Date Presented 04/21/2023

Data from this study suggest that sensory modulation challenges are common among youth who reside in congregate foster homes and may contribute to observed behavior problems. OT services should be considered in the foster care system.

Primary Author and Speaker: Amy Armstrong-Heimsoth

Additional Authors and Speakers: Sarah A Schoen

PURPOSE: Youth who reside in congregate homes are at greater risk of developing physical, emotional and behavioral problems (Williams-Mbengue & Ramirez-Fry, 2017; AOTA, 2017). Thus, this study explored the extent to which youth in congregate foster care present with atypical patterns of sensory modulation and determine if these patterns correlate with behavioral challenges.

DESIGN: This study was a retrospective review of data from 41 children in congregate foster care, 17 males, 15 females and 9 whose gender was missing.

METHOD: The Sensory Profile caregiver and self-report measures were used; the Child Sensory Profile 2 (CSP-2) or the Short Sensory Profile 2 (SSP-2) for children 3-14 and the Adult Adolescent Sensory Profile (AASP) for individuals 11-17. Percentages were calculated to determine the number of individuals who had atypical sensory scores within each age group. Associations between quadrant scores and behavioral problems were examined within the child sample only using scores on the CSP-2 and the SSP-2.

RESULTS: Atypical scores were present across all four quadrant patterns; sensory symptoms were more or much more than typical. Within the child group, 88% had an atypical sensory pattern or processing score, 63% of whom scored as Sensitive. Within the adolescent group, 92% had atypical sensory processing, 47% as Avoiding and 41% as Sensitive. Quadrant scores were associated with conduct problems, social emotional challenges and attention difficulties in 53% of the child sample; highest correlations were Avoiding and Sensitivity with social emotional difficulties (R2 = .50 to .88).

CONCLUSION: These findings reflect the importance of evaluating children in group homes for sensory modulation challenges. Occupational therapists should be included in the multidisciplinary team serving the needs of children and youth in the foster care system. It is critical to advocate for occupational therapy services in the foster care system.


American Occupational Therapy Association. (2017). Occupational Therapy’s Role in Mental Health Promotion . . . Retrieved from∼/media/Corporate/Files/Practice/Children/SchoolMHToolkit/Social-and-Emotional-Learning-Info-Sheet.pdf

Williams-Mbengue, N., & Ramirez-Fry, K. (2017, February 10). Congregate Care, Residential Treatment and Group Home State Legislative Enactments 2009—2013. Retrieved May 28, 2020, from enactments.aspx