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CASE WESTERN RESERVE UNIVERSITY

Sages University Seminar

Touch Throughout the Life Span
Fall 2018

Faculty: Susan M. Ludington, RN, CNM, CKC, Ph.D., FAAN

Carl W. & Margaret Davis Walters Professor of Pediatric Nursing

Office: Third Floor, Room 322D of the School of Nursing

Phone: (216) 368- 5130
Email: Susan.ludington@case.edu or sml15@case.edu
Office hours: Monday and Wednesdays, 4:50-6:05 p.m.
Room: NOA300 on the Ground Floor of the School of Nursing
Office hours by appointment; please email for appointment

I DO NOT answer emails from 4:30 on Fridays until 9:00 a.m. the next working day
which is usually a Monday. So if you send me an email during these hours, do not
expect any response until the next working day. Thank you.

Writing Instructor is: Dr. Carli Leone and her email is cfl30@case.edu. She has office
hours in the Writing Center and please make appointments with her by email.

Brief Course Description: The course covers important aspects of touch

(physiology and issues about touch such as electronic, punishment, abusive, and
supportive forms of touch) across the life span, starting with the importance of touch at
birth and then throughout childhood and in old age. Health aspects of touch will also
be covered along with new touch therapies such as massage, acupuncture, reiki).

Full Course Description: This is a focused seminar course designed to develop

listening, learning, and verbal presentation skills and writing skills about a variety of
topics related to touch throughout the life span. Opportunities are provided to learn
from colleagues and resources available to the public about the structure, functions,
uses, misuses, and health considerations of touch from birth to old age. Touch as it is
conveyed through different venues and with different purposes (i.e. touch for
development, touch for socialization, touch for developmental guidance, teaching
children how to deal with animal touch and what are pets need, touch as punishment,
touch in the workplace, touch and technology, intimate touch, abusive touch, necessity
of touch, healing touch, and comforting and noxious touch) will be explored with
emphasis on touch’s role in adapting to aging throughout childhood, adolescence,
young adulthood, middle age and when elderly.

Short Title for Transcripts: Lifespan Touch

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Course Rationale: The course meets three of the goals of the general education
program: 1) instruction and repeated practice in critical reading and thinking, in writing
and in oral presentation, and the use of information; 2) experience in the process of
ethical deliberation/decision making across a variety of perspectives; and 3) exposure
to experimental and theoretical approaches to understanding human culture related to
touch and to behavior, scientific knowledge, and methods of research as research
studies on each topic are read.

The course also addresses all components related to Thinking about the Social World
because methods to measure and determine human behavior and developmental
touch changes across the life span will be topics of seminars and part of required
readings.

The course fulfills requirements of University Seminar by providing students with an

introduction to the modes of inquiry commonly used in the social sciences (case
reports, qualitative studies and their methods, descriptive and experimental studies),
and by identifying the scientific method incorporated in readings of each topic. The
content of seminars requires students to think critically and analytically about how our
understanding of touch is influenced by evidence. The course is writing intensive and
discussion based.

Student Learning Outcomes. Upon completion of this seminar, you should be able
to…
 Participate in a variety of academic conversations by contributing insightful,
relevant ideas
 Consider differences in values and assumptions to think critically, deliberate
ethically, and respond articulately to questions/problems
 Research and apply scholarly concepts and information
 Write clear, insightful, persuasive, research-based, and appropriately
documented argumentative essays
 Effectively communicate information through oral and/or new media
Presentations
AND IN RELATION TO TOUCH, you should be able to:
1. Identify, describe, and explain physical structures and functions related to two
forms of touch perception, emphasizing changes in touch as the human ages
2. Relate how people adapt to life changes through touch.
3. Evaluate the differences between and consequences of positive versus noxious
touch in infancy, childhood, adolescence and old age as personally, socially, and
legally defined.
4. Explain the role of touch in developmental guidance and punishment during
childhood and adolescence.
5. Understand touch needs of the elderly for connectivity with the environment.

