Psychometrics and Clinical Utility of Sensory Processing Assessments for Children

PURPOSE: Difficulties in any aspect of sensory processing are likely to impact the ability of children to engage productively with play, education, and self-care activities (Schaaf & Miller, 2005; Tomchek & Dunn, 2007). There is a lack of clear evidence for the efficacy of sensory integration and sensory-based approaches that is related, in part, to inconsistencies in which sensory difficulties are described and measured. There is currently no consensus on the best method to identify and document the nature of sensory processing in children (Eeles et al., 2014; Schaaf & Lane, 2015). While several sensory processing assessment tools are available for use by researchers and clinicians, there are no published guides outlining which instrument or set of instruments is the best for a given scenario. The purpose of this study was to answer the question, What instrument or set of instruments is the best for the evaluation of sensory processing in children?

DESIGN: The study design was a systematic review. A comprehensive search was conducted to identify pediatric sensory processing assessments. Assessments were included if they met the following criteria: (1) are intended for children ages 2–10 yr and (2) purport to measure behavioral responses to sensory stimuli in the environment. Assessments were excluded based on the following criteria: (1) infant, adolescent, or adult measure; (2) measure of sensory discrimination; (3) measure of sensory perception; (4) measure of neurophysiological response to sensory stimulation; or (5) measure not published in English.

METHOD: Four reviewers screened titles and abstracts using inclusion and exclusion criteria to establish a priori eligibility. The reviewers met on multiple occasions to establish a consensus on the eligibility of assessments. The eligible assessments were evaluated using a multistep process. First, the research team conducted additional instrument-specific searches of the literature using article reference lists and assessment names as starting points. Second, two researchers independently reviewed each assessment and extracted relevant psychometric data. Third, researchers compared findings of independent reviews and established consensus. Fourth, data were prepared and summarized in table format.

RESULTS: Sixteen assessments met the eligibility criteria. A majority of the assessments were questionnaires completed by the caregiver or teacher and did not include clinical observation.

CONCLUSION: There are many publicly available sensory processing assessments for children ages 2–10 yr. Despite the many assessments available, there is not one single assessment that is the best for evaluating sensory processing in children. More work needs to be done in evaluating the psychometric properties of many of the assessments to determine which is the best evaluative assessment. Occupational therapists who practice in sensory integration should be aware of these strengths and limitations.

References

Eeles, A. L., Spittle, A. J., Anderson, P. J., Brown, N., Lee, K. J., Boyd, R. N., & Doyle, L. W. (2013). Assessments of sensory processing in infants: A systematic review. Developmental Medicine and Child Neurology, 55, 314–326. https://doi.org/10.1111/j.1469-8749.2012.04434.x

Schaaf, R. C., & Lane, A. E. (2015). Toward a best-practice protocol for assessment of sensory features in ASD. Journal of Autism and Developmental Disorders, 45, 1380–1395. https://doi.org/10.1007/s10803-014-2299-z

Schaaf, R. C., & Miller, L. J. (2005). Occupational therapy using a sensory integrative approach for children with developmental disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 11, 143–148. https://doi.org/10.1002/mrdd.20067

Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: A comparative study using the short sensory profile. American Journal of Occupational Therapy, 61, 190–200. https://doi.org/10.5014/ajot.61.2.190