Date Presented 4/19/2018
Atypical sensory response patterns in children with autism spectrum disorder and developmental disabilities were intraindividually stable over a 3-year period but in some cases evidenced a pattern of group-based decline. Further research is needed to explicate unexpected findings related to the role of interventions addressing sensory issues.
Primary Author and Speaker: Grace Baranek
Contributing Authors: Mike Carlson, John Sideris, Anne V. Kirby, Linda R. Watson, Kathryn L. Williams, John Bulluck
PURPOSE: Children with autism spectrum disorder (ASD) are disproportionately likely to manifest unusual responses to sensations (Baranek et al., 2015). Atypical sensory response patterns are frequent targets of occupational therapy intervention because they affect participation of children and families (Bagby et al., 2012). Past research on the stability of such responses has been primarily cross-sectional, leading to unclear results. Determining whether sensory features are stable over time has implications for measuring the added benefit of intervention over maturation. This study addressed the following questions: Does the longitudinal trajectory of sensory features remain stable over time? Does history of interventions contribute to potential changes in children with ASD versus other developmental disabilities (DD)?
METHOD: A nonexperimental longitudinal design was used, with two waves of data collection. Children with ASD (n = 56) and DD (n = 34) were recruited from developmental clinics, family support groups, and a statewide research registry. Ages ranged from 2 to 12 yr (M = 5.69 ± 2.46) at the first measurement time (T1); a second measurement occurred on average 3.3 yr later (T2). At each time point, two sensory caregiver-report measures were administered: the Sensory Experiences Questionnaire (Baranek, 2009) and the Sensory Profile (Dunn, 1999). For each of the three sensory response patterns (i.e., hyporesponsiveness, hyperresponsiveness, seeking), at each time point a summary score across the two measures was generated on the basis of items loading on these constructs. Demographic and other variables, including mental age and nonverbal IQ, were also assessed, and parents were interviewed regarding the amounts and types of services (occupational therapy, speech-language therapy, and total sensory-based therapy) each child received over the longitudinal window.
To examine stability, regression models were used to test the association between sensory features at T1 vs. T2 after controlling for elapsed time, age, and other key variables. Repeated measures t tests were used to document mean change over time per group. We explored the association between intervention dosage levels and change for each of the three sensory response patterns via regression analyses that adjusted for covariates.
RESULTS: For each sensory response pattern, scores at T1 and T2 were highly associated (p < .001). Over the longitudinal interval, the mean severity of seeking scores declined in both groups (p < .001 for ASD; p < .01 for DD), and hyporesponsiveness declined in the ASD group (p < .05). Estimates of therapy dosage were in most cases positively associated with the severity of sensory response patterns at T2, an outcome that may reflect increased intervention given to children who failed to improve over time.
CONCLUSION: Sensory features had high intraindividual stability in children with ASD and DD over a 3-yr period. In some cases, group-based means diminished over time, although there was no evidence that such declines were mediated by commonly used interventions in this sample.
IMPACT STATEMENT: The likelihood of environmental contributors to mean declines in sensory features in children with ASD and DD is consistent with therapeutic attempts to reduce symptoms by focusing on engagement in relevant family occupations. The counterintuitive finding for intervention dosages underscores the need for controlled investigations (e.g., randomized trials) to better document the ability of occupational therapy and other approaches to reduce sensory problems over time, above and beyond what is expected from maturation.
References
Bagby, M. S., Dickie, V. A., & Baranek, G. T. (2012). How sensory experiences of children with and without autism affect family occupations. American Journal of Occupational Therapy, 66, 78–86. https://doi.org/10.5014/ajot.2012.000604
Baranek, G. T. (2009). Sensory Experiences Questionnaire (Version 3.0). Unpublished manuscript, University of North Carolina at Chapel Hill.
Baranek, G. T., Watson, L. R., Turner-Brown, L., Field, S. H., Crais, E. R., Wakeford, L., . . . Reznick, J. S. (2015). Preliminary efficacy of adapted responsive teaching for infants at risk of autism spectrum disorder in a community sample. Autism Research and Treatment, 2015, 386951. https://doi.org/10.1155/2015/386951
Dunn, W. (1999). Sensory Profile manual. San Antonio, TX: Psychological Corporation.
