The Tactile System
Stimulating the Sense of Touch

By Toni Hager
www.kidscanlearn.net

The tactile system is a complicated system that includes primitive (utero) and postural (after birth) reflexes; the 5 nerve receptors for internal and surface touch, temperatures (hot/cold), and pain; sense of space/time; ability to use one muscle or group; vestibular/ balance; and sequencing movements into motor planning.  All of these functions eventually integrate into the other sensory systems allowing the individual complete coordinated movement and skills.

The exercises in these pages will address one prenatal reflex and the five nerve receptors. We use these exercises in our beginning therapy programs for our clients. To receive a comprehensive program developed specifically to your child's developmental needs please call us for a complete evaluation.

In utero the fetus opens and closes his hands very slowly; he may open and close the hand, make a fist with the thumb under the fingers then thumb over the fingers then thumb beside the fingers several hundred times a day as he stretches arms above his head. 

In this exercise we want to ‘put the child back in utero’ and have him go through the motions he skipped or were halted or interrupted. This exercise massages all of the cranial nerves.  The kids love it and the ones who need it the most beg for it.  You can do this in the morning or at bedtime as a gentle greeting or as part of your nightly bedtime routine! Do twice a day.

1.   Have the child lie on their back with one arm above his head and the other resting on the chest.  The legs should be drawn up as close to the body as comfortable; or, bent at the knees with the feet on the floor.

2.    While sitting on the floor you will be gently stroking the face.  Be sure and smile and talk calmly with admirations.

3.   If you are on the child’s right side have him put his left arm above his head and right hand on his chest.  With the hand above the head have him slowly open and close the hand with the thumb in the various positions, the slower the better, as you do the following.  I usually have the child change hand positions with each new step.

4.   Gently rub your finger-tips from the eyebrows up the forehead into the hair to the top of the head about five (5) times.

5.   Repeat but apply more pressure so that you feel the bones.

6.    Gently rub his face starting at the chin and going up the jawbone across the whole ear into the hair to the back of the head. Repeat about five (5) times.

7.    Repeat #5 applying more pressure so that you feel the facial bones. Do five (5) times.

8.   Have child change arms above his head and on chest. Legs still in position.

9.    You’ll need to sit on his other side now.

10.   Repeat steps 2-8 in the same sequence and manner as above.

11.   When finished have the child move his legs in random motions how ever he’d like.

• Avoid touching or brushing over any skin lesions, burns, rashes or other obvious tender or sensitive skin areas.  Never brush over weeping tissues or wounds.

• Reddening or welting of skin while you are touching a substance to the skin may indicate allergic reaction, stop using the substance immediately.

• If the child has joint problems you may need to modify the deep pressure component, please discuss with your doctor or medical professional (the defensive person may have painful joints that are not properly articulate or too much laxity because of low muscle tone)

•  If your child has a fragile medical condition, it is important to have authorization of the child’s medical provider.

• Praise, encourage and motivate your child. Make it fun!  Tell them the improvements you see them making as they start improving.  Use a lot of sincere verbal praise, encouragement, laughter and relationship, plan a treat!

The deep pressure and pain nerves are next to each other… its easiest to find the one for pain.

Tell the child to tell you when it hurts.  Most of the kids are so HYPO (low sensation) you can hit them with a hammer and they wouldn’t notice unless they were looking at you.  Many who are hyper (over sensitive) to surface touch are HYPO (low) to internal sensations. In this case watch for body language, facial expression or eyes.  EVERY CHILD HAS A PAIN RESPONSE AT SOME LEVEL.  This is a firm squeeze not massage.  We don’t want to bruise only get the brains’ attention.  If when you try it and find the child doesn’t respond you can let dad have the job or get a bath massager or rolling pin (yeah the one in the kitchen!) and roll it firmly up and down the arms.  In a couple of weeks you'll notice they respond faster then just use your hands.  Some who is hypo will respond visually meaning they will watch you then say “ouch” even if you’ve verily touched them… let them watch TV, listen to music or look the other way.

Equipment needed: none just your hands and fingers

Do 2 times a day.  It takes about 5-6 minutes; once you know how much pressure is needed for a response. Do both arms from fingertips to shoulders and both legs from toes to hips.  Only do what the child can tolerate… don’t overwhelm.  Even if its only one finger today, tomorrow stretch the tolerance level.

1.   Holding their hand/foot take their pinky finger/toe and squeeze it using your fingertips (thumb & index).  Hold the squeeze until they respond some how. (It may be a blink, or tightening of the lips, verbal word, pull away, or change in body position.  Then go to the next finger/toe and repeat.  Always hold until they respond.  When they respond is actually WHEN the impulse reached the brain.  Sometimes, it is several seconds.  Continue with each finger/toe, top/bottom then sides, until you reach the wrist. 

