Cascio Carissa J, Lorenzi Jill, Baranek Grace T
Department of Psychiatry and Vanderbilt Kennedy Center for Human Development, Vanderbilt University, 1601 23rd Ave, S, Suite 3057, Nashville, TN, 37212, USA.
Division of Occupational Science, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Autism Dev Disord. 2016 May;46(5):1528-37. doi: 10.1007/s10803-013-1961-1.
Tactile defensiveness, characterized by behavioral hyperresponsiveness and negative emotional responses to touch, is a common manifestation of aberrant sensory processing in autism spectrum disorders (ASD) and other developmental disabilities (DD). Variations in tactile defensiveness with the properties of the stimulus and the bodily site of stimulation have been addressed in adults with self-report of perceived tactile pleasantness, but not in children. We presented three materials (pleasant, unpleasant, social) at three bodily sites and measured both examiner-coded defensiveness and self-reported pleasantness from a group of children with ASD and two comparison groups (one with DD, one with typical development (TD)). The main findings were: (1) children with ASD and DD showed significantly more defensiveness reactions and lower pleasantness ratings than the TD group, with higher variability, (2) there was a double dissociation for the effects of material and bodily site of stimulation: while bodily site predicted behavioral defensiveness, material predicted pleasantness rating. Additionally, it was noted that (3) the most pleasant material and the social touch conditions best distinguished ASD and DD from TD on defensiveness, and (4) within the ASD group, social impairment and defensiveness in bodily sites associated with social touch were positively correlated, suggesting a clinically relevant distinction between social and discriminative touch in ASD.
触觉防御表现为对触摸的行为过度反应和负面情绪反应,是自闭症谱系障碍(ASD)和其他发育障碍(DD)中异常感觉处理的常见表现。关于触觉防御随刺激特性和身体刺激部位的变化,已有针对有触觉愉悦感自我报告的成年人的研究,但尚未涉及儿童。我们在三个身体部位呈现了三种材料(愉悦的、不愉悦的、社交性的),并对一组患有ASD的儿童以及两个对照组(一个患有DD,一个发育正常(TD))进行了检查者编码的防御性测量和自我报告的愉悦感测量。主要研究结果如下:(1)患有ASD和DD的儿童比TD组表现出明显更多的防御反应和更低的愉悦感评分,且变异性更高;(2)材料和身体刺激部位的影响存在双重分离:身体部位可预测行为防御性,而材料可预测愉悦感评分。此外,还发现:(3)最愉悦的材料和社交触摸条件在防御性方面最能区分ASD和DD与TD;(4)在ASD组内,社交障碍与与社交触摸相关的身体部位的防御性呈正相关,这表明ASD中社交触摸和辨别性触摸在临床上存在相关区别。