TSBVI Coffee Hour: Exploring the Sense of Touch Ð 8-23-21 >>Kaycee: I'm happy to introduce today's presenters to you, Adam Graves and Sara Kitchen. >>Sara: Hi, everybody. I'm Sara Kitchen and I'm a visual impairment education consultant. >>Adam: And I'm Adam Graves and I am a Deafblind education consultant with the Texas Deafblind Project, when is here at the Texas School for the Blind and Visually Impaired. And we're going to talk to you a little bit today about touch. And I'm just going to -- before Sara starts going into all of our -- into the meat of our presentation here, I just want to give you a brief overview of this presentation and the subject that we'll be covering and how we're going to cover it. So, we're going to talking today about both the physiology of touch and the psychology of touch and what some of the teaching implications are based on what we've learned in some of the research that weÕve done. Sara and I -- this is a project that we have been working on for a little over a year where we wanted to explore some of the implications of touch and specifically looking at hand over hand versus hand under hand touch because we have a lot of materials that we, over the years, have provided to folks out in the field describing the advantages of using hand under hand touch when providing instruction to students as opposed to hand over hand. But a lot of those materials didn't have a tremendous amount of research into the neurology of touch and specifically touch of the hands. And so, we wanted to delve a little bit deeper into that. And so, this presentation today is going to start out with that deeper dive into the biology and the physiology of touch and then we'll talk about how that affects us psychologically. And so, Sara's going to start out with the physiology. >>Sara: So, we really looked at three systems of tactile input and that is basically we're looking at the channels through which we receive tactile information. And one of those is exteroception and we'll go into that a little bit in a bit and then we have interoception and proprioception. I was looking at this slide and thinking about what about movement? It's so important. I think I would include the kinesthetic sense or ability as a way to better access all of these three systems of tactile input. One person who I really admire, Anat Baniel says that movement is the language of the brain and I do think that, you know, we see people moving to get more information from their tactile senses to any of these senses and I think also movement contributes to all of the sensory channels and are experimentation and learning about how those work as we get better at being in our bodies. So the first thing I want to talk about is exteroception. Exteroception is when you get information from the world outside of you and, you know, that can be from things that are touching the body or people that are touching your body. Things like the air temperature or water temperature or when a breeze comes it blows on you. I've known a lot of kids who really love being outside because of all that input to their exteroception sense. It's craving a lot of input and not putting as much as they need. And then we also have interoception and that is perceiving and responding to tactile information that's inside the body. You know, what our bodies really want to do to feel okays to be in a balanced state, neither too much of this or too much of that and our interoseptive sense contains things we need to survive. If you're thirsty it signals that you need to drink water if you're too dry and it signals to you if you need to run to get away from a situation, the heart rate goes up and you feel the need to move. You know, that's where our sympathetic and parasympathetic nervous systems express themselves. So, the interoception system isn't just about physiological states it's also about how we feel, so feeling anxious, feeling sad, feeling happy. All those things are part of the interoceptive system. It tells you how you're doing inside your body physiologically and also emotionally. Proprioception is your kind of ability to figure out where you are in relation to your world outside yourself so I think of this kind of as a bridge between the introception and exteroception inputs. It can tell you where you are in space, how heavy things are, how hard you're pushing against something and, again, thatÕs highly related to movement as well. So that's all the stuff that helps you get information from the outside world, from the inside world. The next thing is what do you do with it next? You process it. So, information comes into the system and we process it and the two main sensory processing channels that Adam and I are looking at are the discriminative touch channel, I guess, and the affective touch channel. The reason why we really focused on these is because if we can understand how these interact with each other it will really help us if we're interacting with people who get information through the tactile sense, mainly, and all of our interactions with them and with objects with them. Teaching, basically, it will really help us better consider how we're approaching our teaching strategies with them. So, let's look closer at discriminative touch. Discriminative touch comes through basically your hands, mouth, and feet. It's your non-hairy skin and it's a different kind of skin. It has the ability to get finer detail than other parts of the skin. And this is when information comes in through the discriminative system it travels mainly tithe cortical regions of the brain. So that's the kind of part that we like to be able to access