OT Kathryn Hamlin-Pacheco on Tactile Defensiveness & the Nervous System

Debbie:
Hey, Kathryn welcome to the podcast.

Kathryn Hamlin-Pacheco:
Hey, thank you so much. Thank you for having me. I’m excited to be here.

Debbie:
Yeah, I’m looking forward to getting into what we’re going to be discussing today because it is, you know, we were just saying before I hit record, it’s a fresh topic for the show, which is, you know, after almost 500 episodes, that’s saying something. And it’s a topic that I know is going to really resonate with so many listeners. And I’m super curious too, because we’re going to be talking about something that has impacted my life. And now I feel like I’m talking around the issue. But before we get into it,

Kathryn Hamlin-Pacheco:
Yeah.

Debbie:
Take a few minutes and introduce yourself and tell us kind of about your work in the world and your why for what you do.

Kathryn Hamlin-Pacheco:
Absolutely. My name is Kathryn Hamlin Pacheco. I am an occupational therapist. I should say I am privileged to be an occupational therapist. It is the most fun job. I am also an autism spectrum disorder clinical specialist, which I just very privileged to hold because I get to work with my favorite people every day as I go into work and it’s quite an honor. I really work a lot with neuroscience. I love neuroscience. I think it’s we’re at this place that we’re being we’re able to understand differences and strengths and challenges through a neuroscience perspective and it’s really helping us appreciate each other and support each other and I find that the neuroscience is very intense. And so I spend a lot of time kind of looking through the neuroscience, learning about it. But before becoming an occupational therapist, I was a teacher. And so I still, I think, have this love of teaching. And so I’ve come to think of myself as a translator of neuroscience. I try to take the neuroscience that applies to whatever work I’m doing and translate it into everyday life for kids, for parents, for caregivers, for clinicians. So that’s kind of where I am and I hope to be able to do some of that today. And I also have to start this by saying that, you know, I think the work that you’re doing here on this podcast and with your program is so important because like we were just saying before we hit record, the language has shifted so much in a positive direction. And I think that we’re supporting each other better. We’re understanding each other better and we’re moving past that acceptance to more of an appreciation. And I think that the work that you’ve done with this platform has just supported that shift so much. It’s truly an honor to be here in this conversation.

Debbie:
That’s so nice. Thank you. Thank you. I love that lens. And yeah, I just shared recently with my community the TEDx talk that I did in Berlin, which was specifically about this idea that the neuroscience is moving so quickly, right? And our language is trying to play catch upa nd then people’s awareness and compassion and kind of integrating this kind of new lens is also lagging behind. So it is a very dynamic time in the neurodivergent space and it’s really exciting to see. So, yeah.

Kathryn Hamlin-Pacheco:
Yes, yes, in the growth that’s happening. It’s a good spot.

Debbie:
Yeah, I agree. So OK, now that I’ve buried the lede let’s talk about the topic for today’s show. So you reached out to me over email and suggested a conversation on clothing, sensory, kids getting dressed, and specifically tactile defensiveness, which is something that I learned about when my kiddo was five. Yeah, must have been five. That’s when we started OT back in Seattle doing DIR floor time. And that was a whole new world for me. So we’re going to dive into tactile defensiveness today. And clothing will go into that experience because that does impact so many listeners. So let’s start with the baseline definition. What is tactile defensiveness? How do you explain that to people?

Kathryn Hamlin-Pacheco:
Yes, and you know, there’s so many terms. The terminology with sensory integration and processing has kind of a history of being a bit confusing and overlapping, but that tactile defensiveness is one of the terms that I really appreciate because what I hope to share today is that for someone who is tactile defensive, so tactile is our sense of touch. How we determine that something is touching our skin and how we understand what’s touching our skin. So that’s the tactile part. And what we’re gonna see is that that defensive part is so important. So tactile defensiveness is when we see a child or a person kind of have a defensive response toward kind of everyday sensations of things that are touching their skin. So when we’re talking about that, you know, clothing is something that’s so, we all get dressed every day. And so that tactile defensiveness means that for this individual, the feelings that they’re getting from their skin contacting the clothing might send them into a state of defensiveness.