Course Conduct:
The course will be conducted as a seminar that focuses on writing and
listening/speaking skills related to development of a cogent “argument” or justification
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for a particular point of view. Each class will have content specifically designated to
improve writing skills and course assignments will include presentations and papers
related to knowledge gained about an aspect of touch in some portion of the life span.
Presentations by faculty are limited as students are to be prepared to participate and
learn from collegial dialogue about a given topic for which the student has prepared
his/her contributions prior to each seminar. Each student may conduct one seminar as
the discussion leader, and each student will verbally present a topic about touch in a
select period of development so that presentation skills are refined, and will develop
papers to demonstrate writing skills, argument development with cited justifications,
and scholarly report of a research study.

Assignments and Evaluation Methods:

Grading Criteria:
Participation in class: 15%
Conducting seminar: 10%
Presentation of topic: 10% 11/19 and 11/26
Research presentation: 10% 11/28 and 12/3
Paper #1: 15% 9/24
Paper #2: 15% 10/15
Paper #3 20% 12/3
Writing Reflection Paper 5% 12/5

Evaluation of your papers will be completed using the SAGES GRADING RUBRIC
disseminated in class. Evaluation of your discussion leadership is
detailed in the section on leading class discussion. Evaluation of your speaking will
be by an evaluation sheet submitted to you at least two weeks before your
presentation and evaluation of your research presentation will be conducted using
another grading rubric that will be disseminated to you at least two weeks before
your research presentation.

Grading Scale:
90-100 A
80-89 B
70-79 C
60-69 D
< 60 F

General Guidelines for Papers:

For the two Short and one Long Paper, the student chooses a topic about touch
related to one period of the life span of a human and provides a definition from the
literature, current thoughts/practices related to the specific topic, and concludes with
presenting evidence to support the student’s BELIEF, Endorsement or Opposition to
current thoughts/practices, and provides a summary of the paper with a concluding
paragraph. Each paper must be about a different touch topic. Sample touch topics
are quality time with infants through touch, spankings, touch to show approval,
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tattoos, intimate forms of touch (holding hands, hugging, petting, loving), healing
touch, changes in touch perception in the elderly, importance of technology touch
and effects on human health and/or development, outcomes of finger touch when
playing computer games, touch as a form of proximity, pain-reducing touch, healing
touch(massage therapy –even in natural disasters, reiki, oxytocin touch, etc.),
abusive touch in relationships (rape, battery) and abusive touch in institutions (i.e.
beating incarcerated people, restraining elderly and demented people).

Do send your paper as a WORD document. Do not send a google document, a

read only document, an adobe documents, and no other electronic forms of
documents because tracking changes is easiest with WORD documents.

There are two short papers (Papers #1 and #2) and one long one (Paper #3).
Send the first paper to both instructors electronically; all other papers are to be sent
only to Dr. Ludington. Papers will be electronically graded within two weeks and the
first paper will be returned to you to make revisions if necessary (if a paper is well
done, revisions may not be requested). The revised paper is due electronically to both
faculty members and will be graded within one week, being returned electronically to
the student. If a paper requires revision, only the revised paper will be scored for an
assignment of a grade. Each paper requires citations of published research studies,
theories, experience papers, commentaries, reviews of the literature, and letters to
editors from reputable publication sources such as professional journals in your
specific field, whatever that field is. Your review of the literature should include
primary and secondary sources. A primary source is original research that reports a
result; a secondary source is a review article or commentary that reiterates the results
or statements in the citation and cites the original source to validate the reiteration.
For example, in March 2018 Ludington’s descriptive study revealed that the commonly
used 1954 scale for assessing the well-being of a newborn does not suit a newborn
who is lying on his mother’s chest instead of lying on a radiant warmer physically
separated from his/her mother (Ludington-Hoe et al., 2018). This is an example of a
PRIMARY SOURCE. An example of a SECONDARY SOURCE is as follows: And
then in Sept 2018 Bass et al. report that they informally observed the unsuitability of
the Apgar score for infants in skin-to-skin contact as has been previously reported
(Ludington-Hoe et al., 2018). Please consider using Gerald Graff and Cathy
Birkenstein;s They Say/I Say: The Moves that Matter in Academic Writing (WW
Norton, 2006, 978-0-393-92409-1 $18.95). to optimize your writing skills.

Papers will be evaluated by Dr. Ludington for writing style and correct format as well
as proper English and citation use. The writing instructor will evaluate the first paper
for writing style and correct format as well. Only the first paper will have to be revised,
if needed.

