Importance: In Chinese-speaking societies, a reliable and valid measure is needed to enable early identification of young children’s challenges in sensory processing. Objective: To examine the psychometric properties of the Chinese version of the Infant/Toddler Sensory Profile (ITSP–C) when used with Taiwanese children. Design: Prospective study. Setting: Multiple settings. Participants: Participants were 367 typically developing (TD) infants ages 0–6 mo (mean [M] age = 3.44 mo, standard deviation [SD] = 1.82) and 677 toddlers ages 7–36 mo (M age = 22.33 mo, SD = 8.15), along with 42 toddlers with developmental disabilities (DD; M age = 28.4 mo, SD = 6.7). Outcomes and Measures: The ITSP, a caregiver questionnaire that measures how children respond to sensory events in daily life, was translated and cross-culturally adapted into a Chinese version (ITSP–C). Results: Internal consistency was high for the 0–6 mo subscale (α = .80) and the 7–36 mo subscale (α = .82). Test–retest reliability was excellent for the 7–36 mo subscale (intraclass correlation coefficient = .94). Logistic regression analysis demonstrated that the ITSP–C discriminated between children with DD and TD children. Conclusions and Relevance: The ITSP was successfully adapted to Chinese with similar reliability and validity to the original ITSP. The 7–36 mo subscale had a higher level of reliability than the 0–6 mo subscale, and quadrant scores were more reliable than section scores. Moreover, the ITSP–C discriminated children with DD from TD children on the basis of their sensory processing patterns. What This Article Adds: The ITSP–C has sound psychometric properties and support for its use in early identification of sensory processing difficulties in young Chinese-speaking children.

Importance: Sensory symptoms in people with autism spectrum disorder (ASD) are commonly reported by researchers. However, an often overlooked sensory aspect of ASD is sensory discrimination in general, and somatosensory discrimination in particular. Objective: To examine what has and what has not yet been learned concerning the somatosensory discrimination abilities of people with ASD and to reveal gaps warranting further research. Design: Scoping review of clinical studies published 1995–2017 located through searches of PsycNET, PubMed, ERIC, and Google Scholar. Inclusion criteria were English-language peer-reviewed studies with (1) participants diagnosed with ASD, (2) a specific somatosensory discrimination measure, and (3) a comparison group. No age or intellectual exclusion criteria were established; studies were excluded if they were theoretical or descriptive, did not incorporate a control group, focused only on neurology or genetics, or used simple threshold detection measures or somatosensory measures integrated with other measures. The final search yielded 12 comparative articles discussing tactile and proprioceptive discrimination in people with ASD. Results: Overall, most results showed atypical somatosensory discrimination in people with ASD, especially among young children. The relationship between sensory discrimination abilities and other sensory symptoms and ASD symptoms is briefly discussed. Conclusions and Relevance: Heterogeneous findings concerning somatosensory discrimination in people with ASD shed light on underlying mechanisms of these disorders and can contribute to improvement of occupational therapy intervention for this population. What This Article Adds: The occupational therapy evaluation of people with ASD can benefit from addressing somatosensory discrimination and its contribution to other clinical symptoms. This type of assessment can help improve intervention strategies for people with ASD by promoting a focus on the effect of discrimination deficits on daily function.

OBJECTIVE. Our objective was to translate the Here’s How I Write: A Child’s Self-Assessment and Goal Setting Tool (HHIW) to Portuguese; adapt it to the Brazilian culture; and analyze its reliability, validity, and clinical feasibility. METHOD. The study was developed in two steps: adaptation of the HHIW to Brazilian Portuguese, followed by experimental application to examine its validity and reliability. The participants were 60 children and their teachers, divided into two groups: Group 1, whose members had handwriting difficulties, and Group 2, whose members did not. RESULTS. Children with poor handwriting scored lower on the HHIW for both self- and teacher report. Test–retest reliability of the children’s (.96) and teachers’ (.93) questionnaires as well as internal consistency (.91 and .95, respectively) were excellent. There was good agreement (.74) between the children’s and teachers’ total scores. CONCLUSIONS. This study adds further evidence of validity and reliability and supports the international use of the HHIW. The HHIW is a useful resource to engage children and teachers in a collaborative relationship to improve handwriting.