2. At the wrist/ankles wrap your both hands around it applying pressure and waiting for a response.  Continue up the arm/leg. Squeeze a bit tighter on the joints such as wrist, elbows, shoulders ankles, knees and hips; the receptors for our sense of space is located in the joints.

3. Remember you may need to start slow and increase the time until you can do both arms and legs in one sitting.

4. Behavior changes you should notice are:  they’ll be calmer, know when they’re hungry or thirsty, stop wetting the bed, just “seem” more aware of self and feelings.

Equipment needed: There are a few items in your program box.

1.   Surface:  Using a feather (or your fingertips) lightly but quickly “tickle” from the fingertips to shoulders, toes to hip and face/neck/back of head.  Tickle the tops, bottoms and between the fingers and toes.  Different types of feathers, fabric or textures feel different; be creative (cotton ball, shaving cream, grass, paper (especially newsprint) rice, beans, Jell-o or pudding) and have fun but don’t overwhelm… it is actually painful to a hyper child. This experience is to be pleasurable not invasive. Introduce the skin to a variety of feelings of different sensations. (Do not do under arms or inner thigh areas and do not scrub any area. When the child can handle it, use a feather or your fingertip to write a letter on their back (not on spine, too many nerves to feel the difference), back of hand or bottom of foot.

Our body has an energy field that goes up the body.  Always start any tactile or deep pressure exercise from the fingers/toes upward.  When you go down your breaking the energy field that will cause the child to feel tired or start misbehaving.

2.    Temperature (hot/cold): A fan or space heater in a room the child must pass by (several times a day) replicates a cool/warm breeze (which most of these kids hate); as does using a blow dryer (low setting) blown on the arms/legs/head and back.  Other ideas to rub on the limbs/head/face and back are: a bag of frozen veggies, compresses, heating pads, pan of hot/cold water to put hands in, shinning a lamp onto the arm (hold 6-12” above limbs) moving it up & down the arms/legs.  Freeze several spoons, they defrost!  Just touch some part of their face, arms or legs.  Baby spoons work well for children who can handle only a small surface area.

3.   Vibration:  You can buy a hand size vibrator at Wal-Mart for about $9.00.  Use it on the limbs, face (tickles the tip of the nose—kids love it!), back of head, and back.

Praise, encourage and motivate your child.  Make it fun.  Tell them how much improvement you see them making as they start improving.  Use lots of verbal praise, plan a treat.

EQUIPMENT YOU'LL NEED:

1.   YOUR LOVE AND KINDNESS: Everything we do is with loving and gentle touch to build the receptors back to normal.

2.    KIND WORDS OF ENCOURAGEMENT: Praise and encouragement, laughter and relationship is very important in this.

3.    BATH GLOVE: Look in the ‘bath’ section of your grocery store, dollar store (sometimes), or Wal-Mart and get a pair of Bath Gloves.  They cost about $4.50 a pair ($2.50 individually), buy a pair so you have an extra one if misplaced.  Using it dry gently (very gently for hyper kids) but quickly rub the child’s limbs, fingertips to shoulder and toes to hips. ONLY do what the child can handle… it really is painful to them.  Even if you can only do one hand at first.  Do this 4 times a day for up to 3 minutes for both arms and legs.

We begin with the light touch (tickling) only with our fingertips starting at Liz’s fingertips. She allowed us to touch her just past her wrists. She preferred me to always touch up to the shoulder not down ward. We started on her toes and we could touch above her ankles. Again she preferred me to touch up from the toes to the hip not downward.

We able to do her head and face. She preferred me touching from just behind the temple down along the trigeminal. On her face I was able to add tapping also. After a few days I added a favorite feather from her feather collection. Then a day later I added light scratches with my fingers in the same sequence.  By now we could move further up her arms and legs. She asked if I would tickle her back and spine.  We begin writing letters on her back with the feather. We then purchased a Bath Glove and used dry rubbing very, very lightly. (She really liked this, especially on her back) I added a very soft face brush and used it to introduce a bit of pressure. We were now able to begin deep pressure by tapping and not pressing.  Soon we could increase the pressure on the glove. We could also use deep pressure, including massaging the palms of her hands and bottoms of her feet. By this time, two weeks into the program, we were beginning to see results. We added hot and cold washcloths, but she hated them. So we added hot and cold packs. Still the cold had too much surface. Since I use this time to enjoy loving touch with Liz, I did not push her into something she wasn’t ready for.  Our clinical nutritionist/sports doctor gave us a cold point tool, which worked exceptionally. I discovered small baby spoons dipped in a glass of ice worked well and didn’t have as much surface area at one time, so she tolerated it better. Today, Liz loves this hour of one-on-one time with mom. And everyone is reaping the wonderful rewards. Best of all Liz.