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Toward a Best-Practice Protocol for Assessment of Sensory Features in ASD
Abstract
Sensory difficulties are a commonly occurring feature of autism spectrum disorders and are now included as one manifestation of the 'restricted, repetitive patterns of behavior, interests, or activities' diagnostic criteria of the DSM5 necessitating guidelines for comprehensive assessment of these features. To facilitate the development of such guidelines, this paper provides an overview of the literature on sensory features in autism spectrum disorder. We summarize the literature pertaining to: terminology, current assessment practices, sensory development, and the relationship of sensory features to core symptoms of autism. The paper concludes with recommendations for clinical assessment of sensory features in Autism.
... Sensory issues may exist in diverse manners and a person may have different kinds of responses to sensory stimuli like over-responsiveness (hyper-sensitivity), underresponsiveness (hyposensitivity), or sensory craving. (Schaaf & Lane, 2000). ...
... Early Childhood-Revised (Egger & Emde, 2011), and by organizations such as the Interdisciplinary Council on Developmental and Early Disorders (Greenspan & Wieder, 2008). As prevalent features of ASD, sensory issues are recognized within the diagnostic criteria of DSM-5 (DSM5 American Psychiatric Association A, 2013) as "restricted, repetitive patterns of behavior, interests, or activities" (Schaaf & Lane, 2000). ...
... 41% of participants of the study in the auditory processing predicted challenges of processing sounds and 45% in the Olfactory domains were classified as being Probable different, suggesting the potential challenges of processing smells. Significant variability in results may be the result of factors such as hearing impairment, auditory processing disorders, or environmental influences (Schaaf & Lane, 2000). These findings suggest that it is essential to address the potential challenges of sensory experiences for the sake of improving the quality of life (Smith & Brown, 2024). ...
... This has led to increased use of the term sensory reactivity by professionals in the field and in the more recent literature. 4,26 Second, the identification of a sensory reactivity assessment resulting from this systematic review will be adapted for use in South Africa, where sensory reactivity is the recommended term. ...
... The current best-practice recommendation for assessing sensory reactivity is the use of both a caregiver questionnaire and a performance-based assessment. 4,[31][32][33][34] This dual approach would enhance diagnostic accuracy. 4,[32][33][34] Neurophysiological measures have also been recommended. ...
... 4,[31][32][33][34] This dual approach would enhance diagnostic accuracy. 4,[32][33][34] Neurophysiological measures have also been recommended. 30,35 These include electroencephalography, salivary cortisol levels, cardiac vagal tone, electrical conduction patterns, and electrodermal responses. ...
Aim
To identify sensory reactivity assessments published in the literature for children aged 3 to 12 years and evaluate their psychometric properties to select the most appropriate one for adaptation to South Africa, with implications for other low‐ and middle‐income countries.
Method
We addressed the following two review questions. What tests have been published in the literature in the past 30 years to evaluate sensory reactivity with children aged 3 to 12 years? What is the validity and reliability of the tests reported in the studies? The COnsensus‐based standards for the Selection of health Measurement INstruments (COSMIN) methodology was used. We searched eight databases. Two reviewers independently screened and selected the studies.
Results
The reviewers identified 41 studies, representing 19 assessments. The most common type of assessment was the proxy‐reported caregiver questionnaire. Sensory systems most often assessed were visual, tactile, auditory, and vestibular. Study populations included those with autism spectrum disorder, attention‐deficit/hyperactivity disorder, and children born preterm. Ratings for measurement properties of most assessments were moderate to low.
Interpretation
Limited psychometric information was reported, with low ratings for many properties. The Sensory Processing 3‐Dimensions Scale was selected on the basis of its psychometric properties and alignment with best‐practice recommendation to use a caregiver questionnaire and a performance test to assess sensory reactivity.
... Although there are "gold-standard" behavioral assessments for diagnosis of ASD and genetic tests for diagnosis of DS, there is not an agreed-upon gold standard assessment to identify problems in sensory processing (Schaaf & Lane, 2015;. Consistent with previous research assessing sensory features Williams et al., 2018), we found that the two caregiver-report measures, the SP and the SEQ, are highly correlated. ...
... Compared to the two caregiver-report measures, there was less agreement between measures using different formats, specifically the caregiver-report and researcher-administered observational measure. This is not meant to say that one type of measure is better or more accurate; rather, it is to emphasize that the two different formats, which also depend upon different informants (caregivers versus researchers), contribute somewhat different yet important and complementary types of information about sensory processing (Kerr, Lunkenheimer, & Olson, 2007;Schaaf & Lane, 2015). The SP and the SEQ measures are based on the caregivers' perception of the child's responses in the context of daily living over time. ...
... Similar to the previously discussed concordance issues between caregiver reports and observational measure, educator reports have may also differ from clinician observations and caregiver reports (Levinson, Neuspiel, Eisenhower, & Blacher, 2021). Further research is needed to understand the relationship between various measure types (observational/questionnaires/ physiologic), across different informants (caregivers, clinicians, and educators), and contexts (home, school, community) to examine their clinical utility for differential diagnosis or intervention planning (Schaaf & Lane, 2015;Tavassoli et al., 2019;Williams et al., 2018). As suggested by Schaaf and Lane (2015), a specific agreed-upon assessment protocol that combines proxy reports (e.g., caregiver or teacher reports) and performance-based (e.g., observational) assessment will allow for more accurate subtyping and enhance precision in research and practice. ...
Background:
Atypical sensory processing impacts children with intellectual and developmental disabilities (IDD). Research has focused on SP in individuals with autism spectrum disorder (ASD); comparatively, little has been written regarding individuals with Down syndrome (DS) and IDDs.
Aims:
We compared patterns of sensory processing in children with DS to children with ASD, other IDDs, and typically developing (TD) peers examining the relationship among different sensory processing measures.
Methods and procedures:
We analyzed cross-sectional data using two caregiver questionnaires (SP, SEQ) and one observational measure (SPA). Groups were compared on three sensory processing patterns: hyporesponsiveness; hyperresponsiveness; and sensory interests, repetitions, and seeking (SIRS) via ANOVA. We assessed concordance through correlations.
Outcomes and results:
Children with DS, IDD, and ASD demonstrated more atypical sensory processing behaviors than TD peers. Children with ASD exhibited the most atypical responses across all measures, significantly more than DS children on all but one subscale. The IDD and DS groups differed on several measures. Measurement concordance was higher between caregiver-report versus observational assessment.
Conclusions and implications:
Differences between three clinical groups indicate that sensory processing features may differ across clinical populations regardless of cognitive functioning. Lower concordance between caregiver-report and observation measures highlights the need to understand sensory processing expression across different tasks and environments.
... Best practice assessment of sensory differences should incorporate multiple modes of measurement and multiple informants (e.g. parents, teachers), including measures of behaviors which can be directly observed rather than inferred (Blackwell et al., 2021;Schaaf & Lane, 2015). ...
... Indeed, those with behavioral difficulties or who have lower intellectually ability are excluded from research (Russell et al., 2019). To compound this issue, there is vast variation in sensory terminology (Schaaf & Lane, 2015), meaning that connections between concepts can be overlooked, or interrelated lines of research perused in silos. Therefore, whilst SOAR was created robustly, drawing on decades of sensory literature and autistic lived experience making it more likely than most measures to tap into the true/real-world sensory construct, it remains that the field still does not agree on the underlying concept we are trying to measure in the first place. ...
... It was on this basis that the stakeholders in the focus groups suggested the development of a companion parent-report measure for SOAR. The combination of measurement approaches is recommended within the field (Schaaf & Lane, 2015) and would likely provide a depth of understanding not possible through a single method of measurement. Relatedly, for clinical utility SOAR was designed to be used with only 5 min of behavioral observation. ...
Autistic people experience the sensory world differently, impacting behavior. First-hand accounts and group-based research have found that sensory differences impact a range of things including family life, anxiety, participation, and daily living. Early sensory differences are widely reported to be associated with a cascade of developmental difference, suggesting that early autism diagnosis and sensory mapping could enable the provision of supports to facilitate flourishing. However, appropriate measurement tools are not available as all rely on proxy report or are observation measures which include limited modalities or domains and require the administration of stimuli. Therefore, following the gold-standard recommendations for measurement development outlined by the PROMIS® framework, we created the Sensory Observation Autism Rating scale (SOAR). We identified sensory behaviors across all primary domains and modalities through an extensive autism-sensory literature review and from focus groups with autism stakeholders. The initial item bank was then refined by an expert panel and through video coding five-minutes of free play from Autism Diagnostic Observation Schedule assessments of 105 age- and gender-matched autistic and developmentally delayed children (aged 13-36 months; 38 female). An additional 25% of the sample were double coded to investigate interrater reliability. Observational data and expert review supported the reduction of the item bank to 37 items. We propose that the refined SOAR has excellent face and ecological validity, along with interrater reliability (Intraclass correlation = 0.87-0.99). Following further data collection and refinement, SOAR has promise to fully characterize sensory behaviors in autistic children and indicate useful supports.
... 10 Sensory modulation is one aspect of 'sensory processing' which broadly refers to an individual's 11 behavioural response to everyday sensory input (Schaaf & Lane, 2015). Sensory modulation refers to the 12 calibration of the intensity of behavioural responses to daily sensory stimuli (Schaaf & Lane, 2015). ...
... 10 Sensory modulation is one aspect of 'sensory processing' which broadly refers to an individual's 11 behavioural response to everyday sensory input (Schaaf & Lane, 2015). Sensory modulation refers to the 12 calibration of the intensity of behavioural responses to daily sensory stimuli (Schaaf & Lane, 2015). ...
... The 7 mean 'sensory processing' domain score on the SSP-2 was 43.03 (SD=55.94). Scores between[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] ...
Sensory modulation symptoms form a diagnostic criterion for autism spectrum disorder and are associated with significant daily functional limitations. Utilizing caregiver report on Short Sensory Profile‐2 (SSP‐2) for 919 autistic children (3–14.11 years), we examined the expression of sensory modulation symptoms by age and sex and investigated the existence of specific sensory modulation subtypes. Sensory modulation symptoms appeared to peak in frequency during middle childhood, particularly in sensory sensitivity and avoidance. Symptoms associated with sensory hypo‐reactivity and seeking tended not differ between age cohorts. Males and females demonstrated similar overall sensory modulation profiles, however, females showed elevated symptoms relating to sensory sensitivity. Model‐based cluster analysis revealed five interpretable sensory modulation subtypes which related to symptom severity (low, mid‐range, high). Subtypes demonstrating mid‐range symptom severity differed in focus on sensory hyper‐reactivity or seeking symptoms. The findings of this study report for the first time that age‐related differences in sensory modulation symptoms may be associated with sensory hyper‐reactivity only. The subtyping results also suggest that sensory modulation symptom severity is a reliable means of classifying variance within autistic children, however, consideration of differences in the behavioral strategies employed by individuals to manage sensory modulation symptoms may inform tailored supportive strategies.
Lay Summary
We studied sensory symptoms such as over‐responding, under‐responding and sensation seeking behaviors in 919 autistic children and adolescents. We found that 6–12‐year‐olds and females displayed the most sensory over‐responding symptoms. Autistic children could be grouped into mild, moderate, and severe levels of sensory symptoms, however, children differed in the type of strategies used to cope with their sensory symptoms meaning that they may require different intervention approaches.
... Assessment to identify SR difficulties has historically been done using a caregiver questionnaire [5][6][7]. The child's caregiver completes a Likert rating scale where they rate the frequency of behaviours that are commonly associated with SR difficulties. ...
... Disadvantages include the strong language base and subjective nature of the questionnaire, where the caregiver's emotions, culture, and parenting styles may influence their responses in the questionnaire [5,8]. To address these disadvantages, the current best-practice recommendation is for a caregiver questionnaire to be used in conjunction with a clinicianadministered, performance-based assessment [5,7]. This approach allows for triangulation of results, thus enhancing the diagnostic accuracy in the identification of SR difficulties. ...
Background: Sensory reactivity (SR) difficulties are characterised by problems regulating an individual’s responses to sensory input such that it interferes with occupational performance in daily tasks. South African occupational therapists use assessments developed in the United States to identify SR difficulties in children. These have been found to be inappropriate for the South African context. This study reports on the methodology used to adapt an assessment for use in the Western Cape Province of South Africa.
Method: The SPM-2 Child and Preschool caregiver self-report questionnaires and seven tests of the performance-based Evaluation in Ayres Sensory Integration (EASI) that assess SR were identified for adaptation. A qualitative methodology was used to identify challenges using the assessment in a sample of the Western Cape population. Cognitive interviews were conducted with six community members from diverse socioeconomic groupings. Inductive analysis was used to identify and group the emerging themes. The test adaptation was conducted by expert occupational therapists based on these findings.
Findings: Challenges were grouped into two themes, namely, language challenges, of which there were three subcategories and inappropriate or threatening assessment tasks. Fifty-three changes were made to the assessment.
Conclusion: A detailed methodology was developed to adapt a SR assessment for use in the Western Cape Province. Challenges in using the assessment were elicited primarily from community members rather than professionals.
... Ils se manifestent de manières variées, en réponse à un stimuli sensoriel et à différentes étapes du traitement de l'information. Ils entraînent des comportements inadaptés qui entravent ou compliquent les activités de la vie quotidienne (11)(12)(13). Il existe plusieurs SPD impactant le fonctionnement global de l'enfant (12,(14)(15)(16)(17). Cependant, la majorité des enfants avec TSA présentent des difficultés de modulation (18). Les SPD perturbent les capacités adaptatives des enfants dans leur vie quotidienne, en limitant leurs possibilités d'indépendance dans leurs activités (19). ...
... Ils entraînent des comportements inadaptés qui entravent ou compliquent les activités de la vie quotidienne (11)(12)(13). Il existe plusieurs SPD impactant le fonctionnement global de l'enfant (12,(14)(15)(16)(17). Cependant, la majorité des enfants avec TSA présentent des difficultés de modulation (18). ...
