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. We
connect most closely with our spouses through touch.
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 the 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.
Coexisting Disorders
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
Bed-wetting
Speech and language delays
Hand-eye coordination difficulties
Motor planning difficulties
Allergies
Frequent ear infections
Poor eating habits
Problems with digestion & elimination
Sleep irregularities
High anxiety and emotional insecurity
In addition there are a number of medical disorders that
commonly have touch sensitivity as a component. These
include: Asperger's Syndrome
Autism
ADHD
Bipolar Disorder
Down Syndrome
Dyslexia Fetal alcohol syndrome
Fragile X
Learning Disabilities
Obsessive compulsive disorder
Pervasive developmental delay
Selective mutism
Causes
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 clearly, 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.
Conclusion
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 has been helping parents of ADHD and
Oppositional Defiant Disorder children online since 2003.
Join over three thousand parents and get help for your
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