Assessment of comorbid symptoms in pediatric autonomic dysfunction

Sally E. Tarbell*, Erin L. Olufs, Philip R. Fischer, Gisela Chelimsky, Mohammed T. Numan, Marvin Medow, Hasan Abdallah, Shelley Ahrens, Jeffrey R. Boris, Ian J. Butler, Thomas C. Chelimsky, Craig Coleby, John E. Fortunato, Raewyn Gavin, Janice Gilden, Renato Gonik, Kelsey Klaas, Lauren Marsillio, Erin Marriott, Laura A. PacePaul Pianosi, Pippa Simpson, Julian Stewart, Natalie Van Waning, Debra E. Weese-Mayer

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose: Pediatric patients with autonomic dysfunction and orthostatic intolerance (OI) often present with co-existing symptoms and signs that might or might not directly relate to the autonomic nervous system. Our objective was to identify validated screening instruments to characterize these comorbidities and their impact on youth functioning. Methods: The Pediatric Assembly of the American Autonomic Society reviewed the current state of practice for identifying symptom comorbidities in youth with OI. The assembly includes physicians, physician-scientists, scientists, advanced practice providers, psychologists, and a statistician with expertise in pediatric disorders of OI. A total of 26 representatives from the various specialties engaged in iterative meetings to: (1) identify and then develop consensus on the symptoms to be assessed, (2) establish committees to review the literature for screening measures by member expertise, and (3) delineate the specific criteria for systematically evaluating the measures and for making measure recommendations by symptom domains. Results: We review the measures evaluated and recommend one measure per system/concern so that assessment results from unrelated clinical centers are comparable. We have created a repository to apprise investigators of validated, vetted assessment tools to enhance comparisons across cohorts of youth with autonomic dysfunction and OI. Conclusion: This effort can facilitate collaboration among clinical settings to advance the science and clinical treatment of these youth. This effort is essential to improving management of these vulnerable patients as well as to comparing research findings from different centers.

Original languageEnglish (US)
Pages (from-to)843-858
Number of pages16
JournalClinical Autonomic Research
Issue number6
StatePublished - Dec 2023


  • Assessment measures
  • Autonomic dysfunction
  • Comorbidities
  • Orthostatic intolerance
  • Pediatric

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology


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