The Safety Net

Nonverbal Signs and Symptoms of Physical Discomfort


As a clinical professional, you may encounter many persons with developmental disabilities who are either nonverbal or have limited ability to describe the symptoms that they may be experiencing. Following is a list of behavioral indicators and some suggestions of possible medical problems. If a consumer exhibits any of these indicators, this information should be discussed with their medical practitioner. Early identification of potential or existing problems helps ensure prompt intervention that may well enhance the quality of life for consumers or perhaps prevent an untimely death.
The following indicators are just some of the clues that may alert you to possible health issues.

Persistent hand chewing or fist in mouth
Look for: GERD (gastroesophageal reflux disease); dental disease; rumination; nausea; sinus; and ear problems

Uneven sitting
Look for: hip pain; genital discomfort; rectal pain

Unusual or recurrent masturbation
Look for: prostatitis; urinary tract infection; vaginitis; pinworms

Waving head side to side
Look for: decreased peripheral vision or reliance on peripheral vision; sinus or ear problems; reflux esophagitis

Head banging
Look for: increased intra-cranial pressure especially when a shunt is in place; migraine; dental pain; otitis-mastoiditis-sinusitis infections

Head tilt
Look for: visual disturbance; cervical body subluxation; gastroesophageal reflux

Sudden sitting
Look for: Atlanto-axial dislocation; vertigo; cardiac problems

Look for: General- obsessive compulsive disorder; hypothalamic problems; history of under-stimulating environments. Cigarette butts nicotine addiction; generalized anxiety disorder. Glass suicidality; and endogenous opiate addiction. Paint chips lead intoxication. Sticks, rocks, other jagged objects endogenous opiate addiction. Dirt iron or other deficiency state. Feces Post
Traumatic Stress Disorder (PTSD); psychosis

General scratching
Look for: eczema; drug effects; liver/renal disorder; scabies

Scratching or rubbing stomach
Look for: gastritis; ulcer; pancreatitis; porphyria; gall bladder disease

Rubbing or hugging chest
Look for: pneumonia; GERD; costochondritis; angina

Forward and truncal rocking
Look for: GERD; hip pain; back pain

General non-specific change in behavior as reported by those most familiar with the individual
Look for: esophagitis with reflux; bone injury (i.e. fracture with or without osteoporosis), dislocated hip, bone infection; dental disease; eye pain (scratched cornea, glaucoma, conjunctivitis); occult infection (sinusitis, otitis media, urinary tract infection, vaginitis, prostatitis); constipation; rectal fissures; hernia


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