Winnie Dunn

• Doctor of Philosophy
• Distinguished Professor at University of Missouri

Introduction The translation and use of evidence-based practices (EBPs) within early intervention (EI) systems presents challenges. The Office of Special Education (OSEP) has emphasized results-driven accountability to expand state accountability from compliance to also include quality services that align with EBPs. OSEP’s results-driven accountabi...

Telehealth is rapidly expanding; however, few studies have investigated hybrid models that include synchronous and asynchronous components. While research recognizes the importance of tailoring interventions to meet individual child needs, we have yet to understand how to tailor interventions to parent characteristics. This study examined how basel...

Consumer experience is a key driver of successful health and education outcomes. Yet, the key factors influencing consumer experiences with care are not fully understood. The aim of this study was to understand, from the perspective of people receiving health care or education services, factors that determine positive and negative experiences with...

Background: Coping strategies were found to predict success in rehabilitation. Research is lacking in identifying the specific coping strategies used to adjust to sensory changes after stroke. Objective: This study utilized a qualitative descriptive method to understand how individuals handle sensory changes after stroke. Method: Researchers d...

Date Presented 04/20/2023 Intervention integrity is considered central to fidelity and the monitoring of intervention fidelity is important as a demonstrated mediator of outcomes. Documenting reliability among raters is critical to these functions. We describe development and field testing of a sensitive, research-based coaching fidelity measure to...

Date Presented 04/22/2023 We present the impact of a statewide evidence-informed professional development (PD) program on the ability of early intervention providers to use a coaching approach with fidelity during both in-person and telehealth visits. PD program features and study findings will engage providers to reflect on their practice and oppo...

Background: Independence in toileting is a vital skill, yet toilet-training interventions for children with autism are limited. Objectives: We investigated the acceptability and preliminary efficacy of a hybrid telehealth intervention that used synchronous individualized coaching sessions and asynchronous online educational materials to support...

Purpose Research about children tends to consider differences from expected patterns problematic, and associates differences with disabilities [e.g., Autism, attention deficit hyperactivity disorder (ADHD)]. When we focus on disabilities and consider differences automatically problematic, we miss the natural variability in the general population. T...

Background Screening guidelines recommend listening closely to parent concerns to aid in the identification of children with disabilities, since parent concerns may be predictive of an eventual child diagnosis. Methods We performed a secondary analysis to examine the extent to which specific parent concerns differentiated six diagnostic categories...

Date Presented 03/29/20 We present on a research project that used telehealth to support parents of children with autism spectrum disorder (ASD) to toilet train their children. Among n=15 children with ASD, results of the 12-week intervention showed significant gains in goal attainment scaling, the Canadian Occupational Performance Measure, and the...

Background Previous literature examined tactile and proprioceptive changes after stroke; however, the lived experience of changes in all sensory systems is still a gap in the literature. Purpose To gain understanding of stroke survivors’ experience of sensory changes and how sensory changes impact participation in daily life activities. Method Th...

Date Presented 04/05/19 While many studies focus on the impact of somatosensory changes on participation after stroke, they do not address the lived experience of all sensory systems (e.g., taste and smell). Researchers used a qualitative descriptive method using semistructured interviews to collect data. Results from this study could be utilized t...

Date Presented 04/04/19 Disparities exist in the early identification of underserved children with ASD. Our study used a large university sample to examine subtypes of children with an eventual ASD diagnosis based on parent concerns and sociodemographics. Results suggest that children with speech parent concerns are most likely identified earlier,...

Occupational therapy services delivered via telehealth can support families of young children with autism spectrum disorders (ASD) in everyday routines such as mealtime, bedtime, and play. The aim of the current study was to understand the lived experiences of parents who participated in a 12-week, telehealth-delivered occupational therapy interven...

[in press]

Sensory changes are common after stroke. Previous literature examined tactile and proprioceptive changes after stroke and its impact on occupational engagement. While these studies focused on the impact of somatosensory changes on participation after stroke, they did not address the lived experience of changes in all sensory systems, and how people...

Date Presented 4/21/2018 In a sample from the general population, including typically developing children and those with conditions, sensory processing predicted social skills and problem behaviors. Different sensory processing patterns were associated with specific social skill and problem behavior domains. Primary Author and Speaker: Noor Ismael...