People may have also heard of sensory over responsive. That’s a term that we’ve been using for a while and is used a lot in the literature. I am very, very careful to spell out when we’re talking about sensory over responsiveness. We are not saying that the child or the individual is over responsive because that is kind of this negative feel. What we’re saying is that their nervous system seems to over respond and that affects them. And then some people might have heard of heightened defensiveness. We’re kind of in this period where we’re shifting from sensory over responsive to sensory heightened responsivity to have a term that may be a bit more respectful for some. But we’re talking about kids or individuals. I work a lot with kids. So I’m going to say, no matter how hard I try, I will say kids in this interview. But individuals who that feeling that they’re getting from their clothing is setting off a defensive response.

Debbie:
That was such a good explanation. So thank you for breaking that down. Of course, as you’re describing that, I am thinking of just the terms that you shared, there’s a lot to unpack there. I had Carol Kranowitz, is kind of, I think, of the godmother of all things, sensory processing differences, who wrote The Out of Sync Child. And recently, that’s been updated. But when she came to visit my community, she had shifted and now is talking about sensory processing differences and was very clear about using that language rather than sensory processing disorder. But even as you talk about the over responsiveness, and I even wonder if that word defensive, it’s so fascinating how we can continue to kind of break things down.

Kathryn Hamlin-Pacheco:
Yes, and I hope to really pinpoint that this is truly a nervous system response. So one thing that I think as an OT who works a lot in sensory integration, I love how much it’s talked about. It’s almost become popular for lack of a better term. And there’s so many benefits because we’re so much more aware, but I do think kind of that growth in popularity has run out ahead of some of the science. So I think it’s important to think about when we’re talking about sensation, and if we’re being specific to clothing, there’s two big sensations I’d like to talk about. First is tactile, and then we can get to the other one. But if you think about your sense of touch, if I’m thinking about how my sleeve feels on my arm or my pants feel on my legs, the fabric contacts my skin, which initiates a signal which ultimately goes to my brain. So we are talking, you know, this is neuroscience. And I think that’s a really important dynamic that often people may miss, but this is really a whole internal nervous system response, an organization of the information that we’re getting from our senses.

Debbie:
Yeah, I was just thinking about the fact that, again, back in the day now, so this would have been maybe 15 years ago that I was really exploring this, sensory processing differences were not really even legitimized in a lot of conversations. It was just like, that’s just some woo-woo thing over there in the corner. It’s not a real thing. So has that changed?

Kathryn Hamlin-Pacheco:
You know, I think yes. And also I have to say personally, so I was a teacher before becoming an OT and I went to Virginia Commonwealth University, which has had some real heavy hitters in the sensory integrative world. And even going to VCU and even going through the program with such phenomenal faculty who knew so much about sensory integrative practice, I wasn’t sure if I really believed in it, even at that point. I was like, oh, I don’t know. And it just didn’t feel so concrete to me. But as often happens when we take our first job, it’s kind of what you get. My first job was in an SI clinic. And I thought, well, I’ll learn a little and move on. And I’ve never moved on because it is so powerful. It’s life changing. And I think there’s this part two where not everyone has sensory processing challenges that interfere with their everyday life. And when we talk about that sensory processing dysfunction, what I think we were trying to say is that those sensory processing abilities don’t function within this person’s everyday life. It’s not the person that’s dysfunctional, but those skills don’t support success in everyday life. But when we can reorganize how their brains and nervous systems understand these sensations, then we have this person who is so much more successful because life is full of sensation. And so, yes, I think it’s changed so much because we see how powerful it is. And so that’s just been really exciting.

Debbie:
OK, so let’s talk about then, you said we know so much more about neuroscience and that that’s a special interest of yours in terms of really figuring out what’s going on. So could you really explain to us what is happening and tie in Polyvagal? Because again, that’s also something that really wasn’t available to us in the same way as it is today. So what is happening within a human, a child’s nervous system when they are having experiencing this distress?

Kathryn Hamlin-Pacheco:
Yes, and to do that, if I can, I’m gonna back up a little bit and can we introduce the two, really the two senses that I think are the key players. Okay, so first is our tactile sensory system. That’s just like we said, that sense of touch. So what’s touching our skin and all of that information is going to go up to our brain. And I think that one’s really obvious when we talk about dressing because we’re talking about that clothing that’s touching our skin. The other piece though that I think is so important is our interoceptive sense. So interoception is kind of the newer kid on the block, if you will, if you’ve been thinking and talking about sensory processing integration. But what interoception is, is a sense that tells us about kind of how we are. A lot of it is thinking about that internal sense. So it does some basic things, like if I feel hungry, we have interoceptors internally that say, I’m feeling hungry. I need to eat. Or if I need to relieve maybe my bladder, it’s detectors on the inside of us that says, well, my bladder’s full. I need to do something about that. But then it also says things like, I don’t feel good. Like if you are getting sick, the day before you’re getting sick, I just don’t feel good today. Well, we have receptors inside of us that tell us about how we’re feeling. Or if we say like, I feel really upset and we have that internal distress, well, what’s happening inside of us is that interoception, we’re feeling it. And of course we can talk about the positives. I feel really good. I feel calm. I feel connected.