Paper #1. Touch in My Culture. For this paper, Reading Chapter 14: Tactile
traditions: Cultural differences and similarities in Haptic Communication pg. 351-369 in
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the Hertenstein & Weiss book may help you formulate your idea for this paper. You
should reflect on your memory of tactile experiences you had within your family and
your family’s cultural context at a particular time in your life or in the life of others. The
life span periods are childhood (birth through 12years), adolescence and teen years
(13-19), young adult (20-30), adult (30-64), senior (65 and older). Choose something
that is quite common and quite acceptable, and perhaps distinct and unique to your
culture that relates to touch to write about. For example, in a White, Christian culture
in the U.S.A., elderly couples often walk about holding hands in public and this
behavior is not considered odd in any way. But when living in an Islamic culture in
Iran for several years, I soon learned that holding hands or kissing was not allowed
and I ended up in jail for misbehavior because a woman is supposed to walk behind
the man and never touch in public. Either one of these “touch practices/expectations”
could be written about. The paper should begin with an introduction that relates the
cultural aspect of touch that has been chosen to be the topic of the paper and
provides a definition from the literature (i,e. what is corporal punishment, current
thoughts/practices related to this touch). Explain your memory of this touch by giving
us examples of the topic in practice. Continue with a discussion of rationale for the
cultural standard or expectation and current thoughts and practices relate to the
chosen touch, present some content on which actual behaviors/practices are
considered acceptable and which are considered unacceptable. Relate the
consequences of ‘misbehaving’ (behaving in ways that violate the cultural norm or
expectations). Next, relate what your reflection of this touch expectation means to you
now as you have aged and what you believe about that touch now (this is the critical
thinking piece –what it means to you now or how it relates to you now), and how you
have come to your meaning about this touch – has it been through knowledge,
through experience, through plans or visions of other ways and meanings, through a
new understanding of the importance of this touch, or perhaps through cultural
pressure? Conclude the paper with an endorsement or oppositional statement to
current thoughts/practices, and provide a summary of the key points of each
paragraph of the paper in a concluding paragraph.
Paper #1 should be 4-6 pages long, no more than that, and will be read and
returned to you within one week. The paper must include at least three references
from the literature to support your argument and all references must be listed in a
Bibliography that follows American Psychological Association 6 th edition format.

Paper #2. An Ethical Deliberation About Touch. The topic of this paper is your
choice, but it has to relate to touch in some way that ethical deliberation is needed.
Examples are “immediate tactile response to infant crying is spoiling the infant,” “use
of spanking is inappropriate,” “pulling on another person or their hair is abusive,”
“child assault or abuse or sexual abuse is unacceptable,” “corporal punishment is not
effective,” “domestic violence is acceptable,” rough treatment when caring for an
elderly person is not bad.” You need to describe what you’ve read, thought about, or
watched that raised ethical concerns, enumerate the ethical concerns, provide data
from your decision making and the decisions/thoughts of others as revealed in the
reading or watching, provide data from 4-5 citations (cited using American
Psychological Association 6th Edition guidelines – available on line) that support either
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your position or the position of others (books, journal articles, newspaper articles,
website materials, etc. to support the argument/point/tenet/stance you want to make in
the paper), use appropriate ethical deliberation terminology, and come to a conclusion
about the ethics of the case you are reviewing and what you think should be legally
done, morally done, and ethically done. I expect you to incorporate the content
conveyed by Dr. Barbara Daly in her seminar on ethical deliberation and you can use
her five steps to ethical deliberation as the organization of your paper. To review, the
five steps are: 1. What is the ethical question? 2. What are the morally relevant
facts/assumptions? (here is where you put some of the citations), 3. What are
the options? (citations can go here, too). 4. How could you evaluate the options
or what evaluation of the options has already been done? (citations could go
here, too). And 5. What is your moral judgement about the ethical issue you
raised – what is right vs. what is wrong? There should be an introduction to the
paper that tells the reader what the paper is about and what the topic sentences of
each paragraph that follows are and how the paper proceeds. Then follow your
topical outline and conclude the paper with a paragraph that summarizes your
position, the position of others, your final decision about what is ethically desirable,
and a sentence or two of what you want the reader to remember about your paper as
the closing remarks. (Mr. Eddy at the Kelvin Smith Library can help and assign you a
consultant librarian who will teach you how to search and secure references related to
your topic. What a wonderful service, so take advantage of it).