Date Presented 4/21/2018 Occupational therapy delivered via telehealth is an innovative service delivery model. Our study indicates telehealth was highly acceptable to families of children with autism spectrum disorder. Telehealth resulted in cost savings for both therapists and families compared with traditional service delivery models. Primary Au...

Date Presented 4/21/2018 We report the reliability and validity of the Spanish version of the Child Sensory Profile 2 (SP-CSP2). The SP-CSP2 has good reliability. We matched participants with a sample that completed the English version of the form. Differences are discussed and can inform culturally competent practice and research. Primary Author a...

Intervention services positively impact outcomes of children with autism spectrum disorder (ASD) and their families. However, families face many burdens when accessing high-quality intervention services such as availability of providers, time, and cost; these burdens are often magnified for underserved families. Therefore, the purpose of this study...

Given the heterogeneity of autism spectrum disorder (ASD), research has investigated how sensory features elucidate subtypes that enhance our understanding of etiology and tailored treatment approaches. Previous studies, however, have not integrated core developmental behaviors with sensory features in investigations of subtypes in ASD. Therefore,...

Objective: We investigated the efficacy of Occupation-Based Coaching delivered via telehealth for families of young children with autism spectrum disorder (ASD). Method: Participants were 18 families of children with ASD ages 2-6 yr. We used descriptive statistics to understand intervention characteristics and paired-sample t tests to examine ch...

Aims: The purpose of this study was to examine sensory processing in children ages 3-14 years with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and typical development (TD) using the Sensory Profile 2nd Edition (Dunn, 2014). Methods: Participants included 239 children (ASD = 77; ADHD = 78; TD = 84) matched on...

Sensory processing is a personal trait that can contribute to challenging behavior. Protective factors, such as resiliency, can support children in managing their behavior, yet little research has addressed the contribution of sensory processing to protective factors. Therefore, in this cross-sectional study we aimed to determine the contribution o...

Children use executive function (EF) skills within everyday occupations; however, EF poses a difficult and complex construct to measure. Currently, many measures of EF lack applicability to daily life, or ecological validity. The aim of this scoping review was to examine two aspects of ecological validity across measures, assessments, and tasks of...

Purpose There is growing evidence supporting the use of strengths-based practices when serving families. The purpose of this study was to examine the use of strengths-based approaches in the context of written professional documentation. We specifically explored whether or not interdisciplinary clinicians in one university-based medical center clin...

As the call for evidence-based practices has risen, discussions about the fidelity of those practices have received increased attention. Although research suggests that Occupational Performance Coaching (OPC) is effective, a systematic evaluation of the fidelity of OPC is needed. The purpose of this study was to test fidelity of OPC intervention th...

Date Presented 3/30/2017 This session describes subtypes and profiles of children based on sensory processing patterns and developmental characteristics in a sample of toddlers under age 3 yr diagnosed with autism spectrum disorder (N = 75). Implications for practice are discussed. Primary Author and Speaker: Scott Tomchek Additional Authors and Sp...

Background: The aim of this study was to subtype groups of children in a community sample with and without developmental conditions, based on sensory processing patterns. Methods: We used latent profile analysis to determine the number of sensory subtypes in a sample of n = 1132 children aged 3-14 years with typical development and developmental...

Date Presented 4/8/2016 The literature emphasizes sensory processing contributions to challenging behavior in children with conditions. Our findings illustrate that children in the general population show similar relationships. By recognizing these relationships, we can better support all children’s participation. Primary Author and Speaker: Evan D...

Date Presented 4/8/2016 The literature emphasizes sensory patterns among vulnerable populations. Our findings illustrate that children in the general population have similar patterns. By recognizing these similarities, we can study children who are participating successfully to discover how they manage everyday life. Primary Author and Speaker: Win...

Date Presented 4/9/2016 This study used confirmatory factor analysis to investigate the validity of the Sensory Profile 2 (SP2). The SP2 demonstrated a good fit with the four-factor model (based on Dunn’s Sensory Processing Framework). Primary Author and Speaker: Evan Dean Additional Authors and Speakers: Winnie Dunn, Lauren Little

Date Presented 4/7/2016 This study is testing the feasibility, acceptability, and preliminary efficacy of a 12-wk coaching intervention for families of children with autism spectrum disorder (ASD) delivered via telehealth. Findings from this study will inform how occupational therapists may use telehealth to expand service delivery for families of...

Date Presented 4/8/2016 This session will describe the relationships between sensory processing patterns and autism spectrum disorder (ASD) risk (as measured by ASD screening measures) in a sample of toddlers diagnosed with ASD. Early identification and intervention implications for occupational therapy practitioners will be discussed. Primary Auth...

