Tactile defensiveness is a term used by our Cleveland occupational therapists to describe hypersensitivity to touch. Those who experience tactile defensiveness say they’re more bothered than others by different textures on their skin. This may extend to different textures of food, fabrics, flooring, certain self-care tasks and showing affection.

Those with touch sensitivities may be extremely averse to certain sensations in a way that impacts their daily lives. They may have much bigger reactions than one would expect to uncomfortable physical sensations. It might manifest in things like refusing to put on certain socks, shirts or underwear. Toothbrushing could be a battle. They may be extremely picky eaters. They may loathe messy play and playing barefoot outside.

Some of this might simply be chalked up to being “quirky.” And of course, all of us have certain aversions or preferences to sensory input. But when we’re talking about tactile defensiveness, we’re talking about hypersensitivity. And with that, there are ways in which tactile defensiveness can impede a child’s health, growth, well-being, development, and personal relationships. This is why our Cleveland occupational therapists intervene with treatment.

We don’t know exactly what causes tactile sensitivity, but it’s extremely common in children with autism spectrum disorder (ASD). (It can also swing the other way – sensory-seeking rather than sensory-averse. This means they exhibit a low threshold for registering a tactile sense, rather than the low threshold noted in those with tactile defensiveness.)

Why Our Sense of Touch Matters

Our sense of touch is one of the first sensory systems that develops in utero. As our Cleveland occupational therapists can explain, literal libraries of research that shows touch experience between parents/caregivers and babies is critically important for their cognitive, behavioral, motor, and social development. The appropriate tactile and proprioceptive responses are pivotal for achieving developmental milestones like grasping, walking, and social/communication skills.

Tactile defensiveness can interfere with a child’s ability to participate in regular, healthy routines and daily activities.

Whereas someone with “typical” sensory integration might not be keen on having an itchy tag on their t-shirt rubbing up against their neck, it doesn’t ruin their entire day. They’ll probably just get used to it and forget about it. However, a child who has tactile defensiveness may be so impacted by this sensation that they may not be able to carry out the tasks of daily functioning – potentially even having a full-blown meltdown until the tag is removed. And even thereafter, they may need some additional time to truly self-regulate.

We can also see this in areas like eating/feeding. A child who is extremely averse to eating foods of different tastes and textures may ultimately have a poor diet – and failure to thrive – because they’re only eating one or two things.

Lots of kids with tactile defensiveness also have major aversions to self-care tasks like brushing their teeth, combing/cutting their hair, or bathing. But not doing those things isn’t really an option. There may be some adaptations and accommodations that can be made, but kids also need to learn how to overcome some of these aversions to ensure they’re healthy, growing, and on the right track developmentally.

Ways Cleveland Occupational Therapists Help With Sensory Integration

We have lots of strategies to help kids with tactile defensiveness process sensory input, and all of it is tailored to their unique needs and goals.

Some of our tips and tricks:

1. Build trust with exposure to certain stimuli being slow and gradual. A child with tactile defensiveness is going to completely melt down if you try to introduce too much at once or make demands that are too high. Yes, we want to challenge the child, but that takes time – going slowly and building trust. Also, we want it to be fun! Sudden, unpredictable changes can cause major anxiety and are ultimately setbacks. We want to set them up for success, so we go at a pace that works for them.

2. Incorporate deep pressure sensory input. This might seem counterintuitive, but lots of kids with tactile defensiveness have a particularly hard time with LIGHT touches. Tickling, brushes against the skin, rain, wind/air conditions, etc. Deep pressure can help calm them, especially if they’re overstimulated. Compression vests can be really helpful. (For bedtime, weighted blankets are great too.)

3. Removing other sensory stimuli. If we’re in a room that’s too loud/crowded or there are lots of visual distractions, it’s going to be really tough to get them to overcome a sensation they’re uncomfortable with. There’s too much else competing for their attention.

4. Make it predictable. We create what we call a visual schedule or visual calendar for when we’re planning on introducing touch experiences that might be challenging. We create a picture chart that shows “first, then, next,” and exactly what we’re going to do. That way, there are no surprises, and they know exactly what is going to come next.

5. Heavy work. These are the kinds of activities that involve pulling and pushing objects that are heavy or create some resistance, which gives them some of that deep pressure impact that can be calming when they’re dealing with challenging sensory input. We’ll do this a lot of times on “break” from messy activities.

In all of these sessions, we think it’s really important for the kids themselves to maintain a degree of control. We give them choices, and control over what we do next, so that they don’t feel so much like this is “work,” but rather play. It also helps build trust between the child and therapist, which helps make the lessons we’re teaching more successful.

Additional Resources:

Best Sensory Strategies for Handling Tactile Defensiveness, Feb. 2, 2022, By Aditi Srivastava, MOT, PGC, Autism Parenting Magazine

More Blog Entries:

5 To-Dos After Cleveland Autism Diagnosis, May 13, 2022, Cleveland Occupational Therapists Blog