So the tactile system and the interoceptive system work really closely together. And for kind of a basic example of that is, if it is a Sunday morning and I woke up early and I’m going to read and I have on my softest pajamas and I get my heavy weighted soft fuzzy blanket, that’s all soft fabric that I’m gonna get information from my tactile system. Maybe I get a warm cup of tea and that warmth is from my tactile system. All of that tactile information is going up into my brain, but also those feelings of goodness, those are really connected with those sensations that I’m getting from that heavy blanket, from the soft fabric. Then if I’m sitting reading and I feel something crawling up my back, if I feel something on my skin on my back, that’s tactile sensory information, something’s touching me and what happens? I’m all of a sudden very alert, I’m jumping up, I’m brushing whatever it might be off. I’m in a heightened state of arousal. And so now internally, I do not feel good. I feel very distressed because of what I felt on my skin. And I think that those are good ways to explain how our tactile systems and our interoceptive systems work so closely together. Does that make sense?

Debbie:
Yeah, absolutely. I love the way you’re explaining this.

Kathryn Hamlin-Pacheco:
So then if we’re talking about dressing, we think about the clothing. And if we want to just go ahead and jump into that tactile defensive individual, for someone who the sensation of their clothing is uncomfortable, is it to the point of distress where they’re getting those internal feelings of, I am not well? Tactile system is coming in together with their interoceptive system. And I think then we can layer on experience if we really want to nerd out on the neuroscience. So first, you know, it might start with the sensation I get from my clothing is feeling in a way my brain does not understand. Our nervous systems want to understand things, because once I understand it, okay, it’s okay. So if the nervous system isn’t able to understand, process, integrate—use all of these words—the information coming from our skin, if it doesn’t make sense, it’s going to be alerting.

Then our nervous system can say, okay, maybe it’s after the holidays. I ate too many cookies. My pants, they’re kind of bothering me the way that they fit. They’re a little tight. But I can kind of say, okay, it’s not comfortable, but I’m okay and I can keep doing what I need to do in everyday life and feel good. If that feeling is so uncomfortable that I start to get distressed, then we start to talk about those internal systems of distress. And once we’re distressed, things feel worse and worse and worse. And I wanna jump into that polyvagal lens, but even before then, if we think about, and I work in pediatrics, so forgive me, but if we use some of those examples with kids, then we get a child who’s uncomfortable in their clothing, so then they don’t want to get dressed because they have a history of clothing doesn’t feel good. So then at seven in the morning, I don’t want to get dressed. And then what might that look like? Are those defensive behaviors? Like I might yell, I might fuss, I might tantrum, I might kick or hide. I’m just trying to protect myself. 

But to a parent who’s trying to get out the door to go to work and go to school, you know, we’re all busy. If that looks like a tantrum, then what happens? If then the parent is busy and says, you know, get dressed, just get dressed, and then it’s more stressful, then we’re co-escalating, right, instead of co-regulating. And then that has a negative memory. And so then we go on and on and layer these negative experiences associated with dressing. And what we get is this really strong model in the brain that says clothing is not good. It doesn’t feel good. It’s not good to get dressed. And then the brain expects it to not be good. And so we kind of get this whole model in the brain that clothing doesn’t feel good, it’s not good, and I’m upset. And so it kind of snowballs. Is that kind of a fair explanation?

Debbie:
Yeah, I hadn’t thought of it that way in that over time, these negative associations that extend beyond just the physical sensation, depending on how they’re responded to by their parents or by others around them who aren’t recognizing the connection between the clothing and their response, how it could reinforce that. I hadn’t thought of it that way before. That’s super interesting.

