Play is important for all children in their formative years as it provides an opportunity to explore, learn about and reflect on the world around them. For deafblind children, play is especially important as it provides an opportunity to explore whilst being safe and supported. Playing with different toys and textures can play a role in supporting children to expand their tactile sensory system – building up their ability to discriminate textures and to establish concepts in the world around them. Deafblind children can face specific barriers to their ability to learn about the world in this way, however:
Firstly, many commercially available toys today are designed with very limited tactile variety. They tend to be made of similar textures, mostly firm plastics. This means that they do not help children who are deafblind to develop their tactile discrimination ability from the earliest opportunity.
Many deafblind children are also ‘tactile selective.’ This means that they either are too sensitive to some textures (such as avoiding light, fluffy textures as they experience them as irritating) or not sensitive enough, in that they needed more information to register what they are feeling (such as preferring firm textures to press really hard into to feel the sensation). Some children may experience a mixed sensitivity, where they are under or over sensitive at different times of the day; different parts of the body; or have different responses to different sorts of textures.
Tactile selectiveness can mean that a child can face challenges in different parts of daily living such as:
- Reaching out and exploring the world with confidence
- Eating and drinking
- Wearing clothes of particular textures
- Walking from different areas (e.g change from carpet to woods floor to grass)
Being sensitive to certain textures impacts on daily living –how many things would you have to avoid if you didn’t like touching fluffy, crinkly, or rough textures?
So what do we do about it?
For some children, touch needs to be introduced gradually. The acceptance of touch on different parts of the body typically develops from the larger to smaller body parts. This means that children are likely to accept textures to their arms, then feet, then hands and then lips – the areas with the most receptors for sensing touch.
In relation to eating and drinking, children typically learn to accept new foods by looking at them, reaching for them, touching them, tasting them, and finally eating them. Both of these developments are hierarchical and can be useful to inform where to go next when introducing different textures.
When working with all children with tactile sensitivity issues, it is important to involve appropriately trained colleagues in the design and management of the programme. Therapists, as part of a multi-disciplinary team, can be trained in this specialist area; particularly occupational therapists and speech and language therapists. Tactile sensitivity work should be managed as part of a holistic programme and include a range of interventions.
Some general strategies that we use when increasing the range of textures include:
- Adopting the ‘exploring, listening, talking hands’ approach. This approach ensures that when children are being supported to explore things in the world, that they have a safe space to retreat back to, in order to ensure that they have control of what is happening to them. This is particularly important when introducing messy play type activities which may challenge their tactile sensory system.
- Massage can be a useful tool to increase awareness of different parts of the body and help to build up tolerance of touch in these areas. Some children may prefer not to use lotions or oils in massage since this can be an unpleasant slimy experience, rather than a relaxing massage.
- Messy play is a really useful tool! It may not be to everyone’s liking to offer messy play at home, but it can be a good way to introduce a range of textures in a controlled way. If combined with a ‘warm up’ massage, and adopting the ‘exploring, listening, talking hands’ approach, it can be particularly effective. Textures can be separated into different categories, from those which fall away and are easy to break contact with (such as feathers and sand) to those that are very sticky and resistant to breaking contact, which require multiple wiping (such as mud and chocolate spread).
- Sense has developed a Messy Play Texture Hierarchy which separates textures into different categories. This helps parents and practitioners who are working on this area to think about which level their child is at and what the next steps are in terms of tactile acceptance. Some children move from accepting easy textures to harder textures and other the other way round, depending on their sensory profile.
Steve Rose is a state registered Speech and Language Therapist specialising in working with people with deafblindness. He has an interest in early intervention and eating and drinking skills development. He is the Head of Children’s Specialist Services at Sense and maintains an active practitioner role within the team.