1. Authors: Christina Heun, Bethany Bates, S/OT, & Alison Lane PhD, OTR/L,
Institutions: Department of Occupational Therapy, The Ohio State University
Acknowledgments: Andrea Stadelman
Sensory Processing Characteristics of Children
with Development Disabilities: A Review
Background and Purpose
• Sensory difficulties that interfere with daily functioning are prevalent in children with developmental disabilities.
• There has not been an attempt to determine whether sensory processing patterns are common among diagnoses.
• In autism, four sensory subtypes have been identified1-3. These subtypes are 1.) No Sensory Impairment (NSI), 2.) Taste /Smell Sensitive, (TSS) 3.) Postural
Inattentive (PI), and 4.) Generalized Sensory Dysfunction (GSD).
• A comparison of sensory characteristics of non-autism diagnoses as compared to these identified subtypes could be beneficial in determining whether sensory
processing patterns are unique based on diagnosis or shared across diagnoses.
• The purposes of this study were to describe sensory characteristics of children with non-autism developmental disabilities and to compare these findings with
sensory subtypes identified in children with autism.
NSI
• All sensory domains are below clinical threshold
TSS
• Extreme score in Taste/Smell Sensitivity
• Clinically significant concerns in Under/Seeks,
Auditory Filtering, Tactile, Visual & Auditory
Sensitivity
PI
• Extreme score in Low Energy Weak suggestive of
postural difficulties
• Clinically significant concerns in Under/Seeks,
Auditory Filtering, Tactile, Visual & Auditory
Sensitivity
GSD
• All domains affected
• Only group to show Movement Sensitivity
References
1. Lane, AE., Bishop, S., & Malloy, C. (in preparation). Sensory based endophenotypes in autism.
2. Lane, AE., Young, R., Baker, AEZ., & Angley, M. (2010). Sensory processing subtypes in autism: Associations with adaptive behavior. Journal of Autism and Developmental Disorders, 40, 112-
122.
3. Lane, AE., Dennis, S., Geraghty, M. (2011). Brief report: Further evidence of sensory subtypes in autism. Journal of Autism and Developmental Disorders, 6, 826-831.
4. Cheung, P. P., & Siu, A. M. (2009). A comparison of patterns of sensory processing in children with and without developmental disabilities. Research in Developmental Disabilities, 30(6), 1468–
1480.
5. Mulligan, S. (1996). An analysis of score patterns of children with attention disorders on the sensory integration and praxis tests. American Journal of Occupational Therapy, 50(8), 647–654.
6. Miller, L. J., et al. (2012). Attention deficit hyperactivity disorder and sensory modulation disorder: A comparison of behavior and physiology. Research in Developmental Disabilities, 33(3), 804–
818.
7. Dunn, W., & Bennett, D. (2002). Patterns of sensory processing in children with attention deficit hyperactivity disorder. Occupational Therapy Journal of Research, 22, 4-15.
8. Yochman, A., et al. (2004). Responses of preschool children with and without ADHD to sensory events in daily life. The American Journal of Occupational Therapy, 58(3), 294–302.
9. Mangeot, S. D., et al. (2001). Sensory modulation dysfunction in children with attention-deficit-hyperactivity disorder. Developmental Medicine & Child Neurology, 43(6), 399–406.
10. Reynolds, S., & Lane, S. J. (2009). Sensory overresponsivity and anxiety in children with ADHD. The American Journal of Occupational Therapy, 63(4), 433–440.
11. Muro, C., et al. (2011). Sensory processing disorders and ADHD subtypes.
12. Engel-Yeger, B., & Ziv-On, D. (2011). The relationship between sensory processing difficulties and leisure activity preference of children with different types of ADHD. Research in
Developmental Disabilities, 3, 1154–1162.
13. Wodka, Talley, &. Mostofsky. (2012).
14. Wuang, Y. P., & Su, C. Y. (2011). Correlations of sensory processing and visual organization ability with participation in school-aged children with down syndrome. Research in Developmental
Disabilities, 6, 2398–2407.