Kathryn Hamlin-Pacheco:
Right. And we’re always learning about sensations. That’s kind of that principle. And I have to say, again, you know, this is not pinpointing anything that a parent may be doing wrong because we’re trying to understand and we can only understand what has been explained to us. But I think that that can end up as this big negative. And then if we bring in the polyvagal theory, that’s transformed what we do. I don’t think we have time to go all the way into that, but I think you’ve got some other interviews that people can go back and explore. But from that lens, we have our neuroceptive sense. So Dr. Porges has developed that term. Neuroception says our nervous system below the level of consciousness is always monitoring and asking, am I safe or am I not? If I’m safe, I can be connected and engaged. I can feel well. If I’m not safe, I initially get that sympathetic nervous system response, which means you mobilize and defend. So this most people I think are familiar with as fight or flight.

So if my nervous system says something’s not safe, I go into a fight or flight response. Again, does this look like the child who’s tantruming, who might kick or run or scream or yell when it’s time to get dressed, or maybe when they’ve been wearing clothing all day and they’re tired from those sensations. They don’t feel safe in those pieces of clothing that they’re wearing. And then also can it escalate into that shutdown? So when a threat is so much that that fight or flight response doesn’t work, eventually we may get to a point where we just shut down. We kind of give up. So then we think about this child in clothing through that lens, then we can go beyond just trying to think about how do we change the clothing. That’s where we get the tagless clothing, the seamless clothing, all of those supports which certainly have a place. But also we need to reconstruct this child’s understanding of that tactile sensation that they’re getting and the feelings, those emotional based feelings and responses from the clothing. And that I think is where we see the big response. And that’s why I love understanding it this way. Cause only once we understand that, then can we say, now I know how to support this kid or individual.

Debbie:
So I want to get more into what you just kind of teased before the break of where the real power is here in helping our kids reorganize their brain and kind of navigate this in a way that’s not just, for lack of a better word, putting a bandaid on by changing the clothes. But I do want to, if you don’t mind, just in case listeners aren’t, this might be a new concept for them. And here’s my little sidebar to this conversation. You know, with my own kiddo, I did not know that this was an issue at all. And it was through OT that that tactile defensiveness, you know, the OT we were working with brought it up. And I was like, oh, so interesting. And she showed in the context of shaving cream, for example, and then it was like, yeah, actually, you know, mud and having stuff on my kid’s hands was really distressing. And I started to put it together, but I hadn’t even, I wasn’t plugged into the clothing experience. So could you just give a couple examples of the types of things that you’ve seen, the types of like clothing experiences that, you mentioned a tag, but that could be distressing just so listeners have those examples.

Kathryn Hamlin-Pacheco:
Yes. Yes, and thank you for asking that because sometimes when you do it every day, you kind of jump over those pieces. I have seen, can I just give some examples about what I’ve seen in practice and then we can continue to clarify. So I’ve had kids come in who may have two outfits that they can wear and feel good in. So these kids might be wearing the same outfit to school every day. You know, the parents that trying to bring them shopping, try different fabrics, nothing feels good, it’s only these two. It might be flip-flops and a t-shirt, but they might live in New York in the winter. I’ve had kids who want to go see Christmas lights with their family, but it’s really cold and they can’t wear, they just couldn’t put on the warm coat, the warm shoes. So they couldn’t go with their family to see that holiday light experience. I’ve had parents who are washing clothes every night but also they’re worried about, you know, what are my child’s peers gonna start thinking if they’re wearing the same clothes day after day. I’ve had parents who I say, ooh, you must be doing a lot of laundry and washing the same outfit every night. And they say, no, my child’s so sensitive that after I wash it, the clothing feels different. So they have a meltdown if I wash it. So now I can’t, they wear the same thing every night and I don’t wash that. I’ve had kids who want to do extracurriculars, dancing, soccer, performance like plays, musicals, but can’t wear the uniform or costume. So they can’t do those things. And we know once we start talking about peer interactions, extracurriculars, we’re talking about holistic wellbeing and development. I’ve had kids who can’t go to sleepovers because for them to sleep, they can’t sleep with clothes on. When you’re 12, you can’t go to a sleepover and sleep naked. And the parents are saying, I don’t understand, I don’t know how to support. So those are kind of the kids that I started seeing. And I thought this was so interesting that honestly, that’s what made me really jump into the science. That’s what made me say, wow, something is going on here.

Debbie:
That was super helpful. And I’ll add one more that I’ve seen is just needing really tight clothing, right? Like needing to be just almost vacuum sealed in clothes can be very comforting, right?

Kathryn Hamlin-Pacheco:
Yes, yeah. Right, trying to find that comfort. And that’s another reason why I really love Dr. Porges Polyvagal Theory is because he says that it helps us re-conceptualize some of those behaviors and responses that we would have said, you know, that’s maladaptive. Those are tantrums. That’s negative behaviors. When we see that this child’s in fight or flight, we see that those are actually valiant attempts to understand what’s going on and keep going. And clothing is hard because we almost every day have to get dressed at some point. And that’s one of the things that I think makes this so complicated.

