Prevalence of sensory modulation disorder among Puerto Rican preschoolers: an analysis focused on socioeconomic status variables

Sensory reactivity assessment in children: A systematic review

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.

Is Birth Method Associated with Sensory Hyperreactivity in Children 3-4 Years in an Upper-Middle-Income Country?

Background

Research has shown that pressure in the vaginal birth process aids the infant's neurophysiological adaption to extrauterine life, including their ability to regulate their responses to diverse sensory stimuli. As pressure is absent in elective caesarean section births, we hypothesised that these children may be at higher risk for developing sensory hyperreactivity (SHR), a sensory modulation difficulty which negatively impacts on the child's engagement in their occupations. This paper reports on a study which investigated associations between birth method and SHR.

Method

In this cross-sectional study, 91 children aged three and four years from various language, cultural, and socioeconomic groups were recruited and categorised based on birth method (caesarean section or vaginal birth). Caregivers of each child completed the Short Sensory Profile-2 and a demographic questionnaire. The prevalence of SHR between the birth method groups was compared.

Results

The prevalence of SHR was greater in the vaginal birth group (29%) than the caesarean section group (9%). Mothers in the vaginal birth group were younger (p ≤ 0.001), of lower-income level (p = 0.003), and more likely to be single (p = 0.037). During data collection with the vaginal birth group, comprehensibility of certain items in the Short Sensory Profile-2 proved challenging for many caregivers.

Conclusion

The statistically significant higher prevalence of SHR in the vaginal birth group supported a null hypothesis. However, the results are questioned due to the challenges related to data collection. Given this, the study supports the need for further investigation of how sociocultural and socioeconomic factors influence the assessment of SHR in the South African context.

Sensory processing challenges as a novel link between early caregiving experiences and mental health

Early caregiving adversity (ECA) is associated with elevated psychological symptomatology. While neurobehavioral ECA research has focused on socioemotional and cognitive development, ECA may also increase risk for "low-level" sensory processing challenges. However, no prior work has compared how diverse ECA exposures differentially relate to sensory processing, or, critically, how this might influence psychological outcomes. We examined sensory processing challenges in 183 8-17-year-old youth with and without histories of institutional (orphanage) or foster caregiving, with a particular focus on sensory over-responsivity (SOR), a pattern of intensified responses to sensory stimuli that may negatively impact mental health. We further tested whether sensory processing challenges are linked to elevated internalizing and externalizing symptoms common in ECA-exposed youth. Relative to nonadopted comparison youth, both groups of ECA-exposed youth had elevated sensory processing challenges, including SOR, and also had heightened internalizing and externalizing symptoms. Additionally, we found significant indirect effects of ECA on internalizing and externalizing symptoms through both general sensory processing challenges and SOR, covarying for age and sex assigned at birth. These findings suggest multiple forms of ECA confer risk for sensory processing challenges that may contribute to mental health outcomes, and motivate continuing examination of these symptoms, with possible long-term implications for screening and treatment following ECA.

Feasibility of a randomized controlled trial of a proprioceptive and tactile vest intervention for children with challenges integrating and processing sensory information

BACKGROUND

Children with challenges integrating and processing sensory information can have difficulties participating in play and learning activities. One way to support participation is to offer sensory stimulation, such as proprioceptive and tactile stimulation provided by wearing a sensory-stimulating vest. The aim of this study was to investigate the feasibility of the key procedures of a planned full-scale randomized controlled trial (RCT) of a proprioceptive and tactile stimulation vest for children aged 6-12 years who have challenges integrating and processing sensory information. The study focused on the feasibility of the recruitment and information processes, the relevance of the study materials, the usefulness of diaries completed by parents, and use of the following outcome measures: Test of Everyday Attention-Children (TEACh), registration of off-task behaviour, and pulse rate.

METHODS

Ten schoolchildren aged 6-12 years (mean 8.4) who had challenges integrating and processing sensory information and sensory-seeking behaviours (based on their Short Sensory Profile scores) participated in the study. Study feasibility was assessed using data from interviews with the participating children, their parents and teachers, and psychologists from the municipal Educational Psychological Counselling Departments.

RESULTS

Recruitment and introductory materials were found to be relevant and non-problematic, while the outcome measurements, diaries, and pulse measurements did not work well, and the tool for registering off-task behaviours needed to be revised. The results indicated that an outcome measure relating to the children's subjective experiences and closer involvement of teachers in the study could be beneficial.

CONCLUSION

The aim of the study was to investigate the feasibility of the planned methodology for a full-scale RCT of a proprioceptive and tactile stimulating vests for children with challenges integrating and processing sensory information. We found that a partial redesign of the study is needed before a full-scale RCT is conducted and that this should include outcome measures on the children's subjective experiences with using the vest.

