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:
- 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.
Best Sensory Strategies for Handling Tactile Defensiveness, Feb. 2, 2022, By Aditi Srivastava, MOT, PGC, Autism Parenting Magazine
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5 To-Dos After Cleveland Autism Diagnosis, May 13, 2022, Cleveland Occupational Therapists Blog
Those first introduced to the world of early intervention therapy are often confused as to why children would need occupational therapy. After all, kids don’t have “occupations,” right?
Actually, they do!
As our Brecksville occupational therapy practitioners can explain, children’s “occupations” involve the business of growing and developing. That means picking up fine and gross motor skills, learning to communicate and socialize, grasping self-care, feeding, and emotional regulation, and overall navigating the world around them. Play is the means through which kids master their neurological and biological development. Engaging in activities that are both fun and creative helps kids to ultimately become independent adults.
That is why play-based occupational therapy is so effective. As noted by the American Occupational Therapy Association (AOTA), it is often through play that kids learn to make sense of and engage with the world around them. Occupational therapists help children who are struggling in certain areas – most frequently with neurological, muscular, and social/communication skills due to a developmental delay, disability or injury/illness. We do this through sensory-rich play that offers opportunities for them to develop/master those skills while also having fun. We never want sessions to feel like work, even if that’s ultimately what they are.
How Brecksville Occupational Therapy Practitioners Use Play-Based Therapy
As occupational therapists, we use play not only to address the child’s goals, but also to help motivate them to challenge themselves.
Some of the ways we work with children during play-based occupational therapy include:
- Helping to modify toys or the environment so that the child can get just the right of sensory input without being overwhelmed.
- Recommending to parents activities for play and toys that can offer just the right amount of challenge for a child so that they are learning/working on a skill set, but also still having fun. We can also incorporate play into a variety of exercises that are geared toward helping build on the child’s abilities and strengths.
- Crafting our sessions around play opportunities that encourage social skills like turn-taking and neurological skills like problem-solving. We’ll take in the unique priorities and routines of your family when formulating strategies you can use to incorporate this kind of play in your everyday life.
Some examples of toys and activities that we frequently use to work on certain skills:
- Manipulative play with toys like board games, play dough and LEGOs. What we’re looking for here is boosting the child’s dexterity and hand-eye coordination.
- Sensory-rich play with things like finger paints, magnets, kinetic sand, water toys, balls and beads. Lots of kids we work with struggle with sensory dysregulation. Playing with toys that incorporate sight, sound, tough, smell, and movement helps them work on sensory integration and regulation.
- Imaginative play with things like dolls, puppets, phones, stuffed animals, etc. Pretend play is an excellent way for kids to practice key social skills.
It’s important that whatever toy or activity we use is appropriate to both the child’s age and maturity level. Toys and activities need not be expensive to be effective. Although our occupational therapists can conduct sessions in the home, at school, or in other settings, one benefit of in-clinic sessions is that we have a wealth of tools and toys within arm’s reach.
Our occupational therapy team works with kids with a broad range of disabilities, delays and challenges. If you’re interested in our play-based occupational therapy services in Brecksville-Broadview Heights, our team would be happy to connect with you!
Therapy & Wellness Connection – your connection to a life without limitations – is a pediatric therapy center providing occupational therapy, physical therapy, speech therapy and ABA/behavior therapy to children in Northeast Ohio. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email. Serving Brecksville, Akron, Cleveland and surrounding communities in Northeast Ohio.
Learning Through Play, American Occupational Therapy Association
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Fun Fall Activities From Our Akron Occupational Therapists, Oct. 8, 2021, Brecksville Occupational Therapy Blog
If we’re doing it right, those peering into a pediatric occupational therapy session will think it just looks like, well, playing! But those glimpses can leave a lot of people confused about what exactly occupational therapy is and why it’s needed for kids. Our Brecksville pediatric therapy team is happy to explain.
As noted by the American Occupational Therapy Association (AOTA), occupational therapy is a branch of health care that helps people of all ages with physical, sensory, social, or cognitive problems. It’s a broad discipline, but the primary goal is helping people to achieve independence in all areas of life. We look at what barriers are standing in the way of that.
