"Tactile defensiveness is a when a child is very sensitive to touch inputs,” explains occupational therapist Julie van Niekerk.
The skin and the inside of our mouths make up our tactile system, and for most of us, when we are touched, we react in a way that helps us make sense of the world around us. This is especially important for babies and toddlers as exploration, touch and feeling the world around them helps them to learn and to find their place in the world.
We have two touch pathways. “There’s the deep pressure touch pathway that calms and contains us – for example, a hug when you are upset, or pressing on a wound when you have been hurt,” Julie says.
“And there’s the protective touch pathway that keeps us safe from danger, such as reacting to pain, heat, cold, being cut or even being tickled.” For someone who is tactile defensive, their protective touch pathway is always on high alert, so they react to any form of touch – from clothing to sticky foods to having their hair brushed as if it is highly irritating – and will try their best to avoid it.
Tactile defensiveness falls on a continuum – some children are highly sensitive and others are less so. “This not only changes from child to child but also on different parts of the body or even from day to day – every child is unique, and it is important to look at the whole picture,” Julie says.
Why is it a problem?
Being tactile defensive becomes a problem when the child’s aversion to touch is interfering with his ability to meet his development milestones at appropriate ages, stops him from learning about the world around him and interferes with his ability to be social. “Being tactile defensive can interfere with sleep when growth and brain development take place,” she says.
”They can be very light sleepers – even the touch of a sheet can wake them up. It can also interfere with basic nutrition as a child will refuse to eat many food types.”
Recognising the signs
A child does not suddenly become tactile defensive; he will always have been tactile defensive and probably gave you a number of signs along the way. The first step, before you rush off for occupational therapy, is to have a good look at your child’s history.
What kind of baby was he? Was he a cuddly baby, or did he not like being hugged? Did he get very distressed at bath time, when you washed his hair and face and brushed his teeth? Has he always hated having his clothes or nappy changed? Did he move from purées to solids and finger food easily, or did he gag a lot and avoid picking up finger foods? Did he want to be fed?
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“A huge red flag is if your baby crawled or not. A tactile defensive baby will go straight from sitting to walking, and they will be pretty demanding about it and insist that you hold them up to walk,” explains Julie. “Crawling is a very sensory-rich activity, so a tactile defensive child will do his utmost to avoid it. These babies also protest a lot while they are on their tummies for tummy time.”
Don’t panic if your child has shown one of these symptoms. As Julie says: “Look at the whole developmental history of your child and put a few puzzle pieces together to get a picture. One piece is not enough to make a ‘diagnosis’ of tactile defensiveness. And therapy is only necessary if a baby or toddler is not doing what is expected developmentally at a certain age with regard to sleeping, eating, playing, socialising or activities of daily living, such as toileting, hair washing or brushing teeth.”