Tactile Perception and Deficits in Autistic persons and methods for overcoming them

TACTILE DEFENSIVENESS IN AUTISTIC PERSONS

By Sushena Sharma & Shruti Siag Fergusson College Pune University

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Abstract

The present article is an investigative overview of deficits in tactile perception and detailed understanding of unusual patterns of touch and sensation in persons suffering from autism. Sensory registration of touch has been looked into from various studies to get a comprehensive idea about the general opinion on autistic children and their reactions the tactile stimuli. Suggestions have also been made for helping such children integrate various sensations and adapt to them.

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Sensation and Perception The processes by which our sense organs receive information from the environment is referred to as sensation whereas the sorting out, interpretation, analysis, and integration of stimuli involving our sense organs and brain is perception. Although perception clearly represents a step beyond sensation, in practice it is sometimes difficult to find the precise boundary between the two. The primary difference is that sensation can be thought of as an organisms encounter with a raw sensory stimulus, whereas perception is the process by which that very stimulus is interpreted, analysed and integrated with other sensory information. The issue of how the intensity of a stimulus influences our sensory responses comes under the branch of psychophysics. Psychophysics is the study of the relationship between the physical aspects of stimuli and our psychological experience of them (Baird, 1997; Geschieder, 1997) Under psychophysics, the most important concept is the concept of Threshold. When we want to study how strong a stimulus has to be for us to detect it, the concept of Absolute Threshold comes in. An Absolute Threshold is the smallest intensity of a stimulus that must be present for it to be detected. Consider the following examples of absolute thresholds for the various senses (Galanter, 1962): Sight: A candle flame can be seen from 30 miles away on a dark, clear night. Hearing: The ticking of a watch can be heard 20 feet away under quiet conditions. Taste: Sugar can be tasted when 1 teaspoon is dissolved in 2 gallons of water. Smell: Perfume can be detected when one drop is present in a three-room apartment. Touch: A bees wing falling from a distance of 1 centimetre can be felt on the cheek.

Differential Threshold It involves noticing the distinctions between stimuli. The differential threshold is the minimum stimulation required to detect the difference between two stimuli, or a just noticeable difference (j.n.d). The stimulus value that constitutes a just noticeable difference

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depends upon the intensity of the initial stimulus. For example, a person in a quiet room is more startled by the ringing of a telephone than a person in an already noisy room.

Tactile Perception and its role in Autism

The most common characteristic of autistic children is their inability to process sensory input. Children must integrate information they receive through all of their senses and from movement and gravity. Many autistic children do not know how to cope with the different sensory input they receive. If the transmission of sensory input to the brain is disorganized, a child often exhibits sensory defensiveness or inability to tolerate various types of sensory stimuli. Some sensory defensive behaviour might include difficulty in tolerating tactile sensation. Children with sensory defensiveness tend to have a nervous system that is on overdrive; such that any variety of sensory stimuli might readily be interpreted as threatening or anxiety provoking. It can be difficult to live with a child with sensory defensiveness (e.g. an autistic child). For example; if a child hears loud sounds or noise, he or she might cry and fuss, if his or her hair is combed or washed, he or she might become upset or he or she may not like his or her hands to be dirty. They might avoid touching unexpected objects. They might dislike a specific food, texture or temperature (Rasmussen, 2005; Bogdashina, 2003; Wilbarger & Wilbarger, 1991). Many autistic children have tactile defensiveness. It is widely reported that autistic people have unusual (from a nonautistic point of view) sensory-perceptual experiences. These experiences may involve hyper- or hypo-sensitivity, fluctuation between different volumes of perception, difficulty in interpreting a sense, etc. All these experiences are based on real experiences, yet these experiences may be interpreted differently. Therefore, in order to design treatment programmes in accordance with his/her perceptual abilities, it is of great importance to understand how the children with autism experience the world through each of the channels, and how he/she interprets what he/she sees, hears, and feels etc. Understanding how these experiences may affect the autistic persons functioning is vital in order to adopt methods and strategies to help the person function in the community.
Signs of Tactile Dysfunction:

1) Hypersensitivity to Touch (over responsive)

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becomes fearful, anxious or aggressive with light or unexpected touch as an infant, did/does not like to be held or cuddled; may arch back, cry, and pull away distressed when diaper is being, or needs to be, changed appears fearful of, or avoids standing in close proximity to other people or peers (especially in lines) becomes frightened when touched from behind or by someone/something they cannot see (such as under a blanket) complains about having hair brushed; may be very picky about using a particular brush bothered by rough bed sheets (i.e., if old and "bumpy") avoids group situations for fear of the unexpected touch resists friendly or affectionate touch from anyone besides parents or siblings (and sometimes them too!) dislikes kisses, will "wipe off" place where kissed prefers hugs

a raindrop, water from the shower, or wind blowing on the skin may feel like torture and produce adverse and avoidance reactions may overreact to minor cuts, scrapes, and or bug bites avoids touching certain textures of material (blankets, rugs, stuffed animals) refuses to wear new or stiff clothes, clothes with rough textures, turtlenecks, jeans, hats, or belts, etc. avoids using hands for play avoids/dislikes/aversive to "messy play", i.e., sand, mud, water, glue, glitter, playdoh, slime, shaving cream/funny foam etc. will be distressed by dirty hands and want to wipe or wash them frequently excessively ticklish distressed by seams in socks and may refuse to wear them