while we're learning and teaching. And things that we want to access like discrimination recognition, identifying, sorting, categorizing, all those building memory types of things that move from concrete to abstract are accessed through discriminative touch. >>Adam: Sara, would you describe that part of the brain as the executive function? >>Sara: Yeah. That part of our brains that we're really proud of as humans, that's bigger in us than in any mammals. All mammals, I think. And so that's the part that we really want to -- we want to access because that's really where we start to build the scaffolding for all future learning and that's based on the memories of our tactile experiences. And then we also have been looking at affective touch. Affective touch travels through the hairy skin, back of the legs, forearms, all of the body that I didn't mention before. And the neural pathway is more -- it goes to the brainstem and the midbrain and those are the parts of the brain that are very survival-oriented and emotion-oriented and they're very -- they're kind of, you know, on the hierarchy. They are going to be more important than the kinds of things that we need. You know, they're more immediate than things that we need for our discriminative for our executive-type functioning. That executive function, you know, if the affective touch is activated, then the discriminative touch takes a backseat. And there's definitely something that happens here that it doesn't have to be a huge response from a person. All it is that the person, if their affective touch system is activated, it takes away from the discriminative system. So, I've tried this with myself and others and it's very interesting. I was doing a presentation with one of my colleagues, Scott, and we were showing people, you know, hand over hand and hand under hand. I closed my eyes and offered him my hands to show the audience what those two things looked like. And I noticed that when he grabbed my forearm, activating my affective touch system as opposed to when he was underneath my discriminative system, not only was it impossible to notice what he was showing me under my hand when he was grabbing my arm -- even though this is a very trusted person. Somebody who I have known many years. I started thinking about where were the exits and my heart rate went up. And so, this is just a physiological response that is triggered by the affective touch system. It works with all people. Pretty much it's just a distraction. It's very, very distracting. That is something that we have to think about when we're touching somebody and activating the affective touch pathways. >>Adam: Can I just mention something real quick too, Sara, about this? >>Sara: Please. >>Adam: Some of you may have seen sort of a picture or a drawing or a figure which represents like the number of nerve endings in certain parts of your body compared to other parts. >>Sara: Oh, the -- >>Adam: Homonculus. I have used that between the hands, mouth, and feet as compared to the rest of the body and I think one of the things that's to keep in mind is when you see that you see that there's a lot more nerve endings in those discriminative areas of, you know, the hands, the feet, the mouth. But an overall surface area of your body you have more affective touch. Affective touch is represented on a greater actual area and parts of your body. So, while, you know, you might be getting more information from those areas where you have more discriminative receptors, it doesn't mean that you're not getting -- the areas that have affective touch are not capable of, you know, bypassing those discriminative areas when they're activated. >>Sara: Oh, right. Yes, the affective touch system is stronger, I think. Is that what you're saying, Adam? >>Adam: Yeah. >>Sara: It's a stronger response even though it's not as much of the body, it's a strong response because it's not refined. >>Adam: Right. And more parts of your body are devoted to receiving information through affective touch receptors. >>Sara: Right. And I think that's just your body, as far as the sensory system is involved -- is concerned. You know, there's one part of your brain that thinks, oh, I'm getting a lot of detail from these things and not much detail. But that doesn't mean that your midbrain -- your midbrain might think that your hairy skin is where it's at and your discriminative system is kind of boring. I don't really pay attention to that guy. >>Adam: Right. But it also speaks to the fact that the survival response is the primary response when given the choice between the two. >>Sara: It's like a reflex. >>Adam: Right. >>Sara: And it's kept us safe. >>Adam: Yes. >>Sara: And we all have it. And here we are talking about it. One of the things that is really important in learning is where is your attention when you're touching, when you're learning anything. Are you attending to the -- your environment, the things around you, the materials that you would like to learn from or are you tending to your environment in a way that you're perceiving as survival related? Whatever we attend to, we learn. So, if we practice going straight from being touched into a survival mode, those neural connections get faster and faster and faster. If we practice accessing information through our discriminative system, then those get faster. So, we really are what weÕre attending to. Where our attention goes is what we learn. This is a nice quote from Anat Baniel. It's something to think about. We always learn from what we experience -- that which is actually happening for us. This is different from learning from our experience. So, this