Haptic perception and the psychosocial functioning of preterm, low birth weight infants

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Abstract

Infants born prematurely are often deprived of normative haptic experiences in utero and during their first few months of life. However, the neural mechanisms and pathways associated with haptic perceptions are the first to develop and the most mature of the sensory systems available to the premature infant at birth. As a result, haptic experience may be particularly salient to these infants and influence their psychosocial development in unique ways. Research to date suggests that the preterm, low birth weight infant's exposure to stimulating touch in the early months of life may improve neuropsychological outcomes and exposure to complex touch has been linked to greater adaptive self sufficiency at age two. Affective touch involving pleasurable, comforting sensations has been associated with fewer emotional and behavioral problems for these children and with greater security of attachment, but only for more robust preterm children. Harsh touch causing pain or distress is linked to more emotional and behavioral problems as well as to less adaptive, self-sufficient behavior. Frequent or supplemental touch has been related to better neuropsychological development, both mental and psychomotor abilities. However, frequent touch also predicts increased behavioral and emotional problems for preterm children, especially for children who are more fragile in their early months. Studies suggest that the infant's degree of tactile vulnerability may interact with actual haptic experience to influence resulting perceptions of touch. These differential haptic perceptions predict psychosocial outcomes and whether various dimensions of touch facilitate or inhibit the preterm infants’ psychosocial functioning. Haptic perceptions also influence and interact with other sensory perceptions to influence infant outcomes.

Section snippets

The role and nature of haptic perceptions

The haptic perceptions to which a preterm infant is exposed may influence substantially his/her resulting neural foundations. Receptors and neural pathways associated with haptic perceptions are the first to develop in utero and the most mature of the sensory systems at birth (Kandel, Schwartz, & Jessel, 2000). As a result, the infant's haptic system is presumed to better use early experience than can other systems such as vision or hearing. This proposition does not negate the importance of

Stimulating touch

Stimulating touch involves properties of strong intensity, proprioceptive stimulation (i.e., actions eliciting vigorous movement of joints, tissue and muscle rather than movement at the skin surface only), and contact with areas of the infant's body having many nerve endings and pathways (such as the face and hands). Somatosensory cortical cells and thalamic cells show differential firing patterns and responsiveness based on (1) the velocity and force or intensity of the touch, (2) the degree

The quantitative dimension of haptic experience

In addition to the qualitative dimensions of haptic experience (i.e., its stimulating, complex and affective qualities), the amount or quantity of touch also influences haptic perception. The amount of touch is reflected in its properties of frequency and duration. Although these two properties are clearly different, they are rarely separated in studies of touch and have not been carefully examined for their distinct relationships to the preterm infant's psychosocial development. Instead,

The importance of differential haptic experience

The outcomes of research to date emphasize the need to distinguish between various dimensions of haptic experience and the differential perceptions they make available to the premature infant. Research examining the effects of touch typically treats it as if all tactile experience exposes infants to similar haptic perceptions, without taking into account the differential nature of the properties or qualities of touch to which preterm infants are exposed. Because of this tendency, most studies

Conclusions

The research presented throughout this paper makes a strong case for the potential value of therapeutic interventions that provide targeted, enriched haptic experience for preterm infants, experience that may serve as a foundation for later psychosocial functioning. However, the success of such interventions will depend upon a better understanding of how various haptic dimensions are perceived. For instance, it will be essential to examine the ways in which the infant's sensitivity, reactivity,

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