Features

The power of touch

18 September 2020

In a time of social distancing, children are missing out on some of the physical affection they need to keep their minds healthy, writes Helen Clark

As schools reopen, it is clear that Covid-19 will be here for the foreseeable future.

In July 2020, the All-Party Parliamentary Group (APPG) on a Fit and Healthy Childhood published Wellbeing and nurture: physical and emotional security in childhood, advocating to a nation adjusting to ‘social distancing’ that touch should be central to child health and welfare strategies.

The damage to children’s mental health because of social isolation and lockdown may be recurrent until a vaccine for Covid-19 is found, says the report. It argues that methods involving positive touch should become an established component of therapeutic working with children, embedded within training and continuous professional development (CPD).

The science 

The APPG report benefits from research by Professor Francis McGlone of Liverpool John Moores University.

From around 12 weeks’ gestation, the sense of touch develops in utero. As the foundation of social bonding and key to emotional communication, touch is pivotal in shaping major functions of the developing brain.

C-tactile-afferent nerves in the skin sub-serve a ‘social touch’ system and are tuned to respond to a ‘pleasant’ gentle stroking touch. Social touch shapes attachment, social reward, cognitive function, communications and emotional regulation from infancy throughout our lifespan. Its enforced lack, occasioned by social distancing, has produced reports of widespread stress, depression, loneliness and anxiety.

Strategies include story massage, in which gentle touch images are ‘drawn’ on an infant’s back while vocalising guided imagery

Professor McGlone says: ‘The nerve fibre fires up areas of the brain that connect to reward. There’s a release of oxytocin, a hormone that plays a fundamental role in our social behaviour. It has an effect on our dopamine levels … It impacts on the release of serotonin ... it has an impact on our stress system … When touch is removed, people will notice that there’s something missing even if they can’t pin down what it is. With the lack of social touch mandated by Covid-19, your brain may well be telling you that you desperately need a hug [Coffey, 2020].’

Early years care 

The sensory experience of ‘skin to skin’ is an important component of a close relationship and thriving infant (Norman, 2019). And baby and infant feeding is central to ideas of the ‘bodily-felt awareness’ (Brody, 1997).

‘Responsive’ feeding is a sensitive interaction between caregiver and infant during which the caregiver responds immediately and appropriately to an infant’s distress signals. Its proponents cite a role in preventing obesity with the emphasis on touch in response to crying rather than feeding in all circumstances.

Too frequently, feeding advice is given by those untrained in responsive feeding and touch-based soothing, and programmes do not encompass at-risk groups, low socioeconomic groups and bottle-feeding caregivers.

Maternal touch is an important means of communication during early social exchanges. A longitudinal UK Millennium Cohort Study of more than 8100 children concluded: ‘The more time mothers spend with their children the higher cognitive and non-cognitive outcomes over ages three to seven’ (Del Bono et al, 2016).

Fortifying the mother/child bond should be a prime objective; ideally, infants and young toddlers should have a great deal of physical contact with their mothers.

The beneficial effect of touch between parents and caregivers and early years children is increasingly recognised. Children’s reflex workshops teach feet and hand reflex for toddlers and babies to stimulate relaxation and bonding. Other strategies include ‘story massage’, in which gentle touch images are ‘drawn’ on an infant’s back while vocalising guided imagery. Safeguarding is essential and Play Therapy UK recommends compulsory therapist registration with a government-approved Professional Standards Authority accredited register.

School and counselling needs 

Educational consultant and trainer Jean Barlow studied experiences of lockdown in primary and secondary schools in Bolton. The children reported feelings of depression, fear, anxiety and emotional isolation.

Jean’s work with children and parents is underpinned by the United Nations’ Convention on the Rights of the Child.

Child-to-child peer massage is a short daily practice that aims to manage stress and improve communication. The benefits are many, says Jean: ‘Children’s behaviour becomes more positive towards each other and they begin to demonstrate greater cooperation, tolerance and good manners. Children play more appropriately and develop assertive language in protection of their wishes.’

The pandemic has seen counsellors using innovative strategies and non-touch skills to counterbalance the lack of physical touch.

These involve mirroring early bonding and attachment techniques – including eye contact, body movement and posture, gesture and facial expressions – alongside enthusiastic and emphatic voice tones to fully engage in their clients’ process. Kate Day, director of KRD Training, which also offers counselling and consultancy services, says: ‘Maintaining a few moments of eye contact shows your client or patient that you are engaged and listening. This is not only supportive but preventative longer term and helps practitioners to gain more in depth diagnostic perspectives.

‘For me, “touch” is replaced by a welcoming smile and showing my client who has just arrived how pleased I am to see them today – appreciating every individual for their differing stories or the psychological journeys they have taken to arrive in my room that day.’

What next? 

The APPG’s report recommendations include:  

  • Positive touch work to become part of the school curriculum, potentially within personal, social, health and economic education.  
  • The Department for Education to produce ‘best practice’ compendium of affective touch strategies for the classroom.  
  • Emotional health and wellbeing incorporated into initial training and CPD for all health/educational professionals involved in care, such as health visitors and school nurses, and advice to children and their parents/carers.  
  • Government to implement an emergency strategy to combat the adverse impact of the pandemic on the mental health of children and young people.

It is hoped that the report offers a holistic approach to child development, contributing to strong, united communities during the pandemic and beyond.  

Helen Clark is lead author for the APPG on a Fit and Healthy Childhood, a leading associate of Royal Public Affairs, and an assessor for the OCR Examination Board.


Resources  

  • The APPG report Wellbeing and nurture: physical and emotional security in childhood fhcappg.org.uk  
  • Infant and Toddler Forum supports families to make healthier nutritional choices and promotes good eating habits in early life, including responsive feeding infantandtoddlerforum.org  
  • Play Therapy UK has published a set of good practice competencies for therapists working with children playtherapy.org.uk  
  • Jean Barlow advises on affective touch strategies within schools and works with children, teachers and parents/carers achild2child.co.uk

References:

Brody V. (1997) The dialogue of touch: developmental play therapy. J Aronson: Maryland.

Coffey H. (2020) Affection deprivation: What happens to our bodies when we go without touch? Independent. See: independent.co.uk/life-style/touch-skin-hunger-hugs-coronavirus-lockdown-isolation-ctactile-afferent-nerve-a9501676.html (accessed 12 August 2020).

Del Bono E, Francesconi M, Kelly Y, Sacker A. (2016) Early maternal time investment and early child outcomes. The Economic Journal 126(596): F96-F135.

Norman A. (2019) From conception to two years: development, policy and practice. Routledge: London.

 

 

 

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