Paper #2 should be 4-6 pages long and will be read and returned to you within
two weeks. The paper must include references that follow American
Psychological Association’s 6th edition format.

Paper #3 is a Report of a Research Study About Touch. This paper, which must
also include at least 6 citations, is a group paper (4 people to a group) that should be
written after you have had the mini-lecture by Dr. Ludington on writing for funds. Here
is the PROMPT: Each group is to develop a statement of need for which you are
asking for funds from a funding source, such as a foundation, a college, a program, a
government office, etc. The purpose of Paper #3 is to develop a simple proposal in
which you try to convince the funding source that money is needed for problem X. You
will develop a simple PILOT project, conduct the pilot, report the results and include
your interpretation of the results in your writing that requests money to do a bigger or
different study. Your project should reflect a way to solve or learn more about problem
X (not knowing if a pat on the shoulder is considered intrusive or welcome, for
example), and relate how much money was needed to do your PILOT project and bow
much money will be needed to do a bigger/different project (i.e. keep costs down,
such as costs to develop the questionnaire and copy it, to get an SPSS (STATISTICAL
PACKAGE) license which is about $80.00/year, to hire people to pat CWRU students
on the shoulder as they leave the dinner hall. A solution to the problem may be asking
people if you can give then one pat on the shoulder and ask them to tell you their
perception of the pat from a stranger as intrusive or welcoming. By knowing the
majority perception of CWRU student, one will gain an understanding of each person’s
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PERSONAL FIELD that can or cannot be invaded without incurring INTRUSIVE

perception. The project should be simple and readily applicable, i.e. ask your dorm
mates a question about touch, (i.e. are you averse to touch?) and then touch them
and ask if they still feel aversive to touch. Your paper should tell us the type of project
you are going to do, what you are going to do, why the project is important to do, and
then conduct the project on a small number of people/dogs/sites, etc (i.e. touch is
important, but students are busy and mostly don’t get much touch. Therefore, we will
observe X number of students at such and such time of day as they sit at dinner and
see how many times a student touches the student next to them or with whom they
are conversing). You should include a paragraph of what your results were and why,
based on your findings, you are asking for money to do a bigger or different study.
ONE GROUP paper will be submitted by all four in the group with all four student’s
names on the face page and signatures by all students that they contributed equally to
the paper. If one student does not contribute equally to the project and the paper, that
student will get no points for the assignment. The student who does not participate
CANNOT do an independent project/paper because the purpose of paper #3 is to
practice collaboration. Each group will be doing a powerpoint presentation of their
research study in class. This paper should be 10-12 pages.

Oral Presentations. The one oral presentation per student will be an analytic and
interpretive report of one aspect of touch of your choosing. Perhaps you are very
interested in the touch therapy called REIKE; if so, you can do your presentation on
REIKI. Each student will make one presentation using powerpoint audio/visual
materials to keep the attention of the listeners. Consult the primer “SPEAK: How To
Talk to Classmates and Others” by William M. Doll (available in the CWRU book store
for < $10.00) to learn how to identify the basic tenant/topic ideas of your presentation
and how to build statements, comments, stories, and content to support the tenet/topic
idea, and bring your presentation to a conclusion within 5 minutes. You will be having
a guest lecture by Mr. Doll to promote success in this requirement.

Discussion Leading: Student will sign up to lead the discussion in one class.
Because there are 18 students and not that many days of discussion, sometimes
there will be 2-3 students leading the discussion. The discussion leading students
have to do the required reading for the class, write 3-5 discussion questions based on
the readings and always including a critical thinking question (such as “What does this
mean to you?” “Can you relate to this situation?” “What do you think about the
arguments that we have been discussing?”), open up the class discussion by
reiterating what the content for the discussion is and encouraging everyone to
participate. Then the discussion leaders begin by asking the first question related to
the readings and/or presenting an audiovisual aid that highlights content from the
discussion topic. The discussion leader listens well, probes deeper in to the
responses, asks what the beliefs/knowledge/opinions/ known evidence of others in the
class is and at the end of the class, summarizes the content conveyed and lessons
learned through the day’s discussion.
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Writing Folder. You must choose one of the three papers from this class to be
included in your Writing Folder that will be submitted to the Sages office to meet this
graduation requirement. In addition to choosing and saving one revised paper, write
a one page reflection paper on each writing assignment, addressing what you
learned about writing and how your writing changed this semester.

