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Positive Relationships: Behaviour - In touch

If a child overreacts to tactile experiences it may be down to sensory processing, says Anne O'Connor.

We have a four-year-old in our setting who seems constantly irritable and has lengthy tantrums. Other children upset her if they stand too close or touch her, yet she often barges into others and squeezes them hard when she is hugging. She doesn't settle well to activities and avoids messy play altogether.

All behaviour is communication, at any age, and this child's irritability is telling you that she is in distress a lot of the time. There are several indicators here that she might have difficulty with sensory processing, which might account for her unhappiness.

There is a lot of debate about how many senses we actually have but let's just focus on the obvious ones first - sight, smell, hearing, taste and touch. Then let's add in two that are less obvious but are fundamental to early child development - proprioception and the vestibular sense.

It is important to remember that problems with sensory processing are not the same as sensory impairment. This is not about whether a child's eyes, ears, tastebuds or nerve endings are functioning properly; it is about how their brain is processing and integrating the information that those senses are detecting. Sensory processing puts all the information together so that we can literally 'make sense' of it.

Imagine eating a peach - it is not just about taste. What we see, smell and touch is also involved, as well as what we hear when we chop it up or suck the juices. Our proprioceptive and vestibular senses play a part, too, as they inform our brains about how we hold the peach and how wide we need to open our mouths to eat it. Our brains integrate all this to tell us exactly what the experience of eating a peach is like, and how it is similar or different to other experiences.

If we think of sensory stimulation as the food that nourishes the brain, then sensory processing is the digestive system that 'digests' the information, so the brain can get all the goodness out and thrive on it. But our brains are bombarded by huge amounts of sensory information all day long, so there is a lot of work to do to absorb it, sort it out and make all those connections (Dejean 1998).

If our digestive systems are not working well, then at best we are 'out of sorts' and at worst we become undernourished and cannot thrive. The same is true of the brain. It needs the right kind of stimulation at the right ages (we don't feed certain foods to children before their stomachs can cope with them) and the right amount of stimulation - too much or too little can be damaging.

In sensory integration theory, based on the work of Dr Anna Jean Ayres, the vestibular, proprioceptive and tactile (touch) senses are considered the most fundamental of all the senses. We are very aware when there is any kind of functional impairment to sight or hearing, for example, but we also know that it is perfectly possible to live a happy, successful life as a blind or deaf person.

Poor development of the vestibular, proprioceptive or tactile senses, however, are not always obvious and yet can be responsible for major problems with life skills and emotional well-being, as well as learning difficulties. Knowing and understanding more about these areas of development can make a big difference to the way we respond to the emotional and learning needs that children communicate to us through their behaviour.

TOUCH SENSITIVE

This child may have some problems with tactile processing. On the one hand, she overreacts to light or unexpected touch, but she also doesn't know how to moderate the touch or pressure she uses with others.

The tactile perceptive system seems to work in two ways. The protective system alerts us to potentially harmful touch of the light or unexpected kind, so we can sense the tickle of an insect that may bite us or we jump away from something hot. The discriminative system allows us to use touch to gain huge amounts of useful information from our skin about ourselves (pressure, pain, pleasure, etc) as well as information about everything we touch in the world around us (hard, soft, smooth, prickly, etc).

The protective system is dominant when we are infants, but the two systems need to become balanced and to integrate and work together, because if we get stuck in the protective system we can never move on and benefit from the discriminative system.

The two systems working together are also very important in developing our body schema - an inner sense of ourselves and our 'body space'. This is closely linked to balance (our vestibular sense), to proprioception and to 'motor planning', which is how we manage to move around without bumping into things, as well as getting the various bits of our bodies to do what we want them to do.

We all have different sensory preferences and tolerances, but we learn which sensory information to tune out and which to attend to. When the senses are not well integrated, it can lead to a range of problems of greater or lesser impact.

When the protective sense is dominant, for example, it can lead to hypervigilance (always being unconsciously on the lookout for harm), which can make it difficult to settle down to activities. This also helps to explain why a child might avoid messy play and why little things seem to irritate them.

You would be grumpy too if the labels on your clothes or the seams in your socks were always bothering you and you felt really unsafe sitting on a carpet that tickled your legs or lining up with children in front and behind you.

It can sometimes be hard for adults to work out what is bothering them in their own lives, so imagine how hard it is for a four-year-old. All they know is that life is uncomfortable, scary and stressful, and their tantrums and challenging behaviours are the only way they can communicate this to us.

Step into her shoes for a moment and think about what might help her. Listen to her parents about the way they address the behaviours at home. Involve them in how you plan to include new strategies into the daily life of your setting so that all children benefit from positive sensory experiences and she doesn't feel 'different'.

Here are just a few suggestions -you will find lots more at the Sensory Integration Global Network, www.siglobalnetwork.org/#!5-parents-resources-page-5/chos.

  • Know that big hugs and deep pressure will feel safer to her than light strokes and pats
  • Have lots of fleecy blankets for wrapping up children for small-group storytimes and big cushions for making 'kid sandwiches'
  • Gently introduce her to messy activities. Warm messy stuff is easier to handle, so try making mud with warm water. Maybe she just puts her hands on yours first while you put your hands in the gloop or paint
  • Put little bars of soap in the (warm) water tray and get messy and clean at the same time. Give soapy hand massages to everybody - adults and children.

Be aware that tactile defensiveness and poor sensory processing can sometimes be linked with other conditions (for example, dyspraxia and autistic spectrum disorders), so always seek expert guidance if you are concerned.


MORE INFORMATION

  • Sensory Integration and the Child, Western Psychological Services by A Jean Ayres (2005).