Tactile Sensitivity In Adults Test Demystified

Understanding Tactile Sensitivity

Tactile sensitivity refers to the way individuals perceive and respond to touch sensations. It can be experienced by both adults and children who have sensory processing differences. Occupational therapists often refer to this issue as 'tactile defensiveness', 'over-responsivity to touch', or touch sensitivity, all of which mean the same thing.

Factors Influencing Tactile Sensitivity

Several factors can influence tactile sensitivity in adults. These include age, sex, fungiform papillae, ethnicity, pathological changes, and other physiological measures. For example, oral tactile sensitivity tends to decline with advanced age in healthy adults, while some pathological changes may negatively affect tactile sensitivity. However, the effect of other factors on tactile sensitivity is contradictory in the literature.

Figures courtesy ScienceDirect

Impact of Tactile Sensitivity on Daily Life

Tactile sensitivity can have a significant impact on the daily lives of individuals. Those with tactile defensiveness may exhibit hypersensitivity to touch, being more bothered by things that touch their skin than others. This sensitivity can manifest with food textures, clothing or fabric textures, self-care tasks, and receiving hugs or kisses.

It can lead individuals to avoid certain sensations or have stronger reactions than expected. For example, some may refuse to wear socks with seams due to irritation on the skin. Autistic individuals frequently report tactile defensiveness.

Living with tactile sensitivity can present challenges in various aspects of life, including personal care, social interactions, and occupational activities. Individuals may struggle with grooming routines, wearing certain fabrics, participating in physical activities, or feeling comfortable in crowded or stimulating environments.

The impact of tactile sensitivity varies from person to person, and it is important to understand and accommodate individual needs to promote well-being and participation in daily activities.

Sensory Overload in Adults

Sensory overload can be a challenging experience for adults, especially those who are sensitive to sensory stimuli. When our sensory systems become overwhelmed with more input than they can effectively process, it can lead to discomfort, stress, and a range of symptoms. Understanding the symptoms of sensory overload and finding effective coping mechanisms can help individuals navigate sensory-rich environments more comfortably.

Symptoms of Sensory Overload

The symptoms of sensory overload in adults may vary from person to person, but they often include feelings of being overwhelmed, anxious, or stressed in sensory-rich environments. Physical manifestations such as headaches, fatigue, muscle tension, or heightened sensitivity to sensory stimuli may also occur. Emotional reactions like irritability and frustration are common, and individuals may engage in coping mechanisms such as withdrawing from social interactions or seeking solitude.

Here are 11 signs of sensory overload in adults to be aware of:

• Heightened sensitivity to sounds
• Discomfort in brightly lit environments
• Difficulty concentrating in settings with multiple stimuli
• Feeling overwhelmed in crowded places
• Aversion to certain textures or fabrics
• Distress from strong odors
• Physical discomfort or aversion to specific food textures
• Constant fatigue
• Increased irritability or anxiety
• Physical symptoms like headaches or nausea
• Difficulty with aspects of intimacy and sex due to sensory aversions

These symptoms can significantly impact an individual's daily life, making it important to recognize and address sensory overload.

Coping Mechanisms for Sensory Overload

Coping with sensory overload involves finding strategies and techniques that help individuals manage and reduce sensory overwhelm. Here are some effective coping mechanisms:

• Sensory breaks: Taking regular breaks in a quiet and calm environment can provide relief and allow the sensory system to reset.
• Deep breathing exercises: Practicing deep breathing techniques can help regulate the nervous system and promote relaxation.
• Utilizing sensory tools: Tools such as noise-canceling headphones, fidget toys, or weighted blankets can provide sensory input and help individuals feel more grounded.
• Engaging in physical activities: Engaging in physical exercise or activities can help release tension and provide an outlet for sensory energy.
• Establishing routines: Establishing predictable routines can create a sense of stability and reduce anxiety associated with sensory overload.
• Seeking support: Connecting with support groups or professionals who specialize in sensory processing difficulties can provide valuable guidance and support.

