Dr. Jude Nicholas Speaks on Tactile-Bodily Working Memory (March 3, 2021)

Jude Nicholas

Today begins day 3 of the Texas Symposium on Deafblind Education. What follows are notes from Deanna Peterson and  Kate Hurst and are not quotes from the presenter.

Tactile working memory involves the bodily system and the sense of touch.

“Through touch, people can learn, communicate and connect with the world.”

Working memory allows us to hold information in mind without losing track of what we are doing – the brain’s sticky notes of what is happening in the moment.

Theoretical Framework

Children who are deafblind are at high risk in the processing of information. Their abilities will be fragmented or limited and they will require compensating strategies and an environment that allows them and us to make the best use of bodily tactile information.

There are two types of sensory system processes.

      • Unisensory system –  a single system such as vision or hearing working alone
      • Multisensory – integrated or transferred information from multiple senses, sensory information converge

Dribbling a basketball is an example of multisensory information that occurs synchronistically  (up-down motion we see visually, silence-sound alternation we hear, touch no-touch alternation as our hand makes contact with the ball).

Information is perceived and processed in ways which include both short-term, working, and long-term memory. Each type of memory  processes information  in different areas of the brain following a sequence of sensation, perception and cognition.  With tactile information we think of this as bodily-tactile processing units.

The pre-frontal cortex of the brain is  where the executive control of processing bodily-tactile information occurs. It is also where visual and auditory information is processed.

The tactile brain has huge potential for plasticity in the somatosensory cortex of individuals. In one study Dr. Nicholas mentioned  with individuals who only have one hand, the information normally processed by that hand could be distributed to the other body parts that share the same functional utility as the absent hand.

Tactile-Bodily Sensations

Somatosensory sensations are formed from several physical sensations receive from the skin, muscles, and  joints, and involve different type of receptors distributed throughout the body. These receptors respond to various input that includes:
      • Light touch vibration
      • Proprioception, pain
      • Temperature
      • Pleasant touch
      • Pressure
The receptors transfer this tactile  information to the tactile brain or somatosensory cortex with the exception of  pleasant touch, which  is processed in the insular cortex and is directly connected to  feelings and emotions. Information from these receptors go through the spinal cord through specialized receptors through dorsal column, the spinothalamic in a way that creates a sort of bodily map for the brain. This system is very sophisticated, but certain clinical conditions impact specific receptors (Parkinson’s, CHARGE- poor proprioception) So this means that with certain conditions, perhaps only certain sensations are affected.

Tactile-Bodily Perception

Tactile-bodily perception is the ability to use active touch and motion to gather information about an object, identify similarities and differences, use information to categorize, and also to locate objects or locations in the environment. Spatial Perception is tied to the dorsal or “where” stream. Tactile-Bodily cognition  refers to the  system organization and integration of tactile sensory perceptual information. Tactile Working Memory refers to the ability to use active touch and motion to hold in mind bodily tactile information and use it in the moment. Cognitive Working Memory refers to the ability to keeping things in mind and track task relevant information according to the needs of the moment.
      • Attention
      • Memory
      • Executive functions
      • Language processing

Social Working Memory

This refers to the ability to keep in mind what has occurred in the past and then integrate this social information in order to achieve a cohesive understanding of the present. Emotional perception is the ability to  perceive and recognize the emotional states of others. Social cognition is the ability to interpret the behavior of others  and their mental states. Each  of these functions has distinct brain networks, but the networks overlap.

Assessment Framework

The goals of the assessment framework are:
      • Recognizing environments or settings in which the individual will function on the optimal level
      • Focusing on the bidirectional and reciprocal exchanges between the person and social partner over time (transactional)
      • Integrating intervention into assessment and to support the individual to successfully perform (dynamic)

Tactile Working Memory Scale

The Tactile Working Memory Scale includes 20 items within 3 theoretically derived domains that measure the cognitive and social cognitive processes of tactile working memory during task/activities and social interactions:
      1. Encoding (detection and interpretation)
      2. Maintaining (temporarily retaining)
      3. Manipulating (actively controlling attention)

Here are several examples of Tactile Working Memory questions from the book:

Item: 3) Uses active touch and motion to identify
similarities or differences among objects

Behavioral Description: Tactile object identification:
(ventral stream function)
Domain: ENCODE

Item: 4)Uses active touch and motion in a
purposeful manner to recognize objects in
the vicinity
Behavioral Description: Tactile object recognition;
retaining task-relevant information
(ventral stream function)

Each item is scored as absent, emerging or present.

Dynamic assessment is a process that integrates intervention into assessment:  assess, intervene, reassess. We need to optimize and mediate effective learning strategies within the assessment.

Social Cognitive Strategies

      • Provide many opportunities for bodily-tactile interactions
      • Be reactive to the emotional needs and moods of person
      • Detect and follow the social attention of the person in a bodily-tactile manner (joint attention)
      • Stimulate

Tactile Perceptual Strategies

      • Optimize tactile exploration
      • Engage in shared exploration
      • Exploration that supports the person to gather information about id of objects, localization, spatial orientation

Tactile Cognitive Strategies

      • Narrative memory strategy
      • Association strategy
      • Chunking strategy
      • Tactile-spatial rehearsal strategy
      • Metacognitive conversation strategy

What follows are notes taken by Kate Hurst and Deanna Peterson and are not necessarily direct quotes of the panelists.

Panel With Dr. Nicholas

Paul Hart: This helps us to understand that people with deafblindness, whose primary access is touch,  can have rich cognitive process related to touch.

My question to Jude is: Why is the working memory is important for any of us?