The objective of this study was to identify and synthesize research about how sensory factors affect daily life of children. We designed a conceptual model to guide a scoping review of research published from 2005 to October 2014 (10 years). We searched MEDLINE, CINAHL, and PsycINFO and included studies about sensory perception/processing; children...

Sensory processing differences in preschool-age children with autism spectrum disorder (ASD) affect their engagement in everyday activities, thereby influencing opportunities to practice and develop skills such as social communication and adaptive behavior. The purpose of this study was to investigate the extent to which specific sensory processing...

Date Presented 4/17/2015 In this session, we present the findings of a study in which we investigated the developmental stability of the seeking-sensory pattern though age groups and across clinical diagnostic groups. Implications for assessment and intervention planning of occupational therapy practitioners are discussed.

Date Presented 4/16/2015 This study describes subtypes/profiles of children on the basis of sensory processing patterns and child characteristics in a large sample of children diagnosed with autism spectrum disorder (ASD; n = 400) between ages 3 and 6 yr. Implications for practice are discussed.

The study aim was to determine natural variability in somatosensation across age groups using brief measures. We validated measures in a community-dwelling population as part of the National Institutes of Health (NIH) Toolbox for Assessment of Neurological and Behavioral Function (NIH Toolbox; http://www.nihtoolbox.org). Participants included commu...

Objective: Given reports of high pain thresholds and reduced auditory response in individuals with agenesis of the corpus callosum (AgCC), this study investigated whether affected participants report atypical experiences and behaviors on a well-established sensory processing measure. Methods: Fourteen participants with AgCC (ages 11-59) complete...

Consumer-directed services (CDS) are a type of support system designed to increase the quality of life and self-determination of clients, such as adults with developmental disabilities. Occupational therapists can play an important role in facilitating people's involvement in CDS supports. This paper describes CDS, evidence that supports their use,...

The literature describing individuals with autism spectrum disorders (ASDs) commonly includes descriptions of differences in sensory processing. The purpose of this study was to describe patterns of sensory processing found in 400 children with an ASD. Exploratory factor analysis identified 6 parsimonious factors: low energy/weak, tactile and movem...

Background: Sensory features, which cluster into sensory processing patterns, differ among diagnostic groups (e.g., Baranek et al., 2006; Dunn & Bennett, 2002). There is limited evidence, however, related to the developmental correlates of sensory processing patterns across diagnostic groups, particularly related to autism spectrum disorders (ASD)...

Touch sensation is one element of sensory function. As such, somatosensation is one of the sensory domains included in the NIH Toolbox, which is an assessment battery for measuring a range of human functions including emotional health, sensation, cognition, and motor function. We evaluated a variety of methods for inclusion in the NIH Toolbox main...

Objective: Pain is an important component of health and function, and chronic pain can be a problem in its own right. The purpose of this report is to review the considerations surrounding pain measurement in the NIH Toolbox, as well as to describe the measurement tools that were adopted for inclusion in the NIH Toolbox assessment battery. Methods...

ABSTRACT The purpose of this study was to understand the perceptions of mothers of children with autism spectrum disorder (ASD) who participated in 10 one-hour coaching sessions. Coaching occurred between an occupational therapist and mother and consisted of information sharing, action, and reflection. Researchers asked 10 mothers six open-ended qu...

OBJECTIVE. We tested an occupational therapy contextual intervention for improving participation in children with autism spectrum disorders and for developing parental competence. METHOD. Using a repeated-measures pretest–posttest design, we evaluated the effectiveness of a contextually relevant reflective guidance occupational therapy intervention...

It is well established that individuals with Asperger syndrome (AS) often show extreme sensory processing patterns. Our study seeks to determine the relationship between behavioral measures of sensory processing and neuromagnetic brain responses in children and adolescents with Asperger syndrome vs. healthy individuals. Sensory profiles were assess...

We evaluated the effectiveness of contextual intervention to increase participation in self- or parent-identified activities for adolescents with autism spectrum disorders (ASD). The eight- session intervention involved the use of coaching principles to convey information, everyday routines, and authentic settings and sensory processing information...

Purpose Growing evidence exists regarding the relationship between sensory processing and affective disorders. However, most of this evidence relates to children. This study aimed to explore the relationship between positive/negative affect and sensory processing patterns as expressed in daily situations among healthy adults. Procedure Two hundred...