Contexte : Les Troubles du Spectre de l’Autisme (TSA) constituent un handicap fréquent dans la population pédiatrique. L’intégration sensorielle d’Ayres apparait dans la littérature comme étant une méthode d’intervention pour répondre aux problématiques sensorielles de ces enfants. Son utilisation est désormais reconnue. Cette étude observationnelle a pour objectif de documenter la pratique de l’Intégration sensorielle d’Ayres en ergothérapie auprès des enfants avec un TSA et en particulier ceux présentant un trouble du traitement de l’information sensorielle. Methode : L’étude est basée sur une enquête, par questionnaire, à destination des ergothérapeutes exerçant avec des enfants avec TSA et étant formés à l’Intégration Sensorielle d’Ayres par l’intermédiaire de l’Association Nationale Française des Ergothérapeutes.Resultats : L’utilisation de l’intégration sensorielle varie en fonction des professionnels, en fonction de leurs caractéristiques identitaires. Cependant, l’étude nous permet de mettre en lumière des tendances de pratiques en lien avec la population autistique, notamment l’utilisation de méthodes d’intervention en compléments. Les professionnels rencontrent des freins dans leurs pratiques et mettent en place des moyens alternatifs pour faciliter leur intervention.Conclusion : Cette étude nous donne une vision limitée sur la pratique de l’Intégration sensorielle par les ergothérapeutes français auprès des enfants TSA. Néanmoins, nous pouvons identifier un delta entre la théorie de l’intégration sensorielle et la pratique.
... Terms relating to sensory features in ASD vary and are poorly operationalized [9]. Hypo-reactivity, hyperreactivity, and sensory seeking are widely used but synonymous terms, such as under/over-reactive, poor registration, high/low threshold, sensory sensitivity, under/over-reactivity, sensory craving, sensory interests, and sensory preoccupation are also found in the literature. ...
... Sensory integration denotes how an individual organizes and uses sensory information [11], while multisensory integration refers to assimilation of spatially and temporally concurrent sensory stimuli [12]. Finally, sensory processing is described in the clinical literature (e.g., occupational therapy) as the overlap of becoming aware of stimuli and evoked behavioral responses [9,13] while addressed in the neuroscience literature as mechanisms of sensation, transduction, and perception. The lack of common terms used to describe sensory features is problematic because differences in nomenclature influence the conceptualization and measurement of the construct. ...
Background
Unusual responses to sensory stimuli are considered a diagnostic symptom of autism spectrum disorder with mounting research efforts put towards understanding, characterizing, and treating such symptoms.
Methods
This paper examines self and caregiver report tools used to measure sensory features in ASD through a systematic review of the psychometric evidence for their use. A total of 31 empirical papers were reviewed across 20 assessment tools. Substantial differences were identified in the specific sensory features defined across assessment tools. Sensory assessment questionnaires were evaluated against quality psychometric evidence criteria to provide a use recommendation.
Results
Five assessments were identified to be “appropriate with conditions,” while no sensory assessment tools were identified to have sufficient quality psychometric evidence to provide a recommendation of “Appropriate” for measuring sensory features in ASD.
Conclusion
Evidence from this review highlights potentially significant shortcomings among the current methods used to measure sensory features in ASD and suggests the need for more efforts in developing psychometrically sound sensory assessment tools for use in ASD populations.
... There is discordance in the literature about the most cited sensory outcome measures, 41 with measures often not covering the depth and breadth of patient symptoms. 20 The comprehensiveness of the Sensory Profile 2 (SP2) and Sensory Processing Measure (SPM) in children with tic disorders and comorbid neurodevelopmental conditions were brought into question because study participants reported sensory dysregulation symptoms that were not rated on either measure. ...
... Thirteen of the studies in this review 41,47,49,50,54,[56][57][58][61][62][63][64]76 reported on the internal consistency rating for 11 of the 12 measures (SEQ-3.0 excluded), indicating that internal consistency is the measurement property most commonly reported. ...
Aim
To determine the quality and utility of proxy‐reported sensory measures for children and adolescents with neurodevelopmental disorders (such as autism spectrum disorder, attention‐deficit/hyperactivity disorder, movement disorders, and intellectual disability).
Method
We systematically searched 11 databases. We applied the updated Consensus‐based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist and criteria for good measurement properties to evaluate instrument development and psychometric properties. Findings were summarized using a COSMIN adaptation of Grading of Recommendations, Assessment, Development and Evaluations.
Results
From 11 databases, 6748 articles were screened. Ninety‐one full‐length articles were reviewed after removing excluded studies and manual searches conducted by two reviewers. Data were extracted for 12 measures from 20 articles. Of the 12 measures, only three provided sufficient data to evaluate content validity and psychometric measurement properties. The Participation and Sensory Environment Questionnaire‐Home (PSEQ‐H) was the only measure that satisfied moderate content validity and moderate‐to‐high quality for measurement properties. These properties included: structural validity, hypothesis testing for construct validity, internal consistency, reliability, and measurement error.
Interpretation
One measure, the PSEQ‐H, met eight criteria for good measurement properties. To facilitate evidence‐informed clinical decision‐making, all psychometric properties of all 12 sensory‐based, proxy‐reported measures were presented. The importance of consumer engagement in measure development and the need for ongoing evaluation of measures against contemporaneous standards is recommended.
What this paper adds
Three measures provided studies on content validity and psychometric measurement properties.
The Participation and Sensory Environment Questionnaire‐Home had moderate quality for content validity studies and high‐to‐moderate quality evidence for psychometric properties.
The Participation and Sensory Environment Questionnaire was the only measure that included consumer involvement through qualitative interviews and pilot testing.
Consumer involvement in measure development is important for content validity.
Ongoing evaluation of measures against contemporaneous standards is recommended.
... Untreated sensory challenges frequently persist into adolescence and adulthood, predicting poorer quality of life, heightened anxiety, reduced occupational performance, and restricted social participation [8,9]. Early, targeted sensory-based interventions that combine environmental modification, graded sensory experiences, and caregiver coaching have been shown to improve adaptive behavior, self-regulation, and daily functioning [10][11][12][13]. ...
Background: Sensory processing difficulties can interfere with daily functioning and participation across adulthood. While standardized assessment tools exist, culturally validated instruments for Arabic-speaking adults remain limited. Objectives: This study aimed to validate the Arabic version of the Sensory Processing Measure-Second Edition (SPM-2) Adult Self-Report form in a Saudi population and evaluate its utility for the early detection of sensory processing challenges in at-risk individuals. Methods: A total of 399 Saudi adults (205 females and 194 males), aged 21 to 87 years (M = 44.1; SD = 16.2), completed the Arabic SPM-2 online. The scale consists of eight subscales, six of which form the Sensory Total score-Vision, Hearing, Touch, Taste and Smell, Body Awareness, and Balance and Motion-representing core sensory processing abilities (i.e., Sensory Total (ST)). The remaining two-Planning and Ideas and Social Participation-capture higher-order integrative functions and do not contribute to the ST. Results: The overall scale demonstrated strong internal consistency (α = 0.89), with subscale alphas ranging from 0.43 (Hearing) to 0.70 (Body Awareness). Confirmatory factor analysis (CFA) (χ 2 [3052] = 4147.4; p < 0.001) showed good absolute fit (RMSEA = 0.030) and moderate incremental fit (CFI = 0.74; TLI = 0.73), values that are typical for large-df models. Descriptive and cluster analyses identified distinct participant subgroups with elevated frequency ratings (scores of 2 or 3) suggestive of sensory risk. Significant age-related differences were observed across multiple sensory domains, while no significant sex-related effects were found. Conclusions: Although Social Participation and Hearing showed lower reliability, the Arabic SPM-2 exhibits sound internal structure and therefore shows promise for future clinical application once criterion validity is established. The findings support its application in culturally responsive screening, early risk identification, and intervention planning in Arabic-speaking contexts.
... estimates of the prevalence of sensory features in asD vary from 45% to 96% [35,36]. studies have shown that both the severity of sensory features [37] and the specific sensory response patterns [38] may be related to compromised adaptive functioning as well as social communication in asD and adapt responses to suit changes in the environment [39,40]. another symptom that may affect young adults with asD is cognitive processes like executive functions, which comprise a set of high-level cognitive controls that facilitate new ways of behaving and optimise one's approach to unfamiliar circumstances. ...
... Independent of intelligence, there have been identified connections between sensory issues and diagnoses such as ASD and ADHD (Dellapiazza et al., 2021;Scheerer et al., 2024). Descriptions of ASD individuals include issues with hypersensitivity, hyposensitivity, and sensory integration (Ben-Sasson et al., 2019;Schaaf et al., 2015). While self-reported atypical sensory processing is strongly linked to ASD, its physiological basis is unclear (Hazen et al., 2014), with links to behavioural and neural correlates being difficult to identify (Sapey-Triomphe et al., 2023). ...
This study introduces sensory responsivity (SR), which describes individual differences in sensory stimuli response strength and is hypothesised to affect stress responses in students and, in turn, their learning. To investigate this, a scale to assess SR was developed and linked to physiological responses. To this end, electrodermal activity (EDA) and sensory gating data was collected from a laboratory study with 100 students (12-21 y) and EDA data was collected in a classroom study with 35 students (17-18 y). In the lab study, sympathetic activation was generally lower for high SR groups, whilst in the classroom study, sympathetic activation was higher for high SR groups in line with differential susceptibility theory. The high SR groups demonstrated overall lower composite EDA values, which negatively correlate with learning, indicating a potential learning benefit. Thus, sensory responsivity moderates sympathetic activation based on the environmental sensory-intensiveness, which may impact learning and stress-related outcomes.
... In addition to these primary symptoms, hyper-or hypo-reactivity to sensory input have been added to the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1][2][3]. Sensory issues in ASD include difficulties adapting to temperature changes, discomfort with specific sounds, textures, or smells, attachment to moving objects, and aversion to light, and these symptoms often manifest simultaneously [4][5][6][7][8][9]. ...
Individuals with autism spectrum disorders (ASD) often exhibit difficulties in sensory processing, including visual hypersensitivity such as photophobia. This study investigates the neural mechanisms underlying photophobia in participants with ASD by analyzing pupillary responses. To achieve this, we examined the amplitude and velocity gradient (latency) of these responses. Pupillary responses were recorded using an eye-tracking system in participants with ASD (n = 17) and typically developing (TD) (n = 23). Stimuli alternated between bright (89.03 cd/m²) and dark (0.07 cd/m²) conditions following a dim state (2.75 cd/m²) with intervals of five seconds in Experiment 1 and 30 seconds in Experiment 2. The sensory profile test (AASP-J) showed that hypersensitivity was significantly defined in the ASD group than in the TD group. The pupillary response in the ASD group often featured missing values due to blinking during rapid alternation between bright and dark conditions, resulting in a decrease in the total number of participants. Specifically, only eight of the 17 participants in the ASD group and 20 of the 23 participants in the TD group remained for analysis in Experiment 1, and in Experiment 2, 15 of the 17 participants in the ASD group and 20 of the 23 participants in the TD group remained for analysis. In the dim state, pupillary diameter was large in the ASD and TD group in both experiments, while the pupil diameter decreased in the TD group in Experiment 2. In both experiments, maximum amplitude and its latency showed no significant differences between the two groups. However, the velocity gradient for the early mydriatic process in the dark condition was significantly faster in the ASD group. ASD individuals with hypersensitivity tend to have large pupil diameters under the dim state, as well as rapid dilation in the dark condition. These results may suggest a problem in the sympathetic nervous system, which controls pupil constriction.
... Sensory issues may exist in diverse manners and a person may have different kinds of responses to sensory stimuli like over-responsiveness (hypersensitivity), under-responsiveness (hyposensitivity), or sensory craving. (Schaaf & Lane, 2000). ...
... Autism spectrum disorders (ASD) affect at least 1% of the world's population (Zeidan et al., 2022). Those with ASD exhibit distinct characteristics, including restricted and repetitive patterns of behaviour (Schaaf & Lane, 2015). Additionally, they often experience challenges in social interaction, such as difficulties comprehending and using gestures within a social context (Stone et al., 2019). ...
Students with autism spectrum disorders (ASD) often feel insecure in new environments due to social challenges, unfamiliarity, and a lack of support or understanding. Despite considerable efforts dedicated to assisting students in adapting to new environments and understanding appropriate behaviours in public settings, there remains a lack of interactive and personalized learning systems. In this work, we developed a robot-assisted scenario training (RAST) system to facilitate inclusive learning and arouse students' learning interests. With the RAST system, we seek to identify effective interactions that can improve students' engagement. To this end, we invited 13 students with ASD to participate in an evaluation study. In the study, self- determination theory (SDT) measures students' learning engagement. Learning engagement and effectiveness are evaluated using variance analysis (ANOVA). Students also participated in interviews to report their user experience regarding the system. The results reveal that learning with the RAST system can significantly arouse students' intrinsic motivation and improve their behavioural, emotional, and cognitive engagement. Additionally, students with ASD increased their learning performance by 8.33%. Furthermore, students exhibited a high level of engagement in scenario training with certain types of interactions, including personalized functions, visual cues and sound quality. Overall, the RAST system demonstrates promising capabilities in enhancing students' learning engagement and proficiency with ASD.
... manifestar hiper ou hiposensibilidade a estímulos sensoriais, incluindo estímulos sensoriais apresentados pelas mídias digitais (Marco et al., 2011;Posar & Visconti, 2018). Essas dificuldades sensoriais podem impactar significativamente a qualidade de vida e o funcionamento diário desses indivíduos, como estudos, lazer e trabalho (Schaaf & Lane, 2015). ...
O desenvolvimento de intervenções efetivas para auxiliar crianças com Transtorno do Espectro Autista (TEA) no processamento e organização de informações sensoriais é essencial, considerando as dificuldades sensoriais frequentemente apresentadas por essa população e o crescente desenvolvimento tecnológico. O objetivo deste estudo foi apresentar o desenvolvimento do jogo sério El-Dorado Senses, ferramenta que visa modular a reatividade a estímulos sensoriais apresentados por tecnologias digitais em crianças com TEA. O processo de desenvolvimento envolveu uma equipe multidisciplinar e seguiu as etapas de análise, design, modelagem e implementação, utilizando ferramentas computacionais como Unity 3D, Adobe Illustrator e Photoshop. Testes de software (caixa preta e caixa branca) foram conduzidos para verificar a qualidade técnica do jogo e avaliação por especialistas para verificar a qualidade da aplicabilidade da ferramenta. Adicionalmente, foi desenvolvida uma plataforma web complementar para permitir que pais e profissionais monitorem o progresso das crianças. Os resultados mostram que o jogo El-Dorado Senses atende aos requisitos especificados.
