Overview
Research suggests that sensory processing differences are prevalent in children with autism spectrum disorder (ASD; Baranek, 2002; Hilton, Garver, & LaVesser, 2007; Kern et al., 2008; Kern, Garver, Carmody, et al., 2007; Myles et al., 2004). While sensory differences have long been included in the IDEA and state definitions of Autism or Other or Pervasive Developmental Disorders, they did not become part of the clinical diagnostic manual until the release of the DSM-5 (American Psychiatric Association, 2013) autism spectrum disorder (ASD) criteria. Beginning with DSM-5, sensory differences were included as one of the possible manifestations of restricted, repetitive patterns of behaviors/interests/activities, which is a core characteristic of ASD (APA, 2013).
Occupational therapists have special training in sensory processing and integration, and these professionals are critical members of multidisciplinary teams during an ASD evaluation. Including sensory assessments in these evaluations is important, and both early and ongoing assessment in this domain is recommended. A recent study suggests that screening high-risk infants (i.e., those with an older sibling with ASD) for unusual sensory behaviors is important because of consistency in such behaviors into the teenage years (Van Etten et al., 2017).
Approaches used to gather information about sensory processing, integration, and functioning include self-report; questionnaires/rating scales completed by others about sensory issues across settings; and observation-based standardized tests completed by professionals with appropriate training.
Included within this section of the TARGET is summary information about the following assessments for motor assessment:
- Adolescent/Adult Sensory Profile
- Degangi-Berk Test of Sensory Integration
- Sensory Integration and Praxis Tests
- Sensory Integration Inventory- Revised for Individuals with Developmental Disabilities (SII-R)
- Sensory Processing Measure (SPM) and Sensory Processing Measure- Preschool (SPM-P)
- Sensory Profile 2
The following summary of sensory processing assessments is not intended to be all-inclusive. Rather, the assessments were selected based on their prevalence within clinical and academic settings as well as their relevance to children with ASD.
Autism Related Research
Not all of the sensory processing or sensory integration measures reviewed in this summary have been standardized for or even studied with children with ASD. However, published research on these instruments that is available is included below.
The Sensory Profile series (Sensory Profile 2, and the Adolescent/Adult Sensory Profile) have been studied more within the ASD population than any other instrument included in this section. Findings with this series include: (a) children and adolescents reported more atypical sensory symptoms than typically developing peers, particularly within the auditory modality (Stewart et al., 2016); (b) that these symptoms negatively affect school functioning (Howe & Stagg, 2016); (c) sensitivity to and avoidance of are the most likely ways that children with ASD experience sensory issues (Simpson, Adams, Alston-Knox, Heussler, & Keen, 2019); (d) sensory hypersensitivity significantly predict repetitive behaviors, and this was found among those who did not have ASD, as well, though both repetitive behaviors and sensory problem scores were higher among those diagnosed (Schulz & Stevenson, 2019); and (e) the Sensory Profile was able to discriminate between children with ASD and those without (Ermer & Dunn, 1998; Kientz & Dunn, 1997; Watling, Deitz, & White, 2001).
Other ASD-related studies using other measures included in this section included that, on the SIPT and SPM, children with ASD display strengths in visuopraxis and difficulties with somatopraxis and vestibular functions, which appeared to greatly affect social participation (Roley, Mailloux, Parham, Schaaf, Lane, & Cermack, 2015). In a recent study, Dugas and colleagues (2018) found that the SPM Home Form was better able to identify children with ASD who presented with sensory features for every domain, compared with the Sensory Profile. Hearing and touch were the areas most likely affected by sensory dysfunction among young children with ASD, and teachers (vs. parents) were more likely to endorse effects in social participation affected by these problems (Fernandez-Andres et al., 2015).