A Case-Controlled Investigation of Tactile Reactivity in Young Children With and Without Global Developmental Delay

Abstract

Assessing tactile function among children with intellectual, motor, and communication impairments remains a clinical challenge. A case control design was used to test whether children with global developmental delays (GDD; n = 20) would be more/less reactive to a modified quantitative sensory test (mQST) compared to controls (n = 20). Reactivity was indexed by blinded behavioral coding across vocal, facial, and gross motor responses during the mQST. On average the children with GDD were significantly more reactive than controls to most tactile sensory modalities including light touch (p = .034), pin prick (p = .008), cool (p = .039), pressure (p = .037), and repeated von Frey (p = .003). The results suggest the mQST approach was feasible and highlights the GDD sample was more reactive than controls to a range of stimuli.

Specific Behavioral Responses Rather Than Autonomic Responses Can Indicate and Quantify Acute Pain among Individuals with Intellectual and Developmental Disabilities

“…These variations in the autonomic responsivity among the aforementioned IDD groups may stem from the IDD etiology; nevertheless, they suggest an overall increased reactivity in IDD. Enhanced behavioral responses to mildly painful calibrated mechanical stimuli were also reported among children with IDD, compared with their siblings [24] and compared with control children [30].…”

“…However, comparisons to normative responses were unavailable. Similar stimuli among children with IDD induced overall increased facial and body responses, compared with control children [30]; however, there was appreciable inter-and intra-individual variability [31]. Therefore, differentiating pain responses from responses to innocuous stimuli was very challenging.…”

A longitudinal study of parent‐reported sensory responsiveness in toddlers at‐risk for autism

“…One clear way forward long acknowledged in the literature is to improve our capacity to measure constructs related to RRB. This could be accomplished through developmentally informed, dimensional approaches to assessment (Uljarevi c et al, 2017;Wolff, Boyd, & Elison, 2016) as well as direct measures that yield results more proximal to underlying mechanisms (Barney, Tervo, Wilcox, & Symons, 2017;Cascio et al, 2012;Duerden et al, 2015). It is also worth considering whether we are measuring the right thing, particularly in regard to sensory-related constructs given the inferences involved in linking observable outward behavior to nervous system function.…”

Preliminary Evidence That Resting State Heart Rate Variability Predicts Reactivity to Tactile Stimuli in Rett Syndrome

“…Barney et al were applied to the back of each hand and top of each foot in a fixed order: light touch (2 g von Frey), pinprick (Medipin), cool (Tip Therm), 4 lb of pressure, repeated von Frey (60 g von Frey), and heat (50 C). 14 Hand stereotypy was allowed to continue during the examination. In rare cases in which hand stereotypy blocked access to the back of the hand for stimulus application, hands were briefly separated to gain access to the back of the hand, but participants were allowed to return to stereotypy.…”

“…We used an observational coding system similar to one used previously in Rett syndrome to assess behavioral responses to each stimulus. 6,14 The coding system included 5 classes: vocalizations (eg, moan, cry), upper and lower facial expressions (eg, furrow, mouth open), motor (eg, flinch), and physiological signs (eg, gasp). Each behavior class was scored from 0 to 3.…”