Occupational therapists may work with adults who have suffered from strokes or serious injuries to regain their independence. With children, we are working to help them achieve independence they likely did not have in the first place. We do this by assisting them when they’re struggling with developmental delays, fine motor skills, gross motor skills, social skills, oral motor skills, visual processing, or sensory disorders. Mostly, we work with children who have some marked developmental delays or diagnosed disabilities, but we do sometimes work with kids on one-off (but important) skills – like handwriting – with which they may be struggling.
How Occupational Therapy Can Help Your Child
In examining whether a child needs our Brecksville occupational therapy services, we look at what day-to-day difficulties they are having at home, at school, and in their community. Often, they’re grappling with challenges that don’t affect most typically-developing children (or don’t affect them the same way).
A great occupational therapist will support not only the child but the child’s family too.
Some of the areas in which we can help:
- Developmental delays. This is when a child is behind other kids their same age in certain areas of development. It’s typically flagged when a child fails to meet certain developmental milestones such as sitting, crawling, walking, learning at an age-appropriate level or failing to develop age-appropriate social and play skills.
- Fine motor skills. Fine motor skills are essential to so many basic tasks of daily living. These are the sorts of fine movements that are needed to do things like hold a pencil, use scissors, button a shirt, feed yourself, etc. It often involves the fine motor of the fingers, but it can also be issues with the toes, wrists, tongue and lips. If your child has trouble feeding themselves, picking up/holding small objects or avoids things like puzzles and coloring, they might have fine motor skill issues. We can help!
Gross motor skills. These include the wider movements of body parts like arms, legs, and core. These are the movements that help us control our body. If a child is having difficulty with movement, balance, or strength, an occupational therapist can help them strengthen these skills to improve independence.
Visual processing. This is the skill that allows us to make use of what we’re seeing. It’s how our brain interprets the information it’s receiving visually. A child with visual processing issues is going to have trouble with things like recognizing letters, shapes, and numbers, finding objects among other objects, visually tracking objects, copying items from the board onto their paper, or ascertaining right from left. An occupational therapist can help.
Oral motor/oral sensory. This is when the child struggles to control the muscle movements of the face and mouth. You’ll notice this is an issue if your child has excessive drool, chews in the front of their mouth rather than in the back, struggles with drinking from a cup or straw when their peers have no trouble, or is an excessively picky eater. Our occupational therapy team has many tools and strategies we can use to help with these problems.
Sensory processing. This is how we make sense of information gleaned from our five senses (sight, smell, touch, taste, sound, and hearing). Kids can be either overly-sensitive or under-stimulated by sensory input. Kids with sensory processing issues (particularly common among those on the autism spectrum) may be constantly moving/jumping/bumping/crashing, under-reactive to certain issues, emotionally reactive or have trouble adjusting to change. They may also have a really tough time calming themselves down with they’re upset.
Social interactions. Humans are social creatures. Our ability to understand social cues and form positive relationships with those around us is central to our ability to function in daily life. If a child has difficulty engaging socially, adapting to new environments, or communicating (delayed language skills or hyper-focused on a single subject), it can impede their ability to function. We have lots of strategies we can teach to help them in these areas.
Learning difficulties. Sometimes referred to as learning disabilities, these are often related to developmental delays and certain conditions. A child with a learning difficulty may be unable to concentrate or focus, be easily distracted, struggle to follow instructions and complete work, have poor impulse control, or need lots of extra help learning new material.
Bear in mind that all kids are going to develop at their own pace. But if you have concerns about your child falling behind or struggling in certain areas, the earlier we can intervene with occupational therapy, the better the chances they’ll be able to “catch up” to their peers and/or have the greatest shot at independence.
Therapy & Wellness Connection – your connection to a life without limitations – is a pediatric therapy center providing occupational therapy, physical therapy, speech therapy and ABA therapy to children with special needs in Northeast Ohio. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email. Serving Brecksville, Akron, Cleveland and surrounding communities in Northeast Ohio.
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Occupational Therapy vs. Physical Therapy: What’s the Difference? July 3, 2021, Brecksville Occupational Therapy Blog
Social skills don’t come easily to many kids with disabilities and delays. But music is a language we can all speak! Music literally moves us and brings people together. It’s uniquely its own kind of therapy, and we love using it in occupational therapy when we’re working on social skills.
