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Updated: Aug 15, 2025
Quantitative Assessment of Cortical Auditory-tactile Processing in Children with Disabilities
Published on: January 29, 2014
Tactile sensitivity and motor coordination in infancy: Effect of age, prior surgery, anaesthesia & critical illness
Laura Cornelissen1,2, Ellen Underwood1,2, Laurel J Gabard-Durnam3
1Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA, United States of America.
Insights
Infant tactile sensitivity and lower limb motor responses are reliably measured with a new bedside protocol. Prior hospital experience did not significantly impact tactile sensitivity in infants, showing central nervous system resilience.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatric Medicine
Background:
- Tactile sensitivity in infants, especially those with prior hospital exposure, is not well understood.
- Developing reliable bedside sensory testing for infants is crucial.
Purpose of the Study:
- Investigate infant tactile sensitivity and lower limb motor coordination.
- Assess the impact of prior hospital experience on sensory processing.
- Develop feasible bedside sensory testing protocols.
Main Methods:
- Prospective, longitudinal study of 69 infants at 2 and 4 months old.
- Applied mechanical stimuli to the foot at graded intensities.
- Measured tactile, nociceptive, and motor flexion thresholds.
Main Results:
- Motor activity magnitude increased with stimulus intensity.
- Tactile sensitivity was unaffected by age, surgery, anesthesia, or ICU stay.
- Age influenced nociceptive threshold, indicating neural maturation.
Conclusions:
- A brief protocol can reliably measure infant tactile and nociceptive reactivity.
- Age is a predictor of nociceptive threshold due to neural circuit maturation.
- Prior hospital experience has minimal impact on infant sensory processing, highlighting CNS resilience.
Background:
Tactile sensitivity in the infant period is poorly characterized, particularly among children with prior surgery, anaesthesia or critical illness. The study aims were to investigate tactile sensitivity of the foot and the associated coordination of lower limb motor movement in typically developing infants with and without prior hospital experience, and to develop feasible bedside sensory testing protocols.
Materials And Methods:
A prospective, longitudinal study in 69 infants at 2 and 4 months-old, with and without prior hospital admission. Mechanical stimuli were applied to the foot at graded innocuous and noxious intensities. Primary outcome measures were tactile and nociceptive threshold (lowest force required to evoke any leg movement, or brisk leg withdrawal, respectively), and specific motor flexion threshold (ankle-, knee-, hip-flexion). Secondary analysis investigated (i) single vs multiple trials reliability, and (ii) the effect of age and prior surgery, anaesthesia, or critical illness on mechanical threshold.
Results:
Magnitude of evoked motor activity increased with stimulus intensity. Single trials had excellent reliability for knee and hip flexion at age 1-3m and 4-7m (ICC range: 0.8 to 0.98, p >0.05). Nociceptive threshold varied as a function of age. Tactile sensitivity was independent of age, number of surgeries, general anaesthesia and ICU stay.
Conclusions:
This brief sensory testing protocol may reliably measure tactile and nociceptive reactivity in human infants. Age predicts nociceptive threshold which likely reflects ongoing maturation of spinal and supraspinal circuits. Prior hospital experience has a negligible global effect on sensory processing demonstrating the resilience of the CNS in adverse environments.
