Related Experiment Video
Updated: Dec 20, 2025
Dried Blood and Serum Spots As A Useful Tool for Sample Storage to Evaluate Cancer Biomarkers
Published on: June 11, 2018
Feasibility of Dried Blood Spots in Children with Behavioral Problems
Sanne M Kloosterboer1,2, Estelle van Eijk1, Monique van Dijk3
1Departments of Hospital Pharmacy, and.
Insights
Dried blood spot (DBS) sampling is feasible for therapeutic drug monitoring in children with autism spectrum disorder (ASD). Most children experienced minimal pain, though some distress occurred, highlighting the need for careful consideration during sampling.
Area of Science:
- Pediatric Pharmacology
- Neurodevelopmental Disorders
- Clinical Chemistry
Background:
- Minimally invasive sampling is crucial for therapeutic drug monitoring and pharmacokinetic research in children with behavioral challenges.
- Dried blood spot (DBS) sampling offers a less invasive alternative for sample collection in pediatric populations.
- Assessing the feasibility and pain associated with DBS sampling in children with behavioral problems is essential for its wider adoption.
Purpose of the Study:
- To evaluate the feasibility of repeated dried blood spot (DBS) sampling in children diagnosed with autism spectrum disorder (ASD) and severe behavioral problems.
- To assess the pain experienced by children, their guardians, and the sampling personnel during DBS procedures.
- To investigate factors influencing pain intensity, including age, sex, and the performer of the fingerprick.
Main Methods:
- Conducted repeated DBS sampling in children (6-18 years) with ASD on antipsychotic medications.
- Utilized the Numeric Rating Scale (NRS-11) and Faces Pain Scale to assess pain from child, guardian, and performer perspectives.
- Employed linear mixed models to analyze the impact of age, sex, and performer on pain intensity.
Main Results:
- 247 fingerpricks were performed across 70 children; 7 children refused all sampling.
- Median pain scores were low: 2 (child), 3 (guardian), and 2 (performer) on the NRS-11.
- Child's age, sex, and the fingerprick performer did not significantly influence reported pain intensity.
Conclusions:
- Dried blood spot (DBS) sampling is a feasible method for children with ASD and severe behavioral issues.
- While most children reported minimal pain, a notable proportion (1 in 5) refused sampling due to distress.
- Repeated DBS sampling can be successfully implemented in this pediatric population, with careful attention to potential distress.
Background:
Minimally invasive sampling methods are important to facilitate therapeutic drug monitoring and pharmacokinetic research in children with behavioral problems. This study assessed the feasibility and pain of dried blood spot (DBS) sampling in this population.
Methods:
Repeated DBS sampling was performed in children with autism spectrum disorder (ASD) and severe behavioral problems using antipsychotic drugs, aged between 6 and 18 years. The child, guardian, and DBS performer assessed pain using the numeric rating scale (NRS-11) or 5-face Faces Pain Scale. The influence of age, sex, and the fingerprick performer on the child's pain intensity was analyzed using linear mixed models.
Results:
Overall, 247 fingerpricks were performed in 70 children. Seven children refused all DBS sampling. The median (interquartile range) NRS-11 pain scores were 2 (3) rated by children, 3 (2.5) by guardians, and 2 (2) by fingerprick performers. The child's age and sex, and fingerprick performer had no significant influence on pain intensity.
Conclusions:
DBS sampling could be performed in most children with ASD and severe behavioral problems. However, 1 in 5 children refused one or more DBS fingerpricks owing to distress. Most expressed minimal pain (NRS < 4). Repeated sampling with DBS is feasible in children with ASD and severe behavioral problems.
