Overcoming Tactile Defensiveness
Children with PDD often find certain types of touch such as light tickles or a pat on the back aversive. They may refuse to walk barefoot on sand or touch certain textures. Some children refuse to wear socks or mittens or prefer not wearing any clothing. Other children may crave deep pressure and layer their clothing to create a tight feeling. The term “tactile defensiveness” refers to atypical perception of touch experiences due to a sensory processing disorder. The first step in helping pdd kids get dressed is to help them tolerate touch sensations. The following activities/adaptations may help them:
- Providing heavy pressure to the body by sandwiching the child between pillows or rolling a ball up and down their body
- Wearing a weighted vest or collar or tight garments such as tights, leotards or spandex undergarments
- Rubbing terry cloth on arms and legs. Explore using other textures
- Rolling up inside a blanket
- Jumping/crashing into a pile of pillows
Parents, teachers and therapists who explore ways to decrease tactile defensiveness should also look at what types of fabric or clothing are best tolerated by their child. This may include socks without seams and elastic waist pants.
Improving Motor Planning Skills to Dress
Children with PDD often have decreased abilities to plan, perform and remember movement sequences such as putting an arm in one sleeve and then the other. Children with poor motor planning skills appear to be clumsy and have poor body awareness. This means that they struggle to understand the relationships between different parts of their bodies and how to move them. Such a child may struggle to fit his or her head through the neck opening on a shirt. Parents can help these children by practicing the types of movements needed in order to dress. Here are a few suggestions:
- Putting arms and legs in and out of fabric rings such as the ones shown below, help children learn the movements needed to dress. The larger ring can be pulled over the head. Make a game where you each take a turning putting them on. The rings are made by stuffing socks or tights with plastic bags.
- Have your child wear wrist or ankle weights. The increased sensory input may improve body awareness.
- Play dress up with large easy-to-put-on fun costumes such as a Batman cape or a fireman’s hat.
- Practice sequencing steps to other activities such as opening up gift wrapping, folding a blanket or undressing a doll
Remember-it is easier to remove than put on clothing. So work on learning the motor skills to undress first.
It is important to remember when helping PDD kids get dressed to teach dressing skills when one is not actually in a hurry to go out. Teach at a time when the child is feeling rested, not hungry and ready to learn, and work in a quiet, non-stimulating environment. The following teaching techniques may be helpful:
- Backward chaining- the parent performs most of the task and allows the child to finish and feel a sense of accomplishment. Pulling up an already attached zipper is a good example.
- Forward chaining- the parent helps the child begin the movements for the task as a way to encourage the child to continue independently. An example is when the parent opens up a shoe and the child pulls out his or her foot.
- Hand-over-hand –involves the parent moving the child’s hands to experience how it feels to perform the task. Use firm touch. This might work well when teaching a child how to open or close buttons.
It is often a good idea to add some type of reinforcement when helping PDD kids get dressed. The reinforcement (i.e. a sticker) may occur after a short step has been completed (i.e. opening one button) or an entire sequence of steps (i.e. putting on and zipping a jacket).
The manipulation activity shown below was created to practice opening fasteners. First a buckle was opened, followed by buttons on a piece of fabric that were undone, and lastly a snap and zipper were unfastened to reveal a toy hidden inside. The materials were sewn onto a cat bed.
Opening up Buckle, Buttons, Snap and Zipper
The information in this article is based on the author’s professional experience.
Photographs used with permission from the author.