Research Article
Abnormal Pressure Pain, Touch Sensitivity, Proprioception, and
Manual Dexterity in Children with Autism Spectrum Disorders
Inmaculada Riquelme,
1,2
Samar M. Hatem,
3,4
and Pedro Montoya
1
1
University Institute of Health Sciences Research (IUNICS-IdISPa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
2
Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
3
Clinic of Physical Medicine and Rehabilitation, Brugmann University Hospital, 1020 Brussels, Belgium
4
Institute of Neuroscience, Universit´ e catholique de Louvain, Brussels, Belgium
Correspondence should be addressed to Pedro Montoya; pedro.montoya@uib.es
Received 30 July 2015; Revised 5 October 2015; Accepted 15 October 2015
Academic Editor: Etienne de Villers-Sidani
Copyright © 2016 Inmaculada Riquelme et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Children with autism spectrum disorders (ASD) ofen display an abnormal reactivity to tactile stimuli, altered pain perception, and
lower motor skills than healthy children. Nevertheless, these motor and sensory defcits have been mostly assessed by using clinical
observation and self-report questionnaires. Te present study aims to explore somatosensory and motor function in children with
ASD by using standardized and objective testing procedures. Methods. Tactile and pressure pain thresholds in hands and lips,
stereognosis, proprioception, and fne motor performance of the upper limbs were assessed in high-functioning children with ASD
( = 27) and compared with typically developing peers ( = 30). Results. Children with ASD showed increased pain sensitivity,
increased touch sensitivity in C-tactile aferents innervated areas, and diminished fne motor performance and proprioception
compared to healthy children. No group diferences were observed for stereognosis. Conclusion. Increased pain sensitivity and
increased touch sensitivity in areas classically related to afective touch (C-tactile aferents innervated areas) may explain typical
avoiding behaviors associated with hypersensitivity. Both sensory and motor impairments should be assessed and treated in children
with ASD.
1. Introduction
Autism spectrum disorders (ASD) have been repeatedly asso-
ciated with motor and somatosensory impairments. Motor
performance is narrowly related to the correct integration
of touch sensitivity, as it is shown by the coactivation of
brain somatosensory and motor areas during motor tasks
[1]. Tus, praxis performance requires representations of the
body, movement and environment (mediated by parietal
regions), and transcoding of these representations into move-
ment plans (mediated by premotor circuits) [2]. Moreover,
sensitivity and motor impairments have been related to the
ability to participate successfully in daily life activities in
children with ASD [3, 4].
It has been shown that perceptual-motor action models
combining somatosensory and motor circuits and necessary
to development of skilled gestures, such as manual dexterity,
are altered in children with ASD [4]. Te development of
gross and fne motor function appears to be delayed in
children with ASD [5–8] and individuals with ASD exhibited
dysfunctional posture and muscle tone, fne manipulative
apraxia, lower grip strength, stifer gait, lack of coordination,
lower movement speed, excessive associated movements,
and, in general, defcits in planning and execution of motor
actions compared to typically developing peers [8–16].
Children with ASD also are characterized by abnormal
sensitivity to touch, proprioceptive, and painful stimuli [17,
18]. Tus, previous work studies have found that high-
functioning children with ASD self-reported strong reactions
and heightened apprehension to external tactile stimuli
(hypersensitivity), as well as hyposensitivity to propriocep-
tion and pain stimuli [19]. Furthermore, questionnaire data
from parents and health professionals have revealed that
individuals with ASD displayed substantial alterations on
Hindawi Publishing Corporation
Neural Plasticity
Volume 2016, Article ID 1723401, 9 pages
http://dx.doi.org/10.1155/2016/1723401