Sensory Processing: Tactile System

Lacey Lubenow, MOTR/L, CLC

Purpose: The tactile system is responsible for receiving information from the environment through touch. It’s important in keeping us safe through the detection of potentially dangerous stimuli such as hot, cold, or sharp objects.

Function: The tactile system is composed of receptors that detect pressure, temperature, vibration, and texture in our external environment. The tactile system works alongside the proprioceptive system to communicate with the brain through sensory receptors throughout the body.

Why it’s important: As mentioned previously, the tactile system serves a lot of purposes, but none more important than safety. Without the tactile system, the body would be at risk of harm through things like heat exposure when cooking or bathing or cold exposure when outside in the elements. It also serves the purpose of emotional attachment (think skin to skin after birth), body position, and feeding and nutrition.

System Breakdown: Because the tactile sensory system is so vast, children who have difficulty with tactile processing may present with a combination of over or under responsive tendencies. Children who are over-responsive to tactile input may be resistant to self care tasks like hair brushing/cutting, nail trimming, tooth brushing, or face washing. They may have a hard time feeding, which can lead to picky eating habits. Children also may avoid or dislike messy play such as finger painting, sand play, or playing with food. Resistance to certain textures of clothing, socks, difficulty with tags or seams, or tight clothing can also be a sign of tactile over-responsiveness. Children who are under-responsive to tactile input may seek out various textures and use parts of their body that have more touch receptors including lips, tongue, and face to feel them. They may not recognize tactile input as easily and thus have a lack of awareness of when their face or hands may be dirty. They also may appear to have a high pain tolerance and seek out messy play opportunities rather than avoid them. Similarly to other sensory systems (proprioceptive and vestibular) children may also engage in active or rough play like running, jumping, or crashing into things.

OT Intervention: Every person is unique to their sensory processing needs. It only warrants intervention if it prevents participation in meaningful activities and impacts their quality of life. Regardless, tactile input is beneficial for children with and without sensory impairments. A sedentary lifestyle restricts the opportunity for engaging the tactile system and can lead to sensory processing difficulty purely due to a lack of exposure. Our sensory systems require frequent input to process information efficiently and effectively. Occupational therapists assist with creating a ‘sensory diet’ that is unique to each child’s needs to help them better process sensory information and promote improved regulation. Examples of activities that OT’s may use to promote exposure to tactile input include:

Water Play: Water is a great way to engage the sensory system without the feeling of being too messy.

Brushing Protocol: The Wilbarger brushing protocol is often used by OT’s to assist with desensitization of the tactile system using a specific brush on the skin. It can decrease over-responsiveness to clothing, food, and self care like hair or tooth brushing.

Deep pressure: A powerful tool that not only helps with regulation of the proprioceptive system, but the tactile system as well.

Exposing children to various textures through play over time will assist in desensitization of an over-responsive tactile system. If a child is under-responsive, providing and educating them with safe sensory opportunities that allow them to feed their sensory system through rough or messy play is equally as important.

Orofacial MyoWHAT?!

Here at Gro we see A LOT of kids and adults for orofacial myology assessment and therapy but what exactly does that mean? Just to confuse everyone further, there are multiple terms for orofacial myology, which all mean the same thing another popular term is orofacial myofunctional therapy.

First off, the short definition of an orofacial myology disorder (OMD) is “the study and treatment of the oral and facial muscles as they relate to speech, dentition, chewing/bolus collection, swallowing, and overall mental and physical health.” (Sandra R. Holtzman)

At Gro, we are all speech language pathologists trained in orofacial myology assessment and therapy. That means when we see a child or adult for speech, articulation, feeding, language or voice therapy we are also looking at them through our “myo” eyes. During an assessment we are looking at how the tongue, oral and facial muscles and bones are affecting speech, feeding, swallowing, breathing and sleep.

 A big part of our assessment is determining if there is a “tongue tie” but actually we are looking to see if where your tongue is attached on the floor of your mouth is affecting any speech sounds or intelligibility (the ability for others to understand you), your ability to nasal breathe, how your chewing and preparing the food in your mouth, your tongue position when swallowing and your quality of sleep. Over the next few blog posts we will dive deeper into how your tongue, oral and facial muscles affect each of these areas.

It’s all about FUNCTION!! We are always looking at how function is impacted. If we see a Grade 4 tongue restriction (i.e. most severe) but there is no functional implication, then we will not recommend a release! To be honest this rarely occurs but it is important to remember that function drives our clinical decision making.

Orofacial myology therapy (OMT) is where we really get to work. We can release the tongue but that’s only going to fix a small portion of the “problem,” you’ve lived however many years with your tongue resting on the floor of your mouth and with limited range of motion. OMT is like physical therapy for your tongue, its job is to teach new habits. These include teaching correct tongue resting position (more to come on this!), strengthening all 8 tongue muscles to easily be able to demonstrate lingual-mandibular differentiation (which is the fancy term for moving your tongue separately from your jaw), chewing and preparing your food so that it’s safe to swallow (which can reduce reflux and aspiration risks!), correct tongue position when swallowing foods and drinks and easily producing sounds that may be affected by the tongue’s limited range of motion.

Be prepared because it’s a lot of work! Because of the nature of OMT we typically look for children to be at least 5-6 years old and able to follow directions because it is a lot of active exercises to complete. We assign weekly homework that consists of exercises that are to be completed daily and when the patient is motivated and on top of it, therapy can be done in 6-12 months but benefits will last a lifetime!

What if your child is younger and you are noticing OMD signs or symptoms?! Stay tuned on more information about this and how this falls into the oral motor/feeding realm!