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Article

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

by 1,2,*, 3 and 2,3,4,5
1
Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
2
Sagol School of Neuroscience, Tel-Aviv University, Tel Aviv 69978, Israel
3
Department of Anatomy, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
4
Miriam and Sheldon G. Adelson Chair and Center for the Biology of Addictive Diseases, Tel-Aviv University, Tel-Aviv 69978, Israel
5
Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv 69978, Israel
*
Author to whom correspondence should be addressed.
Academic Editor: Vincenzo Donadio
Brain Sci. 2021, 11(2), 253; https://doi.org/10.3390/brainsci11020253
Received: 5 January 2021 / Revised: 4 February 2021 / Accepted: 10 February 2021 / Published: 18 February 2021
(This article belongs to the Special Issue Pain Assessment in Impaired Cognition)
Individuals with intellectual and developmental disabilities (IDD) are at a high risk of experiencing pain. Pain management requires assessment, a challenging mission considering the impaired communication skills in IDD. We analyzed subjective and objective responses following calibrated experimental stimuli to determine whether they can differentiate between painful and non-painful states, and adequately quantify pain among individuals with IDD. Eighteen adults with IDD and 21 healthy controls (HC) received experimental pressure stimuli (innocuous, mildly noxious, and moderately noxious). Facial expressions (analyzed with the Facial Action Coding System (FACS)) and autonomic function (heart rate, heart rate variability (HRV), pulse, and galvanic skin response (GSR)) were continuously monitored, and self-reports using a pyramid and a numeric scale were obtained. Significant stimulus-response relationships were observed for the FACS and pyramid scores (but not for the numeric scores), and specific action units could differentiate between the noxious levels among the IDD group. FACS scores of the IDD group were higher and steeper than those of HC. HRV was overall lower among the IDD group, and GSR increased during noxious stimulation in both groups. In conclusion, the facial expressions and self-reports seem to reliably detect and quantify pain among individuals with mild-moderate IDD; their enhanced responses may indicate increased pain sensitivity that requires careful clinical consideration. View Full-Text
Keywords: cognitive impairment; intellectual disability; experimental pain; pain measurement; facial action; self-report; autonomic responses cognitive impairment; intellectual disability; experimental pain; pain measurement; facial action; self-report; autonomic responses
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MDPI and ACS Style

Defrin, R.; Benromano, T.; Pick, C.G. Specific Behavioral Responses Rather Than Autonomic Responses Can Indicate and Quantify Acute Pain among Individuals with Intellectual and Developmental Disabilities. Brain Sci. 2021, 11, 253. https://doi.org/10.3390/brainsci11020253

AMA Style

Defrin R, Benromano T, Pick CG. Specific Behavioral Responses Rather Than Autonomic Responses Can Indicate and Quantify Acute Pain among Individuals with Intellectual and Developmental Disabilities. Brain Sciences. 2021; 11(2):253. https://doi.org/10.3390/brainsci11020253

Chicago/Turabian Style

Defrin, Ruth, Tali Benromano, and Chaim G. Pick 2021. "Specific Behavioral Responses Rather Than Autonomic Responses Can Indicate and Quantify Acute Pain among Individuals with Intellectual and Developmental Disabilities" Brain Sciences 11, no. 2: 253. https://doi.org/10.3390/brainsci11020253

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