Many people live with what’s known as sensory over-reactivity or over-responsiveness. Those with this condition experience an over-reaction to sensory stimuli, such as touch. When overstimulated, the brain triggers a fight-or-flight response, which can lead to irritability, withdrawing from people, and temper tantrums.
Over time individuals can learn to manage this condition, but children often struggle. This can significantly affect their daily lives, from morning routines to school work and participation in sports. Although anyone can experience these challenges, they are particularly prevalent in children diagnosed with conditions such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders.
Clothing plays a role in worsening these sensory issues because it remains in constant contact with the skin, providing sensory input. While it is acknowledged in research literature and by practitioners like occupational therapists that items and elements like socks, shoes, seams and labels are major triggers, research in this area is limited. This is likely due to people underestimating the effects of these seemingly minor everyday elements.
It is important to study clothing items to pinpoint the triggers for sensory over-stimulation. These answers can assist in developing clothing that’s comfortable for every child. By combining the expertise of two distinct disciplines – clothing & textiles and occupational therapy – our multidisciplinary team has initiated a research project focused on exploring the diverse elements inherent in clothing and textiles and their relationship to sensory irritation.
Our study
The team’s first study focused on school uniforms. Occupational therapists, teachers and parents of children with sensory over-reactivity participated in four focus groups. These were virtual meetings, as we started collecting data during the COVID pandemic.
Sample packs of different seams and fabric swatches typically found in school uniforms were compiled and couriered to participants across South Africa to help prepare them for the discussions.
One of our findings was that the collar of a typical school shirt (a collar with a stand) causes irritation, especially if the top button is fastened and worn with a tie. The main reason for this is that they feel restricted and that the clothes are in very close contact with the skin. Parents also mentioned that children often preferred second-hand school uniforms, which they experienced as softer and more tolerable than new items. Pilling – balls of fluff that form on the surface of textiles – can be very intolerable. However, it can easily be removed with a bobble-off device; these are sold at most pharmacies. In all cases, among the participants, labels were removed or completely unpicked from garments.
Apart from providing rich data about clothing and textiles, the study revealed the effect of the clothing on the participation of a child in their daily activities (such as education).
One participant said of her child:
When she was in class, with her uniform on, she was very distracted, because she constantly stood up and had to sort out her clothes and sit down again.
It was also highlighted that children are often misunderstood or wrongly labelled as disobedient when, in reality, the issue could be as simple as discomfort caused by the school uniform. One parent said of their child:
Teachers had tagged or labelled him as disruptive or, as the one teacher even wrote on the board, that this child is ill-mannered.
Through our research it became apparent that this issue extended beyond the child to affect parents, caregivers and siblings. Many parents expressed feelings of guilt, fear and constant uncertainty. An everyday task, such as dressing their child in the morning, could badly disrupt family life.
Simple interventions help
The good news is that simple interventions can make a substantial, positive difference. Awareness of these realities should be highlighted and interventions should focus on improving outcomes not just for the child but for their entire family.
Teachers should be trained to manage sensory over-reactivity in the classroom. They should understand the importance of allowing exceptions in clothing rules for children who experience difficulties in tolerating existing uniforms.
School management should consider modifying school uniform policies to meet everyone’s needs.
Clothing retailers also have a crucial role to play by sensitising designers, developers and buyers to prioritise comfort.
More comfortable clothing would not disadvantage anyone – in fact it could benefit everyone.
More to come
Currently our research team is focusing on underwear and socks, since these are big culprits of sensory irritation. We are also conducting a separate analysis on the tactile properties of various textiles used in children’s wear. In future we would also like to look at sportswear and how clothing might affect participation.
The school uniform study was co-authored by Masters student Wenette Jordaan and Leoné Gouws, also a Masters student, is a co-author of the underwear study.