Debbie:
So let’s pivot then and spend some time talking about how parents and caregivers can support their kids. What are some of the best practices and how do you work with families?

Kathryn Hamlin-Pacheco:
Yes, what can we do? And I think all of that understanding just leads up to that. So the first thing that I encourage families to do is just to understand it on this level, whether you find an OT, whether you find your resources to really understand what’s happening on that nervous system level. And then I think probably one of the most effective ways we can support is through that co-regulation, that felt safety with a polyvagal lens. So I understand, you know, dressing is hard for you. I am here with you. I’m going to lower my voice, slow down my movements, give a positive affect. And that can be hard. And again, I want to give a shout out to the parents, when we’re on our way to work and to school and we’re busy and we have two other kids and everybody’s upset, it’s not easy to slow down and connect here with a child who’s struggling with this. But I think it’s really interesting to compare contrast like co-escalating versus co-regulating. So I might have to wake up a little bit early. I might have to find a quiet room to get dressed. I might have to take this slow. I might have to practice in the afternoons. So kind of trying to find that place where we have felt safety with dressing. The other thing that I might need to do is control some of those other elements. So if it’s a child who has difficulty dressing, you know, I might need to not have all the music on. I might need to find a place where the siblings aren’t there for a moment. And we might need to practice this. So I encourage families to find times where you don’t have to get the clothes on to get out the door to practice wearing clothing. You know, do it on a Saturday, do it in the afternoon.

Because what I really wanna get to, and I talk so much about play, can we play with the clothing? Can we wear it in a meaningful way? Because the brain wants to understand it, and we almost just need to give it an opportunity to. And here’s kind of the last heavy hitting neuroscience I’ll offer. And then we’ll say like, that’s enough for one podcast. But if we think about, I think people are really familiar with kind of that triune brain model where we have the lower level reptilian brain, then we have the emotional brain, and then we have that higher level thinking brain. And we used to think that those were a strict hierarchy, like the bottom reptilian brain basic had to work to the emotional, to enable the higher level thinking. And that is not exactly, it’s not fully a hierarchy, how about that? But they are interconnected. So if you’ll think about it this way, that autonomic nervous system, that felt safety response from that polyvagal lens lives in that lower level brain. It’s underneath conscious, that felt safety is a very basic kind of neural process. When we feel safe, then we can experience our emotions differently or in a more informed way. We can really experience them and then we can use that higher level thinking. It does build as kind of the foundation of a house to the walls, to the roof.

Now here’s where when I got to this, this blew my mind and it still does every single time I say this. Primary somatosensory cortex, the primary part in your brain that is going to process, understand, interpret your tactile, the touch information that you’re getting, that lives in your cortex, which is your higher level brain. So if I have a child that clothing causes a fight or flight response in the lower level brain, what I know is that their higher level brain where that tactile information needs to get for the brain to understand it, it’s not working very well. It almost kind of stops at a lower level, if you will. When I start to support felt safety regulation, we’re connecting, when I can support those more positive emotions, I give the green light to their higher level cortex. And that’s where that tactile information needs to get for the brain to figure out what that sensation from the clothing means, to understand it. And once it understands it, it can use it and integrate it into everyday life. Did that, does that make sense?

Debbie:
Yeah, I have a follow up question. So my follow up question is, just to clarify, you’re saying that when you can regulate and connect with a child while they are playing with or experiencing a tactile sensation that may, in another circumstance, push them into fight or flight, but you’re creating positive associations with it by connecting and co-regulating and that’s how the brain gets rewired. Did I get that right?

Kathryn Hamlin-Pacheco:
Yes, yes, exactly. To me, once we’re in fight or flight, that tactile information gets kind of stuck at the lower levels. Not that it doesn’t travel all the way up to the cortex, not that it’s not there at all, but not in a way that the brain can really work to understand it. So through co-regulation, through understanding how to support this child’s positive emotions, being able to be there and be present, it’s almost like the feeling they get from their clothing reaches the part of the brain that can understand it for the first time. And once we understand it, this child may always have sensory preferences. Everyone has sensory preferences. I can say I will not wear anything wool. It bothers me. It is itchy. I refuse to wear wool. But I can also live a life that feels good to me and is successful, and I can do everything I need and want to do without wearing wool. That’s a preference that’s pretty functional. So not that these kids may not always have strong preferences, but can they then do the things that are meaningful, that they want to do, that they need to do? That’s the goal here. The goal is the child. Does that make sense?

