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Why Touch is So Important - featured November 26, 2010

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Why Touch is so Important

By: Susan N. Schriber Orloff, OTR/L

Touch is part of everyday life. An average child of 4 feet tall and about 50 pounds has about 1410 square inches/ 9.8 square feet of skin. Each square inch of skin mediates the three major types of receptors: touch, pressure and temperature. And each square inch contains dozens of each type of these receptors. This makes skin a huge sensory conduit to the central nervous system processing our immediate environment as well as being our major alarm system.

The most primitive of the receptors is light touch. It is the feeling of a bug creeping on your leg or arm or a brush of light in your visual field, and it is so distracting that it prohibits attention to any other stimuli until the source of the tactile irritation is resolved.

Pressured touch is very important in the learning the process. It does not require vision, such as light touch does. Pressure allows us to recognize what we are touching and what is doing the touching. Think about the pencil in a child’s hand for writing, or knowing where your shoes are under the table without looking for them. Our feet do the “looking”. Teaching a child to “look” with their hands may be one of the most important things they can be taught. Automatic writing happens because we know what it should feel like.

The awareness of pain, heat and cold is directly related to survival. These sensations are mediated so quickly that we even act before we fully know what we have touched. Think about pulling your hand away from something hot. We pull away and then think, ‘that was hot’—the action comes before the identification of the touch.

Tactile irregularities are often seen in children with developmental delays. Abnormal touch processing is often manifested in what can be inaccurately interpreted as “oppositional behavior”. A child may refuse to wear a jacket in cold weather, require that long sleeves be worn all the time irrespective of the weather, even in the summer, and he may not cry at injuries.

And the tactile system is implicated in vision and hearing. The cillia, in the inner ear register by touch where are head is. It is our “this ends up” awareness center. These cillia are mechanosensors for hearing and play a role in balance and midline coordination.

Learning is a process of action and reflection. And actions are unique triggers for both the kinesthetic and the proprioceptive sensory pathways. The kinesthetic system is activated through movement, and is the system that allows us to have a “motor memory” so that frequent actions become “automatic”. The kinesthetic system has receptors located in the tendons and muscles so it is this system that recognizes, for example, when a specific motor sequence (such as in sports, dance or music) has not been performed correctly.

Our tactile system is both inside and outside our bodies. It is enhanced by movement but not dependent upon it. However, learning is dependent upon touch. It is how we experience our world.

Children with deficit sensory processing can have issues with reading across the midline of their bodies, reaching for items across a table, playing on the playground, handwriting, sports, etc. They can be resistive to interacting with their peers and prefer sedentary play to the exclusion of any type of team activity.

This can impact their social skills, self-esteem, self-evaluative abilities, and more. Skewed tactile perception can be at the base of awkward gross motor skills, interfere with balance (think bike riding, running, skipping, etc.) and visual tracking. Head movements may be noxious causing the child to adapt rigid stiff motor postures thus exasperating awkward motor patterns.

In order to help the child with tactile processing issues it is important to discover how the tactile concerns are manifesting themselves. Issues associated with tactile perception are too many to discuss in this small space, but here are some that might help with planning treatment. Remember: ALWAYS stop immediately if the child looks uncomfortable or expresses discomfort.

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Important guidelines:
  1. All introduction of tactile stimuli should be slow and gradual
  2. Do not force the child to try something they do not want to do
  3. Be patient, this will take time
  4. Encourage the child to use words to describe how they are feeling during the activity (give them words if they are having difficulty with expressive language and let them choose what they want to say)
  5. Activities should increase awareness of body in space and body parts—use heavy work activities: lifting, zipline, trapeze bar, etc.
  6. Allow for activity/task “breaks”
  7. Use activities in a variety of body positions: sitting on therapy balls, scooter boards, knee standing, in prone position on elbows, etc.

Touch is a fundamental uniquely inter-related sense. Its implications for wellness are global. It is a direct pathway within the learning system and (in my opinion) should be “standard” within all developmental, school-based and clinical pediatric occupational therapy goals.

This Month's Featured Vendor: Children's Special Services, LLC

Special Thanks to Susan Schriber Orloff for providing an article for this issue's Therapy Corner.

Susan N. Schriber Orloff, OTR/L, is the author of Learning Re-enabled, a guide for parents, teachers and therapists. The National Education Association, and the International Learning Disabilities Association endorse the book. She is the Director of the Modified Developmental Preschool in Dunwoody, GA. Susan writes “Ask the Therapist,” a column in Exceptional Parent magazine, and is CEO and is the executive director of Children’s Special Services, LLC, an occupational therapy service for children with developmental and learning delays in Atlanta, GA.

She can be reached on the Web at or through

Please support our contributing authors and visit Children's Special Services, LLC on the web at: She can also be reached by email at:

Tags: Article OT Tactile Proprioreception Sensory Motor Skills . Sensory Integration Sensory Processing Disorder