OBJECTIVE. Atypical sensory modulation (ASM) is characterized by over- or underresponsiveness to sensory stimuli in one or more sensory systems. Faulty sensory information processing could result in anxiety. Because the relation between ASM and psychological distress has not been examined, we explored psychological distress and ASM in the general population. METHOD. A community-based sample of 204 adults (105 men; mean age = 27.4 yr, standard deviation = 3.71) completed the Sensory Responsiveness Questionnaire—Intensity Scale (SRQ–IS; Bar-Shalita, Seltzer, Vatine, Yochman, & Parush, 2009 ); the Brief Symptom Inventory (BSI; Derogatis & Coons, 1993 ); and the Short Form—36 Health Survey, Version 2 (SF–36; Ware, Kosinski, & Gandek, 2005 ). RESULTS. The ASM group displayed considerably more distress symptoms than the comparison group. Multivariate linear regression showed SRQ–IS and SF–36 scores as significant predictors of BSI score (r = .64). CONCLUSION. ASM may be a risk factor for developing other mental health concerns.

This study examined sensory differences and mealtime behaviors in children with autism spectrum disorder (ASD; n = 34) and compared the results with those of similarly aged peers who were typically developing (TD; n = 34). Results from parent-report and child-report questionnaires indicated that children with ASD scored significantly differently from TD peers on the measures of sensory differences and eating behaviors. Data also supported a correlation between sensory differences and eating difficulties in children with ASD. The results of this study will help caregivers and their children with ASD identify problem eating behaviors that may be associated with sensory differences. Sensory strategies and techniques offered by occupational therapy practitioners may contribute to greater success during mealtimes for children with ASD and their families, with increased comfort and less stress. The findings also support a need to further explore the influence of sensory differences on mealtime behaviors.

OBJECTIVE. Prior research has documented caregiving difficulties in families of children with autism spectrum disorder (ASD). However, Latino families may encounter unique challenges. The purpose of this study was to understand the caregiving experiences of Latino families with children with ASD, including daily activities, coping strategies, and service utilization. METHOD. Fifteen Latino parents of children with ASD were interviewed. The interviews were transcribed for analysis to identify themes of experiences unique to this population. RESULTS. Latino families of children with ASD encounter many similar issues as non-Latino families but also unique issues that affect service utilization. Four themes were identified: dealing with the diagnosis, dealing with stigma and isolation from family and community, understanding the role of mothers in changing family routines, and utilizing services. CONCLUSION. To meet the unique needs of Latino families, services need to be provided in culturally sensitive context that address children’s needs within family units.

Date Presented 4/16/2015 Oral health is integral to well-being. The purpose of this study was to describe the innovative sensory-adapted dental environment and examine its efficacy in children with autism spectrum disorder (ASD) and typically developing children aged 6 to 12 yr. Occupational therapists should be part of the multidisciplinary team to address oral health challenges in children.

Date Presented 4/17/2015 Oral health is integral to physical and psychological well-being. In this study, we describe the behavioral and physiological distress experienced by children with autism spectrum disorder (cASD) during dental cleanings, and we suggest that occupational therapists (OTs) be part of the multidisciplinary team to address these challenges.

OBJECTIVE. To provide an example of an occupational therapy feasibility study and evaluate the implementation of a randomized controlled pilot and feasibility trial examining the impact of a sensory-adapted dental environment (SADE) to enhance oral care for children with autism spectrum disorder (ASD). METHOD. Twenty-two children with ASD and 22 typically developing children, ages 6–12 yr, attended a dental clinic in an urban hospital. Participants completed two dental cleanings, 3–4 mo apart, one in a regular environment and one in a SADE. Feasibility outcome measures were recruitment, retention, accrual, dropout, and protocol adherence. Intervention outcome measures were physiological stress, behavioral distress, pain, and cost. RESULTS. We successfully recruited and retained participants. Parents expressed satisfaction with research study participation. Dentists stated that the intervention could be incorporated in normal practice. Intervention outcome measures favored the SADE condition. CONCLUSION. Preliminary positive benefit of SADE in children with ASD warrants moving forward with a large-scale clinical trial.

