Discriminant Validity of the Adult/Adolescent Sensory History (ASH)

SIGNIFICANCE: Adults with sensory processing disorder (SPD) are an underserved population. The Adult/Adolescent Sensory History (ASH) will allow better identification of these individuals and will facilitate discrimination of individuals with SPD from individuals with autism spectrum disorder (ASD) and typical peers. This distinction will facilitate treatment planning for occupational therapists (OTs) working with this group.

INNOVATION: The ASH is a unique, self-report assessment on areas of praxis, posture, and sensory discrimination. Scores provide practical information on 20 areas of performance that can be used by OTs to facilitate individualized treatment planning for improved functioning.

RESEARCH QUESTIONS: Can the ASH discriminate among adults with ASD, SPD, and typical peers? Are there age or gender differences in sensory processing for adults with SPD or ASD? Are there differences in sensory processing between adults with SPD or ASD?

BACKGROUND: Adults with SPD demonstrate patterns of sensory processing, such as sensory avoiding, sensory sensitivity, or low registration. Differences and similarities in sensory processing between SPD and ASD in children have been found with the Sensory Profile; however, there is no evidence that the adult version can discriminate between diagnoses. A standardized assessment for adolescents and adults proven to discriminate between SPD and ASD would aid in efforts to describe and understand sensory processing within these diagnoses across the lifespan.

METHOD: In this study, we used a descriptive retrospective record review of charts of adults who received services at a private occupational therapy clinic in the northeast. Participants included three groups, each with 101 individuals aged 18 to 95 yr. Typical adults’ age and gender matched with adults with diagnoses of ASD or SPD. ASD and SPD groups were obtained from record review, and the typically developed group was obtained from previous normative research on the ASH.

The ASH is a 188-question, self-report sensory questionnaire for adults examining sensory processing in seven sensory systems and 13 areas of modulation, discrimination, postural control, praxis, and social–emotional function. Total score, sensory section, and subsection scores are obtained. In the analysis, we used descriptive statistics, linear regression for age trends, and one-way analysis of variance (ANOVA) with Bonferroni corrections for comparison of means between groups.

RESULTS: No differences by age were found for ASH total scores in all groups. In regard to gender differences, SPD women were more dysfunctional for auditory, touch, and movement sections (p = .000), but there were no ASD gender differences. Using ANOVAs for three groups, we found a significant difference between groups (p = .000). Using post hoc t tests for ASH total, section, and subsection scores, we found significant differences between typical individuals and individuals with ASD (p ≤ .025 to .00) or SPD (p ≤ .031 to .003). SPD and ASD groups had significant differences on the Visual Spatial section (p = .026), the Touch section (p = .007), and the Social–Emotional section (p = .001), with the ASD group demonstrating more dysfunction. Significant differences were found on subsections, including Visual Spatial (p = .037), Touch Discrimination (p = .001), Touch Modulation (p = .033), Proprioception (p = .017), and Motor Planning (p = .011), with the ASD group showing more dysfunction. Limitations of this study include the inherent shortcomings of retrospective record review and diagnoses based on record review.

CONCLUSION: The ASH can discriminate between typical adults and those with SPD or ASD. Results provide preliminary evidence for differences in sensory processing between adults with SPD or ASD as well as potential gender differences. The ASH provides a unique and useful assessment to identify sensory dysfunction in adults with SPD or ASD.