Progression of Tactile Input Using Sensory Bins

Progression of Tactile Input Using Sensory Bins

The tactile system provides information to the brain on light touch, pain, temperature, and pressure.   Children can experience decreased ability to interpret tactile input or can be oversensitive to tactile input.  Many early childhood classrooms and parents provide children with sensory bins to explore various types of tactile input.  Some children LOVE it,  some children HATE it and many children fall in between the two extremes.  When introducing sensory bins, it may be beneficial for children who are oversensitive to grade the amount of tactile input based on the materials included in the sensory bin.  (Children should never be forced to touch anything they do not wish to touch).

To begin with the least amount of tactile input, children could wear gloves while playing with sensory bins that include dry materials. Therapists and teachers can fill sensory bins with different ranges of tactile input starting with dry materials such as:

• dried beans
• rocks
• fabric scraps
• shredded paper
• leaves
• dried pasta
• uncooked rice

Progress to materials that are not dry but don’t stick to the hands such as:

• play dough
• colored water
• magic sand
• water beads
• cooked pasta
• crushed ice

Finally, increase tactile input to messy play such as:

• finger paints
• shaving cream
• yogurt
• slime
• dish soap bubbles
• lotion

Do you need more handouts?  Check out the Sensory Tools In the Classroom packet.

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Tactile Function in Children with Cerebral Palsy

As pediatric therapists, assessment and treatment of children with cerebral palsy frequently focuses on motor impairments although, children with unilateral cerebral palsy (hemiplegia) are also likely to have sensory impairment.  Research indicates that tactile registration for children with hemiplegia is consistently worse with their impaired hand than their unimpaired hand.  Both hands of children with hemiplegia performed worse than either hand when compared to typically developing children. Forty percent of children with hemiplegia had tactile registration and perception deficits, 37% had perception deficits only and 23% had no tactile deficit. The larger the tactile registration deficit, the poorer the performance on all tactile perceptual tests.  The researchers concluded that tactile dysfunction may contribute to functional impairment and is a possible target for intervention (Auld, 2012).

Here are a few suggestions to encourage tactile registration and perception during therapeutic play activities:

1. Provide different textured toys during playtime.  For example, verbalize and discuss differences between soft/hard, bumpy/smooth, fluffy/scratchy, etc.  If the toys are just smooth plastic, then try and add a sensory component to the toy.
2. Add weight to toys to increase input.  For example, try stacking boxes with weights in them (ie 1 lb. bag of beans).
3. Add to texture during arts and crafts time.  For example, add sand to fingerpaints or use shaving cream.
4. Focus specifically on tactile perception and registration.  For example, the child can close their eyes and rely only on their sense of touch to identify objects.  They will not be able to use their sense of vision to determine what the object is and how to hold it.
5. Add tactile input to weight bearing activities.  For example, when a child is working on weight bearing with an open hand, try performing that skill on different surfaces such as bubble wrap (bumpy), sand paper (rough), dry towel (scratchy), yoga mat (smooth) or cold (gel ice pack).  For the bare feet, try walking or balance with on different tactile surfaces such as grass, sand or dirt.

References:

Auld, ML et al. (2012). Tactile function in children with unilateral cerebral palsy compared to typically developing children. Disability & Rehabilitation, 2012, 1–7, Early Online. DOI: 10.3109/09638288.2011.650314

Teaching Motor Skills to Children with Cerebral Palsy and Similar Movement Disorders – A Guide for Parents and Professionals – The ELECTRONIC version of Teaching Motor Skills is a must have reference for all therapists who work with children with cerebral palsy. Whether you are a beginner or experienced therapist you will find the information concise, informative and very helpful to carry out everyday functional tasks including stretching with children with cerebral palsy. The book provides activity suggestions throughout the developmental sequence such as head control, tummy time, sitting, transitions, walking and beyond. There is also great information that reviews additional interventions for children with cerebral palsy such as bracing, surgical and medical management.  Find out more.

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Infant Responses to Tactile Input

Psychological Science has published research on 9 month old infants reaction to tactile input. The parents sat the infant on their lap while the experimenter stroked the back of the infant's arm with a paintbrush. The experimenter varied the rate of the brushstrokes among three defined velocities: slow, medium and fast (0.3, 3, or 30 cm per second). The experimenters determined the infants' responses of attentional engagement and arousal through physiological and behavioral measures.

The following results were recorded:
1. the infants' heart rate slowed in response to the brushstrokes but only when the strokes were of medium velocity therefore the touch of the medium-velocity brush helped to decrease their physiological arousal.
2. The infants showed more engagement with the paintbrush during the medium-velocity brushstrokes, as measured by how long and how often they looked at the brush while they were being stroked.
3. infants' slower heart rate during medium-velocity brushstrokes was uniquely correlated with the primary caregivers' own self-reported sensitivity to touch. In other words, the more sensitive the caregiver was to touch, the more the infant's heart rate slowed in response to medium-velocity touch.

The researchers concluded that sensitivity to pleasant touch begins early in development and playing an important role in regulating human social interactions.

Reference: M. T. Fairhurst, L. Loken, T. Grossmann. Physiological and Behavioral Responses Reveal 9-Month-Old Infants' Sensitivity to Pleasant Touch. Psychological Science, 2014; DOI: 10.1177/0956797614527114

Mini Sensory Books
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5 Tips for School Children with Tactile Sensitivity

Difficulties processing tactile information can result in some individuals being very sensitive to touch and over-reaction to objects or people in the environment. Conversely, some individuals may have decreased sensation of touch which can result in people using too much force or placing themselves in dangerous situations.

Here are some suggestions to help children with tactile sensitivities:

1.  Encourage proprioceptive input prior to activities that require tactile input.  Examples of proprioceptive input are chair push ups, wall push ups, jumping, carrying heavy objects and push/pulling objects.

2.  Never force a child to touch objects that he/she dislikes.  The child can observe the activity, participate with modifications or touch the objects briefly and wash hands immediately.

3.  Always approach the child from the front or seat the child in an area where he/she has a good view of who is approaching him/her.

4.  Use a firm, gentle touch instead of light touch when you have contact with the child.

5.  If the child exhibits difficulties with personal space (touching people or objects excessively) or over reacts to light touch, provide modifications to the environment to help the child such as providing visual cues where the child needs to sit, provide fidgets for the hands and have the student stand first or last in the classroom line.

Need more ideas or hand outs?  Check out Modifications and Interventions for School at http://yourtherapysource.com/modifications.html or  

What? Why? How? Series 3 at http://yourtherapysource.com/wwh3.html