Early Identification of Sensory Processing Challenges in Infants at Risk for Sensory Processing Challenges

PURPOSE: The purpose of this study was to determine if infants ages 6–24 mo at high risk for sensory processing disorder (SPD) could be differentiated from those at low risk for SPD using standardized developmental tests. Children with SPD have difficulties responding appropriately to sensory input, affecting daily life activities (Miller, Nielsen, Schoen, & Brett-Green, 2009). Early identification of SPD is necessary for early intervention. Little research investigating infants at risk for SPD and characterizing the earliest signs of the disorder has been published. Evidence suggests that SPD is heritable (Keuler, Schmidt, Van Hulle, Lemery-Chalfant, & Goldsmith, 2011); thus, studying siblings of children with SPD prospectively may contribute to understanding early signs of SPD and enable early intervention when the brain is most receptive.

DESIGN: A cross-sectional pilot study was conducted comparing infants and toddlers at high risk for SPD with infants and toddlers at low risk for SPD using standardized developmental tests. High-risk participants had older siblings with SPD (n = 13), and low-risk participants (n = 16) had no sibling or parent history of SPD or DSM diagnoses.

METHOD: Infants and toddlers were administered three subtests of the Toddler and Infant Motor Evaluation, including the Motor Organization, Mobility, and Atypical Position subtests, and the language and cognition subtests of the Bayley Scales of Infant and Toddler Development, third edition. Data were collected during child assessments. t tests were used to test associations between risk status (low risk vs. high risk) and normally distributed group means on standardized measures. A correction for multiple comparisons was made for p values for standardized assessments by dividing alpha (α = .05) by the number of comparisons (α = .05/6 = .0083). The association between risk status and atypical positions was tested with chi-square.

RESULTS: High-risk infants and toddlers had significantly lower scores on the Bayley Cognitive Composite Score, t(26) = –2.92, p = .007; the Receptive Communication Scaled Score, t(26) = –2.87, p = .008; and the Language Composite Score, t(26) = –2.90, p = .008) compared with the low-risk group. Effect sizes were large for cognition (d = 1.14), receptive language (d = 1.11), and language composite scores (d = 1.12). High-risk infants and toddlers presented with more atypical positions (p = .005).

CONCLUSION: Findings suggest that certain outcome measures differentiated risk status for sensory processing challenges and provide valuable information for future longitudinal studies on early indicators of SPD.

IMPACT STATEMENT: The results of this study provide preliminary information on possible early developmental disruptions in infants at high risk for SPD. Early identification of SPD is important as it can lead to earlier intervention to minimize manifestation of symptoms and maximize health, well-being, and participation in early childhood occupations.

References

Keuler, M. M., Schmidt, N. L., Van Hulle, C. A., Lemery-Chalfant, K., & Goldsmith, H. H. (2011). Sensory over-responsivity: Prenatal risk factors and temperamental contributions. Journal of Developmental and Behavioral Pediatrics, 32, 533–541. https://doi.org/10.1097/DBP.0b013e3182245c05

Miller, L. J., Nielsen, D. M., Schoen, S. A., & Brett-Green, B. A. (2009). Perspectives on sensory processing disorder: A call for translational research. Frontiers in Integrative Neuroscience, 3, 22. https://doi.org/10.3389/neuro.07.022.2009