Sensory profile of children with Central Auditory Processing Disorder (CAPD)

PURPOSE

To analyze the sensory profile of children with auditory sensory processing disorder according to the Child Sensory Profile 2 and to verify potential associations between central auditory processing and sensory processing.

METHODS

Sixty children from two public schools in the city of João Pessoa, state of Paraíba, were evaluated. All children had their cognitive skills tested and their socioeconomic and demographic information collected. The children's hearing, central auditory processing, and sensory processing were evaluated. SPSS Statistics version 25.0 was used for data analysis and the significant value adopted was 0.05. Descriptive analysis was performed using the central tendency method. The similarities among the test variables were measured by Student's t-test and Mann-Whitney U test. The effect size (ES) between the groups was measured by Cohen's d or Rosenthal's r coefficient.

RESULTS

The average age of children with CAPD was 8.4 years, and their families had lower levels of income and education when compared to those without the disorder. Children with CAPD present more sensory differences than their peers with normative CAP. The Child Sensory Processing 2 results didn't show any statistic associations with central auditory processing, and the effect size was of moderate magnitude for the visual system.

CONCLUSION

Children with CAPD have more sensory differences than their peers according to the normative results of the Child Sensory Profile 2. An association between sensory and central auditory processing was not observed, except for the visual system.

Prevalence and severity-based classification of sensory processing issues. An exploratory study with neuropsychological implications

Sensory processing issues, mainly known as sensory processing disorder or SPD, are frequent in children with neurodevelopmental disorders and are associated with learning and behavioral difficulties. However, previous studies suggest that these disturbances might also be present in typically developing children, reaching prevalence rates of 10-20%. Nevertheless, published studies have been primary been conducted in non-European countries. Therefore, we aim, as first objective, to explore the frequency of sensory processing difficulties in a random sample of school-age children from Spain to contribute to the study of its prevalence. The Sensory Profile-2 (SP2) assessment tool was administered to 369 participants to study their sensory processing patterns, the absence or presence of sensory processing issues, the affected sensory systems, as well as their socioemotional, attentional, and behavioral impact. Furthermore, as second objective, we have developed a novel strategy to classify SPD by severity ranges using SP2 yielded results; accordingly, the sample was classified as follows: no alteration, mild, moderate, and severe sensory processing alteration. The results show prevalence rates consistent with previous findings: 15.9% of participants met the severe alteration criteria and 10.5%, 11.1% and 62.5% were classified as moderate, mild and no alteration, respectively. Finally, we hypothesize about SPD and underlying neuropsychological processes that might be associated with this condition. Our results highlight the necessity of further research efforts to establish whether high-frequency and severity rates of sensory processing alterations are linked to neuropsychological variables. The provided classification system might be useful to determine such associations.

Sensory processing and its relationship to participation among childhood occupations in children with autism spectrum disorder: exploring the profile of differences

Autism is a condition manifested by persistent deficits in social communication and social interaction across multiple contexts, and, sensory processing difficulties may further affect childhood-occupation and hinders their overall development. This study examines the sensory-processing and childhood participation of children with autism (6 to 10 years), and 'age/gender-matched typical children as control. The Sensory Processing (SSP) and the Participation of childhood-occupation (PICO) measures were used to collect data from 93 parents of children with autism and 95 parents of typically-developing' children, recruited from hospitals, school and care centres. This study had 74 percent (n = 72) male participants (i.e. 4:1 male to female ratio) in the autism group, and found sensory processing difficulties were associated with specific childhood-participation limitation. Children with autism had lower participation (across level, frequency and enjoyment) than the typical children. Sensory-processing' difficulties for the children with autism (n = 93) were at 68.8 percent, compared to 21.5 percent in the typical group (n = 95), and were significantly different (p  < 0.001). The differences in sensory-processing difficulties were significant (p  < 0.05) between groups, across all domains, except for movement sensitivity (p  > 0.28). Auditory filtering was the sole sensory-processing difficulty with significant correlations with all three dimensions of participation [i.e. difficulty (r = 0.36, p  < 0.01), frequency (r = 0.22, p  < 0.05) and enjoyment (r = 0.27, p  < 0.01)]. Our finding highlighted that auditory-filtering difficulties is a key sensory processing difficulty, and it significantly lower the childhood-participation in the autism group. Adding to a growing body of literature on assessment in autism, there is a need for early screening, and to engage parents in early intervention to improve specific sensory processing deficits but also to focus on the child's strengths, for a comprehensive supportive care.

