The tactile system is our sensory system that helps us understand touch sensations from the outside world. It detects temperature, pressure, and pain. Touch receptors in our skin help give our brain information about body awareness through tactile sensations. Did you know that our nervous system has two different kinds of touch receptors? We have receptors for both light touch sensations and deep touch sensations, and sensory processing challenges within the tactile system can impact how our brains process information from one or both of these touch receptors.

One of the most common and confusing presentations of dysfunction within the tactile system is children who are over-responsive (or tactile defensive) to light touch sensations, but under-responsive to deep touch sensations. These children often have difficulty tolerating wearing different clothing textures, and may frequently wear minimal or only soft clothing. They may dislike brushing their teeth or having their hair combed, and interpret these light touch sensations as painful. On the other hand, these children may appear under-responsive to deep touch sensations, like falling down, and may even seek out this kind of input (through big hugs, being wrapped tightly in a blanket, etc.). 

Can children with tactile defensiveness be “cured?” With the help of Sensory Integration therapy, we can help change the way children’s brains process tactile information (how cool is neuroplasticity?) to alter the “pain” response that is elicited with tactile experiences. In the meantime, occupational therapists can work with families to find adaptive strategies and coping skills to help them reduce the impacts of sensory processing dysfunction within children’s systems. 

To help children with tactile defensiveness tolerate these unpleasant sensations (or literally painful sensations, as interpreted by their brains), we can prepare them for light touch experiences by giving them opportunities to get deep touch or proprioceptive (heavy work to the muscles and joints) input. We can also use this input to help override a negative light touch experience. For example, giving a child a foot massage before putting on their socks may improve their ability to tolerate the feeling of the seam on their toes. Rolling around on the floor prior to bath time might help them tolerate the feeling of water on their body. Using a weighted blanket in their lap or wrapping them up in a sheet may help nail trimming feel more tolerable. Trial all kinds of deep touch and heavy work options with your child to see what works best!