Purpose The purpose of the study was to examine the relationship between extreme sensory reactivity as expressed in daily living situations, and trait and state anxiety, among healthy individuals. Procedures One hundred and thirty-five healthy individuals filled in the Adolescent/Adult Sensory Profile regarding their responses to daily sensory exp...

OBJECTIVE. We examined the relationship between pain perception, as expressed by pain catastrophizing level, and sensory processing patterns among typical adults. METHOD. Two hundred ninety healthy adults participated in this study: 138 men and 152 women. Their ages ranged from 18 to 50 (mean age = 30.2 ± 6.8). All participants completed the Adoles...

"Selective" or "picky eating" is a frequent problem in children with autism spectrum disorders (ASD). Many of these children do not treat sensory input, particularly olfactory, auditory, visual, and tactile information in the same manner as their typically developing peers of the same age. The purpose of this paper was to examine the relationship b...

Many children with autism spectrum disorders (ASD) have mealtime problems. Diagnosis and the social environment may influence eating behaviours. We examined whether children with ASD have more mealtime problems than their typically developing siblings, and whether age and sex are associated with mealtime problems. Forty-eight families participated...

The purpose of the study was to determine the relationship between sensory processing and context for children with autism. We examined home and school contexts using the Sensory Profile (Dunn, 1999) and the Sensory Profile School Companion (Dunn, 2006a) questionnaires. Teachers of 49 students with autism completed the Sensory Profile School Compan...

Background: Individuals with agenesis of the corpus callosum (AgCC) have social and communication deficits similar to those reported in autism spectrum disorders (ASD). Furthermore, there are a growing number of studies reporting atypical corpus callosum structure in cohorts with ASD. Consequently, AgCC cohorts serve as an excellent model for study...

This commentary provides an analysis of an article by Gere, Capps, Mitchell, and Grubbs (2009) about sensory sensitivities of gifted children. The article reports that children who are gifted are more sensitive to sensory experiences. Researchers hypothesized that children's sensitivities contribute to their excellent problem-solving skills and mig...

Although the Sensory Profile has provided standardized information about children's sensory processing patterns, the information informs us about everyday life at home and in the community from parents. Therapists working in public schools have been needing information about children's responses to sensory experiences at school. The Sensory Profile...

The purpose of this study was to determine whether students with specific learning disabilities (SLD) with and without attention-deficit/hyperactivity disorder (ADHD) have different sensory processing when compared to students without disabilities. Parents of 240 students ages 5 to 11 years (120 SLD, 120 typical) completed the Sensory Profile. Mult...

This study examined the incidence of extreme sensory modulation behaviors in toddlers with autism spectrum disorders (ASD) and investigated the consistency of sensory information across measures. Parent report of sensory behaviors in 101 toddlers with ASD was compared with 100 toddlers who were typically developing matched on chronological age and...

There is an accumulating literature describing sensory processing in young children and suggesting the importance of this knowledge for understanding the characteristics of vulnerable children. Professionals and families need a working knowledge about sensory processing because it enables them to understand and interpret children's behaviors and to...

The purpose of this study is to investigate differences in sensory processing among age-matched children between ages 3 and 6 years with autism spectrum disorders (ASD) and those who are typically developing. Reported sensory processing abilities of 281 children with ASD were compared to age-matched peers who were typically developing, using the Sh...

The purpose of this study was to examine whether children with Asperger Syndrome and children with autism exhibit difference sensory profiles. The Sensory Profile (Dunn, 1999), completed on 86 individuals with Asperger Syndrome and 86 persons with autism matched for age, revealed differences in three of 23 areas evaluated: (a) Emotional/Social Resp...

This study investigated whether there are age-related differences in sensory processing within daily life. Participants included 404 community-dwelling adults divided into three age groups: 19 to 34 years old (127 individuals), 35 to 64 years old (126 individuals), and 65 years and older (151 individuals). Each participant completed the Adolescent/...

We report on initial development of the Infant/Toddler Sensory Profile; a parent questionnaire assessing a child's sensory processing abilities. Parents of 401 typically developing infants and toddlers completed the 81-item questionnaire. Findings suggest that 48 of 81 items best characterized sensory processing for children 7 to 36 months of age,...