15. Brandt, B. R. (1996). Impaired tactual perception in children with down’s syndrome. Scandinavian Journal of Psychology, 37(3), 312–316.
16. Bruni M., et al. (2010). Reported sensory processing of children with down syndrome. Physical and Occupational Therapy in Pediatrics, 30(4), 280–293.
17. Engel-Yeger, B., et al. (2011). Sensory processing dysfunctions as expressed among children with different severities of intellectual developmental disabilities. Research in Developmental
Disabilities, 32(5), 1770–1775.
18. Baranek G.T, et al. (2008). Developmental trajectories and correlates of sensory processing in young boys with fragile X syndrome. Physical and Occupational Therapy in Pediatrics, 28(1), 79–
98.
19. Miller LJ., et al. (1999). Electrodermal responses to sensory stimuli in individuals with fragile X syndrome: a preliminary report. American Journal of Medical Genetics, 83(4), 268–79.
20. Baranek GT, et al. (2002). Sensory processing correlates of occupational performance in children with fragile X syndrome: preliminary findings. The American Journal of Occupational Therapy,
56(5).
21. Rogers, S. J., et al. (2003). Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders. Journal of Autism and Developmental Disorders, 33(6),
631–642.
22. OCEBM Levels of Evidence Working Group (2011). “The Oxford Levels of Evidence.” Oxford Center for Evidence based Medicine. http://www.cebm.net/index.aspx?o=5653.
Interpretation
NSI
ADHD
TSS
PI
Down Syndrome
GSD
Fragile-X
Based on the review we concluded:
• There is some overlap of sensory processing characteristics between diagnoses
• Children diagnosed with autism spectrum disorder present with more varied sensory processing patterns, whereas
children with the other diagnoses tend to present with similar sensory processing patterns
• Overall findings show that the four autism spectrum disorder sensory subtypes may be useful in describing specific
patterns in non-autism developmental disabilities and guide future intervention planning
Limitations
• Fragile X: Small samples sizes and wide age range
• ADHD: ADHD participants were not separated based on ADHD subtype, most studies included participants on
medications and with comorbid diagnoses
• Down Syndrome: Most studies only included the Short Sensory Profile (parent report) without naturalistic observation
or objective data of child performance
• All articles reviewed were Level 3 evidence22
Conclusion
Results
• The age range of participants in the included studies was 9 months to 15 years, with the exception of one Fragile X study that ranged from 4-49 years of age.
• The final review included 10 x ADHD, 4 x Down Syndrome, 3 x Fragile X Syndrome articles. An additional article addressed both Fragile X Syndrome and Down
Syndrome21.
General Trends
ADHD
• Elevated sensory symptoms compared to typically developing children, but not always clinically significant
• Sensory modalities that may be particularly affected include auditory, tactile, and body position
• Sensory symptoms tend to be mild in intensity
Fragile X
• Pattern of high frequency sensory symptoms in all domains
• Symptoms tend to be severe in intensity
• Vestibular Sensitivity and Movement Sensitivity problems
• No extreme Taste/Smell Sensitivity
Down Syndrome
• Pattern of sensory under-responsiveness and Low Energy Weak
• Auditory Filtering may be problematic
• Problems tend to be moderate in intensity
Methods
• A literature review was conducted for ADHD4-13, Down Syndrome14-17, and Fragile X18-20. Articles were identified via Google Scholar, PsychInfo, CINAHL, and
PubMed. Common search phrases included “sensory processing,” “sensory issues,” “sensory modulation,” and the diagnostic titles of conditions reviewed.
Additional research was done using the reference list of the identified articles.
• Included research was in the form of peer reviewed journal articles, as well as one professional poster and one dissertation regarding ADHD.
• Inclusion criteria included a non-physiological measure of sensory processing, no use of an intervention, and involved a pediatric population.
Sensory Subtypes in Autism