learning from our experience might be what other people think we should be learning from what they are perceiving that we are experiencing. What we're actually learning is how it feels inside us to be doing whatever it is we're doing. Do you want to add anything, Adam? >>Adam: Oh, I was just going to say, yes, that we -- if we're in a position where we're focusing on survival, then what we're learning is merely how to survive. And if we can get out of that survival mode and focus on the -- and provide more attention on the parts of our bodies that are dedicated to exploring the world around us then we can go into learning mode and really start to build the memories and the scaffolding, as you were talking about, Sara, for a future concept building. >>Sara: Yeah, and I think that just, you know, for us, for those of us who are teaching tactile learners, the application of that is we have to be really careful what kind of system we're activating. Because do we want that person to leave us and to leave the activity at hand? Because they will, to some degree, be distracted. And maybe to a large degree. And for those who have practiced using that system that, you know, I'm easily, easily activated with my sympathetic nervous system, the one that goes into the fight or flight response or freeze. You know, some people have that already built in. They've practiced it a lot and so they can be easily activated and that affective system that triggers their survival. And that sends them way far away and triggers sometimes behavior and, you know, what we call behavior, you know, things that are there serving that person to get away from what is perceived as a threat. And we don't want to do that. We want the child to stay with us and we want them to be able to build learning. And so, we have to really think, you know, one of the basics is how are we touching this person. So, one of the things -- I think we talked about this a lot and I think we can -- when I say physiological and psychological homeostasis, we really want somebody to feel okay and not to be overriding their cortical processes. As long as somebody is feeling okay and not getting triggered, they can stick with it and trigger that executive function part of that brain and keep it going and not be distracted. So self-directed movement is required for human brains to form neural pathways. And this was studied in 2013. The study was called active [Indiscernible] >>Adam: Oh, no. We've frozen. Sara, you have frozen. Sara, you froze. >>Sara: Oh, am I still frozen? >>Adam: No, you're live now. >>Sara: What did I? >>Adam: You were giving the title of the study, so if you'll go back to that. It looks like Sara froze again. So, well, while we're working out the issues with Sara's Zoom, if one of our -- one of the tech folks, if you have the PowerPoint that you can bring up, maybe we can -- >>Yeah, let me go grab that for you really quick. >>Adam: Okay. >>Kaycee: It looks like Sara is coming back on. There she is. >>Sara: Sorry about that. I got kicked off. Let me share my screen. All right. Can you see the PowerPoint again? >>Adam: Yes. >>Sara: Now, where was I? >>Adam: We can also see all of your windows up at the top there. >>Sara: Okay. >>Adam: She froze again. I can pull up the PowerPoint here and see if we can get Sara to call in. >>Kaycee: That would be great. It looks like the study title is on the bottom here. Active perspective control is required for affective sensory motor learning is the name of the study that she was referring to. >>Adam: Yes, that's correct. And I will -- I'm going to wait just a little bit to see if Sara can get back on so that she can describe that study to you. Otherwise, if not, then I can try and do it. >>Sara: Okay. One more time. >>Kaycee: Hey, Sara, do you want to turn your video off and let David share? Maybe that will save your bandwidth and keep you with us? >>Sara: Okay. I'll turn my video off. Where's the video? Yeah, David, can you pull up the PowerPoint? Thank you. >>Is that the correct slide? >>Sara: Yes, I think so. So, we were talking about -- look how great your Internet works. We were talking about the study called active perspective control is required for affective sensory motor learning -- and that's a 2013 study. There's a reference to it in your handout so that you can look it up if you want to read it. It's super interesting. There were three groups of adults, typical adults -- I don't remember what their age ranges were. They were given a video game to learn how to play with a joy stick. And each group had initial, you know, opportunity to try and their results were recorded how well they did and such. And then one group had the opportunity to practice the video game and they controlled the movement of the joystick. Another group had an opportunity to practice the video game but the joystick was always moved for them. So, they never moved it on their own. And then the third group did not have the opportunity to practice playing the video game, other than that first time. So, they gave the first two groups multiple opportunities to practice by moving or not moving the joystick but by having their hand on it and witnessing the movement of the joystick. And then after they had a certain number of opportunities to learn, they came back and all three groups were -- their scores were recorded. And the first group, the one who had the opportunity to move the joystick and practice that way, they had improved. Their scores improved significantly. The second two groups performed exactly the same way. So those who did not move their own joystick performed exactly the same way as those