Sensory modulation and sleep quality among adults with learning disabilities: a quasi-experimental case-control design study

The Impact of Weighted Blanket Use on Adults with Sensory Sensitivity and Insomnia

Purpose

This study's purpose was to determine the impact of weighted blanket use on moderate to severe insomnia in adults with sensory sensitivity greater than the average population.

Methods

For this study, a four-week, single-case, multiple-participant ABA study design was used. Through convenience sampling, four participants scoring 15 or greater on the Insomnia Severity Index (ISI), which categorizes them as having moderate to severe insomnia, and much more than most people in sensory sensitivity on the Adolescent/Adult Sensory Profile were recruited. First, seven-day baseline sleep data was gathered, followed by two weeks of weighted blanket use, concluding with a seven-day withdrawal phase. Additional outcome measures included: Tuck and Snooze Survey, Consensus Sleep Diary Morning, and Additional Sleep Diary Questions. Data analysis included visual analysis, mean comparisons, Tau-U calculations, and pre- to post-ISI category comparisons.

Results

All participants' ISI scores were categorized as one level less severe postintervention. All participants demonstrated increased sleep quality, and three participants showed an increase in sleep duration based on individual mean comparisons between baseline and intervention phases.

Conclusion

Weighted blankets appear beneficial in reducing insomnia severity in adults with much more than the average population sensory sensitivity. In addition, those with self-reported anxiety may have increased benefit from this intervention.

Sensory modulation interventions for adults with mental illness: A scoping review

Introduction

Sensory Modulation Interventions (SMI) assist people with mental illnesses to regulate emotional and physiological arousal. We aimed to conduct a scoping review to identify the study designs, geographical distribution, modality/regimen, barriers and facilitators in using SMI for individuals with mental illnesses.

Methods

A systematic search was conducted using Arksey and O'Malley's framework with studies published on SMI from January 2010 to November 2020.

Results

17 articles were found to be relevant. One was a case-control study, qualitative (N = 3), mixed-method (N = 3), and case studies (N = 3), and the rest were pilot interventional studies (N = 8). The duration of sessions ranged from 2 to 30 minutes for 2 days to 3 years. The facilitators in using SMI were of being cost-effective and easily adaptable. Barriers were in terms of maintenance of sensory items. Sensory modulation based items related to proprioception, vestibular and tactile were the frequently used in the SMI based interventions used in the included studies.

Conclusions

SMI as an occupational therapy intervention for individuals with mental illnesses is evolving and more robust studies in the future are recommended.

Impaired extraction and consolidation of morphological regularities in developmental dyslexia: A domain general deficit?

The current study examined whether adults with Developmental Dyslexia are impaired in learning linguistic regularities in a novel language, and whether this may be explained by a domain general deficit in the effect of sleep on consolidation. We compared online learning and offline consolidation of morphological regularities in individuals with Developmental Dyslexia (N = 40) and typical readers (N = 38). Participants learned to apply plural inflections to novel words based on morpho-phonological rules embedded in the input and learned to execute a finger motor sequence task. To test the effects of time and sleep on consolidation, participants were assigned into one of two sleep-schedule groups, trained in the evening or in the morning and tested 12 and 24 h later. Unlike typical readers, Dyslexic readers did not extract the morpho-phonological regularities during training and as a group they did not show offline gains in inflecting trained items 24 h after training, suggesting that the deficit in extraction of regularities during training may be related to the deficit in consolidation. The offline gains in dyslexic readers, were correlated with their prior phonological abilities, and were less affected by sleep than those of typical readers. Although no deficit was found in the consolidation of the motor task, dyslexic readers were again less successful in generating an abstract representation of the motor sequence, reflected in a difficulty to generalize the motor sequence knowledge acquired using one hand to the untrained hand. The results suggest that individuals with Developmental Dyslexia have a domain general deficit in extracting statistical regularities from an input. Within the language domain this deficit is reflected in reduced benefits of consolidation, particularly during sleep, perhaps due to reduced prior phonological abilities, which may impede the individual's ability to extract the linguistic regularities during and after training and thus constrain the consolidation process.

