Autism and Transitioning Youth: A Pilot Study of Sensory Processing and Family Quality of Life

Relationship Between Childhood Sensory Processing Differences and Quality of Life as Adults

Research suggests a relationship between sensory processing, motor skills and quality of life (QOL) in a variety of clinical populations of adults and children. There have been no studies which investigated the relationship of childhood sensory processing and integration and related motor performance (sensori-motor) patterns identified using an Ayres Sensory Integration® (ASI) frame of reference and later QOL of those children as adults. This longitudinal follow-up study examined this relationship. Adult QOL was also examined in relation to current adult sensori-motor patterns. Fifty-three adults who received occupational therapy services as children, were identified as having sensori-motor difficulties at that time and completed a sensory history and a quality-of-life measure as adults participated. Measures included the OTA the Koomar Center Sensory History (SXHX), Adult/Adolescent Sensory History (ASH), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF). MANCOVA found that Total childhood sensori-motor scores had a small relationship to Physical Health QOL as adults that approached significance. Pearson Correlations found that adults with childhood sensori-motor challenges who report sensori-motor challenges as adults had a moderate significant relationship among overall sensori-motor functioning and Physical Health (r = −0.56, p = 0.018). Visual (r = −0.76, p = 0.001), movement (vestibular; r = −0.48, p = 0.042) and tactile processing (r = −0.63, p = 0.008) had moderate to large significant relationships with Physical Health. Visual processing (r = −0.54, p = 0.024) was also significantly related to Psychological Health. Motor Coordination trended to significance for Physical Health (r = −0.42) and Psychological Health (r = −0.41). Conversely, adults who reported typical sensori-motor scores as adults, despite childhood sensori-motor challenges, had a good QOL. Furthermore, similar to previous research, there was a relationship between current visual, movement (vestibular) and tactile (touch) sensory processing and adult Physical and Psychological Health. A multivariate linear regression found Sensory Discrimination and Modulation accounted for one-quarter of the variance in QOL in adults with only Discrimination being statistically significant. Therefore, it is important to consider childhood sensori-motor function as well as adult functioning when examining QOL. Further, heretofore unexamined Sensory Discrimination was found to play a role in adult QOL.

Family Experiences of Decreased Sound Tolerance in ASD

Decreased sound tolerance (DST) is the most common sensory difficulty experienced by autistic individuals. Parents of 88 autistic children and young adults between the ages of 3 and 30 described coping strategies and physical and emotional responses used to deal with distressing sounds, and their impact on daily activities. Loud, sudden, and high-pitched sounds were most commonly endorsed as distressing, most often causing autistic children and young adults to cover their ears or yell, while producing stress, irritation, fear, and anxiety. Parents reported warning their child, providing breaks, or avoiding noisy settings as the most used coping strategies. Overall, findings indicate that DST leads to fewer opportunities for autistic children and young adults to participate at home, at school, and in the community. Further, results suggest hyperacusis, misophonia, and phonophobia, subtypes of DST, are present in autistic children and young adults.

Occupational Therapy-Related Assessments for Adults With Intellectual Disability: A Scoping Review

IMPORTANCE

Occupational therapy practitioners use structured assessment tools to gather information from adults with intellectual disability (ID) in order to develop the occupational profile, guide occupational therapy intervention, and assess change over time.

OBJECTIVE

To identify occupational therapy-related tools in the peer-reviewed literature for use in practice with adults with ID.

DATA SOURCES

Peer-reviewed literature published between January 2002 and January 2018 included in CINAHL, PsycINFO, PubMed, and Scopus. Study Selection and Data Collection: The review included articles that had information on occupational therapy-related assessment with adults 18 yr or older who had primary or co-occurring ID.

FINDINGS

Fifty-eight articles identified 73 occupational therapy-related assessment tools.

CONCLUSIONS AND RELEVANCE

This scoping review identified a broad range of assessment tools in the occupational therapy domain that are appropriate for adults with ID, some of which may be unfamiliar to occupational therapy practitioners. What This Article Adds: This scoping review provides occupational therapy practitioners with a summary of occupational therapy-related assessment tools for adults with ID and an assessment reference guide.

Effectiveness of Noise-Attenuating Headphones on Physiological Responses for Children With Autism Spectrum Disorders

Objective: The purpose of this study was to evaluate the proof of concept of an intervention to decrease sympathetic activation as measured by skin conductivity (electrodermal activity, EDA) in children with an autism spectrum disorder (ASD) and auditory hypersensitivity (hyperacusis). In addition, researchers examined if the intervention provided protection against the negative effects of decibel level of environmental noises on electrodermal measures between interventions. The feasibility of implementation and outcome measures within natural environments were evaluated.

Method: A single-subject multi-treatment design was used with six children, aged 8–16 years, with a form of Autism (i.e., Autism, PDD-NOS). Participants used in-ear (IE) and over-ear (OE) headphones for two randomly sequenced treatment phases. Each child completed four phases: (1) a week of baseline data collection; (2) a week of an intervention; (3) a week of no intervention; and (4) a week of the other intervention. Empatica E4 wristbands collected EDA data. Data was collected on 16–20 occasions per participant, with five measurements per phase.

Results: Separated tests for paired study phases suggested that regardless of intervention type, noise attenuating headphones led to a significance difference in both skin conductance levels (SCL) and frequency of non-specific conductance responses (NS-SCRs) between the baseline measurement and subsequent phases. Overall, SCL and NS-SCR frequency significantly decreased between baseline and the first intervention phase. A protective effect of the intervention was tested by collapsing intervention results into three phases. Slope correlation suggested constant SCL and NS-SCR frequency after initial use of the headphones regardless of the increase in environmental noises. A subsequent analysis of the quality of EDA data identified that later phases of data collection were associated with better data quality.

Conclusion: Many children with ASD have hypersensitivities to sound resulting in high levels of sympathetic nervous system reactivity, which is associated with problematic behaviors and distress. The findings of this study suggest that the use of noise attenuating headphones for individuals with ASD and hyperacusis may reduce sympathetic activation. Additionally, results suggest that the use of wearable sensors to collect physiological data in natural environments is feasible with established protocols and training procedures.

Development and Pilot of the Caregiver Strategies Inventory

Children with autism spectrum disorder often demonstrate unusual behavioral responses to sensory stimuli (i.e., sensory features). To manage everyday activities, caregivers may implement strategies to address these features during family routines. However, investigation of specific strategies used by caregivers is limited by the lack of empirically developed measures. In this study, we describe the development and pilot results of the Caregiver Strategies Inventory (CSI), a supplement to the Sensory Experiences Questionnaire Version 3.0 (SEQ 3.0; Baranek, 2009) that measures caregivers' strategies in response to their children's sensory features. Three conceptually derived and empirically grounded strategy types were tested: cognitive-behavioral, sensory-perceptual, and avoidance. Results indicated that the CSI demonstrated good internal consistency and that strategy use was related to child age and cognition. Moreover, parent feedback after completing the CSI supported its utility and social validity. The CSI may be used alongside the SEQ 3.0 to facilitate a family-centered approach to assessment and intervention planning.

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.