who had not practiced at all. So, we really need to have self-directed movement. ItÕs very, very important. That is, you know, the difference between active and passive movement. When we're thinking about tactile learning, a person needs to be able to move their own body and be in charge of their own body, at least according to this study, which is something our students have been teaching this for a long time. Some of us we didn't need a study, necessarily, but it's nice to have one for backup. I think we're ready for the next slide. >>Adam: So, this slide, again, it sort of provides a brief little way of thinking about passive versus active movement. Passive is more just an awareness and a response to the stimuli in your environment. It's not -- you're not actually doing anything, you're just being -- your body is just taking in the information but not acting on it. And then active is that you're focusing your attention, you're initiating movement. You're initiating actions. You're experimenting, you're building understanding and memory and you're taking a more participatory approach in finding out what's going on around you. And the passive -- the passive system, the affective touch system is a passive system. You know, you don't really -- we don't act -- we don't act on objects or our environment with the parts of our body that are dedicated to taking in information through our affective system. The parts of our body that are dedicated to taking in messages and information from our discriminative system, our hands, mouth, and feet, those are parts of our body that are active and help us build attention. And so those are the areas of the body that we want to be able to focus on and we want individuals who rely on touch to build their conceptual frameworks. Those are the parts of the body that we want them to be using and we want them to be using them on their own. You know, we want them to be using them in a self-directed way, as the study pointed out that Sara referred to. And, you know, and so it's important to think about which of these neurological pathways we are reinforcing. And there's -- at our Deafblind symposium last year we had Dr. Judy Cameron come and talk to us about the different parts of the brain and, you know, the neurology of trauma and things like that and how pathways in the brain -- when we start out as young children -- when we're first born we have this massive just sort of neural network of neurons in our brain that everything is just connected to everything else . Every part of the brain is completely interconnected and it's just a mishmash of wires going everywhere. And as we learn and develop, we start reinforcing certain pathways, some of those neurons and those connections become stronger and they get strengthened. And as those pathways get strengthened, the other pathways that we don't use as much, they get pruned is the phrase that she used. And so, it's really important when we're thinking about using touch as a vehicle for learning, which pathways are we reinforcing and building and which are the ones that are getting pruned. And so, knowing that the affective -- the areas of the body that are responsible for affective touch those, you know, the back of your hands, your arms, your legs, you know, those hairy areas. Knowing that those areas are the areas that help us focus on our survival, you know, we want to make sure that whenever possible we're being mindful of that when we're using touch so that we're touching the students in a way that helps promote their active exploration. And, David, if we could go to the next slide. And all of these neural pathways are also helping to inform our social and emotional responses to the people around us and the people that we interact with. And so when we're thinking about how we're touching or how are we're using touch to teach, we want to think about, you know, not only the concepts that we want to teach or not only what it is that we want the students to explore, but we also need to be thinking about the social and emotional messages that we are sending to the person that we're touching but also the other people in the environment who might be observing the way that we are interacting with that person through touch. So social messages and relatedness and autonomy and competence are other things that we can reinforce through touch. So, we'll go to the next slide and talk a little bit more about that. So social messages and relatedness. You know, I included this quote that says who do the persons you seek to communicate with and engage perceive you as being? And that is a quote that is brought up in a book on doing social research and it's really asking the question, you know, about if you're doing research with someone, do they see you as being someone who is equal or do they see you as someone who is being above them or looking down on them or doing things to them as opposed to doing things with them? And I think that that is -- it's applicable in research but it's also I think very applicable in teaching because, you know, a lot of times we come from a place as teachers of having knowledge that we want to impart to others but we also know that learning takes place when the learners are active participants in the process of learning. And so, the way that this relates to learning through touch is that, you know, one of the things that Sara and I have been looking into and thinking about is the ways that our touch conveys messages to the people that we're working with about how we perceive them. Do we perceive them as somebody who is capable of being in control of their own learning? And that's