Do you have a child who recoils from touching many textures, or who is particularly picky about what s/he wears? Or perhaps prefers to be naked as often as possible? Some children (and adults) are hypersensitive to touch, making it very hard (like fingernails on a chalkboard hard) to tolerate light touch or the brush of a shirt label or an unusual texture against the skin. Speaking in generalizations, such children may prefer to be naked, or wear tight clothing that doesn’t brush up or move against the skin, or wear only very soft, silky, or smooth clothing; they may learn to use utensils early (to avoid fingerfeeding) or may avoid crawling (on carpet, grass, anything), crafts (fear of touching dough, glue, sand, glitter), or getting messy – ever!
Therapy Brushes: An Effective Treatment
These brushes are used for Wilbarger’s brushing protocol, recommended by many therapists to treat tactile defensiveness. It has been theorized that brushing the skin firmly fires the hypersensitive nerves and essentially makes them less hypersensitive (reactive) for the next 90-120 minutes, and this can have great benefit behaviorally, for a less oversensitive, stressed/anxious child can naturally tolerate life’s twists and turns (and transitions) more easily. It can also help set up a child to have more success tolerating textures orally, increasing the variety of foods eaten. For effective treatment and guidance on the protocol, contact your therapist or book a consultation here.
Tactile Defensiveness Treatment
Often, kids with tactile defensiveness will try to desensitize themselves (it’s part of learning and growing!) by becoming hyperfocused on a specific tactile experience, such as water: they may start as very nervous about it (it might splash), and they may need water toys they can touch before touching the water itself, but eventually they may just never seem to get enough of water play. This is a good thing. Giving the child freedom to explore a texture in a multitude of ways and on multiple areas of the body is helpful for increasing tolerance. The next task is to help the child migrate to a new texture, perhaps adding it to the tolerated texture.
Another place a child naturally desensitizes is with food: letting a child fingerpaint with purees, applesauce, yoghurt; get hands on oatmeal or a banana, and touch these foods to the face, is a good way to increase tolerances (and even start eating new foods). Moving away from foods, children can explore texture with playdoh, clay, putty, fingerpaints, silly string, soap crayons, and shaving creams. These can even be used as a whole body experience in a bathtub (to enable a good rinse-off afterwards). If there is a lot of hesitation around such textures, styrofoam letters or other lightweight objects can be affixed to the textures, so the child focuses on the “non-foamy/slimy” objects before venturing into touching the texture itself (in their own time, with modeling, encouragement, and an atmosphere of fun).
Sensory bins are another way to go: fill a bin with rice or beans or sand (any variety) and hide “treasures” within it. The child can seek out the treasure by diving in with their hands, or they can use tools or toy plows or dump trucks to move the media around to their liking. Rewards can also be placed at the bottom of a sensory bin so that when your child does something good (such as during potty training or finishing clean up, or any challenging task), they can dive in to find their prize.
Additional Tips
General rules of thumb for tactile defensiveness treatment include using firm/deep pressure (not light touch, unless your child seems to like it) when handling your child, and encouraging much play with tolerated textures, gradually expanding to include more textures. Keep things fun, and give your child as much control as you can within accepted guidelines – remember: your child may feel less in control of their body than typical, and therefore s/he may tend to demand more control over the environment. Children that feel secure and confident in having control over their own bodies are more willing to explore, and thus desensitize themselves more effectively than anyone else trying to force it on them too fast (which only increases anxiety and defensiveness).
Oral Defensiveness
Oral defensiveness is like tactile defensiveness in the mouth. There may be difficulty tolerating specific textures such as cream of wheat, or mixed textures, like foods of differing textures put together into a dish (lasagna, nachos), or having sauces added to food. These kids might need their food to be separated, for that way it is easier for the child to see one texture and think “Okay I can handle that” and then see the next one and think, “Okay, I can now handle that one” but the two together could be overwhelming until the child feels competent with each separately. Oral defensiveness can also cause a child to be uncomfortable with sensations when moving the mouth, or food in the mouth, which can make learning motor patterns far more difficult. For example, the sensation of food at the middle or back of the tongue may cause an “early gag” reflex, making safe swallowing (and trust of food) challenging. Hypersensitivity in the mouth can also diminish exploration of, and attention to, motor movements in the mouth, delaying babbling, enunciation and speaking skills.
Oral Defensiveness Treatment
I like to start with treating the whole body, using the Wilbarger brushing protocol to brush the body, then switch to other methods that approach the face and mouth as tolerated. A rule of thumb is to let the child have as much control as possible over the experience. Speak with your therapist or book a consultation to discuss specifics for your child. Ultimately, we want to provide a wealth of experiences that involve exploring and moving the mouth, because when there is oral defensiveness, there is usually decreased awareness and control of movements in the mouth because the sensations are overwhelmingly strong and are “tuned out”, including the sensations we need to move in a coordinated manner to eat and speak, sip drinks and blow bubbles.
Under-registration of oral input
Children who do not obtain adequate sensation in the mouth tend to exhibit the following behaviors:
- putting many non-food items in the mouth, perpetually and beyond the age this is normally expected
- overstuffing the mouth (with food, to the point of “chipmunk cheeks”)
- preferring very crunchy, dry textures (that poke the mouth, increase sensation, like tortilla chips)
- preferring cold or spicy, salty or pungent foods (increasing awareness of the food in the mouth)
- speech delays and/or difficulty with enunciation (it’s hard to move oral structures with coordination when you don’t feel them adequately)