... Currently, assessment of sensory discomfort in autistic people in community settings is largely through selfor parent-report questionnaires that gauge behavioral and affective responses to sensory stimuli (Schauder & Bennetto, 2016)-using the Short Sensory Profile (Tomchek & Dunn, 2007), for example-, with sensory phenotyping beyond these measures rare in clinical practice (Schaaf & Lane, 2015;Schauder & Bennetto, 2016). There is a notable lack of evidence demonstrating the clinical utility of sensory measures to support an autism diagnosis or monitor outcomes relevant to effective service interventions. ...
We need to combine sensory data from various sources to make sense of the world around us. This sensory data helps us understand our surroundings, influencing our experiences and interactions within our everyday environments. Recent interest in sensory‐focused approaches to supporting autistic people has fixed on auditory processing—the sense of hearing and the act of listening—and its crucial role in language, communications, and social domains, as well as non‐social autism‐specific attributes, to understand better how sensory processing might differ in autistic people. In this narrative review, we synthesize published research into auditory processing in autistic people and the relationship between auditory processing and autistic attributes in a contextually novel way. The purpose is to understand the relationship between these domains more fully, drawing on evidence gleaned from experiential perspectives through to neurological investigations. We also examine the relationship between auditory processing and diagnosable auditory conditions, such as hyperacusis, misophonia, phonophobia, and intolerance to loud sounds, as well as its relation to sleep, anxiety, and sensory overload. Through reviewing experiential, behavioral and neurological literature, we demonstrate that auditory processes interact with and shape the broader autistic profile—something not previously considered. Through a better understanding of the potential impact of auditory experiences, our review aims to inform future research on investigating the relationship between auditory processing and autistic traits through quantitative measures or using qualitative experiential inquiry to examine this relationship more holistically.
... However, due consideration must be given to methodology because assessments of this nature do exist. The vast variation in terminology within the field and the lack of a shared (common) researcher and clinician language constitute a problem of practice yet to be fully addressed (Schaaf & Lane, 2015). Our review methodology further highlights this issue, requiring multiple iterative searches to locate all known or seminal literature. ...
Importance: Children with sensory processing challenges often need supports to access, participate in, and achieve at school. However, research on best practice is varied, presenting difficulty for practitioners to assess the appropriateness of each support.
Objective: To provide evidence-informed recommendations regarding best practices in school-based supports for students with sensory processing challenges via a Rapid Evidence Assessment of current literature.
Data Sources: Searches were run in CINAHL Complete, Education Research Complete, ERIC, MEDLINE, PsycINFO, and Scopus (for articles published 2010 to 2023). Informed by a 2010 review, articles citing publications identified in the prior review were also included.
Study Selection and Data Collection: A reviewer screened the title and abstract of each article for inclusion, and another screened the full texts, with 10% of each reviewer’s articles assessed by the other. Interrater reliability was excellent.
Findings: The review included 61 articles, with only 15% constituting good evidence (38% provided adequate evidence, 31% provided poor evidence, and 16% were reviews). No support could be wholly recommended without caveats, but there was some evidence that sound amplification systems, alternate seating, and multisensory environments may be beneficial in certain conditions or with certain populations. The use of weighted vests is not recommended.
Conclusions and Relevance: Most research had small sample sizes and inconsistent protocols, highlighting the importance of ongoing research. Evidence-informed practitioners should review research findings carefully and integrate evidence from comprehensive clinical assessment and understanding of the child, school, and family contexts when assessing the appropriateness of a support for each student.
Plain-Language Summary: Children with sensory processing challenges often need supports to access, participate in, and achieve at school. Occupational therapists provide school-based supports for children with sensory processing challenges with the goal of enabling access, participation, and achievement. It is difficult, however, for practitioners to assess the appropriateness of each support because research on best practice varies. This review of the current literature provides practitioners with evidence on supports for school children with sensory processing challenges to inform decision-making and the selection of appropriate supports for their clients. When assessing the appropriateness of a support for a student, practitioners should carefully review current research findings and integrate evidence from comprehensive clinical assessments along with an understanding of the student, school, and family contexts.
... In contrast, Hilton et al. (2007) have reported strong association between sensory hyper-responsivity and various measures of social functioning derived from scores on the Social Responsiveness Scale (Constantino & Gruber, 2012) which measures social behaviours and RIRB. Schaaf and Lane (2015) suggest that discrepancies in the literature may reflect differences in how sensory processing is measured in individual studies. Boyd et al. (2010) report a strong positive association between hyper-responsivity, but not hypo-responsivity, and various repetitive behaviours in autistic children and in children with other developmental conditions. ...
Background: Although noted in the earliest descriptions of autism, differences in sensory processing , including hyper-responsivity, hypo-responsivity and sensory seeking, have only been included as a diagnostic criterion more recently. Understanding how these unique features of sensory processing are related to the emotional and social aspects of autism is an ongoing question. Here we ask whether differences in sensory processing are associated with alexithymia, a trait characterised by an inability to identify and describe one's feelings, which has a high incidence in autism. Method: Parents of autistic children (n = 38) and parents of non-autistic children (n = 35) completed four standardized scales, the Short Sensory Profile-2, Social Responsiveness Scale-2, Social Communication Questionnaire, and the Children's Alexithymia Measure. Results: Across all four scales the autistic children showed higher scores than the non-autistic children, with large effect sizes. Using the subscales of the SSP-2 we show that, for the autistic children but not for the non-autistic children, sensory hyper-responsivity is predictive of alex-ithymia, of core social features of autism and of restricted interests and repetitive behaviour (RIRB), after controlling for hypo-responsivity and sensory seeking. Conclusions: These results add to a small but growing literature on the relationship between sensory processing and social and emotional behaviours in autistic children, and are discussed with reference to predictive coding and 'sensory first' accounts of autism. As sensory differences in autism impact children's daily functioning and educational opportunities, understanding how these differences relate to social and emotional behaviour is important.
... Sensory phenotypes manifest across various modalities (e.g., auditory, visual, and tactile domains) in ASD individuals, involving alterations in sensory modulation and reactivity, as well as multisensory integration (Feldman et al., 2018;Proff et al., 2022;Robertson & Baron-Cohen, 2017;Schaaf & Lane, 2015). A recent meta-analysis revealed higher levels of hyperreactivity in ASD individuals compared to NTC (Ben-Sasson et al., 2019). ...
Evidence suggests different mismatch negativity (MMN) and P3a responses in individuals with autism spectrum disorder (ASD). Since unaffected siblings shared aberrant neurocognition and brain connectivity with ASD probands, this study investigated MMN and P3a responses in unaffected siblings and explored its neurocognitive implications and effects modifiers. We assessed 43 unaffected siblings of ASD probands and 64 non-autistic comparisons (NTC) using MMN and P3a on both frequency and duration oddball paradigms. The amplitude and latency of MMN and P3a were compared between unaffected siblings and NTC, and validated in 67 ASD probands. In addition, the neurocognitive correlates of MMN and P3a parameters were explored in attention performance, spatial working memory (SWM), and visual research via the tasks of the Conners’ Continuous Performance Test and the Cambridge Neuropsychological Test Automated Battery. Compared to NTC, unaffected siblings and ASD probands presented a shorter MMN latency. The P3a amplitude of the duration paradigm (dP3a) was correlated with fewer commission errors, fewer SWM total errors, higher detectability, and more correct responses on visual search tasks. In addition, the dP3a amplitude significantly interacted with sibship, age, and full-scale IQ to predict attention performance, SWM total errors, and total correct response on visual search. Findings suggest that unaffected siblings of ASD may have earlier brain responses upon novelty discrimination. P3a amplitude may correlate with better neurocognitive performance, but the effect was moderated by sibship, age, and intelligence.
... 19 In the Diagnostic and Problems with sensory abnormalities are found in a variety of senses, including sight, hearing, touch, smell, taste, and proprioception. 22 In particular, sensory abnormality problems in ASD have been reported to be associated not only with core symptoms but also with a variety of clinical features, including anxiety, attention problems, self-injury, problematic and maladaptive behaviors, and sleep disturbances, [23][24][25] making assessment and intervention important. Although there are several standardized rating scales for the assessment of sensory abnormality problems, objective assessment is difficult because of the highly subjective component and inevitable rater bias. ...
Aim
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is thought to involve a variety of neurophysiological characteristics. Event‐related potentials (ERPs) reflect cognitive functions in the brain's cognitive processing. In this study, we investigated differences in P300 and N100 of ERPs between ASD and typically developing groups and focused on the relationship between the components of ERPs and measures of autistic traits and sensory processing characteristics.
Methods
ERPs were measured in 96 subjects in the ASD group and 62 subjects in the age‐ and sex‐adjusted typically developing group. Correlations between each component and the scores of the Autism‐Spectrum Quotient Japanese version (AQ‐J) and the Adolescent and Adult Sensory Profile (AASP) were also evaluated.
Results
The ASD group showed a significant decrease in the amplitude of N100 at C3. Furthermore, a negative correlation was found between lower amplitude at C3 of N100 and low registered sensory scores in both groups.
Conclusion
Our findings imply that the N100 amplitude at C3 could be a potential indicator for examining the neurophysiological traits of ASD; however, these results should be interpreted with caution due to their preliminary nature. These tentative insights into sensory processing anomalies may be discernible in specific subsets of the ASD population, providing a foundation for future investigative pathways.
... Različne raziskave (Robertson in Simmons, 2013;Lane idr., 2010;Tavassoli idr., 2018) ugotavljajo, da imajo osebe z avtizmom pogosto posebnosti pri predelavi senzornih informacij. Sopojavnost avtizma in motnje senzorne predelave je med 45% do 96% (Dellapiazza idr., 2018;Schaaf in Lane, 2015;Jorquera-Cabrera idr., 2017;Thye idr., 2018;Ben-Sasson idr., 2009;Tomchek in Dunn, 2007). Na pomen prepoznavanja motnje senzorne predelave pri osebah z avtizmom kaže tudi dejstvo, da so senzorne posebnosti v peti izdaji Diagnostičnega in statističnega priročnika za diagnosticiranje duševnih motenj (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition --DSM-5; APA, 2013) zajete v enem od dveh osnovnih diagnostičnih kriterijev za motnjo avtističnega spektra. ...
In addition to difficulties with social communication and behaviour flexibility, children with autism spectrum disorder (ASD) often experience difficulty responding to sensory input. Our aim was to assess the sensitivity of the Questionnaire on Children’s Processing of Sensory Input to sensory issues experienced by children with ASD. Based on the responses of 108 parents of neurotypical children and 27 parents of children with ASD (3 to 10 years), we found that the questionnaire differentiated well between the groups. The questionnaire may be used by health, education or social services professionals and represents a novel tool for recognizing sensory processing difficulties in children. Information gained from it can help plan additional supports for children with sensory challenges.
... Differences in behavioral responses to sensory inputs from the environment have been associated with autism spectrum disorder (hereafter "autism") 1 since the first clinical descriptions of the condition [6,7]. Sensory phenotypes are present across multiple modalities (e.g., auditory, visual, tactile) and include differences in sensory reactivity and modulation, multisensory integration, and certain aspects of perception [8][9][10][11][12][13][14]. With regard to sensory reactivity, these features are frequently parsed into three specific behavioral "response patterns": hyperreactivity (HYPER; i.e., excessive and/or defensive reactions to stimuli that most individuals find innocuous), hyporeactivity (HYPO; i.e., diminished or absent responses to sensory stimuli that most individuals would respond to), and sensory seeking (SEEK; i.e., unusually strong fascination with or craving of sensory stimulation, often accompanied by repeatedly seeking out specific sensory inputs [15][16][17]). ...
Background:
Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population.
Methods:
Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO, and SEEK (sub)constructs.
Results:
All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses supported the validity of a supra-modal HYPER construct (ωH = .800) but not a supra-modal HYPO construct (ωH = .653), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ωH = .800; 4/7 modalities). Modality-specific subscales demonstrated significant added value for all response patterns. Meta-analytic correlations varied by construct, although sensory features tended to correlate most with other domains of core autism features and co-occurring psychiatric symptoms (with general HYPER and speech HYPO demonstrating the largest numbers of practically significant correlations).
Limitations:
Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to caregiver report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences.
Conclusion:
Of the three sensory response patterns, only HYPER demonstrated sufficient evidence for valid interpretation at the supra-modal level, whereas supra-modal HYPO/SEEK constructs demonstrated substantial psychometric limitations. For clinicians and researchers seeking to characterize sensory reactivity in autism, modality-specific response pattern scores may represent viable alternatives that overcome many of these limitations.
... Proff and colleagues [5] highlight the heterogeneity of sensory perception among people with autism and the different methodological approaches used to investigate it. A distinction, between hypo-and hyper-responsivity, has been proposed [6], and it has been found how these two profiles were associated with different behaviors and developmental outcomes [7]. In a recent study, on a large sample of children and adults with autism [8], the authors identify five sensory phenotypes. ...
Sensory features of autism include hypo- or hyper-reactivity to pain; however, previous studies on pain in autism lead to conflicting results. Here, we present the state of the art and the methodological challenges concerning pain perception in autism, focusing on studies that used standardized protocol as Quantitative Sensory Testing (QST) to measure perception. Despite there are still scant evidences found with the use of QST, they have challenged the presumed hyposensitivity to pain in autisms, which emerged from parents’ reports. Both, peripheral and central mechanisms, have been found involved in typical features of perception in autism. Nonetheless, evidences with controlled protocols are still scarce, and even scarcer are studies focused on children. Overall, complex ethical challenges have to be overcome in order to collect subjective and objective measures from autistic children. With heterogeneous neurodevelopmental features, or intellectual disability, novel or modified protocols are needed.
... Actually, this overrepresentation of the hyper-sensitivity compared to the hypo-sensitivity in the descriptions of autism spectrum could be the consequence of a reporting bias. This reporting bias stress out the need of quantitative methods to explore sensory sensitivities and to complete the available questionnaires such as SSP based on observational, non-quantitative scales (Schaaf & Lane, 2015;Yamasaki et al., 2014). ...
