Touch Sensitivity: A Bedside Test for Autism

STUDY: Kadlaskar G et al, JCPP Advances 2026

STUDY TYPE: Cross-sectional cohort study

FUNDING: National Institute of Mental Health; Indiana Clinical and Translational Sciences Institute; Purdue Big Idea Challenge 2.0; Riley Children’s Foundation

Background

Autism is typically diagnosed around age 4 in the United States, years after the first symptoms appear. Clinicians have long noticed that autistic children respond differently to touch, but it wasn’t clear whether that pattern could help distinguish autism from other developmental conditions. This study tested whether a brief tactile assessment could serve as a diagnostic marker in young children referred for developmental evaluation.

The Study

• 151 children ages 19 to 48 months: 108 with autism, 43 with other developmental concerns including language delay and global developmental delay.
• Children were tapped on the shoulder (social touch) or exposed to an air puff (non-social touch) while distracted by a toy, using the Sensory Processing Assessment.
• Clinicians recorded whether and how quickly each child turned toward the stimulus.

Autistic children were slower to orient to both the shoulder tap and the air puff. On the shoulder tap, 62% of autistic children failed to orient on the first trial, compared to 23% of non-autistic children (sensitivity 0.62, specificity 0.76). On the air puff, 21% of autistic children didn’t respond, versus 7% in the non-autism group (specificity 0.93).

The most distinctive finding: 14% of autistic children failed to orient to both touches, while none in the non-autism group missed both. If a child didn’t respond to either touch, the test correctly identified autism 100% of the time (positive predictive value 1.0). Across all children, reduced touch responsivity correlated with greater autism symptom severity, lower language and cognitive scores, and weaker adaptive skills.

Limitations

The air puff and shoulder tap were each paired with specific distractor toys, which may have influenced attention differently. No neurotypical comparison group was included.

Practice Implications

1. A child who ignores both a shoulder tap and an air puff during a brief play-based assessment has a high chance of autism, not just developmentally delayed.
2. This assessment requires no specialized training, making it feasible in primary care where access to autism specialists is limited.