Class Attendance, preparedness, and participation in discussion

The primary teaching strategy will be discussion of readings and issues, necessitating
substantial student participation. For each topic, possible readings and resources for
information have been identified. In addition, students are encouraged to identify
other readings in their areas of interest that fit within the course. Students are
expected to do assigned readings and to choose readings and activities for each topic
that augment their existing knowledge of the topic. Students are not expected to read
all of the readings; however, it will be assumed that they have read in sufficient depth
before class to actively participate in class discussions. Successful learning in this
course depends upon continual reading, reflection, and verbal and written sharing.
Students are expected to attend every class, to come to class with questions and
thoughts about the readings and assignments, and to actively participate in the
discussion.

Texts:
Required: Field, T. (2014). Touch. 2nd Edition. Cambridge, MA: The MIT
Press. 250 pages. ISBN: 978-0-262-52659-3

Recommended: Hertenstein MJ & Weiss, SJ (Editors). (2011). The

Handbook of Touch. Neuroscience, Behavioral, and Health Perspectives. NY:
Springer Publishing Company. PP.520 ISBN: 978-0-8261-2191-2
.
Additional Reading:
Phillips, R. (2013). The sacred hour: uninterrupted skin-to-skin contact
immediately after birth. Newborn and Infant Nursing Reviews. 13(2), 67-72.

You will be going to the library for a full session on how to find primary and
secondary sources of published literature to cite in your papers. Some of the
likely topics may be as follows:

Physiology of Touch and physiologic changes in mechanical receptors across the life
span

Infancy touch needs: Brazelton, T.B. The Irreducible Needs of the Child

Touch for Guidance in Infancy and Childhood:

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Supportive Touch for Children and Adolescents:

No more touch of school-age children by adults

Punishing Touch for Children and Adolescents:

What to do with combative children, hitting/physically hurting others,

Abusive Forms of Touch and Battery:

Gang rituals and violence, battery and beating others, rape

Socially Appropriate and Inappropriate Forms of Touch in Adulthood:

The chemistry of the RIGHT touch, touching strangers. Touch to
acknowledge respect and/or introduction

Touch Therapies and Human Responses

(Reiki, Massage, Acupuncture)

Changes in the Skin and Touch Needs of the Elderly

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Schedule of Classes
Date Day fTopic for the class Activities for the scheduled class time
class
8/27 MON Introductions, syllabus
8/29 WED Class is attendance at
Convocation Severance
Hall at 4 p.m.
9/3 MON HOLIDAY- LABOR DAY
9/5 WED Mind of the Blind field Meet Ms. Leone at the Cleveland Botanical Gardens
Trip at the Botanical for the MIND of the BLIND exhibit and learn how the
mind stimulated by touch alone enables the blind to “see” – a
Gardens process called stereognosis in which the tactile a
afferent (going to the brain) nerves stimulates the
visual cortex of the brain. We meet in the main lobby
by the ticket desk at 4:50. You will finish at 5:50.
You need to walk there. Wear safe shoes as you will
be blindfolded while walking on uneven surfaces.

9/10 MON Kelvin Smith Library
9/12 WED First WRITING class
with Writing Instructor
9/17 MON Importance of touch
9/19 WED Touch at birth
Meet with Mr. Mark Eddy to learn how to find
Literature resources and request individual librar-
ian assistance. Meet in KSL 215
Dr. Leone- Understanding the prompt for the
first paper requirement.
Field Chapters 1 and 2 Touch Hunger and Touch as Communication
Pages 1-43
Discussants:
Watch The Miracle First Hour 20 minute film
Phillips, R.M. (2013). The sacred hour: uninterrupted skin-to-skin
contact immediately after birth. Newborn & Infant Nursing Reviews,
13(2), 67-72.
Field, Chapter 3 Touch in Early Development (45-63)
Discussants:

9/24 MON Ethical Deliberation Dr. Barbara Daly conducts this seminar
Paper #1 Due
9/26 WED Childhood Touch Field,pgs. 63-85;
McGlone F 2014. Discriminative &
Affective Touch. Neuron 82: 737-789.
Discussants:
10/1 MON Childhood Adversive Touch Temple JR et al. 2018. Childhood corporal punishment & &
future perpetration of physical dating violence, J
Pediatr,194:233-237.