As an integral part of autism spectrum symptoms, sensory processing issues including both hypo and hyper sensory sensitivities. These sensory specificities may result from an excitation/inhibition imbalance with a poorly understood of their level of convergence with genetic alterations in GABA-ergic and glutamatergic pathways. In our study, we aimed to characterize the hypo/hyper-sensory profile among autistic individuals. We then explored its link with the burden of deleterious mutations in a subset of individuals with available whole-genome sequencing data. To characterize the hypo/hyper-sensory profile, the differential Short Sensory Profile (dSSP) was defined as a normalized and centralized hypo/hypersensitivity ratio from the Short Sensory Profile (SSP). Including 1136 participants (533 autistic individuals, 210 first-degree relatives, and 267 controls) from two independent study samples (PARIS and LEAP), we observed a statistically significant dSSP mean difference between autistic individuals and controls, driven mostly by a high dSSP variability, with an intermediated profile represented by relatives. Our genetic analysis tended to associate the dSSP and the hyposensitivity with mutations of the GABAergic pathway. The major limitation was the dSSP difficulty to discriminate subjects with a similar quantum of hypo- and hyper-sensory symptoms to those with no such symptoms, resulting both in a similar ratio score of 0. However, the dSSP could be a relevant clinical score, and combined with additional sensory descriptions, genetics and endophenotypic substrates, will improve the exploration of the underlying neurobiological mechanisms of sensory processing differences in autism spectrum.
... Emerging work suggests that considerable variance is accounted for by modality-specific response patterns versus supra-modal response patterns (Ausderau et al., 2014;Tillmann et al., 2020). Given our differential findings for theorized links with later communication, we recommend that future studies employ multiple measures with at least some prior psychometric support for tapping all patterns of sensory responsiveness across the broadest possible range of sensory modalities in infants and/or autistic children (e.g., Eeles et al., 2013;Schaaf & Lane, 2015;Yeung & Thomacos, 2020). Doing so will further our understanding of which sensory responsiveness scores have the highest validity or clinical utility for predicting communication outcomes. ...
Early differences in sensory responsiveness may contribute to difficulties with communication among autistic children; however, this theory has not been longitudinally assessed in infants at increased familial versus general population-level likelihood for autism (Sibs-autism vs. Sibs-NA) using a comprehensive battery of sensory responsiveness and communication. In a sample of 40 infants (20 Sibs-autism, of whom six were later diagnosed with autism; 20 Sibs-NA), we tested (a) associations between sensory responsiveness at 12–18 months and communication 9 months later and (b) evaluated whether such associations were moderated by sibling group, autism diagnosis, or age. We found negative zero-order correlations between sensory responsiveness (i.e., caregiver reported hyperresponsiveness and hyporesponsiveness; an observational measure of hyperresponsiveness) and later communication. Additionally, caregiver reported sensory seeking was negatively associated with later expressive communication only in Sibs-NA. Limitations include our relatively small sample size of infants diagnosed with autism. Implications for future research are discussed.
... Autism is associated with various sensory atypicalities across multiple domains (Nicholson et al., 2018;Shah et al., 2016). Studies estimate 45-96% of autistic people report experiencing difficulties with regulating sensation and perception (Schaaf & Lane, 2015). The interoceptive sense includes the sensations of pain, temperature, hunger, satiety (Craig, 2015). ...
Lower levels of experiential processing are associated with poorer therapeutic outcomes. Clients with autistic process are reported to experience sensory-body awareness processing problems which is recognized as an interoception marker. The Step-Out is a simple bodily technique, used within the Alba Method, to achieve an emotionally neutral, relaxed, and alert state. The aim of this study was to explore the experiences of clients with autistic process with the Step-Out. Eleven clients learned and spoke about the technique. A thematic analysis of clients’ responses produced an overall theme ‘In sensing me to connecting to you’. This contained three broad themes: In-and-out of interoceptive contact, letting go of tension and beyond self-experience. Clients were able to verbally describe their internal sensations and perceptions following the task. Responses ranged across an experiential continuum from emotional overwhelm, to no felt change to experiences of relational connection. Preliminary findings provide promising support for the utility of the Step-Out as a mini experiential task to help clients with autistic process shift their attention from an externalized to an internalized process, and to recognize, express, and regulate their internal states. Findings are tentative due to the exploratory nature, limited participants, and lack of assessment measures.
... Disruptions in sensory functioning are commonly observed in autistic individuals 1 . These differences have been observed via a broad range of measurement techniques and across all sensory modalities (Baum et al., 2015;Schaaf & Lane, 2015;Schauder & Bennetto, 2016). Audiovisual integration, or the ability to combine information from auditory and visual sensory inputs, has been particularly well studied in this population (Soto-Faraco et al., 2012;see Feldman et al., 2018 for a review). ...
Differences in audiovisual integration are commonly observed in autism. Temporal binding windows (TBWs) of audiovisual speech can be trained (i.e., narrowed) in non-autistic adults; this study evaluated a computer-based perceptual training in autistic youth and assessed whether treatment outcomes varied according to individual characteristics. Thirty autistic youth aged 8–21 were randomly assigned to a brief perceptual training (n = 15) or a control condition (n = 15). At post-test, the perceptual training group did not differ, on average, on TBWs for trained and untrained stimuli and perception of the McGurk illusion compared to the control group. The training benefited youth with higher language and nonverbal IQ scores; the training caused widened TBWs in youth with co-occurring cognitive and language impairments.
... Furthermore, sensory modulation is rarely assessed routinely in individuals with neurodevelopmental conditions and particularly those with more severe intellectual disability. Best practice is that assessments should collate information from multiple sources (Schaaf & Lane, 2015). As for pain and discomfort, informant report has the inevitable problem of reliance on informants' interpretations of behavior and experience. ...
Previously, we have proposed that there are nine domains that warrant assessment when intervening to decrease challenging behavior and\or increase well-being in people with profound or severe intellectual disability and complex needs. These domains are: pain and discomfort, sensory sensitivity, anxiety and low mood, sleep, emotional dysregulation, cognitive difference, learned or functional behaviors, and expressive communication. In this article we: (1) identify specific challenging behaviors that might be influenced by these domains, (2) describe the relationship between these domains and the specified challenging behaviors, (3) identify assessments for each domain and (4) describe interactions between the domains. Our aim in this article is to provide practitioners with a framework for assessment and to stimulate debate about the domains that are demonstrably important when considering challenging behavior and well-being in people with profound or severe intellectual disability and complex needs.
... Given emerging body of evidence supporting its' use for autistic people, components of Ayres's sensory integration approach can potentially be embedded by both occupational therapy and applied behavior analysis professionals to improve engagement (Schaaf, Benevides, Kelly, & Mailloux-Maggio, 2012;Schaaf et al., 2014;Schaaf & Lane, 2015;Schoen et al., 2019). Yet Case- Smith et al. (2015) provide a crucial distinction, differentiating between less-beneficial, sensory-based interventions, isolated sensory strategies used primarily in educational settings, and high-fidelity, sensory-integration therapies, immersive, rich, clinic-based approaches. ...
ABSTRACT
Both applied behavior analysis (ABA) professionals and occupational therapy (OT) professionals have vital roles on interprofessional teams serving autistic individuals and other developmental challenges. Existing literature highlights that biases and misconceptions regarding each other’s practice methods may discourage collaboration among ABA and OT professionals. This research aims to explore the percep- tions of ABA and OT professionals on interdisciplinary teams, while identifying supports and barriers to collaboration between the profes- sions. A virtual focus group and survey were conducted with a total of 12 participants, comprising six ABA professionals and six OT profes- sionals. Data analysis via grounded theory approach resulted in four themes: (1) funding as a logistical barrier, (2) preconceived biases, (3) differences in philosophical principles (4) collaboration as a potentially beneficial yet effortful endeavor. Results of this study provide insight into collaborative processes between ABA and OT professionals, and suggest that intentionally committing to a collaborative relationship can be helpful in future practice.
... Researchers have recently begun to address the need for universal sensory language from diagnosis to treatment (Blanche et al., 2019). Inconsistencies in the language used to measure sensory processing have presented challenges in interpreting the results of sensory-related research and have caused disagreement across sensory-based OT interventions (Ismael et al., 2018;Schaaf & Lane, 2015). The purpose of the review was to examine the consistency of OT research in using sensory models, assessments, and terminology to guide ASD evaluation and treatment in children. ...
Date Presented 04/02/2022
The present scoping review aims to determine how the OT literature conceptualizes and defines sensory modulation behaviors in the evaluation and treatment of children with autism spectrum disorder (ASD). The review identified overall inconsistencies in the systematic use of sensory models to direct assessment and terminology in OT practice. The results indicate the need for cohesion in sensory terminology use and application to OT treatment.
Primary Author and Speaker: Tanner Petty
Additional Authors and Speakers: Anna Bland, Andrea Brown
Contributing Authors: Amanda Carpenter
... Sensory processing difficulties are expressed as adverse behavioural or emotional responses to daily sensory inputs from the environment or the body (Schaaf & Lane, 2015). During infancy, sensory processing difficulties can impact social, cognitive and sensorimotor development (DeGangi et al., 2000), and can impede co-regulation during parent-infant interactions (Degangi et al., 1997;Williamson & Anzalone, 2001). ...
Background
Parent-infant interactions provide the foundation for the development of infant socioemotional wellbeing. Preterm birth can have a substantial, and often detrimental, impact on the quality of early parent-infant interactions. Sensory processing difficulties, common in preterm infants, are further associated with poorer interaction quality. There is a paucity of research, however, examining the links between the quality of parent-infant interaction, preterm birth, and sensory processing difficulties. This study aimed to characterise the quality of interactions of parent-infant dyads involving preterm infants who may display sensory processing differences and examine the associations between parent-infant interaction quality, preterm status and infant sensory processing.
Method
67 parent-infant dyads (12-months infant age, 22 preterm, 45 full-term) participated in a recorded, semi-structured 15-minute play interaction. Parents also filled out questionnaires on demographics, and infant sensory processing (Infant and Toddler Sensory Profile-2; ITSP-2). Interaction quality was rated using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO).
Results
Preterm and full-term infants differed in sensory processing and parent-infant interaction. Infant prematurity was associated with the sensory domains of; visual (r = − 0.37, p = .005), touch (r = − 0.39, p = .002), and movement (rs = − .32, p = .01), as well as the interaction domains of; responsivity (rs;= − .43, p = .001), teaching (rs = − .31, p = .02), and interaction total score (r = − 0.34, p = .01). Interaction quality was related to sensory registration (rs = − .38, p = .008), auditory (rs = − .34, p = .02), seeking (rs = .29, p = .05) and sensory behavioural scores (rs = − .52, p < .001). Overall, interaction quality was best predicted by infant prematurity and auditory scores, R2 = .15, F(1, 47) = 4.01, p = .02.
Discussion
Preterm infants differed from their full-term peers in both their sensory processing and in their dyadic interactions with parents. Preterm status was associated with less responsivity and teaching and was found to predict overall interaction quality. Poorer infant sensory processing was associated with less parental teaching, affection and responsivity during interactions. Our results suggest that preterm birth is related to sensory processing difficulties, and that prematurity and sensory processing are differentially associated with aspects of interaction quality. These findings support the further examination of the interplay between preterm birth, sensory processing, and parent-infant interaction quality.
... It defined sensory features as "hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment" (50). Sensory features refer to patterns of behavior suggesting differences in how daily sensory stimuli are processed (Schaaf and Lane, 2015). They may manifest differently across individuals with ASD and across time and contexts for the same person. ...
Pain sensation in autism spectrum disorder (ASD) has been a growing research field in the last two decades. Existing pain research has focused on pain sensitivity, suggesting either hyposensitivity or hypersensitivity to pain in individuals with ASD. However, research about other aspects of pain experience is scarce. Moreover, most pain-related research in ASD focused on quantitative measures, such as neuroimaging or parental reports. Instead, this paper aimed to illuminate the various aspects of pain experience as perceived by adults with ASD. Its descriptive qualitative research design incorporated semi-structured interviews and deductive thematic analysis. This phenomenological approach captured the subjective pain experience through the lens of people with ASD. Four primary themes emerged from the data: (a) physical pain experience, including the sequence of pain sensitivity, pain awareness, pain-related emotional aspects, and pain communication; (b) direct and indirect coping strategies; (c) function and participation outcomes; and (d) suggestions for Healthcare Providers. The findings echo the crucial role of pain awareness and communication in the pain experience of people with ASD. These two factors have been reported as profoundly influencing coping strategies, function, and participation. The results emphasize the need to expand the exploration of pain in this population, calling for greater understanding, and listening to this population’s unique pain profiles and experiences to promote better-suited evaluation, diagnosis, and intervention in pain conditions.
In this chapter the effect of auditory hypersensitivity and synaesthesia on musical experience and development will be explored through first-person accounts of autistic musicians. These show that auditory and other hypersensitivities can create difficulties in live rehearsal and performance, but may also motivate creative exploration of musical form and enhance multi-sensory experiences of music.
p>Absence of exposure to nature can lead to deficiencies in several aspects of life. For many children with autistic spectrum disorders, these limitations manifest in areas such as language and collaborative skills, imaginative abilities, attention span, and a sense of wonder, all of which are crucial for lifelong learning, health, and overall lifestyle. This study aimed to investigate the impact of nature exposure therapy on enhancing sensory integrative abilities in pupils with autistic spectrum disorders in the Buea municipality. Employing a qualitative approach, the study utilized interview guides and observational checklists for data collection. Purposive sampling was employed to select 15 participants, including 5 pupils, 5 teachers, 3 parents, and 2 caregivers of children with ASD. The findings indicated that learners with autism benefited from exposure to various therapeutic natural environments, including horticultural, pet, and aquatic zones, all of which positively influenced their sensory integration abilities. Moreover, it was observed that most children with autism, whether exhibiting hyper- or hypo-reactivity, showed moderate reactivity to nature after undergoing nature expo therapy. However, several barriers to this intervention were identified, such as fear of the unknown, poverty, natural disasters, insecurity, and overprotective parenting. Despite these challenges, the nature expo therapy led to significant improvements in various aspects of children with autistic spectrum disorders, including attention, motor skills, cognitive function, anxiety reduction, agility, and coordination. In conclusion, the study highlighted the diverse positive impacts of nature expo therapy on learners with autistic spectrum disorders, particularly in enhancing sensory integration abilities. It was recommended that teachers, school administrators, parents, and other stakeholders incorporate outdoor activities into the lives of children with autism to facilitate their engagement with nature.
