seams

· Avoids playing with or touching messy textures such as finger paint, glue and play-dough

· Difficulty at mealtime, avoiding and refusing certain textures of foods, or food that is mixed so that there are different textures in one bite, food with lumps, food that is too cold or too hot

· Avoids playtime with dry textures like sand, dry noodles, dry rice, craft materials (like feathers, lace, yarns, glitter)

· Resists brushing their teeth

· Resists brushing their hair, or having a haircut

· Resists finger nail or toe nail care and trimming

· Easily irritated by the feeling of clothing tags, clothing seams, a loose thread, the fit of their clothes (too tight or too loose)

· Dislikes the feeling of certain fabrics (blankets, sheets, car seat, etc.)

· May pull off and remove clothing that is irritating them no matter if it is at home, in public, at school

· Easily irritated and overwhelmed by temperature changes, windy days, rainy days

OT Activities, Ideas, and Suggestions for Reducing Impact of Tactile Defensiveness

The following activities, ideas, and suggestions may help you support your child in reducing the impact of their tactile defensiveness.

Please speak with your child’s pediatrician, OT, ST, PT, and service providers for their input, advice and guidance before making or attempting changes – these ideas may or not be the best choice for your child, and working with those who do know your child is the best bet for success!

If your child withdraws or becomes overwhelmed with any of the activities or media presented, move on to something else!

If you have serious concerns about your child’s eating habits, always consult with your pediatrician to rule out medical or oral-motor structural problems, consult with a dietitian/ ST/ feeding therapist, and discuss with your child’s service providers.

Working to Reduce Tactile Defensiveness:

Activities, Ideas, and Suggestions

Your child may only tolerate one or a few of the ideas suggested – remember it’s trial and error and giving your child some control over what they will work with will help in preventing sensory overload.

Talk with your child’s service providers – they can help modify, adapt, or give suggestions on how to make changes that will be the most effective for your child.

• Massager (manual or electric/battery operated) – small massagers may be less intimidating and more easily accepted; they may only tolerate to certain areas of their body – start with these spots and move on from there as tolerated

• Soft body friendly sponges, loofahs, soft flannel pieces of fabric (for body rubs, holding, use during deep pressure activities, massages); start with the body areas they can tolerate and move on as tolerated

• Soft blanket for rolling up in, hiding under, wrapping up in; provide deep pressure and massage through the blanket as tolerated – start on specific areas that they can manage, slowly increase time they will tolerate and move on to other parts as they allow

• Bubble wrap (to squeeze, walk on, pop – vary the size of the bubble wrap to allow experience with different types of pressure and force needed to “pop” the bubbles with their hands, or feet); encourage walking on bare foot; try letting them roll on the bubble wrap

• Bag of feathers, textures fabrics, etc., to feel, walk on bare foot, rub on their bodies; if they can hold, try letting them rub these on to you as a start

• Paint brushes and sensory brushes – rub on their body if tolerated and have them tell you where you are touching them for body part identification and self-awareness; can do with their eyes closed if they will tolerate; let them “paint” you

• Bubble solution – have them blow (or you blow) and then have them try to “clap” or “kick” the bubbles to break them, or have them “blow” or “wave” the bubbles to try and keep them in the air; keep wet wipes / paper towels on hand in case it gets “too sticky” for them; let them try to break the bubbles with a foam pool noodle if they cannot tolerate touching the bubbles yet – shorten the noodle slowly until they are also needing to touch the bubbles with their hands

o   Kid classes for martial arts or yoga

o   Gymnastics (kid classes, or kid-safe areas at a facility)

o   Letting your child help with setting the table, meal preparation (stirring or mixing), and clean up

o   Let your child help with home tasks like folding towels and putting them away, hanging their clothes on a rod, wiping off the table after meals, putting silverware back in the drawer, mopping or sweeping, carrying out the bag of garbage, and so on (CLICK & GO for Home Skills / Self Help Blog here on TheraPlay4Kids.com) 

o   Help you wash the dog – a great activity that addresses so many sensory issues!

o   Heavy work activities (CLICK & GO for Heavy Work Blog here on TheraPlay4Kids.com) 

o   Body part awareness activities (CLICK & GO for Body Part Awareness Blog here on TheraPlay4Kids.com)

o   Set up an obstacle courses inside using furniture, pillows and blankets, empty box to crawl through, a taped line to follow, creating areas to crawl on, under and through. Outdoors, you can use things like hula-hoops to jump in to and out of, adding in movement task “stations” that ask them to perform jumping jacks, commando crawling, bear walking, walking on a line or low balance beam, and other creative movements that challenge your child to balance, crawl, jump, skip, and run.

o   Hippotherapy or Equine Therapy (check for what is in your area!)

o   Make a Tactile / Touch Sensory Box (CLICK & GO for Tactile Sensory Box here on TheraPlay4Kids.com)

o   Give Sensory Texture Rubs (CLICK & GO for Tactile Sensory Box here on TheraPlay4Kids.com)

o   Brushing or Willbarger brushing program does make a difference to help decrease touch sensitivity. This technique needs education and training by an experienced therapist and it is not the right solution for every child. 

o   Weighted items (lap blanket, weighted stuffed toys, soft hand or ankle weights)

o   Compression vest or clothing

o   Lycra body sock / sensory bag

o   Chewy toys / “chew jewelry” / kid-safe chewable items – there are hundreds of items available on line

o   Squeeze balls / stress balls / racquet balls

o   Stretchy toys (be sure they are kid-safe!)

o   Small rubbery bounce pads / wiggle pads

o   Ask your child to lie on their back on a large piece of brown wrapping paper or opened up big cardboard box, and draw around them, making their outline on the paper. Have your child draw on features and clothes to the outline and name the body parts while they are doing this. Let them get as creative as they want. Hang on the wall to let the see a life-size “them.”

o   Warn the child prior to touching them – let them know you are going to touch their arm, their back, their hair, etc.

o   Use firm direct pressure when touching your child – avoid light touch – let them know you will be giving a hug, or holding their hand and be deliberate about it without hurting them

o   Avoid tickling the child, especially if that will cause a reaction that may escalate

o   Mealtime – Adding New Foods and Textures (CLICK & GO for Mealtime Blog on Adding New Foods and Textures here on TheraPlay4Kids.com)

o   Foods Outside Your Child’s Comfort Zone (CLICK & GO for Mealtime Blog on Foods Outside Your Child’s Comfort Zone here on TheraPlay4Kids.com)

o   Ask your child’s therapists what other strategies and techniques may work for your child. Let the whole team work with you to help support you and your child.

See Main OT Blog Page for a variety of topics to CLICK & GO on! 

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