Creating a sensory-friendly environment is also essential for managing sensory overload. This involves customizing lighting, reducing background noise, tidying and decluttering areas, introducing comforting textures and aromas, and utilizing sensory tools and strategies [3]. Allocating time for sensory downtime is crucial, allowing the sensory system to rest and rejuvenate, promoting overall wellness and averting sensory overload.

By recognizing the symptoms of sensory overload and implementing effective coping mechanisms, adults can navigate their daily lives with greater comfort and well-being. It's important to find strategies that work best for each individual's unique sensory needs, providing a balance between sensory stimulation and self-care.

Tactile Sensitivity in Autism

Individuals with autism often experience tactile sensitivity, which can have a significant impact on their daily lives. In this section, we will delve into the concept of tactile defensiveness and explore the effects of tactile sensitivity on autistic individuals.

Tactile Defensiveness Explained

Tactile defensiveness, commonly reported by autistic individuals, refers to an extreme sensitivity or aversion to certain touch sensations. While there is no confirmed cause for tactile sensitivity, it is believed that touch pressure and proprioceptive sensory input can help reduce sensitivity to touch [1].

When an individual with tactile defensiveness encounters everyday touch sensations, their brain can interpret them as threats, activating a fight, flight, or freeze response. This can lead to meltdowns, arguments, and avoidance of certain situations. Some adults with touch hypersensitivity have even reported that certain everyday touch sensations feel painful.

Effects of Tactile Sensitivity on Autistic Individuals

Tactile sensitivity can have a profound impact on the lives of autistic individuals. It can affect their ability to engage in daily activities, form relationships, and navigate social environments. The hypersensitivity to touch can make simple tasks, such as getting dressed or receiving a hug, overwhelming and distressing.

It is important to note that tactile sensitivity can vary among individuals with autism. While some may exhibit extreme aversion to touch, others may seek out certain types of tactile input. The manifestation of tactile sensitivity can differ from person to person.

To assess tactile sensitivity in autistic individuals, self- and proxy-report questionnaires have been commonly used in research. The Adolescent and Adult Sensory Profile (AASP) is one of the widely used assessment measures for individuals with high-functioning ASD. However, it is important to seek advice from an occupational therapist who can use questionnaires and observations to assess tactile defensiveness, as there is no formal test or diagnosis for tactile sensitivity.

Research utilizing neuroimaging techniques, such as functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG), has aimed to uncover the neurological basis of sensory behaviors in individuals with ASD. These studies explore the neurological underpinnings of specific aspects of sensory processing dysfunction, providing valuable insights into the sensory experiences of autistic individuals.

By understanding tactile defensiveness and its effects on autistic individuals, caregivers, educators, and healthcare professionals can implement strategies to create sensory-friendly environments and support individuals in managing their tactile sensitivity.

Assessing Tactile Sensitivity

To better understand and diagnose tactile sensitivity in adults, various tools and techniques are utilized. However, there can be challenges in accurately diagnosing tactile sensitivity due to its subjective nature.

Tools and Techniques for Assessment

The assessment of tactile sensitivity involves evaluating an individual's response to different sensory stimuli. Here are some common tools and techniques used in the assessment process:

