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- Does your child cringe when you stroke his face?
- Must he have all the labels cut out of his clothing before he will wear them?
- Does your child refuse to wear certain fabrics, such as wool because it is scratchy?
- Does your child refuse to touch anything sticky, slimy, or dirty with his hands?
- Does washing or brushing your child's hair result in a major battle?
- Does your child hate to have his feet touched?
It could be that your child has a sensory motor integration deficit known as tactile defensiveness or touch sensitivity.
What is Touch Sensitivity?
The sense of touch is essential for normal social and emotional development. It is this system that allows us to make the deepest connections with others. It is through touch that the mother and child bond to each other. This is how we connect most closely with our spouses.
Touch also serves a protective function. It is through tactile discomfort or pain that we realize that things like fire are dangerous. Painful or unpleasant touch experiences tell us to prepare for a physical threat that might require a need to run away or retaliate.
In some people this tactile sensory system is not functioning properly. These people experience pain or distress from touch sensations that other people find non-threatening or even pleasant. These people have sensory integration disorder known as tactile defensiveness or touch sensitivity.
Children with touch sensitivity are often in the state of "red alert". Many of the sensations that we take as meaningless, they view as a physical threat. Children with touch sensitivity also experience tactile sensations differently than others. Something that we experience as smooth can seem to them painful. The result is that often their behavior is affected. Casual contact can cause what others view as extreme and inappropriate reactions. These children may whine cling lash out or run away as a result of normal things in their environment.
Sensory motor integration deficits need not affect a child's learning ability, but his resulting reaction often does. Because the child is frequently on the defense, he can be emotionally insecure and extremely distractible. This is one of the things that differentiate touch sensitivity from ADHD. ADHD children have difficulty sustaining attention, but they are not more easily distracted than other children. Small stimuli that would not affect an ADHD child who is engaged in an activity, may cause disturb a touch sensitive child.
To give you an idea of how these children experience the world, imagine the feeling you have when someone scrapes his nails along a blackboard, or the feeling you have when you cut your nails too short. This is how a touch sensitive child might experience a warm caress. There is a difference, however. When you cut your nails too short, it bothers you for a while, but the discomfort goes away. If a child is touch sensitive, the discomfort never goes away.
The child may not be able to wear his dress pants because the feel of wool is too uncomfortable to bear. He may not be able to concentrate in school because he is enduring the hardness of the chair or the rush of air blowing on him from the ventilation system. He may be quick to lash out when another child bumps him, because of the perceived attack by the other child. He may be unable to make friends because of the fear of being bumped prevents him from interacting in a normal fashion.
Adults with a sensory integration disorder may have problems in their relationships with their spouses. Normal daily contact may disturb them, and they may avoid physical contact with their spouses even when such contact is appropriate. This desire not to be touched can have a seriously negative impact on a marriage.
What You Might See
Here are some of the things that may indicate that your child is touch sensitive. Your child may be touch sensitive if he:
- Reacts strongly to sensations that most people don't notice.
- Tries to avoid tactile experiences.
- Gets distracted because of the things that are touching him are bothering him.
- Insists on having certain textures of clothing.
- Makes you cut all the tags and labels out of his clothing.
- Won't eat certain foods because of their texture.
- Craves certain sensations the he finds calming, like rocking or firm pressure.
- Fights irrationally when you are combing or shampooing his hair, cutting his fingernails, or brushing his teeth.
In adults and children with sensory motor integration deficits the palms of the hands, soles of feet, mouth and tongue are usually most sensitive areas.
Touch sensitivity is a sensory integration problem. Although this disorder can exist by itself, more often it is part of a constellation of other problems that children have. Children with touch sensitivity often have the following other disorders:
- Motor coordination problems
- Speech and language delays
- Hand-eye coordination difficulties
- Motor planning difficulties
- Frequent ear infections
- Poor eating habits
- Problems with digestion & elimination
- Sleep irregularities
- High anxiety and emotional insecurity
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In addition there are a number of medical disorders that commonly have touch sensitivity as a component. These include:
- Asperger's Syndrome
- Bipolar Disorder
- Down Syndrome
- Fetal alcohol syndrome
- Fragile X
- Learning Disabilities
- Obsessive compulsive disorder
- Pervasive developmental delay
- Selective mutism
Like so many other disorders of the brain and complex neurological function, we do not know why children and adults have sensory integration disorders. In medicine, when we don't know the cause of something we like to say that the cause is idiopathic. This is a term which is a term derived from Greek or Latin or some other dead language, which means "we don't know."
However as scientists, not knowing something makes us very uncomfortable. Therefore there a number of theories on what causes disturbances in sensory processing. There are at least five competing hypotheses. The most recent research suggests that the abnormality may lie in the cerebellum, the part of the brain that modulates sensory motor activity. There might be something to these theories. However, based upon the review of current literature it seems to me that the cause of touch sensitivity is idiopathic.
What Should You Do Next?
Touch sensitivity is a sensory motor integration deficit. The goal of treatment is to repair the sensory processing disorder by giving the child a means to develop his or her sensory integration. The goal of therapy is to normalize sensory integration and motor planning by improving the way the nervous system registers and interprets tactile information.
Treatment of touch sensitivity is usually done under the auspices of an occupational therapist. If you feel that your child may have touch sensitivity you should first try to confirm the diagnosis by going to someone who is trained in diagnosing sensory integration problems. You should first consult your pediatrician with your concern and try to get a referral to a Pediatric Occupational Therapy Service for diagnosis and treatment. They will manage your child's treatment plan and teach you what you can do at home to help your child.
Touch sensitivity is one of a number of sensory motor integration deficits that affect children. It often accompanies other disorders such as ADHD, Bipolar Disorder, and other developmental childhood disorders.
I have not seen any statistics, but it seems that sensory integration disorders are fairly common. This condition can be severely handicapping. However, it is often very treatable. If you feel that your child may have this condition, it is definitely in your child's best interest to have a thorough evaluation by an Occupational therapist trained in sensory integration and motor planning.
Anthony Kane, MD
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