Sensory Processing Relationships to Autism Spectrum Disorder (ASD) Risk in Toddlers Diagnosed With ASD Open Access

PURPOSE: The purpose of this study was to examine the extent to which sensory processing patterns are related to autism spectrum disorder (ASD) risk status as measured by the Modified Checklist for Autism in Toddlers (MCHAT) and Screening Tool for Autism in Toddlers and Young Children (STAT) in very young children with a diagnosis.

RATIONALE: Early identification of ASD in young children creates opportunity for early intervention to improve outcomes. Sensory processing differences are common in toddlers with an ASD and been reported to predate diagnosis. This, coupled with the addition of the new Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2014) item related to hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment heightens the need to better understand sensory processing in toddlers with ASD and the relationship to early screening measures.

DESIGN: Retrospective collection was used to gather data on toddlers diagnosed with ASD during a comprehensive interdisciplinary evaluation at a university-affiliated tertiary diagnostic center.

PARTICIPANTS: Participants included children with a diagnosis of ASD (N = 31), mean age of 28.03 mo (standard deviation = 5.07; range = 17–35 mo). The sample currently includes 21 boys and 10 girls; sample size will increase to 75 by time of presentation.

METHOD: We analyzed developmental and sensory processing variables from the evaluation process. Sensory pattern variables were compared with ASD screenings. We used the Toddler Sensory Profile–2, the MCHAT, and the STAT.

ANALYSIS: We used Pearson correlations to determine the association between sensory processing patterns (avoiding, sensitivity, registration, seeking) and MCHAT risk score. We also used Pearson correlations to investigate the association between sensory processing patterns and STAT total score and subscale risk scores (i.e., play, request, direct attention, imitation). With an increased sample size, we will use a linear regression model to determine the relative contribution of sensory processing pattern scores to total MCHAT and STAT risk scores.

RESULTS: Preliminary results suggest that sensitivity and registration scores were positively associated with MCHAT total risk score (p < .01 and p < .05, respectively). Although sensory processing scores were not significantly associated with STAT total risk score, analysis of STAT subscale risk scores showed that sensitivity and registration neared significance with directing attention (p = .077 and p = .081, respectively).

DISCUSSION: Research has suggested that the ways in which toddlers process sensory information contributes to participation in daily routines and to their overall development. Caregivers of children with ASD notice sensory processing differences early in development, particularly when children show aversion to sensory experiences (i.e., sensitivity) or seem to be unaware of sensory stimuli (i.e., registration).

In this very young sample of children with ASD, sensitivity and registration were associated with early risk scores on ASD screening measures. It may be that particular behaviors associated with these patterns illuminate aspects of early development in ASD, providing potential avenues for both early identification and intervention approaches in this population.

IMPACT STATEMENT: Occupational therapists’ expertise in sensory processing patterns provides insight into early identification and intervention of ASD.

References

American Psychiatric Association. (2014). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.