Jude Nicholas: Working memory is linked with many cognitive processes. It is a critical element in cognition, language development, etc. We don’t know how one effects other (working memory and other development), but we know it is connected. We hope if we understand it better we can improve the intervention for supporting learning. A deafblind individual could use multisensory or unisensory modalities. This means we need to focus in on the person supporting the deafbblind person – what is it that we do? Bodily-Tactile cognition is poorly understood.

Heather Withrow: With tactile learning for individuals who are deafblind, we have to look at the science. I know that if these individuals don’t get it through touch it won’t get into their brain and they won’t be able to output it. If he (my son, Orion) never touches or experiences things he will not know about these things. I am fascinated with the body map of the brain. In my family we use tactile signing with  other adults, so trying to understand the differences between the adults and my young son is interesting. We sign into my son’s hands and we use hand-under-hand to explore. But thinking about body map and protactile … we have to take advantage of his whole body to get information in.

Jude Nicholas: Touch is a learning sense. For example,  wetness is a combination of information from many receptors related to temperature, pressure. We don’t have a receptor that identifies “wet”. Understanding more about this we can use this information to develop more and better intervention strategies.

David Wiley: This makes me think of how my eyes experiencing optical illusions. If I only use my vision I may think I am seeing one thing, but if I combine it with other sensory information like the sound of the water or of people swimming, I can be sure it is water and not something else I am looking at.

Jacqueline Izaguirre: It took me back to when my daughter was a child. So I am thinking, ” Instead of trying to protect them and say don’t touch, we need encourage then touching everything.” As a hearing-sighted person, I also need to become okay with being touched by a deafblind person. My daughter, when she was young, wanted to touch jewelry, hair, etc. but I wanted to stop that. It seemed inappropriate, but it is important for her to be able to do that. I am learning that a deafblind person needs and wants touch.

Jude Nicholas: Provide opportunities is so important. There is a social dilemma about appropriate touch, and it is difficult. When we say DON’T USE touch, we need to have ways to address social touch. We need to know a lot more about emotions, about the subtle emotional changes demonstrated through bodily-tactile sensory information. It is not just the cognitive aspects, but the social emotional aspects.

Robbie Blaha: It seems like as a practitioner when you go to meet a bodily-tactile modality user, there is that feeling of awe and the challenge about how do you ask permission and how do you organize information for them. Dr. Nicholas, you have filled a gap, but also validated much of our practice. To find out that there is an insular cortex – Excuse My Insular Cortex – this is very powerful. I also love your bodily-tactile strategies that we can fit it in to what we are all doing. That is a rehearsal strategy and that actually builds cognition.

Also, chunking strategy – We do that in a routine. I love this. It really helps re-commit to the strategies we have used. I think this type of validation is important in our field.

I love the quality of your product (Tactile Working Memory Scale). It can be used in teacher training programs. There are a 1000 wrong moves we can make with a bodily-tactile modality child if we don’t know this.

Jude Nicholas: That’s strategies that we use as sighted-hearing people – chunking 1st, 2nd , …. This should be practical information for the teachers and others to use. My colleagues (who helped write the book) have really helped connect the theory to the practical strategies to connect this complex information to practice.

Chris Montgomery: What a great thing for our field, to echo Robbie. One of my takeaways is the idea of touch…as sighted-hearing people we think of touch as our hands or maybe even just our fingertips, but it is our whole body that experiences tactile information. It is up to us to go further into touch as sighted-hearing people.

Heather Withrow: Active touch, if you really want to understand an object you really have to interact with the object. So with O&M we think about the knowledge of our body, where our head is, us in relation to the world around us, the location of things in the space around the body. I learned a lot of O&M from my son. He needs support for walking. He knows where the living room, kitchen, bathroom, etc. is. He will grab our hand and gesture at what he wants to show us. I follow his movement. When my son misses an opportunity to experience something, for example if he trails the  couch in the living room at the end he can turn right to get to a specific place in the house. If he is not trailing the couch he misses it and then realizes he wasn’t paying attention. Then he has to find himself. I feel that Tactile Working Memory is involved in that. Some people are using a cane and they lose the information, so they move their cane around to get more information around them.

Jude Nicholas: Yes exactly. It is learning to keep the information to get one step further. You use it at the time and you begin to remember it –Tactile Working Memory. It is a similar thing with a child with low vision – it is important to provide lots of opportunities to navigate in the world.

Jacqueline Izaguirre: Does age impact things or a progressive loss impact that? So with my daughter if I knew that  in the future she will lose her vision should I have focused more on tactile information earlier.

Jude Nicholas: The earlier you start the better it is. It is not an age-based issue; it is about having necessary strategies to handle the overload you meet in your daily life. So the model is strategy-based. The better strategies you have the better you can solve the problem.

Paul Hart: One of the most powerful things, it helps us understand… that if touch is your primary sensory contact with the world, it’s not about having vision or hearing.  It’s a positive thing because the brain is wired for touch and the world can be just as rich! There’s so much information about how emotions can be caught by the body.  If I haven’t seen my mom for a very long time, a hug can mean more than any words or signs.  Are Deafblind people better at reading emotions than any of us? We can hide our emotions from colleagues if we’ve had a bad morning….but our bodies might carry those emotions and convey the bad morning to the student.

Jude Nicholas: We as people with vision and/or hearing don’t use our tactile sense as much…but practice makes perfect!

Excuse My Insular CortexBe aware. It’s important to consider that your emotional state may be perceived by others – especially people whose primary mode of communication is tactile such people who are deafblind.

Comment from GroovyHil

Many repetitions helps stimulate your tactile memory.

Comment from Allana Pierce

Touch reveals so much more cognitive meaning – a HUG at the end of this pandemic will have so much more meaning than words! Great thought Dr. Paul Hart!

Comment from Canadian Deafblind Association British Columbia CDBA-BC