Le manque de temps passé dans la nature entraîne des déficiences dans plusieurs domaines de la vie. Pour la plupart des enfants atteints de troubles du spectre autistique, ces insuffisances sont observées dans des domaines tels que le langage et les compétences de collaboration, les capacités imaginatives, l'attention et le sens de l'émerveillement, qui sont vitaux pour l'apprentissage tout au long de la vie, la santé et le mode de vie. Cette étude a cherché à examiner l'effet de la thérapie d'exposition à la nature sur l'amélioration des capacités d'intégration sensorielle chez les élèves atteints de troubles du spectre autistique dans la municipalité de Buéa. L'étude a adopté une approche qualitative et a utilisé des guides d'entretien et des listes de contrôle d'observation pour la collecte des données. La technique d'échantillonnage par choix raisonné a été utilisée pour sélectionner 15 participants (5 élèves, 5 enseignants, 3 parents et 2 personnes s'occupant d'enfants atteints de TSA) pour l'étude. Les résultats ont révélé que les apprenants autistes étaient exposés aux environnements naturels suivants, identifiés comme zones thérapeutiques : Zone thérapeutique horticole, Zone thérapeutique animalière et Zone thérapeutique aquatique. Ces trois zones ont eu un impact positif sur la capacité d'intégration sensorielle des apprenants autistes. Il a également été constaté que la plupart des enfants autistes (hyper et hypo) présentaient une réactivité modérée à l'environnement naturel après l'exposition à la nature, plutôt qu'une hyper ou hypo réactivité avant l'utilisation de la thérapie d'exposition à la nature. Cependant, il existe des obstacles majeurs à cet exercice tels que la peur de l'inconnu, la pauvreté, les catastrophes naturelles, l'insécurité, la nature surprotectrice des parents, et bien d'autres encore. On s'est également rendu compte que l'expo nature a permis d'améliorer considérablement les aspects suivants chez les enfants autistes : l'attention, la motricité, les fonctions cognitives, la réduction de l'anxiété, l'agilité et la coordination. Il a été conclu que la thérapie de l'expo nature a un impact positif sur les apprenants atteints de troubles du spectre autistique de diverses manières, y compris sur la capacité d'intégration sensorielle. Il a été recommandé que les enseignants, les administrateurs scolaires, les parents et les autres parties prenantes intègrent des moments en plein air dans la vie des enfants autistes et leur permettent de vivre dans la nature.
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Otizm spektrum bozukluğu olan çocuklarda duyusal işlemleme bozuklukları gelişimin en erken dönemi olan bebeklikten itibaren gözlenmekte ve bu sorunlar yetişkinlikte de devam etmektedir. Araştırmalar, otizmli bireylerin yaklaşık %80’inde duyusal işlemleme bozuklukları olduğunu göstermektedir. Bu sorunlar DSM-5’te de OSB’nin tanılanmasında kullanılan kriterler arasında yer almaktadır. Tipik gelişim gösteren çocuklar ve diğer gelişimsel yetersizlikleri olan çocuklara kıyasla, otizmli çocuklarda duyusal işlemleme sorunlarının sıklığı ve yoğunluğunun farklılık gösterdiği ifade edilmektedir. Otizmli çocuklarda duyusal işlemleme ile ilgili sorunların bilişsel, motor, sosyal ve dil becerileri gibi çeşitli alanları doğrudan ya da dolaylı olarak etkilediği düşünülmektedir. Duyusal işlemlemeye ilişkin yaşanan bu sorunların hem otizmli birey hem de aile üzerinde olumsuz etki ve deneyimlere neden olmaktadır. Ayrıca, otizmli çocukların öğrenme, okula başlama ve devam etme, günlük yaşam aktiviteleri ve toplumsal yaşama katılımlarında pek çok soruna neden olduğu da alan yazında vurgulanmaktadır. Bu çalışmada, OSB’nin temel yetersizlik alanlarından biri olan duyusal işlemleme bozuklukları ve OSB’li bireylerin davranışları üzerindeki olası etkileri incelenerek otizmli bireylerin öğrenmelerini ve günlük yaşamlarını kolaylaştırabilecek bazı önerilere yer verilmiştir.
Interpreting the world around us requires integrating sensory information across modalities to derive meaning and shape our experiences and interactions with and within everyday environments. Recent interest in sensory-focused approaches to supporting autistic people has fixed on auditory processing—the sense of hearing and the act of listening—and its crucial role in language, communications, and social domains, as well as non-social autism- specific attributes, to understand better how sensory processing might differ in autistic people. In this narrative review, we synthesize published research into auditory processing in autistic people and the relationship between auditory processing and autistic attributes in a contextually novel way. The purpose is to understand the relationship between these domains more fully, drawing on evidence gleaned from experiential perspectives through neurological investigations. We also examine the relationship between auditory processing and diagnosable auditory conditions, such as hyperacusis, misophonia, phonophobia, and intolerance to loud sounds, as well as its relation to sleep, anxiety, and sensory overload. Our review reveals that autistic people often exhibit differences in their auditory profile early in life and that this intrinsically impacts their neurological development and shapes their broader autistic profile. Through a better understanding of the potential impact of auditory experiences on daily life, our review aims to inform future research on how to support the auditory profile of autistic people through accessible environments and improved strategies, technologies, and strategies for supporting autistic people in everyday life.
Families of children with autism and other special educational needs may often feel excluded from social activities and/or report on lack of quality family time. Some museums offer individual booking times for families outside their regular public opening hours. Such relaxed openings in museums present opportunities for families to participate in leisure activities that suit their sensory and social needs. However, further exploration of the meaning of such programs to families is needed to enhance the inclusive offer of museums. This research study evaluated the feedback and reflection of creative workshops conducted in The National Museum of Computing during its relaxed openings for families with children with autism and other special educational needs. The findings of the project highlight the benefits of the creative workshops with sensory‐friendly aspects, evidenced by the observed engagement of children and families in the activities and interpreted through data from child and parental questionnaires and facilitator reflective log.
Strategies to support children’s participation when their sensory needs are not met are misunderstood and not sufficiently supported by scientific evidence. However, early childhood educators who work with autistic children in an inclusive setting need support to understand these reactions and implement effective strategies to promote their participation. The goal of this paper is to evaluate the outcomes of a capacity-building intervention, including five educational videos and three to five coaching sessions, to support educators in the identification and implementation of strategies to promote the participation of an autistic child. A multiple case study was conducted in six different early childhood daycares with six dyads of educators and autistic children aged between three and five years old. Qualitative and quantitative data were triangulated to ensure validity. Educators implemented different strategies throughout the project, but the strategies were more complex during the coaching sessions. The strategies implemented by the educators facilitated the performance of autistic children in 63% of the goals identified. This article suggests that building capacity of educators can promote autistic children’s participation and emphasizes the relevance of inclusive strategies.
Sensory issues impact participation and are frequent in people with schizophrenia. To provide clinicians in Spain with reliable and valid tools to assess sensory integration in adult mental health, we analyzed the internal reliability and discriminant validity of Adolescent/Adult Sensory Profile (AASP-Spain). Cross-sectional descriptive study that analyzed internal reliability (Cronbach’s Alpha; n = 434 neurotypical) and discriminant validity (n = 18 schizophrenia; n = 54 neurotypical). Cronbach’s Alpha for AASP categories ranged from 0.69 to 0.73. Individuals with schizophrenia had higher scores (more problems) than controls in the three categories. The AASP-Spain offers promising internal reliability and discriminant validity.
Importance:
Assessment of tactile perception is foundational for addressing aspects of occupational performance.
Objective:
To evaluate the construct validity and internal reliability of four new tactile perception tests.
Design:
Causal comparative groups design.
Settings:
Homes, schools, and therapy practices across the United States.
Participants:
Children ages 3 to 12 yr: typically developing (n = 174) and those with sensory integration concerns (n = 153).
Outcomes and measures:
Rasch analyses to evaluate construct validity; analysis of covariance to evaluate group differences.
Results:
The Rasch model confirmed evidence of construct validity for each of the four tests. The typically developing group scored significantly higher than the clinical group on all tests (η2p = .040-.105, p < .001). Person reliability indices and strata indicated moderate to strong internal reliability (Rasch person reliability indices = .69-.87; strata = 2.33-3.82).
Conclusions and relevance:
The Evaluation in Ayres Sensory Integration® (EASI) Tactile Perception Tests are reliable and valid measures for assessing tactile perception in children ages 3 to 12 yr. Findings suggest that these tests are likely to be clinically useful and appropriate for children in this age range and may provide critical information regarding underlying sensory functions necessary for optimal occupational performance. What This Article Adds: This article provides data supporting the reliability and validity of the EASI Tactile Perception Tests in a U.S.
Sample:
These assessments can be used by therapists trained in their administration to assess tactile functions that may affect participation in activities, tasks, and occupations.
Background
Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these “supra-modal” traits in the autistic population.
Methods
Leveraging a combined sample of 3,868 autistic youth drawn from 12 distinct data sources (ages 3–18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a “general response pattern” factor for each supra-modal construct and determine the added value of “modality-specific response pattern” scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO and SEEK (sub)constructs.
Results
All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses unambiguously supported the validity of a supra-modal HYPER construct (ωH = .800), whereas a coherent supra-modal HYPO construct was not supported (ωH = .611), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ωH = .799; 4/7 modalities). Within each sensory construct, modality-specific subscales demonstrated substantial added value beyond the supra-modal score. Meta-analytic correlations varied by construct, although sensory features tended to correlate most strongly with other domains of core autism features and co-occurring psychiatric symptoms. Certain subconstructs within the HYPO and SEEK domains were also associated with lower adaptive behavior scores.
Limitations
Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to parent-report of observable behaviors and excluded multisensory items that reflect many “real-world” sensory experiences.
Conclusion
Psychometric issues may limit the degree to which some measures of supra-modal HYPO/SEEK can be interpreted. Depending on the research question at hand, modality-specific response pattern scores may represent a valid alternative method of characterizing sensory reactivity in autism.
It is perplexing that some preschool teachers not only advise parents who have children
with autism spectrum disorder (ASD) to go to religious healers, but also attribute such neurological
disorders to The curse of The “evil eye” or vaccines. Although it is now The twentieth century, this
behavior simply reflects The concerns of over-protective teachers and The cultural misperceptions
about The actual definition of ASD. In Yemen, The term “ASD”, with its wide range of symptoms,
is still ambiguous among preschool teachers. Thus, in a rather insightful piece for The education
community, this study has attempted to look beneath The surface of The beliefs (religious belief–social
belief–personal belief) of Yemeni preschool teachers regarding ASD. Based on The data collected from
213 teachers (20–30\31–40-~≥40 age) in The Taiz district, this study found that misconceptions specific
to autism spectrum disorder were strongly evidenced among teachers who taught preschoolers.
Due to personal ignorance and growing superstitions, these teachers tend to believe The society’s
perceptions of ASD, thus resulting in The ignorance of scientific views. However, The mass media
can increase this group’s awareness of ASD by continually assessing The inaccurate views on ASD,
and correcting them. And by influencing The teachers to take a more conceptual scientific approach
in serving their special needs students, furthermore, by informing preschool teachers of children’s rights in normal life in The future through providing children with an optimal chance of development
by early intervention.
Sensory features are part of the diagnostic criteria for autism and include sensory hypo/hyper reactivity and unusual sensory interest; however, additional sensory differences, namely differences in sensory integration, have not been routinely explored. This study characterized sensory integration differences in a cohort of children (n = 93) with a confirmed diagnosis of autism (5–9 years) using a standardized, norm-referenced battery. Mean z scores, autism diagnostic scores, and IQ are reported. Participants showed substantial deficits in tactile perception, praxis, balance, visual perception, and visual-motor skills. Relationship with autism diagnostic test scores were weak or absent. Findings suggest additional sensory difficulties that are not typically assessed or considered when characterizing sensory features in autism. These data have implications for a greater understanding of the sensory features in the autism phenotype and the development of personalized treatments.
Objectives
Because atypical global neural connectivity has been documented in autistic youth, but only limited data are available regarding the association between generalized anxiety disorder (GAD), sensory features (SF), and neural connectivity between frontal and parietal brain regions, these links were investigated in a sample of male autistic children and adolescents.
Methods
Forty-one autistic males aged between 6 and 18 years and their mothers were recruited as volunteer participants from Queensland, Australia. Participants underwent 3 min of eyes-closed and 3 min of eyes-opened electroencephalography (EEG) under resting conditions. EEG connectivity was investigated using Granger causality between frontal and parietal regions in alpha (8–13 Hz) and beta (13–30 Hz) bands.
Results
There was a significant ( p < .01) positive correlation between SF and GAD. GAD was associated with some characteristics of SF in the sample population. Additionally, there was a significant ( p < .01) inverse correlation between directional frontoparietal connectivity and SF during the eyes-closed condition, specifically in relation to avoiding stimuli and sensitivity to the environment.
Conclusions
Reduced frontoparietal connectivity in association with higher anxiety and SF may demonstrate reduced relaxation due to greater sensitivity to sensory input.