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distressed by clothes rubbing on skin; may want to wear shorts and short sleeves year round, toddlers may prefer to be naked and pull diapers and clothes off constantly or, may want to wear long sleeve shirts and long pants year round to avoid having skin exposed distressed about having face washed distressed about having hair, toenails, or fingernails cut resists brushing teeth and is extremely fearful of the dentist is a picky eater, only eating certain tastes and textures; mixed textures tend to be avoided as well as hot or cold foods; resists trying new foods may refuse to walk barefoot on grass or sand may walk on toes only

2) Hypo-sensitivity to touch (under-responsive) may crave touch, needs to touch everything and everyone is not aware of being touched/bumped unless done with extreme force or intensity is not bothered by injuries, like cuts and bruises, and shows no distress with shots (may even say they love getting shots!) may not be aware that hands or face are dirty or feel his/her nose running may be self-abusive; pinching, biting, or banging his own head mouths objects excessively frequently hurts other children or pets while playing repeatedly touches surfaces or objects that are soothing (i.e., blanket) seeks out surfaces and textures that provide strong tactile feedback thoroughly enjoys and seeks out messy play craves vibrating or strong sensory input has a preference and craving for excessively spicy, sweet, sour, or salty foods

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Treating Children with Tactile Defensiveness Apart from professionals, parents the world over too have come up with their own unique ways in stimulating their autistic children. These creative solutions are easily applicable at home and can be innocently incorporated into play without making the child feel the frustration of having to go through therapy. Some suggestions are: -I used a large Tupperware container and coloured the rice and put small toys in and my daughter would look for them. (Linda Standiford) -You can put hair gel (DEP) in a gallon-size zip-lock baggie adding strong tape across the zip lock. Put enough gel so that the bag can lay flat. He can poke at it with his finger or feel the squishiness of the bag. A. (now 11) would draw pictures and letters on it with his finger when he was five to seven years. You can also do bags with different colours. (Dale Lips) -Towel rub down after a warm bath (firm, quick strokes) -Wearing spandex or lycra exercise-type clothes under regular clothes for calming, evenly distributed deep pressure input - play gyms with sound and lights - tons of tactile toys play mats with unique sensory experiences - vibrating toys - textured puzzles - unique balls to sit on, play with or touch - fun balance boards and games

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- slimy, squishy, squeezy toys - toys to sit on, spin on, ride on, climb on, twirl on. - Playing in the sand or water provides essential yet fun ways to experience necessary tactile input. Use your creativity, get plenty of towels, and have fun filling these tables with sand, rice, shaving cream, water, or any textured substance you can think of. Of course, put little toys in as well to encourage exploration. More generally speaking, some useful strategies for dealing with tactile defensiveness are: Strategies to Treating Tactile Defensiveness Disorder 1. Avoid the sensation. This strategy is used for stimuli that isnt necessary in the persons daily life. For example, if clothing tags disturb the individual, remove the tags. Remove intolerable 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 and 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 persons 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 small amounts of the stimulus to 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 behaviours. 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, brush their teeth softly and frequently. 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

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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.

Deficits in tactile perception is not only a feature of Autism but is also related to Aspergers Syndrome, ADHD, Sensory Processing Disorder. The similarity in the tactile symptoms makes diagnosis difficult but since they are common to all of them, the treatment for one is flexible and can be applied to the other. However, it is important to remember that Autism is also accompanied with additional problems such as impaired social interaction and communication and requires additional efforts when dealing with affected persons. Autism partly arises from distraction from the real focus of events and leads to compulsive and repetitive behaviour. This in turn puts a constraint on their communication skills and participation in social events. I believe that we should help persons suffering from autism to first conquer the physical events that disturb them so that their mind is more receptive to the mental events happening around them for better mental health.

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References

Sunay, S (2009). Teaching of Tactile Perception Skills to Children with Autism in Early Childhood. Ozean Journal of Social Sciences, 157-158. Feldman, R.S. Understanding Psychology, Tata McGraw Hill Edition 2006. Signs of tactile dysfunction (n.d.) Retrieved from http://www.sensory-processingdisorder.com/sensory-processing-disorder-checklist.html Tactile Defensive Activities (n.d.) Retrieved from http://www.comeunity.com/disability/sensory_integration/activities-tactile.html