Debbie:
Yeah, yeah, one hundred percent. So what I’m hoping you can do is walk us through an example of what this looks like, even this kind of co-regulation or connection with a child, just so we can envision how you actually do this work, because parents might explore doing this with their own child as well.

Kathryn Hamlin-Pacheco:
Yes, absolutely. This is so individualized, but we can still give a cohesive example to put all the information together. So if I have a child who comes in and has those characteristics of tactile defensiveness, the first thing that I do is work to connect with the child. That’s that co-regulation connection and finding what feels good to them. When I talk about co-regulation from a polyvagal lens, when I go into the room, I’m going to sit on the floor, make myself small to connect, even if it’s a teenager, because I don’t want to be this adult coming in over top of them. I slow down. I soften my voice. I soften my face. I soften my body. This is all polyvagal theory. I offer a space to connect.

The other thing I do is use sensory information to help calm, regulate, and engage. Slow, rhythmic, predictable sensory input can help. I really spend time figuring out how this child regulates, because first I need to know how you regulate so I can support you. Then we introduce clothing, and I do it in a very play-based model. With older kids, we adjust so it feels developmentally appropriate. We may dance with clothing. We may try on clothing. We may put on mom’s clothing. We may dress mom. We may dress dad. We may dress mom with dad’s clothing. We engage in playful interaction because by definition, play means you’re engaged and connected, and when you’re engaged and connected, the brain is ready to learn. It’s a dance with how much the child can do. For some kids, just seeing a shirt without intense distress is a win. Maybe next time they put it on.

In some ways it’s similar to feeding approaches where you play with food and build positive experiences. And as the child engages in a positive way, their brain builds a more positive understanding of clothing. Parents often say, “What does swinging a shirt around or putting a tutu on your head have to do with wearing a school uniform?” And I say, hang with me. Because once the script flips and positive experiences happen, kids often make leaps you didn’t expect. Sometimes we even talk about the neuroscience with kids, when it’s appropriate. We might say, “Your body is in fight or flight. How can we help you feel safe?” That’s what this looks like in practice.

Debbie:
Yeah, no, this is super helpful. I really appreciate the way you explain things in a way that helps me understand them differently. And I hope the same is true for my listeners. So as we wrap up, for listeners who are connecting some dots and want to get more curious about what might be going on with their child’s nervous system, what would you encourage them to pay attention to or explore next?

Kathryn Hamlin-Pacheco:
Be an observer of your child. Notice what happens around clothing. Are they moving into fight or flight or shutdown? Does that resonate? Try co-regulatory practices. Get small. Slow down. Relax your voice and your face. Approach it from a different perspective and see what changes you notice. This doesn’t happen overnight. But you’ll see small changes, and those small changes matter. We’re restructuring the brain. We’re helping kids learn about clothing in a completely different way. Before, clothing was immediate distress. Now we’re charting a path toward curiosity or neutrality. That’s the work.

Debbie:
Absolutely. If this is newer information for you and you want to explore it further, go to the show notes page for this episode on Tilt Parenting. I’ll link to my conversation with Carol Kranowitz about sensory processing differences, my episode with Deb Dana breaking down polyvagal theory, and my episode with Dr. Stephen Porges and Karen Onderko on polyvagal theory and the Safe and Sound Protocol. Kathryn, can you let listeners know where they can connect with your work?

Kathryn Hamlin-Pacheco:
Yes. My website is brainexecutiveprogram.com. I currently have a course for parents and caregivers on dressing, and in January 2026 I’ll be opening a clinical course for occupational therapists and clinicians who want to go deeper into the neuroscience. I also have a free ebook on dressing that walks through eight approaches to support kids, including everything we talked about today. You can download it from my website. I’m also on Instagram, and you can always email me through my site. Sensory health is health, and if you’re not sure where to start, I’m happy to help connect the dots or point you to a local pediatric occupational therapist.

Debbie:
Fantastic. Listeners, definitely check out the show notes. Kathryn, I’m really glad you reached out. This was fascinating, and I know this will be one of those episodes people come back to again and again. Thank you so much.

Kathryn Hamlin-Pacheco:
Thank you so much for having me. It was a joy. And thank you for the work you’re doing.