Tactile Defensiveness Explained!


In the last post we discussed about sensory modulation and how it affects tactile system. The summary sheet gives the brief review of different characteristics of hypersensitivity, hyposensitivity and tactile discrimination. 

This post is all about Tactile Defensiveness explanation.

Hope it makes sense to readers!!

Tactile defensiveness means a sensory issue related to unusual sensations or heightened sensitivity when a person or child is being touched anywhere on his or her body. It is a tendency to react negatively and emotionally to touch sensations.

Let’s consider an example of lovely boy referred to me  for Occupational Therapy by a class teacher called as Jack (pseudonym). 
He is 6 years old and has got special needs. The reason for referral is functional difficulties in activities of daily living (ADL’s). The observations made about Jack stated that he is accident prone, drops things from his hands, dislikes hair being washed, or being touched in the face or unexpectedly, prefers standing last in the queue, misbehaves on being instructed, and cannot manage buttons, zippers, laces and ties. He is distractible and hyperactive (home /school environment) which makes his learning difficult. Moreover, he was very impulsive and aggressive on Fridays due to whole week fatigue. He is often in fight and flight mode on being touched or spoken about his behaviour.

Now from above mentioned observations regarding Jack’s behaviour what can be concluded?

Well, the child doesn’t behave well in the classroom or at home.

Is this behaviour due to his attention seeking behaviour or Sensory Sensitivities?

The answer is, Sensory!  It can be hypothesised that he has a disorder in tactile processing, showing tactile defensiveness and poor tactile discrimination characteristics.

Most of the times children with ADHD, Developmental Delay, Autism or Dyspraxia show tactile defensiveness in their behaviours and have difficulties in concentrating or paying attention to a particular topic. Their behaviour is antisocial, not because of their bad intentions but due to lack of parent’s and teacher’s understandings about child’s struggle caused by sensory sensitives. These children avoid touch interactions with other people often exhibiting hyperactive and distractible behaviour at home and classroom in an everyday situation.

Making sense of Sensory experiences, let's discuss another example, how would you feel if you are completely wet from top to bottom and you are not allowed to change clothes rather being asked to focus in a lecture fully. Definitely, you will be unfocused and distracted easily since your clothing is not comfortable. 

Furthermore, consider, no one understands your problem, rather the lecturer in lecture room instructs you to be attentive on the topic and stay calm without being distracted. That moment will be so frustrating for you which can lead you to misbehave or speak rudely with the lecturer.

The same issue happens with our sensory kids, they do not misbehave intentionally or on purpose, however, they are trapped by their own body sensitivities. It will be so wrong to reprimand a child who is vulnerable, frustrated and emotional due to his own sensory issues.

Usually, parents show great concern to Occupational Therapist (OT) regarding child's learning processes and behavioural issues. Mostly, they ask whether their child’s learning will be affected due to TD. 

The answer to this is NO! 

TD does not interfere in child’s learning process academically, socially and developmentally, however, it may cause discomfort leading to (emotional liability, distractibility) behavioural problems that can affect his learning to some extent. The emotionally child has to be given extra attention since TD sometimes makes emotions upset.

Due to tactile defensiveness,child’s In-Hand-Manipulation skills are affected means doing buttons, laces or ties can be difficult tasks.

Sensations received from clothes or their tags can be disrupting in nature. Child in classroom will not be able to focus however will constantly keep on scratching himself all over the body. Avoidance for getting hands messy or dirty in glue or finger paint. He may not like walking barefoot in grass or on sand. Fabrics such as synthetic wool or rough textured may cause discomfort He would like to stand last in a queue to avoid touch from other people and also does not like games such as Tag.

To understand physiology of this system in simple terms, consider that brain as an electric circuitry system which has numerous wires (neurons pathways and fibres) working together so that power supply (appropriate functioning & behaviours) can constantly run in the house. Now imagine, one-day power supply of partial house has stopped suddenly however, it is available in other half of house. 

Electrician is being called and mistakenly he reconnects wrong wires together which results in high voltage (hypersensitivity towards touch, hugs) and current over flow in half of house however no light supply (hypo-sensitivity towards touch, poor fine motor skills) in other half of house.

Since the pathways don’t send appropriate messages in required (correct) brain centres therefore child reacts adversely, negatively and shows escape-like behaviour on being touched, hugged or kissed.

Protective system is automatic reaction whereas discriminative system involves complex refinement in brain. Human body switches to which ever system is needed at the particular moment. Pain sensations activate protective touch system however deep pressure sensations activate discriminative touch system.

The child with TD will do too much of protection of himself so that he does not get any pain stimuli and therefore his discrimination activity will also be less.

Different intervention strategies include Deep firm pressure, Wilbarger's Brushing technique, vibration, heavy work activities, Wall or chair push-ups, swing play or therapy ball exercises for core strengthening.

There are no shortage of resources regarding Tactile Defensiveness,
Sensory integration Network
Sensory processing Disorder

To have a brief description about hypersensitivity (tactile defensiveness), hypersensitivity or Tactile discrimination refer to,
Sensory Modulation & Tactile dysfunction