Photo: Annie Spratt

This Week’s Guest

Occupational Therapist Maude Le Roux is back again this week to discuss the sense of touch, or tactile perception, part of the ‘I‘, Individual differences. Maude is a Developmental, Individual differences, Relationship-based (DIR) Model Expert and Training Leader and has a DIR/Floortime clinic, A Total Approach, in Glen Mills, PA, just outside Philadelphia where I’ve brought my son many times. She is a trainer in many other modalities of remediation and can be found training at her Maude Le Roux Academy both online and in person around the world.

The Somatosensory System

The somatosensory system includes components of the tactile system. It is such a very big cue for many other pieces, including how we experience ourselves as a body, or the body awareness piece, Maude says. Part of it is that you have an exterosensory system where sensory input comes in, touching on you. This alerts you that someone has touched you, or that there’s a fly on your leg, for instance. Then, there’s the proprioceptive system, which we talked about a bit in our last podcast about the vestibular system, which also plays a role in the somatosensory system. Then, there’s the interoceptive system which also plays a very significant role, Maude continues.

As an aside, Maude likes to think of the term ‘neuroception’ as used by Dr. Stephen Porges in the Polyvagal system as ‘interoception’. Dr. Porges discusses the way that the body experiences the social engagement system as the way that the body responds from the vagus nerve. Interoception is all about the vagus nerve, Maude says. 

The touch system has countless receptor fields across the body, Maude continues. It is incredibly emotional. It harkens back to the in utero period with the amniotic sac around the body, she says. As the baby kicks, the baby is practicing proprioception, which is the way that your body tells you in your joints where it is and how it’s moving through space. Exteroception is all of the influences coming from the outside. For instance, if you touch your child from the side and your child yells, “Don’t touch me!“, it’s a modulation response to the system. It’s a very crude pathway, Maude explains.

There’s three big pathways in the brain for touch, Maude explains, and the ‘crude’ pathway is the one that is the more ‘tactile defensive’ pathway, and it’s used when the child hasn’t yet developed the fine discrimination pathway. Often, kids who are not finely discriminating their touch system will present with a tactile defensive system, Maude says. It doesn’t always have to, but we tend to see that frequently, she clarifies.

Discrimination

Discrimination changes the way that you look at objects, Maude explains. At the beginning of life, the baby explores everything that is within reach through the mouth. What that exploration tells the brain is incredibly important, she continues. When you have a child with touch issues, give them time to explore any object that is new, Maude advises. Let them explore the properties of it and feel what it feels like in their hands. All of that exploration is feeding that discriminatory system to understand that when they see it in the future, they can feel the touch of it.

That connection of what you’re seeing and what your touch system is doing is at a specific place in the brain called the superi colliculi and this is why when you touch something, you don’t have to see it, because you know in your mind’s eye what you’re seeing. If you don’t have that, it’s difficult for you to use a new tool in a practical way, Maude explains.

Touch, Proprioception, and Mouthing Objects

I wanted to clarify the points Maude made so far. I explained that when my son was young he craved proprioceptive input and would squeeze his body between tight places, loved being in the pool, and loved feeling snug in a lycra swing–all proprioception, involving a touch component (since these things would touch his skin). If you just take the touch piece, that’s exteroception, but if he then pushes against it, that goes into proprioception, Maude explains.

Next, a lot of parents notice that their autistic kids put everything in their mouth. Maude explains that it’s a very important phase. We wonder if it’s a negative behaviour. It has many different origins. Because touch is so connected to the emotional centers in the brain, Maude continues, putting something to the mouth, can be a reminder of Mommy’s breast or the pacifier that they used to soothe them when they were babies. They might put things to their mouth when they are stressed to self-regulate.

Maude says that if you treat mouthing, such as biting your shirt collar, as a ‘behaviour’ and try to stop it, you’ll see it pop out in a different way. Instead, think about what other soothing behaviour or activity you can replace it with. You can also work with an Occupational Therapist, Maude explains, to get the need for that behaviour to decrease over time. When you do bottom-up sensory integration therapy, you see that the child naturally starts decreasing the need to go there. Most parents that Maude sees will have already tried to stop the behaviour with some kind of behavioural strategy, but if the child gets the message that something they’re doing is ‘wrong’, Maude explains, or ‘not pleasing’, it almost increases the anxiety and the need to do it.

So, I wanted to again clarify that our children will explore objects through their mouth and put things in their mouth to self-regulate, but also do so when they are teething, and again when their adult teeth and molars come in. In addition, I asked Maude to explain what she told me at some point when my son’s speech was starting to come in more and that his senses in his mouth were awakening, so to speak, thus causing him to seek oral input yet again. This is the discriminatory part, Maude says.