The prevalence of sleep dysfunction is considerably higher in the autistic population than in the non-autistic. Similarly, the incidence of sensory reactivity differences in autism exceeds that in the neurotypical population. The basis of sleep disorders in autism is multifactorial, but sensory integration/processing concerns may play a role. Research that investigates this interplay for autistic individuals is limited but vital. In this scoping review, we examined literature addressing the following research question: What is the relationship between sleep and sensory integration/processing in autism? We included articles if they were peer-reviewed, English or Spanish, purposefully addressed sensory integration/processing differences, were sleep focused and included autism as the primary diagnosis or population. Articles were excluded if the language was not English or Spanish, research was conducted with animals, they were non-peer-reviewed, the primary population was not autistic, the sensory focus reflected a specific sensorineural loss (e.g., blindness, or deafness), there was not a clear inclusion of sensory integration/processing or sleep. We searched six databases and included all citations from the inception of each database through June 2021. The search strategy identified 397 documents that were reduced to 24 included articles after exclusion criteria were applied. The majority of studies we identified characterized the relation between sleep and sensory integration/processing differences in autism. Investigators found multiple sleep concerns such as bedtime resistance, sleep anxiety, delayed sleep onset, night awaking, and short sleep duration in autistic individuals. Identified sensory concerns focused on reactivity, finding hyper- and hypo-reactivity as well as sensory seeking across sensory domains. Co-existence of sleep concerns and sensory integration/processing differences was frequently reported. Few intervention studies showed a clear sensory focus; those that did emphasized pressure, movement, touch, and individual sensory preferences/needs. Swimming programs and massage showed promising results. No studies were of high quality. At a minimum, there is a co-existence of sensory reactivity differences and sleep concerns in autistic children, and possibly autistic adults. The relationship between poor sleep and sensory integration/processing differences is complex and multi-faceted, requiring additional research. Interventions that purposefully include a central sensory component have not been well studied in autistic children or adults. Overall studies with greater rigor and purposeful use of sensation and sensorimotor supports as a component of intervention are needed. This study was not funded.
Background : Ayres Sensory Integration (ASI) is widely employed by occupational therapists working with clients who experience challenges in sensory integration, including those with autism spectrum disorder (ASD). However, there is a dearth of research examining the feasibility of ASI outside of Western nations. This study documented the barriers associated with ASI in Saudi Arabia and assessed whether the intervention could improve process and participation skills.
Methods : Single-Subject experimental design was used. The participant was a 4-year-old girl with ASD from Saudi Arabia. Data were gathered on sensory processing, motor skills, and participation in activities of daily living. The study used semi-structured interviews and assessments (Sensory Integration and Praxis Tests, the Sensory Processing Measure-Preschool, and the Peabody Developmental Motor Scale-2) to develop goals, identify outcome measures, and plan an ASI intervention.
Results : Despite the limited availability of resources (e.g., toys, treatment spaces) and Arabic measures, improvements were observed on motor and sensory tasks and in occupational performance.
Conclusion : ASI that adheres to the ASI fidelity tool can be of value for Saudi Arabian children with ASD. Additionally, the study provides a stepping-stone to further research for occupational therapists in Saudi Arabia working with children with ASD.
Children with a diagnosis of autism and normally developing children, matched for age and general ability, were tested on a series of visual search tasks in 2 separate experiments. The children with autism performed better than the normally developing children on difficult visual search tasks. This result occurred regardless of whether the target was uniquely defined by a single feature or a conjunction of features, as long as ceiling effects did not mask the difference. Superior visual search performance in autism can be seen as analogous to other reports of enhanced unique item detection in autism. Unique item detection in autism is discussed in the light of mechanisms proposed to be involved in normal visual search performance.
This poster describes the features of the new edition of the Sensory Processing Measure
OBJECTIVE. We sought to characterize sensory integration (SI) and praxis patterns of children with autism spectrum disorder (ASD) and discern whether these patterns relate to social participation. METHOD. We extracted Sensory Integration and Praxis Tests (SIPT) and Sensory Processing Measure (SPM) scores from clinical records of children with ASD ages 4-11 yr (N = 89) and used SIPT and SPM standard scores to describe SI and praxis patterns. Correlation coefficients were generated to discern relationships among SI and praxis scores and these scores' associations with SPM Social Participation scores. RESULTS. Children with ASD showed relative strengths in visual praxis. Marked difficulties were evident in imitation praxis, vestibular bilateral integration, somatosensory perception, and sensory reactivity. SPM Social Participation scores were inversely associated with areas of deficit on SIPT measures. CONCLUSION. Children with ASD characteristically display strengths in visuopraxis and difficulties with somatopraxis and vestibular functions, which appear to greatly affect participation.
Copyright © 2015 by the American Occupational Therapy Association, Inc.
Over 90% of children with Autism Spectrum Disorders (ASD) demonstrate atypical sensory behaviors. In fact, hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment is now included in the DSM-5 diagnostic criteria. However, there are children with sensory processing differences who do not meet an ASD diagnosis but do show atypical sensory behaviors to the same or greater degree as ASD children. We previously demonstrated that children with Sensory Processing Disorders (SPD) have impaired white matter microstructure, and that this white matter microstructural pathology correlates with atypical sensory behavior. In this study, we use diffusion tensor imaging (DTI) fiber tractography to evaluate the structural connectivity of specific white matter tracts in boys with ASD (n = 15) and boys with SPD (n = 16), relative to typically developing children (n = 23). We define white matter tracts using probabilistic streamline tractography and assess the strength of tract connectivity using mean fractional anisotropy. Both the SPD and ASD cohorts demonstrate decreased connectivity relative to controls in parieto-occipital tracts involved in sensory perception and multisensory integration. However, the ASD group alone shows impaired connectivity, relative to controls, in temporal tracts thought to subserve social-emotional processing. In addition to these group difference analyses, we take a dimensional approach to assessing the relationship between white matter connectivity and participant function. These correlational analyses reveal significant associations of white matter connectivity with auditory processing, working memory, social skills, and inattention across our three study groups. These findings help elucidate the roles of specific neural circuits in neurodevelopmental disorders, and begin to explore the dimensional relationship between critical cognitive functions and structural connectivity across affected and unaffected children.
The new DSM-5 diagnostic criteria for autism spectrum disorders (ASDs) include sensory disturbances in addition to the well-established language, communication, and social deficits. One sensory disturbance seen in ASD is an impaired ability to integrate multisensory information into a unified percept. This may arise from an underlying impairment in which individuals with ASD have difficulty perceiving the temporal relationship between cross-modal inputs, an important cue for multisensory integration. Such impairments in multisensory processing may cascade into higher-level deficits, impairing day-to-day functioning on tasks, such as speech perception. To investigate multisensory temporal processing deficits in ASD and their links to speech processing, the current study mapped performance on a number of multisensory temporal tasks (with both simple and complex stimuli) onto the ability of individuals with ASD to perceptually bind audiovisual speech signals. High-functioning children with ASD were compared with a group of typically developing children. Performance on the multisensory temporal tasks varied with stimulus complexity for both groups; less precise temporal processing was observed with increasing stimulus complexity. Notably, individuals with ASD showed a speech-specific deficit in multisensory temporal processing. Most importantly, the strength of perceptual binding of audiovisual speech observed in individuals with ASD was strongly related to their low-level multisensory temporal processing abilities. Collectively, the results represent the first to illustrate links between multisensory temporal function and speech processing in ASD, strongly suggesting that deficits in low-level sensory processing may cascade into higher-order domains, such as language and communication.
This study evaluated a manualized intervention for sensory difficulties for children with autism, ages 4-8 years, using a randomized trial design. Diagnosis of autism was confirmed using gold standard measures. Results show that the children in the treatment group (n = 17) who received 30 sessions of the occupational therapy intervention scored significantly higher (p = 0.003, d = 1.2) on Goal Attainment Scales (primary outcome), and also scored significantly better on measures of caregiver assistance in self-care (p = 0.008 d = 0.9) and socialization (p = 0.04, d = 0.7) than the Usual Care control group (n = 15). The study shows high rigor in its measurement of treatment fidelity and use of a manualized protocol, and provides support for the use of this intervention for children with autism. Findings are discussed in terms of their implications for practice and future research.
Anecdotal reports and empirical evidence suggest that sensory processing issues are a key feature of autism spectrum conditions. This study set out to investigate whether adults with autism spectrum conditions report more sensory over-responsivity than adults without autism spectrum conditions. Another goal of the study was to identify whether autistic traits in adults with and without autism spectrum conditions were associated with sensory over-responsivity. Adults with (n = 221) and without (n = 181) autism spectrum conditions participated in an online survey. The Autism Spectrum Quotient, the Raven Matrices and the Sensory Processing Scale were used to characterize the sample. Adults with autism spectrum conditions reported more sensory over-responsivity than control participants across various sensory domains (visual, auditory, tactile, olfactory, gustatory and proprioceptive). Sensory over-responsivity correlated positively with autistic traits (Autism Spectrum Quotient) at a significant level across groups and within groups. Adults with autism spectrum conditions experience sensory over-responsivity to daily sensory stimuli to a high degree. A positive relationship exists between sensory over-responsivity and autistic traits. Understanding sensory over-responsivity and ways of measuring it in adults with autism spectrum conditions has implications for research and clinical settings.
We sought to examine concurrent and longitudinal associations between sensory response patterns (i.e., hyperresponsiveness, hyporesponsiveness, and sensory seeking) and verbal status of young children with autism spectrum disorder (ASD) as a potential factor influencing the development of verbal communication. Seventy-nine children with ASD (verbal, n = 29; nonverbal, n = 50) were assessed using cross-sectional analyses (Study 1), and 14 children with ASD (verbal, n = 6; nonverbal, n = 8) were assessed using prospective longitudinal analyses (Study 2). Data were collected regarding sensory response patterns and verbal ability. Hyporesponsiveness and sensory seeking behaviors were associated with verbal status in both cross-sectional and longitudinal analyses; nonverbal children were more likely to demonstrate higher hyporesponsive and sensory seeking patterns. Hyperresponsiveness did not significantly differ between verbal and nonverbal groups in either design. Sensory hyporesponsiveness and seeking behaviors may be important factors hindering the development of functional verbal communication in children with ASD. Unusual sensory responsiveness can often be observed before the onset of speech and may yield important prognostic capabilities as well as inform early interventions targeting verbal communication or alternative communication options in young children with ASD.
Background. Normally one habituates rapidly to steady, faint sensations. People with sensory hypersensitivity (SH), by contrast, continue to attend to such stimuli and find them noxious. SH is common in Tourette syndrome (TS) and autism, and methods to quantify SH may lead to better understanding of these disorders. In an attempt to objectively quantify SH severity, the authors tested whether a choice reaction time (CRT) task was a sensitive enough measure to detect significant distraction from a steady tactile stimulus, and to detect significantly greater distraction in subjects with more severe SH.
Methods. Nineteen ambulatory adult volunteers with varying scores on the Adult Sensory Questionnaire (ASQ), a clinical measure of SH, completed a CRT task in the alternating presence and absence of tactile stimulation.
Results. Tactile stimulation interfered with attention (i.e., produced longer reaction times), and this effect was significantly greater in participants with more SH (higher ASQ scores). Accuracy on the CRT was high in blocks with and without stimulation. Habituation within stimulation blocks was not detected.
Conclusion. This approach can detect distraction from a cognitive task by a steady, faint tactile stimulus that does not degrade response accuracy. The method was also sensitive to the hypothesized enhancement of this effect by SH. These results support the potential utility of this approach to quantifying SH, and suggest possible refinements for future studies.
Sensory abnormalities were assessed in a population-based group of 208 20–54-month-old children, diagnosed with autism spectrum disorder (ASD) and referred to a specialized habilitation centre for early intervention. The children were subgrouped based upon degree of autistic symptoms and cognitive level by a research team at the centre. Parents were interviewed systematically about any abnormal sensory reactions in the child. In the whole group, pain and hearing were the most commonly affected modalities. Children in the most typical autism subgroup (nuclear autism with no learning disability) had the highest number of affected modalities. The children who were classified in an “autistic features” subgroup had the lowest number of affected modalities. There were no group differences in number of affected sensory modalities between groups of different cognitive levels or level of expressive speech. The findings provide support for the notion that sensory abnormality is very common in young children with autism. This symptom has been proposed for inclusion among the diagnostic criteria for ASD in the upcoming DSM-V.
Unusual responses to sensory stimuli have been described in autism spectrum disorder (ASD).The study examined the frequencies of 'unusual sensory interests' and 'negative sensory responses' and their relation to functioning in a large ASD population (n = 679). Having 'unusual sensory interests' was reported in 70.4 % and 'negative sensory responses' in 66.0 % of the ASD group. Having 'unusual sensory interests' was associated with more severe reported and observed autism symptoms, lower cognitive ability and lower adaptive skills. In contrast, having 'negative sensory responses' was only associated with more severe reported stereotyped behaviors. It is suggested that having 'unusual sensory interests' is a part of a primary more severe type of ASD involving numerous developmental domains that might have a unique neurobiological origin.
Children with autism may have atypical sensory processing abilities, which are known to impact child's performance and participation. However, lack of information exists regarding the expression of these abilities in specific groups on the spectrum, as children with high-functioning autism spectrum disorder (HFASD). This study aimed to characterize the sensory processing abilities of children with HFASD and examine their relationship to participation in leisure activities. Participants were 50 children aged 6–11 years: 25 children with HFASD and 25 with typical development. Sensory processing abilities were examined by the short sensory profile (SSP). Participation was assessed by the children's assessment of participation and enjoyment (CAPE). Children with HFASD had atypical sensory processing abilities. They also had lower participation in leisure activities expressed in limited range of activities, performed less often, mainly alone and at home. Their atypical sensory processing patterns were correlated with lower participation, specifically in social, physical and informal activities. In conclusion, children with HFASD may have atypical sensory processing abilities and restricted participation. Intervention should refer to each of these parameters and to the relationship between them in order to enable optimal inclusion of children with HFASD in society.
Background
Early emerging characteristics of visual orienting have been associated with a wide range of typical and atypical developmental outcomes. In the current study, we examined the development of visual disengagement in infants at risk for autism.
Methods
We measured the efficiency of disengaging from a central visual stimulus to orient to a peripheral one in a cohort of 104 infants with and without familial risk for autism by virtue of having an older sibling with autism.
Results
At 7 months of age, disengagement was not robustly associated with later diagnostic outcomes. However, by 14 months, longer latencies to disengage in the subset of the risk group later diagnosed with autism was observed relative to other infants at risk and the low-risk control group. Moreover, between 7 months and 14 months, infants who were later diagnosed with autism at 36 months showed no consistent increases in the speed and flexibility of visual orienting. However, the latter developmental effect also characterized those infants who exhibited some form of developmental concerns (but not meeting criteria for autism) at 36 months.
Conclusions
Infants who develop autism or other developmental concerns show atypicality in the development of visual attention skills from the first year of life.