Visual and social differences in dyslexia: deep phenotyping of four cases with spared phonology

Diagnostic criteria for dyslexia describe specific reading difficulties, and single-deficit models, including the phonological deficit theory, have prevailed. Children seeking diagnosis, however, do not always show phonological deficits, and may present with strengths and challenges beyond reading. Through extensive neurological, neuropsychological, and academic evaluation, we describe four children with visuospatial, socio-emotional, and attention impairments and spared phonology, alongside long-standing reading difficulties. Diffusion tensor imaging revealed white matter alterations in inferior longitudinal, uncinate, and superior longitudinal fasciculi versus neurotypical children. Findings emphasize that difficulties may extend beyond reading in dyslexia and underscore the value of deep phenotyping in learning disabilities.

Learning based PTSD symptoms in persons with specific learning disabilities

Specific learning disorders (SLD) persist into adulthood. Persons with SLD frequently experience emotional and social difficulties. Following qualitative descriptions of individuals with SLD who experienced learning, as traumatic, we hypothesized that individuals reporting SLD would report higher levels of learning-based post-traumatic-stress-disorder (PTSD) symptoms. In Study 1 (N = 216), participants responded to questionnaires concerning SLD and learning-based PTSD. A separate sample (N = 43) was queried about adjustment disorder symptoms. Study 2 (N = 176) examined if current psychological distress was predicted by levels of learning-based PTSD at each developmental stage (elementary/high-school/post-high-school) and whether SLD links to current psychological distress. Finally, we assessed if SLD-psychological distress associations are mediated by cumulative levels of learning-based PTSD across these school periods. In Study 1 individuals reporting SLD displayed higher learning-based PTSD levels than those without SLD. SLD-PTSD associations held beyond adjustment disorder symptom levels. In Study 2, SLD was linked with psychological distress, mediated by accumulated learning-based PTSD symptom levels across school periods. These results suggest that in individuals with SLD, learning experiences may be associated with learning-based PTSD symptoms. Further, persons with SLD may be scarred by their traumatic learning experiences linking with current psychological distress, a link mediated by cumulative difficulties experienced over school years.

Sensory processing difficulties in psychiatric disorders: A meta-analysis

In clinical practice, many individuals with psychiatric disorders report difficulties in sensory processing, including increased awareness or sensitivity to external stimuli. In this meta-analysis, we examined the sensory processing patterns of adolescent and adult individuals with a broad spectrum of different psychiatric conditions. A systematic search in various databases resulted in the inclusion of 33 studies (N=2008), all using the Adolescent/Adult Sensory Profile (AASP). By comparing diagnostic subgroups to the corresponding reference group of the AASP, we detected a general pattern of sensory processing, indicating elevated levels of low registration, sensory sensitivity and sensory avoiding and lowered sensory seeking behavior in patients with different types of psychiatric disorders. The majority of effect sizes were large to very large. In conclusion, sensory processing difficulties can be considered as a non-specific transdiagnostic phenotype associated with a broad spectrum of psychiatric conditions. Further research into the relevance and role of sensory processing difficulties in psychiatric disorders may improve long-term prognosis and treatment.

Work participation, sensory processing and sleep quality in adults with attention deficit hyperactive disorder

BACKGROUND: Although studies have indicated significant effects of attention-deficit hyperactive disorder (ADHD) on work participation, the mechanism underlying work participation of adults with ADHD is still unclear. OBJECTIVE: Following the World Health Organization’s international classification of functioning, disability, and health concepts, this study compares sensory processing and sleep quality (body functions) with work participation among adults with and without ADHD and examines predictive relationships among adults with ADHD. METHODS: Sixty-nine adults with ADHD and 52 matched controls completed a sociodemographic questionnaire, the Adult/Adolescent Sensory Profile, the Mini Sleep Questionnaire, and the Occupational Questionnaire. RESULTS: The ADHD group had significantly poorer body functions, sensory processing (i.e., low-registration, sensory-sensitivity, and sensation-avoiding patterns), sleep quality, and work performance compared to the control group (p <  .001). For adults with ADHD, sensory sensitivity accounted for 10.9%, and sleep quality accounted for 22.0%, of the variance in their work performance. CONCLUSIONS: The deficient body functions of adults with ADHD may affect their work performance and therefore should be considered in further research, as well as in clinical applications.