There are so many proprioceptive inputs in the mouth and jaw area that give you the discrimination to speak in an articulate way, Maude explains, which calls on a lot of input to make it work and operate. Maybe your oral awareness has been limited in your development because your speech is delayed, or you don’t chew the same way that other do, or you haven’t yet developed the required postural control for the jaw to then have control to articulate (since feeding and articulation go hand-in-hand). It’s the same as fine touch sensors on your hand, Maude offers. When you are listening to your own voice and feeling the feedback when you say “p“, or “t“, it’s the same as body awareness as you feel where your tongue is.

Regressions of Old Behaviours

Maude says that parents panic when behaviours that were gone return. The brain always remembers, she says. Regression is only possible with a blunt force brain injury or if there’s a diagnosis there that causes regression. Neuroplastic brains only move forward, she emphasizes. It’s not that you lose the skill. It’s that it goes into recess–into the subconscious–while you’re learning the newer skills. This old behaviour is coming back to support the new growth, that is also stressful to the nervous system, even though it’s positive growth. 

Maude says that when we see what we think of as regression in our child, think about what has changed. Is there a new teacher? Are they sick? Are they teething? Did we lose a grandparent? Was there some additional growth? What else is happening? Your interoceptive system connects all of these experiences in the brain which gives you the emotional connection you give to the experience, Maude says. The only way our kids can understand what their body is experiencing is by going through older behaviours again, checking in if they will still be helpful. They can’t tell us, “Mommy, I feel so nervous today” Maude emphasizes.

An Emotional Experience

Typical children often learn to say their first words before they start moving, Maude says. Then, when they start walking, they stop talking as their body figure out this new feeling of ‘being upright’ and using their body to move through space.
And, I add, feeling their feet touching the ground: if they’re wearing socks or are barefoot, if they’re on concrete or on the grass, etc. Information that’s touching from the outside helping you move, to help you motor plan, connects to your interoception, to know how your body connects to emotion, Maude explains.

Maude shares that Dr. Ruth Lanius is a psychiatrist who does beautiful webinars on trauma, explaining this whole piece on the embodied self where she explains that your skin is your container and your separateness from others. Looking at the somatosensory system, Maude summarizes, you can look at kids who are tactile defensive, and those who are not developing enough fine discrimination to use utensils or a pencil properly, for instance, but remember that the touch system is very emotional so you’ll often see inconsistency. For instance, today the child is playing in the mud with their full body, then tomorrow they won’t play with finger paints. There’s other things at work at the same time which fools us into thinking that it’s ‘behaviour’ and that the child is not wanting to do what we, or the teacher, says.

The somatosensory system is the one most connected to the emotional piece directly due to the link with the interoception, so we must be very careful before we judge, Maude shares. Body awareness is also the piece that takes us into self-awareness, which is both physical and emotional, and between the physical and emotional is where we get our social awareness, she explains. I told Maude I loved that she brought in the emotional component as I’ve touched on this in a few of the recent podcasts, namely with Dr. Neufeld and with Mary Beth Crawford last podcast. Emotion was the component brought in by Dr. Greenspan that is so essential to development.

Experiencing the Body

This somatosensory system is a beautiful system for us to harness, Maude shares, to get a child to a place of “Where am I? Who am I?” and, “Where do I belong?” Working with adult autistics, Maude works a lot with vibrations and tactile massage, with rhythm in an enveloped touch circumstance (such as in a lycra swing), and working with rhythmical movement in that ‘simply feeling’ from the vestibular into the somatosensory, into the rhythm piece (i.e., just experiencing the body). These sessions tend to be very quiet because she’s not putting in that audio and visual that often takes over everything else, but just giving the experience of the body to the individual.

Maude says that if you take the autistic who is severely impacted by some of the symptomology that we can find associated with autism, she’ll see them often on the periphery of the room, looking with a sideways glance, and they often have low muscle tone, which increases the possibility of decreased registration of somatosensory information. Their sense of body is not really separated unless they put physical space in between them and a group. It’s about finding a way in, and the somatosensory system is a huge doorway in to those client profiles, Maude asserts, as it is with everyone else, too. We all have the desire to connect, but some of us can’t communicate that as easily.

I shared with Maude that this reminded me of my case study I presented when she taught my DIR/Floortime® Basic Certificate course. I presented myself doing Floortime with a little girl in a lycra swing where I was driving a little wooden choo choo train along her back and she was so calm, enjoying the sensations, asking for more. I commented that I didn’t know anything about all this somatosensory stuff at the time. Maude says to parents listening that you don’t need to know all of this. 

If you follow their lead, are queued in to what they’re giving you, and you’re queued in to following their interest, it’s a gift that keeps on giving because the child responds to what you are putting in to the Relationship. That’s why it’s so important to follow the child’s lead because they will tell you through their cues what they enjoy and want. The touch system is an intimate system. It’s a system that gives you a beautiful sense of being in this world, physically as well as emotionally, Maude concludes.

Thank you to Maude Le Roux for sharing her knowledge about the somatosensory system and its importance. I hope that you learned something valuable and will share it on Facebook or Twitter and feel free to share relevant experiences, questions, or comments in the Comments section below.

Until next time, here’s to choosing play and experiencing joy everyday!