For decades autism has been defined as a triad of deficits in social interaction, communication, and imaginative play. Though there is now broad acknowledgment of the neurological basis of autism, there is little attention paid to the contribution of such neurological differences to a person's development and functioning. Communication, relationship, and participation require neurological systems to coordinate and synchronize the organization and regulation of sensory information and movement. Developmental differences in these abilities are likely to result in differences in the way a person behaves and expresses intention and meaning. The present paper shares our emerging awareness that people may struggle with difficulties that are not immediately evident to an outsider. This paper explores the symptoms of sensory and movement differences and the possible implications for autistic people. It provides a review of the history and literature that describes the neurological basis for many of the socalled behavioral differences that people experience. The paper emphasizes the importance of our acknowledgment that a social interpretation of differences in behavior, relationship, and communication can lead us far away from the lived experience of individuals with the autism label and those who support them. We suggest alternative ways to address the challenges faced by people with autism.
Objective:
We developed an observational tool, the Comprehensive Observations of Proprioception (COP), for identifying proprioceptive processing issues in children with developmental disabilities.
Method:
Development of the COP underwent three phases. First, we developed items representing proprioceptive functions on the basis of an extensive literature review and consultation with occupational therapists. We then established interrater reliability and content, construct, and criterion validity. Finally, we completed a factor analysis of COP ratings of 130 children with known developmental disabilities.
Results:
Adequate validity and reliability were established. Factor analysis revealed a four-factor model that explained the underlying structure of the measure as it was hypothesized.
Conclusion:
The COP is a valid criterion-referenced short observational tool that structures the clinician's observations by linking a child's behaviors to areas identified in the literature as relevant to proprioceptive processing. It takes 15 min to administer and can be used in a variety of contexts, such as the home, clinic, and school.
Autism spectrum disorder is typically associated with social deficits and is often specifically linked to difficulty with processing faces and other socially relevant stimuli. Emerging research has suggested that children with autism might also have deficits in basic perceptual abilities including multisensory processing (e.g., simultaneously processing visual and auditory inputs). The current study examined the relationship between multisensory temporal processing (assessed via a simultaneity judgment task wherein participants were to report whether a visual stimulus and an auditory stimulus occurred at the same time or at different times) and self-reported symptoms of autism (assessed via the Autism Spectrum Quotient questionnaire). Data from over 100 healthy adults revealed a relationship between these two factors as multisensory timing perception correlated with symptoms of autism. Specifically, a stronger bias to perceive auditory stimuli occurring before visual stimuli as simultaneous was associated with greater levels of autistic symptoms. Additional data and analyses confirm that this relationship is specific to multisensory processing and symptoms of autism. These results provide insight into the nature of multisensory processing while also revealing a continuum over which perceptual abilities correlate with symptoms of autism and that this continuum is not just specific to clinical populations but is present within the general population.
OBJECTIVE. Sensory processing difficulties among children with autism spectrum disorders (ASD) have been extensively documented. However, less is known about this population’s ability to process proprioceptive information.
METHOD. We used the Comprehensive Observations of Proprioception (COP; Blanche, Bodison, Chang, & Reinoso, in press) to describe the proprioceptive difficulties experienced by children with ASD. A sample of 32 children with ASD, 26 children with developmental disabilities excluding ASD, and 28 typically developing control children were studied using the COP.
RESULTS. Children with ASD present with proprioceptive processing difficulties that are different from those of children with developmental disabilities and their typically developing counterparts. Specific data, potential clinical applications, and directions for future research are described.
CONCLUSION. Results suggest that the COP has useful clinical research applications. Further assessment of psychometric properties, clinical utility, and meaningful differences among diverse clinical populations are needed.
OBJECTIVES. We examined whether children with and without autism spectrum disorder (ASD) differ in autonomic activity at rest and in response to auditory stimuli and whether behavioral problems related to sounds in everyday life are associated with autonomic responses to auditory stimuli.
METHOD. We measured skin conductance (SC) at rest and in response to auditory stimuli as well as behavioral responses using the Sensory Processing Measure (SPM) Home Form. Participants were 25 children with ASD and 25 typically developing (TD) children, aged 5–12 yr.
RESULTS. The ASD group had significantly higher resting SC and stronger SC reactivity to tones than the TD group. Correlations between SC and SPM indicated that more severe auditory behavioral difficulties were associated with higher sympathetic activation at rest and stronger sympathetic reactivity to sound.
CONCLUSION. High sympathetic reactivity to sound may underlie the difficult behavioral responses to sound that children with ASD often demonstrate.
Individuals with Autism Spectrum Disorders (ASDs) tend to have sensory processing difficulties (Baranek et al. in J Child Psychol Psychiatry 47:591-601, 2006). These difficulties include over- and under-responsiveness to sensory stimuli, and problems modulating sensory input (Ben-Sasson et al. in J Autism Dev Disorders 39:1-11, 2009). As those with ASD exist at the extreme end of a continuum of autistic traits that is also evident in the general population, we investigated the link between ASD and sensory sensitivity in the general population by administering two questionnaires online to 212 adult participants. Results showed a highly significant positive correlation (r = .775, p < .001) between number of autistic traits and the frequency of sensory processing problems. These data suggest a strong link between sensory processing and autistic traits in the general population, which in turn potentially implicates sensory processing problems in social interaction difficulties.
The Autism Diagnostic Observation Schedule—Generic (ADOS-G) is a semistructured, standardized assessment of social interaction, communication, play, and imaginative use of materials for individuals suspected of having autism spectrum disorders. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language. Psychometric data are presented for 223 children and adults with Autistic Disorder (autism), Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) or nonspectrum diagnoses. Within each module, diagnostic groups were equivalent on expressive language level. Results indicate substantial interrater and test—retest reliability for individual items, excellent interrater reliability within domains and excellent internal consistency. Comparisons of means indicated consistent differentiation of autism and PDDNOS from nonspectrum individuals, with some, but less consistent, differentiation of autism from PDDNOS. A priori operationalization of DSM-IV/ICD-10 criteria, factor analyses, and ROC curves were used to generate diagnostic algorithms with thresholds set for autism and broader autism spectrum/PDD. Algorithm sensitivities and specificities for autism and PDDNOS relative to nonspectrum disorders were excellent, with moderate differentiation of autism from PDDNOS.
Currently there are no brief, self-administered instruments for measuring the degree to which an adult with normal intelligence has the traits associated with the autistic spectrum. In this paper, we report on a new instrument to assess this: the Autism-Spectrum Quotient (AQ). Individuals score in the range 0–50. Four groups of subjects were assessed: Group 1: 58 adults with Asperger syndrome (AS) or high-functioning autism (HFA); Group 2: 174 randomly selected controls. Group 3: 840 students in Cambridge University; and Group 4: 16 winners of the UK Mathematics Olympiad. The adults with AS/HFA had a mean AQ score of 35.8 (SD = 6.5), significantly higher than Group 2 controls (M = 16.4, SD = 6.3). 80% of the adults with AS/HFA scored 32+, versus 2% of controls. Among the controls, men scored slightly but significantly higher than women. No women scored extremely highly (AQ score 34+) whereas 4% of men did so. Twice as many men (40%) as women (21%) scored at intermediate levels (AQ score 20+). Among the AS/HFA group, male and female scores did not differ significantly. The students in Cambridge University did not differ from the randomly selected control group, but scientists (including mathematicians) scored significantly higher than both humanities and social sciences students, confirming an earlier study that autistic conditions are associated with scientific skills. Within the sciences, mathematicians scored highest. This was replicated in Group 4, the Mathematics Olympiad winners scoring significantly higher than the male Cambridge humanities students. 6% of the student sample scored 327plus; on the AQ. On interview, 11 out of 11 of these met three or more DSM-IV criteria for AS/HFA, and all were studying sciences/mathematics, and 7 of the 11 met threshold on these criteria. Test—retest and interrater reliability of the AQ was good. The AQ is thus a valuable instrument for rapidly quantifying where any given individual is situated on the continuum from autism to normality. Its potential for screening for autism spectrum conditions in adults of normal intelligence remains to be fully explored.
Successful integration of auditory and visual inputs is crucial for both basic perceptual functions and for higher-order processes related to social cognition. Autism spectrum disorders (ASD) are characterized by impairments in social cognition and are associated with abnormalities in sensory and perceptual processes. Several groups have reported that individuals with ASD are impaired in their ability to integrate socially relevant audiovisual (AV) information, and it has been suggested that this contributes to the higher-order social and cognitive deficits observed in ASD. However, successful integration of auditory and visual inputs also influences detection and perception of nonsocial stimuli, and integration deficits may impair earlier stages of information processing, with cascading downstream effects. To assess the integrity of basic AV integration, we recorded high-density electrophysiology from a cohort of high-functioning children with ASD (7-16 years) while they performed a simple AV reaction time task. Children with ASD showed considerably less behavioral facilitation to multisensory inputs, deficits that were paralleled by less effective neural integration. Evidence for processing differences relative to typically developing children was seen as early as 100 ms poststimulation, and topographic analysis suggested that children with ASD relied on different cortical networks during this early multisensory processing stage.
Since the first English edition of this book appeared three years ago, the authors have received many useful comments from readers. In preparing this amended edition we have carefully examined each chapter, improving and expanding the text where necessary; in the process, we have been greatly helped by their remarks. Further commentary on this edition will be much appreciated. Again, I should like to express the gratitude of all the authors to the staff of Springer-Verlag for expediting the publication of the book. Kiel, Germany, July 1981 ROBERT F. SCHMIDT Preface to the First Edition In the field of sensory physiology we are concerned with what our sense organs and the associated central nervous structures - can do and how that perform ance is achieved. Research here is not limited to description of the physi cochemical reactions taking place in these structures; the conditions under which sensations and perceptions arise and the rules that govern them are also of fundamental interest. Sensory physiology thus demands the attention of everyone who wishes to - or must - delve into the potentialities and limitations of human experience.
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 which parents report the frequency with which their children engage in particular behaviors indicative of sensory responsiveness. In future phases, researchers will conduct a national standardization of the profile, and validation studies.
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 which parents report the frequency with which their children engage in particular behaviors indicative of sensory responsiveness. In future phases, researchers will conduct a national standardization of the profile, and validation studies.
The purpose of this study was to examine the construct validity of the praxis tests of the Sensory Integration and Praxis Tests (SIPT) and to determine whether the practic component of sensory integration-based developmental dyspraxia is a unitary or a multidimensional disorder. Developmental dyspraxia is an impaired ability to plan and execute skilled or nonhabitual motor tasks; however, its underlying cause, or even whether praxis is a unitary or multidimensional function, is not yet clarified. In this study, the Rasch model of measurement (Linacre, 1989; Wright & Masters, 1982; Wright & Stone, 1979) was used to explore the underlying construct of developmental dyspraxia. The Rasch model was chosen because its use enabled us to (a) confirm goodness-of-fit of individual items within SIPT praxis tests and (b) examine the hierarchical structure of item difficulties.
The data included the raw scores of the SIPT praxis tests of 210 subjects from Canada and the United States. The results of the Rasch analyses revealed that each of these five SIPT praxis tests measures a single, unidimensional construct. When the items from the five tests were combined to create a single 117-item test, the items continued to define a single practic function. This indicates that a unitary practic component underlies both bilateral integration and sequencing deficits and somatodyspraxia. Finally, examination of the hierarchy of item difficulties resulted in recommendations for the development of a single screening test for developmental dyspraxia. The implications of these results for clinical practice and future research are discussed.
Background: Sensory features are highly prevalent in children with ASD and have been suggested to have negative consequences in the daily life of children and families. Lacking in the literature is the identification of homogeneous sensory phenotypes that can be used to analyze the relationship of such subtypes with functional outcomes as well as inform precise diagnostic instruments and targeted treatment strategies.
Objectives: This study describes the methodology of characterizing sensory features in children with ASD using latent profile analysis (LPA) to create sensory subtypes and presents the association of the subtypes to child characteristics such as autism severity and mental age.
Methods: Data were collected as part of a national online survey from 1307 participants with ASD, ages 2-12 years. Sample consisted of 1068 boys (CA 93 (34) mos.) and 239 girls (CA 96 (35) mos.). ASD symptom severity was assessed using the Social Responsiveness Scale. The Sensory Experience Questionnaire 3.0 (SEQ) was used in a confirmatory factor analysis (CFA), which yielded four factors of sensory response patterns (i.e., hyporesponsiveness, hyperresponsiveness, seeking, and enhanced perception). Factor scores from the CFA were exported for analysis of latent profiles. LPA was used to detect the presence of distinct groups in the data set. Model fit was assessed with BIC and AIC as well as the Lo-Mendell-Rubin test. Mixed models, allowing for nesting of observation within family, were used to explore the association of autism severity and mental age to the subtypes.
Results: Four distinct profiles (sensory subtypes) emerged as supported by model fit indices with increasingly small changes in both AIC and BIC values after the inclusion of the fourth profile. Further, the Lo-Mendell-Rubin test of change in the likelihood ratio was significant only up to the fourth profile. The first subtype (n=402, 31%) describes children who scored low on all sensory patterns, while those in the second subtype (n=288, 22%) showed exactly the opposite profile with the high scores in all four sensory patterns. The remaining two subtypes showed a split in their factor scores. The third subtype (n=404, 31%) scored close to the mean on all patterns, with some tendency to score low on seeking and hyporesponsiveness, but slightly above on hyperresponsiveness and enhanced perception. The fourth subtype (n=213, 16%) had the opposite pattern of the third subtype with scores tending to be more extreme on seeking and hyporesponsiveness. Autism severity was significantly related the subtypes while controlling for mental age, with subtypes two and four expressing the highest levels of autism severity, followed by the third subtype, and finally, the first subtype that expressed the least amount of autism severity.
Conclusions: The LPA further explores the co-existence of different sensory patterns in children with ASD. The identification of homogenous subtypes will allow for characterization of children within the subtype to functional child outcomes leading to improved assessment and treatment as well as potential identification of biological markers. Further analyses will determine the extent to which there are significant associations between the identified sensory subtypes with various child characteristics.
