Understanding Tactile Defensiveness Disorder and Treatment Strategies

What Is It?

Tactile defensiveness often occurs in combination with other disabilities such as autism, Down syndrome, ADHD and Fragile X Syndrome. Children who suffer from tactile defensiveness disorder repeatedly overreact to normal touching and textures, such as teeth brushing, hair brushing, tags and seams in clothing, and food textures. These normally innocent sensations can be overwhelming and possibly painful to the child who is tactile defensive. A child with tactile defensiveness disorder may have sensory reactions that:

• Interfere with daily hygiene such as washing the face or hands or brushing teeth and hair.
• Interfere with normal participation at school, daycare, home, or family gatherings.
• Interfere with the child’s ability to socialize and form relationships.

Strategies For Treatment

1. Avoid the sensation. This strategy is used for stimuli that isn’t necessary in the person‘s daily life. For example, if clothing tags disturb the individual, remove the tags. Remove untolerated food textures from the diet. If an individual is sensitive to a hygiene product, such as shampoo, substitute a new consistency of shampoo–for example, foam shampoo rather than liquid shampoo. Also, consider shampoos without fragrance as the scent may also be causing the negative reaction. Avoid places where tactile stimuli known to be offensive will be present. Avoidance may interfere with a person’s quality of life; for that reason, building a tolerance to negative sensation can be useful.
2. Build tolerance to a negative sensation. This strategy works by exposing the person to small amounts of the stimulus to desensitize the individual. This works well when there is a mild negative response. Do not use this strategy for tactile stimuli that lead to violent or self-injurious behaviors. An example of exposure to build tolerance would be to offer the texture of crackers to a child who is tactile defensive and does not like crunchy foods. Continue to offer the crunchy food daily, until the child is able to tolerate the texture. Another example is tooth brushing. Many young children who are tactile defensive dislike having their teeth brushed. Using a very soft toothbrush or NUK brush that the child can tolerate and brushing their teeth softly and frequently might help.
3. Become aware of sensations that may trigger an unwanted response. Introduce new stimuli slowly. For example, when introducing a new lotion allow the person to see someone else smelling it and using it without a negative response. Allow them to smell it and look at it before attempting to place it on their hands. Slow exposure, without negative responses, can prevent the person from being overwhelmed.

Tactile defensiveness is not an uncommon condition and may coexist with other conditions or sensory integration problems. However, avoidance, exposure and simply understanding triggers can help the person with tactile defensive disorder to overcome these problems.

Resources

Taber’s Cyclopedic Medical Dictionary [F.A. Davis, 1993]

Sears, Carol J. (1994) Recognizing and Coping with Tactile Defensiveness in Young Children. Infants and Young Children, 6(4), 46-53