a really important thing to consider when you're working with someone who relies on touch. >>Sara: I have a -- it made me think of something, Adam. >>Adam: Yeah. >>Sara: That you and I haven't really talked about very much lately. But, you know, I was thinking about when you're interacting with somebody through touch and, you know, you're allowing them to control their own body completely and not holding on to them or moving them through something. Your hands may be up or your hands maybe under but either way it's more like I'm inviting you. I trust you to tell me when you're ready and what you're ready to pay attention to. I know you know yourself and as opposed to holding on to another person and directing their movement. It kind of is like I am putting a demand on you and, you know, if we think about the people that we like to see and we like to interact with and that inspire us to want to do more, think about it. Is it the person who invites or is it the person who is always demanding something of us? I know that many people would, you know, various jobs -- not mine, I got lucky -- but lots of people when their boss is approaching theyÕre like, oh, no. Because the person is going to ask something of them and maybe they haven't had enough invitations in their relationship to look forward to seeing that person and say, oh, it's you. Nice to see you. Instead it's, oh, no. Here you come. I'm ready for you and I'm already shutting down. So that's, you know, that's part of that power dynamic that we may or may not be aware of. But everything that we communicate to a person non-verbally is also communicating to that interception system and whether or not we call it that it's still felt. It's an important thing to take into consideration. >>Adam: Yes. Also along with that is I would add to that as well is that, you know, if we're in a classroom of students who are, you know, the peers of the student that we're working with and they see us touching the peer in a way that doesn't allow the student who is using touch to get information to control that information, you know, we run the risk I think of sending a social message to their peers, that child's peers, that they are not capable of exploring the world on their own and that they are not equal to the task of performing the same sort of activities without some sort of guidance or direction. So that's something else to keep in mind too. IÕll talk a little bit more about that in the next slide, which is autonomy and competence. And so, I want to talk a little bit about self-determination and there's a website for the center for self-determination theory. This comes out of research that some of you may be familiar with from Jesse and Ryan where they talk about the three needs that every human being has in terms of competence. And that is competence, connection, and autonomy. And so, we all, as human beings, need to feel as though we are competent. We need to be connected to the people that we're with and we also need to feel as if we have autonomy and agency over our environment in order to feel grounded and, you know, like we're members of a society. And so, when we're looking at the way that we are working with the students and we're using touch, you know, and this gets directly to hand over hand versus hand under hand. If we are touching the students in a way that seems as though we are directing them and if it is perceived by the students internally as being directed, then we are actively inhibiting their capacity for feeling as though they have autonomy and agency over their environment and over their learning. And so, when we respect their capacity to explore and make decisions on their own by maybe not directing them quite so much, it helps them to develop a sense of self-assurance and related dance, not just to us but to all of the objects and everything that is around them in their classroom and their home. And also independence. One of the things that we talk about a lot in terms of working with students who have visual impairments and multiple impairments and who are Deafblind is we talk a lot about building independence. And I think one of the things that is really important to consider when we start talking about independence is how independent are they in their learning. And we can create an environment of independent learning through the way that we use touch when we are working with those students. And so just a couple of questions that I wanted to pose in relationship to this topic is do we want the students to feel as though they can act independently? And how does the way that we use touch with those students either promote or prohibit them from doing that? So those are just some things to think about when you're using touching your interactions with students. Next slide, please. I want to talk a little bit here about some of the teaching implications of the things that we've learned through this research and the first one is when you are using touch to convey information or as a learning media, you want to make sure that you touch the student carefully and with consideration for some of the things that we talked about in terms of whether or not you're promoting that independent exploration and that autonomy for those students. And also thinking about which systems of touch you might be activating when you're interacting with them and which systems of touch you want them to be using. >>Sara: Something occurs to me. You know, there are often students that we meet them and they've already had a number of experiences where they practiced finding something unpleasant about touch over and over again and their