Exploration of Sensory Processing Difficulties among Children Attending Primary School in Denmark

Current research shows that children with sensory processing (SP) difficulties have limited participation and enjoyment in their daily activities at school. The aim of this study was to explore the prevalence of SP difficulties among Danish children and to explore possible associated factors. Since SP difficulties can affect children's prerequisites for participation in school activities and learning possibilities, this study focused on primary school children. Method. The study was designed as a cross-sectional survey. The sample consisted of 1723 children age 5 to 11 years, who were attending Danish public school (45.5% girls, 53.2% boys). The parents or caregivers of the child completed a Short Sensory Profile (SSP) questionnaire and a demographic questionnaire. One-way ANOVA was used to examine differences between girls and boys regarding sports, geographic area, and parental level of education. Chi-square analysis was used to explore the relationship between sex and SPP scores in the different behavioral sections. Logistic regression analysis was used to investigate possible associations between SP difficulties and sex and the included demographics. Results. A total of 21.3% of the children had SSP scores suggesting SP difficulties. Boys had a higher probability of having SP difficulties than girls (odds ratio (OR) = 1.55, confidence level (Cl): 1.22, 1.97). An association was found between participating in sports outside of school and SP difficulties (OR = 0.55, Cl: 0.47, 0.65 (p ≤ 0.001)). Additionally, a slight association between SP difficulties and parental education level (OR = 0.80) was found. No association was found regarding geographic area, i.e., where in Denmark the children attended school (OR = 1.00). Conclusion. The study results suggest that approximately 20% of the children in Danish public schools might have SP difficulties and over 20% might be at risk of having SP difficulties. The results suggest that Danish schools should focus on both identifying children with SP difficulties and implement interventions such as sensory integration through occupational therapy to help children with SP difficulties, in order to improve their ability to participate and learn from school activities.

Sleep Duration and Quality and Sensory Reactivity in School-Aged Children: The Spanish Cross-Sectional InProS Study

Background: The relationship between children's sleep and health has been widely examined; however, research focused on the link between sleep and sensory reactivity in children without medical conditions is relatively new and based on studies with small samples. Hence, we aimed at exploring the association between sleep duration and quality and prevalence of sensory reactivity in a population-based sample of children aged 3-7. Methods: We examined data on 579 school-age children from the InProS project, a cross-sectional population-based study. Children's sleep duration was classified as <10 vs. ≥10 h/day, and sleep quality was measured using the Pediatric Sleep Questionnaire, defining poor quality sleep as a score of ≥0.33. The Short Sensory Profile (SSP) was used to classify children with or without sensory reactivity using the cut-off points proposed by W. Dunn for SSP total score and each SSP subscale. Prevalence ratios (PR) using Poisson multiple regression models with robust variance were estimated to examine main associations. Results: Around a third (32.6%; n = 189) slept <10 h/day and 10.4% presented poor sleep quality. The prevalence of sensory reactivity was 29.5% for total SSP (<155), 11.4% for tactile sensitivity (<30), 15% for taste/smell sensitivity (<15), 22.5% for movement sensitivity (<13), 49.1% for under-responsive/seeks sensation (<27), 44.4% for auditory filtering (<23), 12.4% for low energy/weak (<26), and 25.4% for visual/auditory sensitivity (<19). Main findings indicated that poor sleep quality was significantly associated with a greater prevalence of sensory reactivity for SSP total score (PR = 1.27; IC 95%: 1.18; 1.38), tactile sensitivity (PR = 1.09, IC95%: 1.00-1.19), taste/smell sensitivity (PR = 1.18, IC95%: 1.08-1.30), under-responsive/seeks sensation (PR = 1.28, IC95%: 1.20-1.37), auditory filtering (PR = 1.31, IC95%: 1.23-1.39), low energy/weak (PR = 1.14, IC95%: 1.04-1.25) and audiovisual sensitivity (PR = 1.15, IC95%: 1.05-1.26) scores after adjusting for potential confounders. Conclusions: In this study, we observed that poor sleep quality was statistically significantly associated with a higher prevalence of sensory reactivity as measured by the total SSP and almost all SSP subscales. To our knowledge, this is the first time that this association has been explored and reported. Further research from prospective studies is required to confirm these findings.

Sensory processing patterns in developmental coordination disorder, attention deficit hyperactivity disorder and typical development

BACKGROUND

Sensory processing difficulties (SPD) are present in children with Developmental Coordination Disorder (DCD) and Attention Deficit and Hyperactivity Disorder (ADHD). However, little is known about sensory processing variability in these disorders.

OBJECTIVE

The purpose of this study was to explore SPD among children with DCD, ADHD and co-occurring symptoms in comparison to children with typical development (TD) and to determine how potential social confounders may influence these associations.