Social-Emotional Profile of Children with and without Learning Disabilities: The Relationships with Perceived Loneliness, Self-Efficacy and Well-Being

The current study examined whether perceived social support mediated the effects of loneliness and self-efficacy on well-being among students with or without a learning disability (LD). Participants included 834 elementary, middle, and high school students from Israel (29.6% students with LDs) who completed self-report questionnaires. The results of structural equation modeling indicate that social support mediates the indirect effects of age, gender, loneliness and self-efficacy on well-being. In addition, the results show differences between groups, as non-LD girls noted a higher self-efficacy and well-being than boys, and well-being had indirect effects in the non-LD group than in the LD group. These results indicate students with LDs have a unique social-emotional profile that affects their well-being. The study highlights the importance of enhancing self-efficacy and reducing loneliness in order to increase social support, thus predicting positive well-being. Effective and practical educational programs are needed for both groups across age and gender.

Specific Learning Disability Unmasked by Psychophysiological Insomnia

Sleep is essential for good cognition and academic performance. Children with deficits in learning and cognition thus have various sleep disturbances. Learning disabilities in dyslexia are exaggerated with associated sleep problems which also impact the daily routine. Although it is essential to rule out organic etiologies in insomnia, it should also be borne in mind to probe the child's functional performance in school. Psychophysiological insomnia should be considered in perpetuating stressful conditions. Any scholastic difficulty in a child has to be seriously evaluated to estimate the underlying condition. We report a rare case of psychophysiological insomnia diagnosed in a child with specific learning disability. Awareness of the associated sleep difficulties in dyslexia helps in improved assessment and treatment of such children.

Sensory Hypersensitivity Predicts Reduced Sleeping Quality in Patients With Major Affective Disorders

The goal of this study was to examine the sensory profile (expressed as hypersensitivity or hyposensitivity) of patients with major affective disorders and its relative contribution to the prediction of sleep quality while considering affective temperaments and depression, which may impact sleep quality. We recruited 176 participants (mean age, 47.3 y), of whom 56.8% had a diagnosis of unipolar major depressive disorder and 43.2% a diagnosis of bipolar disorder. Reduced sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Affective temperaments were assessed using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego. Sensory hypersensitivity, assessed using the Adolescent/Adult Sensory Profile, significantly distinguished between poor and good sleepers. Sleep quality was mainly predicted by the Beck Depression Inventory-II total score and anxious temperament. Sensory hypersensitivity contributed to this prediction mainly with regard to sleep efficiency and related daytime dysfunction.

Executive Functions, Time Organization and Quality of Life among Adults with Learning Disabilities

PURPOSE

This study compared the executive functions, organization in time and perceived quality of life (QoL) of 55 adults with learning disabilities (LD) with those of 55 matched controls (mean age 30 years). Furthermore, relationships and predictive relationships between these variables among the group with LD were examined.

METHODS

All participants completed the Behavioral Rating Inventory of Executive Functions (BRIEF-A), the Time Organization and Participation (TOPS, A-C) and the World Health Organization Quality of Life (WHOQOL) questionnaires. Chi-square tests, independent t-tests and MANOVA were used to examine group differences in each of the subscales scores and ratings of each instrument. Pearson correlations and regression predictive models were used to examine the relationships between the variables in the group with LD.

RESULTS

Adults with LD had significantly poorer executive functions (BRIEF-A), deficient organization in time abilities (TOPS A-B), accompanied with negative emotional response (TOPS- C), and lower perceived QoL (physical, psychological, social and environmental) in comparison to adults without LD. Regression analysis revealed that Initiation (BRIEF-A) significantly predicted approximately 15% of the participants' organization in time abilities (TOPS A, B scores) beyond group membership. Furthermore, initiation, emotional control (BRIEF-A subscales) and emotional responses following unsuccessful organization of time (TOPS-C) together accounted for 39% of the variance of psychological QoL beyond the contribution of group membership.

CONCLUSIONS

Deficits in initiation and emotional executive functions as well as organization in time abilities and emotional responses to impairments in organizing time affect the QoL of adults with LD and thus should be considered in further research as well as in clinical applications.