OBJECTIVE. We investigated sensory integration (SI) function in children with cochlear implants (CIs). METHOD. We analyzed deidentified records from 49 children ages 7 mo to 83 mo with CIs. Records included Sensory Integration and Praxis Tests (SIPT), Sensory Processing Measure (SPM), Sensory Profile (SP), Developmental Profile 3 (DP–3), and Peabody Developmental Motor Scales (PDMS), with scores depending on participants’ ages. We compared scores with normative population mean scores and with previously identified patterns of SI dysfunction. RESULTS. One-sample t tests revealed significant differences between children with CIs and the normative population on the majority of the SIPT items associated with the vestibular and proprioceptive bilateral integration and sequencing (VPBIS) pattern. Available scores for children with CIs on the SPM, SP, DP–3, and PDMS indicated generally typical ratings. CONCLUSION. SIPT scores in a sample of children with CIs reflected the VPBIS pattern of SI dysfunction, demonstrating the need for further examination of SI functions in children with CIs during occupational therapy assessment and intervention planning.

This article explores the use of the postrotary nystagmus (PRN) test for children younger than current norms (children 4.0 yr–8.11 yr). In the first study, 37 children ages 4–9 yr were examined in the standard testing position and in an adult-held adapted position to determine whether holding a child affected the reflex. Because the position did not affect the reflex, in the second study, PRN in 44 children ages 2 mo–47 mo was compared with published normative mean raw scores for 44 children age 5 yr to determine whether norms for older children were applicable to younger children. No statistically significant differences were found between <4-yr-old and 5-yr-old children, suggesting that the PRN test can be used in infants and toddlers with valid comparison to current norms for 4-yr-olds on the Sensory Integration and Praxis Tests (4.0 yr–8.11 yr). Future research exploring the predictive value of this measure is warranted.

OBJECTIVE. We examined content and construct validity of Here’s How I Write: A Child’s Self-Assessment and Goal Setting Tool, to assess children’s perception of their handwriting and set child-directed goals. METHOD. In Study 1, a content validity study, 6 occupational therapists and 2 educators assessed the need for this type of measure and examined the proposed items. Thirty-four occupational therapists and educators then completed an online survey examining the items. Study 2, a construct validity study, compared the self-ratings of 20 children with poor handwriting and 20 children with good handwriting in Grades 2–5 with their teachers’ ratings. RESULTS. Results supported test content and indicated freedom from culture and gender bias. The assessment discriminated between good and poor writers. The relationship between teacher and student ratings was significant, although teachers of poor writers rated the children lower than the children rated themselves. CONCLUSION. These studies provide support for the tool’s validity.

We examined sensory-related aspects of oral care at home and the dentist’s office in children with autism spectrum disorders (ASD) and their typically developing (TD) peers. Results from parent questionnaires (n = 196 ASD, n = 202 TD) and one focus group were analyzed to determine whether sensory experiences were different between groups. Significantly more parents of children with ASD reported difficulties with sensory-related oral care variables in the home and dental office; this finding was supported by qualitative data. Using sensory strategies to modify the environment may enhance the dental experience and improve quality of life for children with ASD and their families.

OBJECTIVE. We investigated the application of dynamic assessment in examining learning potential for adults with right hemisphere stroke and unilateral neglect. METHODS. Forty adults with right cerebrovascular accident were randomly assigned to a control or dynamic group. Both groups were administered standard pretests and posttests of unilateral neglect. The dynamic group received cues, strategy training, and feedback during an object search task. RESULTS. Multivariate analysis of covariance indicated significant differences between groups on the object search task, with reduced unilateral neglect in the dynamic group. Greater initiation of left-sided search, strategy use, and near and intermediate transfer of learning were observed in the dynamic group. CONCLUSIONS. The brief dynamic assessment, developed for this study, provided an opportunity to observe the client's ability to incorporate strategy training and feedback across visual search tasks. This assessment approach has the potential to characterize learning profiles and to guide intervention decisions.