METHODS

The study involved 452 children aged 6-12 years. The Short Sensory Profile-2 was used to assess sensory processing patterns. Multiple linear regressions were utilized to investigate the relationship between DCD, ADHD and co-occurring symptoms and sensory processing patterns, adjusting for social covariates.

RESULTS

Children with DCD and ADHD symptoms showed greater variability of atypical sensory processing patterns compared with TD children. Low registration and sensory sensibility issues were more prevalent in the DCD group. ADHD children showed higher rates of low registration, sensory sensibility and sensory seeking, and all children in the co-occurring symptoms group presented sensory sensibility.

CONCLUSION

This study reports significant variability in sensory processing among children with DCD, ADHD and co-occurring symptoms using a population-based sample. These differences can contribute to understand how neurological and social factors correlates across diagnoses.

The Infancia y Procesamiento Sensorial (InProS-Childhood and Sensory Processing) Project: Study Protocol for a Cross-Sectional Analysis of Parental and Children's Sociodemographic and Lifestyle Features and Children's Sensory Processing

Sensory processing difficulties may have potential detrimental consequences on the physical, social and intellectual development of children. It includes serious disturbances affecting emotional regulation, motor performance, social behavior and daily life functioning, among others factors. Since these symptoms are more frequent among children with disabilities, most research has been carried out in clinical populations. However, recent studies have suggested that sensory problems may be prevalent in around 20% of children without clinical conditions. To date, epidemiological research on sensory dysfunctions in normally developing children is lacking; therefore, it is unknown whether or not sensory processing difficulties are significant factors that affect child’s development. Hence, this study has a double general purpose: (1) to determine the sensory profile of school-aged children; (2) to examine the associations between atypical sensory processing patterns and socio-demographic, health and lifestyle features of these children and their parents. The Infancia y Procesamiento Sensorial (InProS, Childhood and Sensory Processing in English) project is a population-based cross-sectional study of Spanish children aged 3–7 years. Data were gathered from different ad hoc questionnaires and several standardized tests. We propose an objective and reliable methodology using statistical and research procedures to describe and determine associations with sensory processing outcomes. We believe that this project will contribute to filling the gap in epidemiological research on sensory issues by providing more convincing evidence. Nevertheless, the potential results should be corroborated in other larger samples.

Parent-Offspring Transmission of Internalizing and Sensory over-Responsivity Symptoms in Adolescence

Reactions to sensory experiences are an overlooked correlate of affective regulation, despite the importance of bodily states on psychological processes. Children who display sensory over-responsivity (i.e., adverse reactions to typical sensations) are at greater risk for developing affective disorders. We extended this literature to adolescents and their middle-aged parents. Participants in a birth record-based study of families of adolescent twins (N = 506 families; 1012 adolescents; 53% female) completed a subset of items from the Adult Sensory Profile. We derived adolescent self-reported internalizing disorder symptoms and parent affective diagnoses from structured diagnostic interviews. Structural equation models tested the relationship between parent sensory over-responsivity symptoms and affective diagnoses and their adolescent offspring's sensory over-responsivity and internalizing symptoms. Adolescent sensory over-responsivity symptoms were correlated with internalizing disorder symptoms. Parents with a diagnosis of anxiety or depression (mothers only) reported more frequent SOR symptoms than parents without a diagnosis. Parent depression was significantly related to adolescent sensory over-responsivity symptoms, over and above parent sensory over-responsivity symptoms (β = 0.26, p < 0.001 for mothers; β = 0.13, p = 0.004 for fathers). Father alcohol abuse/dependency also predicted offspring sensory over-responsivity symptoms. Offspring of parents with affective disorders were at additional risk for sensory dysregulation via parents' influence on offspring internalizing problems.

The State of the Science on Sensory Factors and Their Impact on Daily Life for Children: A Scoping Review

The objective of this study was to identify and synthesize research about how sensory factors affect daily life of children. We designed a conceptual model to guide a scoping review of research published from 2005 to October 2014 (10 years). We searched MEDLINE, CINAHL, and PsycINFO and included studies about sensory perception/processing; children, adolescents/young adults; and participation. We excluded studies about animals, adults, and review articles. Our process resulted in 261 articles meeting criteria. Research shows that children with conditions process sensory input differently than peers. Neuroscience evidence supports the relationship between sensory-related behaviors and brain activity. Studies suggest that sensory processing is linked to social participation, cognition, temperament, and participation. Intervention research illustrates the importance of contextually relevant practices. Future work can examine the developmental course of sensory processing aspects of behavior across the general population and focus on interventions that support children's sensory processing as they participate in their daily lives.