At Therapy & Wellness Connection, we offer music therapy because it is a research-based practice in which we use music to actively support people working toward improvement in their health, function and well-being. And it’s so versatile! Music is powerful and a very effective way to help children with special needs meet their occupational therapy goals, including improvement of:
- Motor skills
- Speech & language skills
- Cognition/neural processing skills
- Self-regulation/reducing anxiety
It’s common knowledge in the music community that regular music lessons can help improve academic performance, increase IQ scores and reduce the risk of depression. Still, many parents aren’t aware that music – especially when used in an occupational therapy setting – can help encourage so many important life skills.
Researchers Tout Benefits of Music for Kids With ASD
One recent study specifically had the potential to improve the development of social skills among children with autism spectrum disorder. Further, researchers wanted to know if the effects were long-lasting.
Researchers noted that children with autism often have difficulties with direct social engagement, and that musical activities in the social context can provide them with valuable opportunities for interacting with their peers. They also pointed out prior studies that found even though children on the spectrum have difficulty processing and controlling their emotions, they can identify the rich emotions that are embedded in music as well as any typically-developing child.
Dozens of kids in the study were given pre- and post-music therapy social skills tests. Kids were categorized as having mild to severe autism and social scores that were ranked active to passive. What they found was that social skills was one area of distinct improvement for kids who had undergone musical therapy intervention, and that it was most effective when it was controlled in an occupational therapy setting.
Study authors said the results were encouraging, and called for more research examining the benefits for different age groups, populations, levels of ASD and skill focuses (motor skills, communication skills, etc.).
How We Use Music in Occupational Therapy
Just like a conversation, musical activities usually require body awareness and understanding of nonverbal cues. We can plan lots of fun games and activities around these goals. Specifically for social-pragmatic skills, we can target language objectives, joint attention, eye gaze and cooperative play with games like musical chairs or “musical statutes,” or animal dances.
One we’ve had a lot of fun with is “musical clothes,” where we have a pile of props/costumes in the middle and music is played and each child has to choose one prop/article and quickly don it before the music stops. In summer camps, sometimes we’ll have the kids team up, choose a theme song and create a dance routine with it – with a performance at the end (it’s SO much fun and a great team-building/communication exercise!).
Music can also be used before an occupational therapy session to help prepare the patient emotionally/induce the appropriate amount of arousal (or calming/regulation). It can also be used at the end of a session to help prepare for a transition.
Often in OT, music can be used to help keep kids focused and on-task. Sometimes we’ll listen to a combination of binaural (two-tone frequencies) and classical music, either on headphones or from a speaker. This has been shown to promote alpha brain wave and keep kids calm. For some kids, this music combo or ambient music helps improve dizziness during vestibular training.
If you have questions about occupational therapy or music therapy, our team at Therapy & Wellness Connection can help.
Therapy & Wellness Connection – your connection to a life without limitations – provides occupational therapy to children in Cleveland, Brecksville-Broadview Heights, Akron and surrounding communities. We also offer summer camp, day programs, homeschooling, tutoring, vocational services and more. Call us at (330) 748-4807 or send us an email.
Using Music Activities to Teach Social Skills to Children with Autism, April 17, 2018, ASHA
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Best Occupational Therapy Board Games for Kids, Oct. 15, 2020, Cleveland Occupational Therapy Blog
Occupational therapy helps children when they have difficulties in day-to-day activities in their home, school and community.
It’s a very broad discipline, and many parents who come to Therapy & Wellness Connection have never really heard of it or understand why it’s so helpful for so many kids.
Occupational therapy has always been integral to our clinic, but we’re highlighting it now because the impact of the pandemic has left many kids falling even more behind when it comes to developmental milestones. Maybe they are on track with their speech and language, but they struggle with holding a crayon or pencil correctly. They’re getting ready for preschool, but have a tough time with things like using scissors or tracing lines. They have a very difficult time dressing themselves. Maybe they have no desire to even start potty training – even though it’s well past time.
