Nonverbal communication tool for children with severe motor and intellectual disabilities using biochemical measurement.

Children with severe motor and intellectual disabilities (SMID) find it almost impossible to communicate whether they are feeling comfortable or uncomfortable. Most of the children with SMID rely on medical care involving disposable-type life support devices such as tracheostomy tubes or gastric tubes. It is believed that the insertion and removal of these medical devices could cause extreme physical pain under certain circumstances. The authors have previously reported a hand-held type salivary amylase (AMY) activity monitor that can be used to evaluate the sympathetic nervous system. This report proposes a nonverbal communication procedure based on a biochemical measurement using AMY activity for children with SMID. The physiological conditions of these children were evaluated using a hand-held type AMY activity monitor that we fabricated. The AMY activity and heart rate of six subjects, who required daily insertion and removal of tracheostomy tubes or gastric tubes, were simultaneously measured before and after medical care. Apart from one subject who required a respirator due to severe cerebral palsy, the experimental results showed that the AMY value increased sharply by 200 400% after medical care compared to the resting state. Furthermore, the rate of change of AMY activity was 10 times larger than the change in heart rate. Therefore, it is suggested that using these biochemical measurements a nonverbal communication tool for children with SMID can be established.