The purpose of this article is to discuss sensory processing concepts and their application to the needs of children who have Asperger syndrome (AS). First we will outline the basic characteristics of the sensory systems, then discuss a model for sensory processing, and, finally, present a summary of the data supporting the application of this mode...

The possible coexistence of supersensitivity and overinhibition (Schizophrenia: Origins, Processes, Treatment and Outcome (1993) 335-350) in schizophrenia was studied using the Adult Sensory Profile as a measure of Dunn's (Infants Young Children 9 (1997) 23-25) model of sensory processing. The quadrant model describes sensory sensitivity, sensation...

The purpose of this study was to identify the sensory processing patterns of children with Asperger syndrome. Researchers compared the performance of 42 children with Asperger syndrome and 42 children without disabilities on section and factor scores of the Sensory Profile. As reported by parents on the Sensory Profile, the children with Asperger s...

The experience of being human is embedded in sensory events of everyday life. This lecture reviews sensory processing literature, including neuroscience and social science perspectives. Introduced is Dunn’s Model of Sensory Processing, and the evidence supporting this model is summarized. Specifically, using Sensory Profile questionnaires (i.e., it...

This article describes a series of studies designed to evaluate the reliability and validity of the Adult Sensory Profile. Expert judges evaluated the construct validity of the items. Coefficient alpha, factor analysis, and correlations of items with subscales determined item reliability, using data from 615 adult sensory profiles. A subsample of 2...

Infants and toddlers acquire information about the world from their senses. When this process occurs as expected, children learn; when young children have disabilities, the process can be disrupted. This preliminary report outlines the initial phase of measurement development for the Infant-Toddler Sensory Profile, a caregiver questionnaire in whic...

This article reports some of the findings from a national study of occupational therapy practice conducted by the National Board for Certification in Occupational Therapy (NBCOT) as part of its fiduciary responsibility to ensure that its entry-level certification examination is formulated on the basis of current practice. The NBCOT developed a surv...

The purpose of this study was to determine which factors on the Sensory Profile, a measure of children's responses to commonly occurring sensory experiences, best discriminate among children with autism or pervasive developmental disorder (PDD), children with attention deficit hyperactivity disorder (ADHD), and children without disabilities. Data f...

The purpose of this study was to identify relationships in the 125 items of the revised Sensory Profile, a tool designed to assess children's responses to commonly occurring sensory events. Parents of 1,115 children ages 3 to 10 years and without disabilities completed the Sensory Profile. The parents reported the percentage of time their children...

The purpose of this study was to determine whether the Sensory Profile discriminates between children with and without autism and which items on the profile best discriminate between these groups. Parents of 32 children with autism aged 3 to 13 years and of 64 children without autism aged 3 to 10 years completed the Sensory Profile. A descriptive a...

The article describes a proposed model for considering sensory processing an important factor in young children's performance. The author reviews constructs from neuroscience and behavioral science to propose how the transaction among these constructs may provide a framework for understanding various patterns of behavior and for developing methods...

Although rehabilitation professionals are increasingly aware that environments can support or interfere with an individual's ability to function, environmental factors are not emphasized in assessment and intervention planning across rehabilitation disciplines. Conceptual and methodological issues related to creating a measure for assessing the reh...

The purpose of this study was to obtain data about a national sample of children without disabilities on the 125-item revision of the Sensory Profile, a tool derived from sensory history items reported in the literature and designed to evaluate children's responses to commonly occurring sensory events. Parents of 1,115 children completed the Sensor...

This paper proposes a model framework, The Ecology of Human Performance (EHP) framework, for organizing adult basic education to utilize the skills of occupational therapists. The paper also includes two responses to the proposed framework by Janet S. Stotts and Cheryl Keenan. Reasons for the inclusion of occupational therapy in adult education pro...

This study examined the intervention success of weekly collaborative consultation between therapists and teachers. Ten therapist-teacher pairs consulted for 60 min weekly throughout the school year about students identified as having sensory integration dysfunction with learning problems. Each week, the pairs identified a specific functional classr...

The purpose of this study was to obtain data about typical children on the 99-item Sensory Profile, a newly developed tool derived from sensory history items reported in the literature and designed to assess children's responses to commonly occurring sensory events. Parents of 64 typical children 3 to 10 years of age completed the Sensory Profile;...

In theory and in practice, context (as an area of concern to occupational therapists) has not received the same attention as performance components and performance areas. The Ecology of Human Performance serves as a framework for considering the effect of context. Context is described as a lens from which persons view their world. The interrelation...