They may have struggled with these things before schools and daycare centers closed, but now they’ve been home for months, with parents who are overwhelmed and no children their age to help motivate them, make it fun. The good news is these are all things with which occupational therapy can help-and it’s not just for kids with disabilities.
Learning how to write is one of the most vital skills a child learns early on in their education. As a Cleveland occupational therapist can explain, the skills needed to be successful in this task actually start much sooner than kindergarten – or even pre-school.
Some of the complex skills needed for handwriting include:
- Knowing the letters of the alphabet
- Visual motor skills
- Letter formation
- Sequence following
- Visual perception skills
- Maintaining control of the paper (to stay in the lines)
- Bilateral coordination
- Recognition of left-to-right progression
- Recognition of top-to-bottom progression
- Movement tracking of the hand, pencil and paper
- Crossing midline skills
- Fine motor skills (in-hand manipulation, pencil grasp, visual hand-eye coordination)
- Gross motor skills (muscle memory, posture, body control)
Not all teachers have formal training in how to teach handwriting skills. When a student struggles with handwriting, a Cleveland occupational therapist can help.
Summer vacation travel plans have no doubt been stifled by coronavirus concerns. For the first time in two decades, AAA didn’t issue a Memorial Day travel forecast. And while it’s expected a record low will be vacationing this summer than in years past, our occupational therapy team knows some families are still planning trips to get away, yet still incorporate social distancing.
Fewer flights are being booked as some families are opting instead to travel by car. Some excursions may include road trips to lake houses, beaches or mountain cabins, RV adventures and camping. For those with little ones, particularly those with special needs, it will be important to come prepared. (Of course, that’s true whether we’re in the midst of a pandemic or not.)
But our Cleveland occupational therapy team has some tips to help everyone keep their cool – and have a great time!
Chores have many benefits for kids of all ages and abilities. In addition to help with learning personal responsibility, perseverance, teamwork, improved life skills and self care, chores can be a great way for your child to work on their occupational therapy goals.
Chores can be great for targeting things like:
- Gross motor skills. These are are abilities that allow children to do things that involve using the large muscles in the torso, arms and legs to complete whole-body movements
- Fine motor skills. These are the skills that allow coordination between small muscles, like those used for grasping small objects, writing and fastening buttons.
- Upper body strength. These are skills like shoulder girdle stability, which allows surrounding muscles to support the body structure and allow accurate hand functions.
- Bilateral coordination. This is the ability to use both sides of the body at the same time in a manner that is controlled and organized.
- Proprioceptive input. These are the sensations we get from our joints, connective tissues and muscles that allow us to have body awareness.
If your child isn’t sleeping well, it impacts not only their daytime functioning, but that of the family at-large. Children with special needs are at increased risk for sleep disorders and sleep disturbances, which can have a major impact on their mood, behavior, learning, physiology and just generally how well they feel. This can have a profound impact on how well a child functions each day. Occupational therapy can help.
Many people don’t consider that sleep is one of the primary occupations of children until they turn 5. Even after that, it’s critical to healthy growth and development.
According to the Sleep Help Institute, kids under 2 should be receiving anywhere from 14-16 hours of total sleep (including naps) every day. Kids 2-3 should be getting 10-11 hours at night (plus 1-2 hours of nap time). Kids 3-5 should be getting 10-13 hours of sleep with an extra hour of nap time, and kids 5-12 should be getting 10 to 11 hours of sleep each night.
Kids With Special Needs Especially Prone to Sleep Trouble
The Centers for Disease Control and Prevention reports that insufficient sleep is a serious public health problem, as it contributes to motor vehicle crashes, work-related accidents and chronic disease. “Sleep inefficiency” is understood to be a lack of restorative sleep, which includes an adequate amount of restorative sleep (meaning all five stages of it).
Childhood sleep problems are more common than you might think. They affect about 25 percent of all preschool children and 43 percent of school-age kids. Children with developmental delays and disorders are even more likely to be referred for sleep studies. One study found that 49 to 89 percent of children on the autism spectrum had trouble sleeping. Same goes for 25 to 50 percent of children with attention deficit hyperactivity disorder and 34 to 86 percent of children with intellectual disabilities.