Discussants:
10/3 WED Writing workshop Dr. Leone conducts writing workshop to help with
formulating paper #2.
10/8 MON Touch in Elderly Dr. Nathaniel Schreiner conducts this seminar
Refer to previous reading of McGlone on 9/26

10/10 WED Touch in Adulthood &dHertenstein & Weiss, chapter 12 The communi-
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adversive touch (rape,cative functions of touch in adulthood. Pg 273-298.

domestic violence) Additional reading to be assigned.
Discussant:
10/15 MON Speaking in public-even if Mr. Doll presents his seminar on speaking well’
it is a touchy subject Paper #2 Ethical Deliberation is due
10/17 WED Touch Physiology Field, chapter 5 Touch messages to brain.
Discussants:
10/22 MON No Class- FALL BREAK MIDTERM was 10/20/2018
10/24 WED The research process Dr. Ludington presents the research process
Form groups for project and develop
purpose today in class
10/29 MON Touching Base about writing Dr. Ludington – questions/performance in first 2
papers.
10/31 WED Writing workshop Dr. Leone helps with difficulties in writing
11/5 MON Healing touch with animals Beetz et al., 2012.Psychosocial & psychophysio-
Logical effects of human-animal
interactions. Frontiers in Psychology, 3(234), 1-6
Discussants:
11/7 WED Touch Therapies Field, chapter 6 Touch therapies, pg119-145
Discussants:
11/12 MON Touch Therapies Field chapter 8 Massage for Children, ado-
lescents, and adults pg. 161-188
11/14 WED Writing Workshop Dr. Leone helps with writing tasks
11/19 MON Student Speaking Present- Each student to present - first ½ of class
ations
11/21 WED Thanksgiving, no class
11/26 MON Student Speaking Each student to present- second ½ of class
Presentations
11/28 WED Research Presentations 2-3 groups present
12/3 MON Research Presentations 2-3 groups present Paper #3 DUE
12/5 WED Last class Bruce Springstein Song “HUMAN TOUCH”
You Tube, Oct. 3, 2009 video,
Evaluations, Reflections on Writing Paper DUE

All papers are due in APA 6th edition format.

www.atomiclearning.com/highed/apa-word-2013-training offers great APA tutorials that are free
to students. Here is the list of tutorials you can access for free:
 APA (6th Ed.) Research Paper Basics - Word 2013

o A. Overview of APA Style Guidelines

 General overview of APA Guidelines

 Intro to style: point of view, voice, reduce bias

 Title page basics

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 Abstract basics

 Main body basics

 Reference basics

 Appendices, tables, & figures basics

 Starting a new document

 B. The Title Page & Abstract

 What to include on the title page

 Formatting the title page

 Creating the title page header

 Starting a new page for the abstract

 Adding abstract content & formatting

 Listing & formatting keywords in the abstract

 Formatting the header on the second and subsequent pages

 C. The Body of the Paper

 Formatting the body of your paper

 Overview of in-text citations

 In-text citations: the author-date format

 Including quotes in your paper

 A word about summarizing and paraphrasing

 Adding footnotes

 Formatting the 5 heading levels

 Formatting tables in your paper

 Formatting figures in your paper

 Special considerations for graphics and photos

o D. The Reference List

 Reference list basics

 Formatting a reference - print or online source

 What is a "DOI?"

 Publication by one or more authors

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 Organization, editor, or unknown as author

 Referencing a book

 Referencing a journal or magazine

 Referencing a newspaper

 Referencing a translation

 Referencing a multi-volume resource

Be sure students have SAGES grading Rubric and other

evaluation tools.