修改定量感觉测试以研究智力和发育障碍儿童的触觉感觉功能及行为反应性：确定可行性并测试性别、自闭症及自我伤害的影响。

Modifying quantitative sensory testing to investigate tactile sensory function and behavioral reactivity in children with intellectual and developmental disabilities: establishing feasibility and testing sex, autism, and self-injury effects.

作者信息

Gunderson Jaclyn, Worthley Emma, Byiers Breanne, Merbler Alyssa, Huebner Andrea, Hofschulte Deanna, Lee Jasmine, Riodique Catherine, Symons Frank

机构信息

Department of Psychiatry and Psychology, Mayo Clinic, 200 1st street SW, Rochester, MN, 55905, USA.

College of Education and Human Development, University of Minnesota, Burton Hall, 178 Pillsbury Dr SE, Minneapolis, MN, 55455, USA.

出版信息

J Neurodev Disord. 2025 Mar 27;17(1):15. doi: 10.1186/s11689-025-09603-x.

DOI:10.1186/s11689-025-09603-x

PMID:40148783

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11948723/

Abstract

BACKGROUND

Sensory reactivity differences are common across neurodevelopmental disorders (NDDs), however very few studies specifically examine tactile or pain responses in children with NNDs, especially those with communication challenges. The current study aimed to (a) replicate the feasibility of a modified quantitative sensory test (mQST) with a sample of children with NDDs, (b) assess validity evidence based on behavioral reactivity during mQST application and the corresponding behavioral measurement coding system, and (c) explore group differences in behavioral reactivity to mQST stimuli by demographic (sex), clinical (autism status), and behavioral pathology (self-injury) variables.

METHODS

The mQST protocol was implemented and blindly coded across 47 participants aged 2-12 years (M age = 6.7 years, SD = 2.6; 70% male) with NDDs. Feasibility was measured by completion of the mQST protocol and interobserver agreement. Validity was assessed using paired t-tests investigating differences between behavioral reactivity to active stimuli compared to a sham trial. Boxplots were used to visually explore differences in group characteristics (sex, autism status, and self-injurious behavior), with two-sample t-tests used to further characterize differences in SIB group characteristics in behavioral reactivity to mQST stimuli.

RESULTS

The mQST provided codable data across 91% of stimuli applications with high IOA (84.7% [76.7-95%]). Behavioral reactivity was significantly higher for active vs. sham stimuli. Children reported to engage in self-injurious behavior showed significantly more reactivity to the second half of the repeated von Frey stimulus application compared to children without caregiver-reported self-injurious behavior (M = 6.14, SD = 3.44), t (40)= -2.247, p =.04).

CONCLUSION

The mQST is a feasible approach to investigate tactile reactivity in children with NDDs and complex communication needs. The mQST may be useful in understanding sensory variables in relation to developmental and behavioral outcomes such as self-injurious behavior.

摘要

背景

感觉反应性差异在神经发育障碍（NDDs）中很常见，然而很少有研究专门考察患有神经发育障碍的儿童，尤其是那些有沟通障碍的儿童的触觉或疼痛反应。本研究旨在：（a）在患有神经发育障碍的儿童样本中重复改良定量感觉测试（mQST）的可行性；（b）基于mQST应用过程中的行为反应性及相应的行为测量编码系统评估效度证据；（c）通过人口统计学（性别）、临床（自闭症状态）和行为病理学（自我伤害）变量探索对mQST刺激的行为反应性的组间差异。

方法

对47名年龄在2至12岁（平均年龄=6.7岁，标准差=2.6；70%为男性）的患有神经发育障碍的参与者实施mQST方案并进行盲法编码。通过mQST方案的完成情况和观察者间一致性来衡量可行性。使用配对t检验评估效度，该检验考察主动刺激与假刺激的行为反应性之间的差异。箱线图用于直观地探索组特征（性别、自闭症状态和自伤行为）的差异，使用两样本t检验进一步刻画自伤行为组在对mQST刺激的行为反应性方面的特征差异。

结果

mQST在91%的刺激应用中提供了可编码数据，观察者间一致性较高（84.7%[76.7 - 95%]）。主动刺激的行为反应性显著高于假刺激。与没有照顾者报告的自伤行为的儿童相比，报告有自伤行为的儿童在重复应用von Frey刺激的后半段表现出显著更高的反应性（M = 6.14，标准差 = 3.44），t（40）= -2.247，p = 0.04）。