Individuals with autism spectrum disorders (ASDs) have been assumed to show evidence of abnormal visuospatial processing, which has been attributed to a failure to integrate local features into coherent global Gestalts and/or to a bias towards local processing. As the available data are based on baseline performance only, which does not provide insight into cognitive/neural plasticity and actual cognitive potential, we investigated how training-resistant possible visuospatial processing differences between children with and without ASD are. In particular, we studied the effect of computerized versus face-to-face visuospatial training in a group of normally intelligent children with ASD and typically developing children as control. Findings show that (a) children with and without ASD do not differ much in visuospatial processing (as assessed by a tangram-like task) and the few differences we observed were all eliminated by training; (b) training can improve visuospatial processing (equally) in both children with ASD and normally developing children; and (c) computer-based and face-to-face training was equally effective.
Background
Sensory features are highly prevalent and heterogeneous among children with ASD. There is a need to identify homogenous groups of children with ASD based on sensory features (i.e. sensory subtypes) to inform research and treatment.Methods
Sensory subtypes and their stability over 1 year were identified through latent profile transition analysis (LPTA) among a national sample of children with ASD. Data were collected from caregivers of children with ASD ages 2–12 years at two time points (Time 1 N = 1294; Time 2 N = 884).ResultsFour sensory subtypes (Mild; Sensitive-Distressed; Attenuated-Preoccupied; Extreme-Mixed) were identified, which were supported by fit indices from the LPTA as well as current theoretical models that inform clinical practice. The Mild and Extreme-Mixed subtypes reflected quantitatively different sensory profiles, while the Sensitive-Distressed and Attenuated-Preoccupied subtypes reflected qualitatively different profiles. Further, subtypes reflected differential child (i.e. gender, developmental age, chronological age, autism severity) and family (i.e. income, mother's education) characteristics. Ninety-one percent of participants remained stable in their subtypes over 1 year.Conclusions
Characterizing the nature of homogenous sensory subtypes may facilitate assessment and intervention, as well as potentially inform biological mechanisms.
This study examines whether sensory differences can be used to classify meaningful subgroups of children with autism spectrum disorder (ASD). Caregivers of children with ASD aged 2–10 years (n = 228) completed the Short Sensory Profile. Model-based cluster analysis was used to extract sensory subtypes. The relationship of these subtypes to age, gender, autism symptom severity, and nonverbal intelligence quotient (IQ) was further explored. Four distinct sensory subtypes were identified: (a) sensory adaptive; (b) taste smell sensitive; (c) postural inattentive; and (d) generalized sensory difference. The sensory subtypes differ from each other on two dimensions: (a) the severity of reported sensory differences; and (b) the focus of differences across auditory, taste, smell, vestibular and proprioceptive domains. Examination of the clinical features of each subtype reveals two possible mechanisms of sensory disturbance in autism: (a) sensory hyperreactivity; and (b) difficulties with multisensory processing. Further, the sensory subtypes are not well explained by other variables such as age, gender, IQ, and autism symptom severity. We conclude that classification of children using sensory differences offers a promising method by which to identify phenotypes in ASD. Sensory-based phenotypes may be useful in identifying behavioral features responsive to specific interventions thereby improving intervention effectiveness. Further validation of the sensory-based phenotypes by establishing neural and physiological correlates is recommended. Autism Res 2014, ●●: ●●–●●. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.
OBJECTIVE. The purpose of this study was to empirically derive dimensions of activity participation among a sample of school-age children with autism spectrum disorder (ASD; n = 713). Additionally, we examined the associations between dimensions of activity participation and child characteristics (i.e., chronological age, autism severity, gender) and family demographics (i.e., maternal education). METHOD. Exploratory factor analysis was used to determine the factors on the Home and Community Activities Scale (HCAS). Multiple regression was used to examine the extent to which child characteristics and family demographics were related to HCAS dimensions. RESULTS. A six-factor model best characterized activity participation among the school-age children with ASD, and child characteristics and family demographics were differentially associated with HCAS dimensions. CONCLUSION. The findings have implications for how activities may be categorized for children with ASD and suggest that the frequency of specific activities is affected by child characteristics and maternal education.
A review of records was completed to determine whether children with auditory hypersensitivities have difficulty tolerating loud sounds due to auditory-system factors or some other factors not directly involving the auditory system. Records of 150 children identified as not meeting autism spectrum disorders (ASD) criteria and another 50 meeting that criteria were reviewed. All participants had normal hearing. Tolerance was measured up to 110 dBHL. Findings revealed a smaller-than-expected percentage of children were unable to tolerate loud sounds. The conclusion drawn is that auditory hypersensitivity is not based in the auditory system, but rather is a conditioned response to sounds perceived as aversive or annoying. Treatments for auditory hypersensitivity should not be auditory based but should include desensitization training. Implications for practice are provided.
This national online survey study characterized sensory features in 1,307 children with autism spectrum disorder (ASD) ages 2-12 years using the Sensory Experiences Questionnaire Version 3.0 (SEQ-3.0). Using the SEQ-3.0, a confirmatory factor analytic model with four substantive factors of hypothesized sensory response patterns (i.e., hyporesponsiveness; hyperresponsiveness; sensory interests, repetitions and seeking behaviors; enhanced perception), five method factors of sensory modalities (i.e., auditory, visual, tactile, gustatory/olfactory, vestibular/proprioceptive), and one of social context were tested with good model fit. Child and family characteristics associated with the sensory response patterns were explored. The effect of sensory response patterns on autism severity was tested, controlling for key child and family characteristics. The SEQ-3.0 demonstrates an empirically valid factor structure specific to ASD that considers sensory response patterns, modalities, and social context.
Background:
Sensory reactivity in people with autism spectrum conditions (ASC) has been found to differ in comparison to reactivity in people without ASC. In this study sensory experiences of high-functioning individuals with ASC were explored and described.
Method:
Interview data from 15 participants with a diagnosis of ASC were analysed by content analysis.
Results:
Seven aspects of sensory experiences were identified: Being hyper- and hypo-reactive, reacting to general overload, having strong stimuli preferences, managing attentiveness to stimuli, managing sensory/motor stimuli, and dealing with consequences of sensory reactions in daily life.
Conclusions:
The categorisation of sensory reactivity in this study can guide clinicians on how to pose questions about sensory issues to individuals with ASC. The assessment of spectrum-specific sensory experiences in high-functioning ASC and their association with other social and nonsocial features of ASC are goals for further research.
Identification and diagnosis of autism spectrum disorders is essentially based on behavioral presentation and developmental history. The current average age at diagnosis is older than 3 years.
Over the past 15 years, there has been increasing documentation of the early signs of autism spectrum disorders through both individual retrospective parental reports and screening studies. Recent longitudinal studies have focused on early medical and behavioral features of children regarded at risk, namely younger siblings of children with autism spectrum disorders or children who required neonatal intensive care, with a later diagnosis of autism spectrum disorders.
Potentially useful early neurological signs and developmental predictors for autism spectrum disorders could be identified, with a typical profile that evolved with age.
Assessment of early social attention and communication skills with adapted scales in children before the age of 18 months in very large community-based settings may lead to high positive predictive values.
The Test of Sensory Function in Infants (TSFI), a 24-item test designed to measure sensory processing and reactivity in infants, was administered to 196 normal infants, 27 infants with developmental delay, and 27 infants with difficult temperament from 4 to 18 months of age. The development of sensory functions in infants was explored for the normal sample. Developmental trends are reported for both individual items and subtest performance across the age ranges tested. Tactile deep-pressure and reactivity to vestibular stimulation were found to develop very early in infancy while visual-tactile integration, adaptive motor responses, and ocular-motor control develop gradually over the first year of life. The performance of developmentally delayed and difficult temperament infants on the TSFI was also described. Tactile defensiveness, poor ocular-motor control, and vestibular dysfunction occurred in substantial proportion of both sample. Difficulties in visual-tactile integration and adaptive motor responses were present in both samples, but to a lesser degree. The overall incidence of sensory processing dysfunction was approximately 55% to 85% in both samples for 7- to 18-month-old infants.
1 General Sensory Physiology, Psychophysics.- 1.1 Basic Concepts in General Sensory Physiology.- 1.2 Relation Between Stimulus and Behavior Conditioned Reflex.- 1.3 Measurement of the Intensity of Sensations Psychophysics.- 1.4 Spatial, Temporal, and Affective Aspects of Sensation.- 2 Somatovisceral Sensibility.- 2.1 Mechanoreception.- 2.2 Proprioception.- 2.3 Thermoreception.- 2.4 Visceral Sensibility.- 3 Neurophysiology of Sensory Systems.- 3.1 Transformations of Stimuli in Receptors.- 3.2 Sensory Functions of the CNS - a Survey.- 3.3 Properties and Operation of Sensory Neurons and Aggregates of Neurons.- 3.4 The Somatosensory System: Spinal Cord, Ascending Pathways, and Brain Stem.- 3.5 The Somatosensory System in Thalamus and Cortex.- 3.6 The Sensory System in the Light of Information Theory.- 4 Nociception and Pain.- 4.1 The Qualities and Components of Pain.- 4.2 Neurophysiology and Psychophysics of Pain.- 4.3 Pathophysiology of Pain Special and Abnormal Forms of Pain.- 4.4 Factors that Affect Pain Pain Therapy.- 5 Physiology of Vision.- 5.1 The Eye.- 5.2 Psychophysics of Visual Perception.- 5.3 Neurophysiology of Vision.- 5.4 Eye Movements and Sensorimotor Integration in Vision.- 6 Physiology of Hearing.- 6.1 Anatomy of the Ear.- 6.2 Auditory Performance.- 6.3 Functions of the Middle and Inner Ears.- 6.4 The Auditory Nerve and the Higher Stations of the Auditory Pathway.- 7 Physiology of the Sense of Equilibrium.- 7.1 Anatomy and Physiology of the Peripheral Organ.- 7.2 Central Nervous Basis of the Sense of Equilibrium.- 8 Physiology of Taste.- 8.1 Morphology of the Organs of Taste Subjective Taste Physiology.- 8.2 Objective Taste Physiology.- 9 Physiology of Olfaction.- 9.1 The Olfactory Mucosa Peripheral Mechanisms of Olfactory Reception.- 9.2 Subjective Olfactory Physiology Central Connections.- 10 Thirst and Hunger: General Sensations.- 10.1 Thirst.- 10.2 Hunger.- 11 Suggested Reading.- 12 Answer Key.- 13 Subject Index.
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, whereas 36 items appeared relevant for children birth to 6 months of age. Principal component analysis for 7 to 36 month olds produced an 8-component structure accounting for 47% of score variance. Reliability analyses were consistent with clusters previously identified in Dunn's model of sensory processing for older children (Dunn, 1997a). Implications for future work include replication with a large national sample and with specific disability groups.
Background:
Sensory over-responsivity (SOR) affects many individuals with autism spectrum disorders (ASD), often leading to stressful encounters during daily routines.
Methods:
This study describes the associations between early SOR symptoms and the longitudinal course of restrictions in family life activities and parenting stress across three time-points in families raising a child with ASD (n = 174). Covariates were child diagnostic severity, emotional problems, and maternal affective symptoms. At time 1 mean chronological age was 28.5 months. Children were administered the Autism Diagnostic Observation Schedule (ADOS) and Mullen Scales of Early Learning (MSEL). Parents completed the Infant Toddler Sensory Profile (ITSP), Infant-Toddler Social Emotional Assessment (ITSEA), Beck Anxiety Index (BAI), and the Center for Epidemiologic Studies Depression Inventory (CES-D) at time 1; and the Parenting Stress Index (PSI) and Family Life Impairment Scale (FLIS) at the three annual time-points.
Results:
Latent Growth Curve Models indicated that higher SOR scores on the ITSP at time 1 were associated with higher initial levels of family life impairment and parenting stress and with a smaller magnitude of change over time. These associations were independent of severity of ADOS social-communication symptoms, MSEL composite score, ITSEA externalizing and anxiety symptoms, and maternal affective symptoms as measured by the BAI and CES-D. On average FLIS and PSI did not change over time, however, there was significant individual variability. Concurrently, SOR at time 1 explained 39-45% of the variance in family stress and impairment variables.
Conclusions:
An evaluation of SOR should be integrated into the assessment of toddlers with ASD considering their role in family life impairment and stress.
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 for handling young children's sensory processing needs in a functional and supportive manner. The author reviews data from a series of studies on the Sensory Profile, a family-report measure of a child's responses to sensory experiences during daily life, to illustrate the utility and possible quantitative support for the proposed model components in young children with and without disabilities
(C)1997Aspen Publishers, Inc.
The neural underpinnings of sensory processing differences in autism remain poorly understood. This prospective magnetoencephalography (MEG) study investigates whether children with autism show atypical cortical activity in the primary somatosensory cortex (S1) in comparison with matched controls. Tactile stimuli were clearly detectable, and painless taps were applied to the distal phalanx of the second (D2) and third (D3) fingers of the right and left hands. Three tactile paradigms were administered: an oddball paradigm (standard taps to D3 at an interstimulus interval (ISI) of 0.33 and deviant taps to D2 with ISI ranging from 1.32 s to 1.64 s); a slow-rate paradigm (D2) with an ISI matching the deviant taps in the oddball paradigm; and a fast-rate paradigm (D2) with an ISI matching the standard taps in the oddball. Study subjects were boys (age 7-11 years) with and without autism disorder. Sensory behavior was quantified using the Sensory Profile questionnaire. Boys with autism exhibited smaller amplitude left hemisphere S1 response to slow and deviant stimuli during the right-hand paradigms. In post-hoc analysis, tactile behavior directly correlated with the amplitude of cortical response. Consequently, the children were re-categorized by degree of parent-report tactile sensitivity. This regrouping created a more robust distinction between the groups with amplitude diminution in the left and right hemispheres and latency prolongation in the right hemisphere in the deviant and slow-rate paradigms for the affected children. This study suggests that children with autism have early differences in somatosensory processing, which likely influence later stages of cortical activity from integration to motor response. Autism Res 2012, 5: 340-351. © 2012 International Society for Autism Research, Wiley Periodicals, Inc.
An aspect of cognitive functioning in autistic children was investigated by comparing their performance on the Children's Embedded Figures Test with that of MA-matched normal and MA-and CA-matched mentally retarded non-autistic children. The autistic children were significantly more competent at this task than either group of control children, and also showed qualitatively different strategies. Since the performance of the autistic children was better than predicted from MA and commensurate with CA, it can be regarded as an islet of ability. This finding is discussed in terms of orientation and visualization factors involved in visuo-spatial abilities and is also related to cognitive deficit.