• Light Touch Test: Tactile sensation can be tested by lightly touching areas of the face, trunk, and extremities with a wisp of cotton, a small piece of paper, or the gentlest possible touch of fingerpads. The patient is asked to respond "yes" each time a stimulus is applied. Tactile localization can also be tested by having the patient point to the area stimulated or describe the area tested.
• Pain Sensation Test: Painful stimuli can be applied using a safety pin with the point and guard in a random fashion. The patient is asked to respond with "sharp" or "dull" with their eyes closed. Pain sensation is evaluated in the same areas tested for tactile sensation, comparing each side and distal and proximal portions of each extremity [5].
• Temperature Sensation Test: Temperature sensation can be tested by applying cool and warm objects to various parts of the body. Test tubes filled with warm water or cracked ice and water may be used for testing. Patients are asked to describe the stimulus as hot or cold with their eyes closed. Temperature testing is often a more sensitive measure of subtle dysfunction than pain testing [5].
• Joint Position Sense Test: Joint position sense, a proprioceptive sensation, can be evaluated by starting with the most distal joints of each extremity. If abnormalities are found in the distal joint, more proximal joints should be tested successively until a normal joint is reached. The third and fourth digits of both upper and lower extremities are more likely to show early proprioceptive dysfunction.
• Vibratory Sense Test: Vibratory sense, another proprioceptive sensation, can be assessed using a 128 Hz or C tuning fork. The timed vibratory test is a sensitive method to detect mild to moderate impairments in vibratory sensation. The patient is asked to describe the sensation felt and indicate when it stops. Proper application of the tuning fork is crucial for accurate testing.

Challenges in Diagnosing Tactile Sensitivity

Diagnosing tactile sensitivity can be challenging due to its subjective nature and the varying responses individuals may have to sensory stimuli. Some of the challenges include:

• Individual Variability: Tactile sensitivity can vary widely among individuals. What may be perceived as uncomfortable or painful for one person may not elicit the same response in another. Understanding an individual's baseline sensitivity and their specific triggers is crucial for accurate diagnosis.
• Subjective Reporting: Tactile sensitivity relies heavily on self-reporting by the individual, which can be subjective and influenced by various factors such as personal experiences, emotions, and cultural differences. It is important for healthcare professionals to establish open communication and trust with the individual to gather accurate information.
• Overlap with Other Conditions: Tactile sensitivity can be present in various conditions, including autism spectrum disorder and sensory processing disorder. Distinguishing tactile sensitivity specific to one condition from others requires careful evaluation and consideration of other symptoms and diagnostic criteria.
• Limited Standardized Assessments: While there are tools and techniques available, there is a lack of standardized assessments solely dedicated to tactile sensitivity. Healthcare professionals often rely on a combination of subjective reports, observation, and existing assessments to gather information and make informed diagnoses.

By utilizing appropriate tools and techniques, healthcare professionals can assess tactile sensitivity in adults and gain a better understanding of how it impacts an individual's daily life. However, it is important to acknowledge the challenges in diagnosing tactile sensitivity and to approach the assessment process with sensitivity and flexibility.

Managing Tactile Sensitivity

For individuals experiencing tactile sensitivity, implementing effective strategies can greatly enhance their ability to cope with and navigate daily life. By understanding and addressing tactile sensitivity, individuals and caregivers can create a more comfortable and supportive environment. Two key aspects of managing tactile sensitivity include implementing strategies for coping and creating a sensory-friendly environment.

Strategies for Coping with Tactile Sensitivity

When it comes to managing tactile sensitivity, there are various strategies that can help individuals cope with their sensory challenges. These strategies can be personalized to meet individual needs and preferences. Here are some common approaches:

• Self-awareness and self-regulation: Developing self-awareness of one's sensory triggers and learning to regulate emotional responses can be empowering. This may involve identifying specific textures, fabrics, or activities that cause discomfort and finding ways to minimize exposure or engage in desensitization techniques.
• Sensory breaks and downtime: Allocating time for sensory downtime is crucial to allow the sensory system to rest and rejuvenate. This practice can involve engaging in calming activities such as deep breathing exercises, physical activities, or engaging with sensory tools like fidget toys or stress balls. It helps the nervous system recalibrate and regain balance, supporting overall sensory well-being.
• Gradual exposure and desensitization: Gradually exposing oneself to textures or activities that trigger tactile sensitivity can help desensitize the nervous system over time. This can be done through a systematic approach, starting with less challenging stimuli and gradually increasing exposure as comfort levels improve.
• Communication and advocacy: Openly communicating with others about tactile sensitivity can foster understanding and support. Advocating for one's needs, whether in personal relationships or professional environments, can help create a more inclusive and accommodating environment.