immediate response to somebody touching anywhere near their hands, especially, is just to pull away, you know, because for whatever reason they have found that to be an unpleasant thing. Whether or not it was because that activated a -- not a neurological, a physiological response or a certain kind of emotion or it could be that, you know, they've practiced going right to that brainstem or midbrain with the affective touch that they have generalized to all touch or just be like, no, I want to be in control and I know you're going to make me do something. I know what's going to happen but I don't want it to happen so I'm going to get away. That is a valid response that that person has to their environment and it's not personal. It's something that they have learned and the only way for them to unlearn that is for them to always have control of their own hands and body. I mean, of course barring a situation where there's rapidly whirring blades and don't let them stick their hand into the old-style fan. But other than an emergency, you know, that -- and understanding that this person needs to practice being in control of their hands even when somebody else is nearby. So, it may take a while for them to unlearn and feel comfortable and also feel safe with being with even you inviting them. It's not always going to work immediately. When you switch from hand over hand to hand under hand or when the child is in a different environment, that is switched from hand over hand to hand under hand. >>Adam: Yeah, and as you were talking I was thinking about how, you know, a lot of times we use the term tactile defensiveness or we hear the term tactile defensive and I think there was somebody -- I can't remember who it was but there was someone who was talking about that and saying that it's not so much -- tactile defensiveness is there fora reason. As you said, it's a valid response and so a better term might be tactile selectiveness. You know, that they're very selective in what it is that they choose to touch because of the experiences that they've had with touch in the past. >>Sara: Michael McClendon. >>Adam: Yeah, that's who it was. Exactly. And I really like that because I think especially after having, you know, learned about which parts of the brain are activated during certain types of touch, I think a child that is demonstrating what we would call tactile defensiveness, what they really are showing us is that they have really well-honed affective touch pathways that they've had a lot of practice in avoiding touch that is unpleasant, touch that makes them feel as though they are not capable of exploring on their own, and they are letting you know that by, you know, withdrawing. And so that's something that has really sort of come to the front of my mind as we've been talking about this and exploring this. And it goes back to the second point that we have here which is to use brain-friendly hand under hand assistance instead of hand over hand. That is really about, again, the control. You know, allowing the child to have control of their discriminative pathways in their brain by allowing them to have control of their hands. And building those pathways, reinforcing those discriminative pathways so they can learn how to problem solve through touch and tell the difference between different objects through touch and become more tactilely sensitive to different qualities of objects through touch because they have the ability to use more of their prefrontal cortex and less of their brainstem and midbrain. And hand under hand promotes that in a way that is better for that type of learning than hand over hand most of the time. And so that's why we use that term "brain-friendly." And also hand under hand allows you to follow the child's lead and acknowledge and promote their competence. It helps builds that sense of autonomy and agency and competence that is so important to learning and to building that sense of self and also it allows the other students who are around that student to view them as being more capable, more competent and puts them on a more equitable plain with their peers. >>Sara: Right. I would also add even if the student is not entirely a tactile learner or if the student doesn't have the capacity to move their body very well due to cerebral palsy, I would say the same thing applies because, remember, everybody responds to their affective touch in one way and their discriminative touch in another way. So, you can bring items close to the child and you can still encourage their movement through, you know, many different kinds of teaching strategies but it has to be self-directed to go to their brain. If we move them or just making it so they can't pay attention. >>Adam: Right. >>Sara: That was my little addition to that. I think we're out of time, Adam. I didn't see a question. Oh, we have one. How do you convince teams of experienced teachers that this is preferred? This is our new way of trying to convince. We talk about the science and just what is it that happens in the body and we're hoping that that can help us and help our TVIs to be able to explain better to others the same kinds of things that we're talking about today. >>Adam: Yes, and one of the things that we wanted to do, just to follow up on what you were saying, Sara, is that we have -- and maybe after we're done here I can share a list of more of the resources that we have. But we've compiled a list of resources that explain how touch is processed in the brain so that, you know, when you're trying toilet teachers know that this is a preferred way of teaching you have that scientific sort of basis to go from.