title: Pain sensitivity of children with Down syndrome and their siblings: quantitative sensory testing versus parental reports.
abstract: OBJECTIVE
  The aim of this study was to compare thermal detection and pain thresholds in children with Down syndrome with those of their siblings.
  
  
  METHODS
  Sensory detection and pain thresholds were assessed in children with Down syndrome and their siblings using quantitative testing methods. Parental questionnaires addressing developmental age, pain coping, pain behaviour, and chronic pain were also utilized.
  
  
  RESULTS
  Forty-two children with Down syndrome (mean age 12y 10mo) and 24 siblings (mean age 15y) participated in this observational study. The different sensory tests proved feasible in 13 to 29 (33-88%) of the children with Down syndrome. These children were less sensitive to cold and warmth than their siblings, but only when measured with a reaction time-dependent method, and not with a reaction time-independent method. Children with Down syndrome were more sensitive to heat pain, and only 6 (14%) of them were able to adequately self-report pain, compared with 22 (92%) of siblings (p<0.001).
  
  
  CONCLUSIONS
  Children with Down syndrome will remain dependent on pain assessment by proxy, since self-reporting is not adequate. Parents believe that their children with Down syndrome are less sensitive to pain than their siblings, but this was not confirmed by quantitative sensory testing.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Abraham J
authors.initials: AJ
authors.lastname: Valkenburg
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D059350:Chronic Pain / Q000209:etiology*; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D008297:Male; D009043:Motor Activity; D017288:Pain Threshold / Q000502:physiology*; D010290:Parents / Q000523:psychology; D010812:Physical Stimulation; D011930:Reaction Time / Q000502:physiology; D035781:Siblings; D011795:Surveys and Questionnaires