Creating a Sensory-Friendly Environment

Creating a sensory-friendly environment is essential for individuals with tactile sensitivity to feel comfortable and supported in their daily lives. Here are some strategies for creating such an environment:

• Lighting: Customize lighting to reduce harsh or bright lights that may be overwhelming. Utilize softer, diffused lighting or adjustable lighting options to create a calming atmosphere.
• Noise management: Reduce background noise that may be distracting or overwhelming. Consider using noise-canceling headphones or earplugs when in noisy environments.
• Tidiness and decluttering: Minimize clutter and organize living and working spaces to reduce visual and tactile distractions. A tidy environment can help create a sense of calm and order.
• Comforting textures and aromas: Introduce comforting textures, such as soft blankets or cushions, that can provide a soothing sensory experience. Aromatherapy with calming scents, such as lavender, can also contribute to creating a relaxing atmosphere.
• Sensory tools and strategies: Provide access to sensory tools and strategies that can help individuals manage tactile sensitivity. This may include fidget toys, stress balls, weighted blankets, or other sensory aids that promote relaxation and self-regulation.

By implementing these strategies and creating a sensory-friendly environment, individuals with tactile sensitivity can better manage their sensory challenges and improve their overall well-being. It is important to tailor these strategies to individual needs and preferences, and to seek support from healthcare professionals and occupational therapists when necessary.

Research on Tactile Sensitivity

Research on tactile sensitivity has shed light on its impact and provided valuable insights into its assessment and management. Recent studies have focused on understanding the nuances of tactile sensitivity in adults and its findings have implications for treatment strategies.

Recent Studies on Tactile Sensitivity

A study conducted by NCBI aimed to assess lingual tactile sensitivity in children and adults using Von Frey filaments and a gratings orientation test. The study compared the cognitive and perceptive suitability of these tools and investigated the relationship between lingual tactile sensitivity, food texture preferences, and food neophobia.

Findings from the study showed that the gratings orientation test provided better separation of participants based on their performance compared to the Von Frey filaments. This suggests that the tools measure different dimensions of lingual tactile sensitivity. However, no significant differences were found in lingual tactile sensitivity between children and adults, indicating that tactile sensitivity in this aspect does not significantly change with age.

Additionally, the study found that children aged 8 to 9 years were more sensitive than children aged 6 to 7 years and adults when tested with the finest Von Frey filament (0.008 g). However, no age-related differences were observed for other tools used in the study.

Findings and Implications for Treatment

The research highlighted a weak but significant positive correlation between lingual tactile sensitivity to the finest Von Frey filament and food neophobia in the youngest age group (6 to 7 years). This suggests that children with higher levels of food neophobia are more sensitive to oral tactile stimuli [6].

These findings provide valuable information for clinicians and caregivers working with individuals who experience tactile sensitivity. Understanding the nuances of tactile sensitivity can help tailor treatment approaches and interventions to address the specific needs of individuals with sensory challenges. By considering the relationship between tactile sensitivity and food neophobia, strategies for managing food aversions and improving oral sensory experiences can be developed.

Further research in this area is essential to expand our understanding of tactile sensitivity and its impact on individuals' daily lives. By continuing to investigate the underlying mechanisms and exploring effective interventions, we can enhance the quality of life for those affected by tactile sensitivity.

References

[1]: https://www.griffinot.com/what-is-tactile-defensiveness/

‍[2]: https://www.sciencedirect.com/science/article/pii/S0950329322000994

‍[3]: https://neurodivergentinsights.com/blog/sensory-issues-in-adults

‍[4]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575628/

‍[5]: https://www.ncbi.nlm.nih.gov/books/NBK390/

‍[6]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694000/