Measuring Oral Sensitivity in Clinical Practice: A Quick and Reliable Behavioural Method
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ORIGINAL ARTICLE
Measuring Oral Sensitivity in Clinical Practice: A Quick and Reliable Behavioural Method Terence M. Dovey • Victoria K. Aldridge Clarissa I. Martin
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Received: 15 December 2012 / Accepted: 18 February 2013 Ó Springer Science+Business Media New York 2013
Abstract This article aims to offer a behavioural assessment strategy for oral sensitivity that can be readily applied in the clinical setting. Four children, ranging in age and with a variety of developmental and medical problems, were used as test cases for a task analysis of tolerance to touch probes in and around the mouth. In all cases, the assessment was sensitive to weekly measures of an intervention for oral sensitivity over a 3-week period. Employing an inexpensive, direct, specific to the individual, replicable, reliable, and effective measure for a specific sensory problem would fit better with the edicts of evidence-based practice. The current method offered the initial evidence towards this goal. Keywords Dysphagia Tactile sensitivity Oral sensitivity Treatment Assessment Task analysis Deglutition Deglutition disorders
Oral sensitivity (also known as defensiveness) has yet to be operationally defined within the literature. It should be noted that several similar terms exist. Oral sensitivity has previously been described as a generic term that refers to the T. M. Dovey (&) V. K. Aldridge C. I. Martin Loughborough University Centre for Research into Eating Disorders (LUCRED), School of Sport, Exercise and Health Sciences, Loughborough University, Brockington Building, Loughborough, Leicestershire LE11 3TU, UK e-mail: [email protected] V. K. Aldridge Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK C. I. Martin Midlands Psychology, Midland House (Main Office), Stowe Court, Stowe Street, Lichfield, Staffordshire WS13 6AQ, UK
assessment of nociperception (pain) to items in the mouth, e.g., chilli burn [1]. Oral tolerance refers to immunoreactivity to items in the mouth [2]. Finally, oral sensory processing refers to the ability to discriminate the energy value of food based on its oral sensory perception [3]. These apparently related terms are difficult to parse in continuingeducation forums, especially when addressing their measurement and impact on a child’s behaviour in the clinical setting. The literature struggles to differentiate the specific term ‘‘oral sensitivity’’ from the global components of tactile sensitivity (deriving insult from tactile interaction with objects in the environment that most would find inoffensive) [4], other food refusal behaviours such as head shaking and vomiting [e.g., 5], and taste sensitivity (deriving insult from the taste of a food item once placed on the tongue) [e.g., 6]. This has left many published studies simply choosing not to define the phenomenon beyond the fact that the questionnaires employed measure that the child has these difficulties. Despite difficulties in defining oral sensitivity, it has been studied in a variety
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