This study examined the incidence of extreme sensory modulation behaviors in toddlers with autism spectrum disorders (ASD) and investigated the consistency of sensory information across measures. Parent report of sensory behaviors in 101 toddlers with ASD was compared with 100 toddlers who were typically developing matched on chronological age and 99 additional infants or toddlers matched on mental age. Measures included the Infant/Toddler Sensory Profile, Infant–Toddler Social Emotional Assessment, Autism Diagnostic Interview–Revised, and Autism Diagnostic Observation Schedule–Generic. Toddlers with ASD were most distinct from typically developing groups in their high frequency of underresponsiveness and avoiding behaviors and their low frequency of seeking. Within the toddlers with ASD, there were significant associations across sensory parent report measures, but parent report was not correlated with clinical observation. Findings point to the early onset of an extreme sensory profile in ASD. Occupational therapists need to assess multiple domains of sensory behaviors to accurately identify the needs of toddlers with ASD.

OBJECTIVE. We investigated whether children institutionalized in an orphanage would engage in more developmentally competent play with their caregivers as opposed to playing alone and whether specific qualities of caregiver–child interactions were associated with more developmentally competent play. METHOD. Twenty-six children, ages 10 to 38 months, participated in independent play sessions and in a play session with a caregiver. Interrater reliability for coding play performance was established using the weighted kappa statistic (M = .82). Twelve pediatric experts rated both child and caregiver behaviors for the interactive sessions (mean effective reliability with intraclass correlations = .89). RESULTS. The children demonstrated more developmentally competent play when interacting with a caregiver than when playing alone, t (25) = −1.88, p ≤ .04, one-tailed. The effect size was moderate (d = .53). Longer periods of institutionalization were associated with less improvement in play performance from independent to interactive play sessions (r = −.51, p ≤ .01). Successful engagement for the child was associated with having a caregiver who provided more structure and assistance and who was directive and encouraging (r = .82, .75, .75, and .64, respectively). CONCLUSION. Caregivers facilitated more developmentally competent participation in play with children residing in an orphanage, despite the fact that these interactions occurred in an environment vulnerable to many challenges not typical of an exclusive caregiver–child relationship. Findings are discussed in the context of environmental challenges and occupational therapy practice.

OBJECTIVE. This study developed an assessment of ideational praxis, examined its psychometric properties, and analyzed age and gender trends in children who were typically developing. METHOD. Part 1 developed items and scoring criteria of the Test of Ideational Praxis (TIP) and examined interrater reliability and internal consistency. Part 2 studied performance of 80 typically developing children between ages 5 and 8 years. RESULTS. The TIP demonstrated acceptable interrater reliability (ICC = .85) and internal consistency (coefficient alpha = .74). Children who were typically developing demonstrated age and gender trends. Girls scored higher than boys, and older children scored higher than younger children. CONCLUSION. The TIP is the first objective assessment for identification of ideational abilities and is a reliable assessment tool. Further research is needed to validate the construct of ideation and examine the TIP’s ability to discriminate between children with and without ideational difficulties.

Objective. The purpose of this study was to examine whether children adopted from Romanian orphanages have difficulty with sensory processing and related behaviors. Method. Seventy-three children adopted from Romanian orphanages were compared with 72 peers who were typically developing. The subjects’ ages ranged from 3 to 6 years. The parent-report Developmental and Sensory Processing Questionnaire was used to assess sensory processing and related behaviors. The tool consists of questions in six sensory processing domains and five related behavioral domains. Results. Multiple t tests indicated that the subjects adopted from Romanian orphanages demonstrated significantly greater problems than those in the control group on five of the six sensory processing domains: touch, movement-avoids, movement-seeks, vision, and audition. Additionally, the Romanian subjects exhibited significantly greater problems than the control subjects on four of the five behavioral domains: activity level, feeding, organization, and social-emotional. Conclusions. These findings substantiate clinical observations and parent reports of sensory processing deficits in children adopted from Romanian orphanages and highlight the critical importance of the environment for sensory integration. The findings also enhance our understanding of how children who were previously institutionalized respond to the human and physical environment.