Alison E. Lane

Sensory Processing Subtypes in Autism: Association with Adaptive Behavior

Children with autism are frequently observed to experience difficulties in sensory processing. This study examined specific patterns of sensory processing in 54 children with autistic disorder and their association with adaptive behavior. Model-based cluster analysis revealed three distinct sensory processing subtypes in autism. These subtypes were differentiated by taste and smell sensitivity and movement-related sensory behavior. Further, sensory processing subtypes predicted communication competence and maladaptive behavior. The findings of this study lay the foundation for the generation of more specific hypotheses regarding the mechanisms of sensory processing dysfunction in autism, and support the continued use of sensory-based interventions in the remediation of communication and behavioral difficulties in autism.

Physical and sedentary activity in adolescents with cerebral palsy

Participation in regular physical activity (PA) provides health, psychological, and physiological benefits for people with and without a physical disability. This study investigated the physical and sedentary activity patterns of adolescents with cerebral palsy (CP). A cross‐sectional, descriptive, postal survey was used, consisting of the Physical Activity Questionnaire for Adolescents (PAQ‐A), self‐reported level of gross motor function (based on the Gross Motor Function Classification System [GMFCS]), and specific questions regarding weekly sedentary activities. Following piloting to determine test‐retest reliability (intraclass correlation [ICC] for PA=0.90; total weekly sedentary time=0.84) and concurrent validity (survey PA score vs pedometry, Pearsons r=0.24; survey PA score vs accelerometry, r=‐0.21; survey weekly sedentary time vs logbook, r=0.38), the survey was mailed to all adolescents with CP in South Australia registered with Novita Childrens Services (n=219). One hundred and twelve valid surveys were returned (76 males, 36 females; age range 11‐17y, mean age 13y 11mo [SD 23mo]; GMFCS Level I, n=42; Level II, n=27; Level III, n=10; Level IV, n=17; Level V, n=15; level not reported, n=1). Results were compared with recent normative age‐ and sex‐matched data sets. Key findings were that PA level of adolescents with CP was related to level of gross motor function and inversely related to age, and that adolescents with CP were less physically active than their peers without disability. Comparisons with normative data sets suggested that adolescents with CP tend to participate in less structured and lower intensity PA compared with non‐disabled adolescents, though sedentary activity patterns (TV and computer use) of adolescents with and without CP were similar.

Classification of Children With Autism Spectrum Disorder by Sensory Subtype: A Case for Sensory-Based Phenotypes

This study examines whether sensory differences can be used to classify meaningful subgroups of children with autism spectrum disorder (ASD). Caregivers of children with ASD aged 2–10 years (n = 228) completed the Short Sensory Profile. Model‐based cluster analysis was used to extract sensory subtypes. The relationship of these subtypes to age, gender, autism symptom severity, and nonverbal intelligence quotient (IQ) was further explored. Four distinct sensory subtypes were identified: (a) sensory adaptive; (b) taste smell sensitive; (c) postural inattentive; and (d) generalized sensory difference. The sensory subtypes differ from each other on two dimensions: (a) the severity of reported sensory differences; and (b) the focus of differences across auditory, taste, smell, vestibular and proprioceptive domains. Examination of the clinical features of each subtype reveals two possible mechanisms of sensory disturbance in autism: (a) sensory hyperreactivity; and (b) difficulties with multisensory processing. Further, the sensory subtypes are not well explained by other variables such as age, gender, IQ, and autism symptom severity. We conclude that classification of children using sensory differences offers a promising method by which to identify phenotypes in ASD. Sensory‐based phenotypes may be useful in identifying behavioral features responsive to specific interventions thereby improving intervention effectiveness. Further validation of the sensory‐based phenotypes by establishing neural and physiological correlates is recommended. Autism Res 2014, 7: 322–333.

Brief Report: Further Evidence of Sensory Subtypes in Autism

Distinct sensory processing (SP) subtypes in autism have been reported previously. This study sought to replicate the previous findings in an independent sample of thirty children diagnosed with an Autism Spectrum Disorder. Model-based cluster analysis of parent-reported sensory functioning (measured using the Short Sensory Profile) confirmed the triad of sensory subtypes reported earlier. Subtypes were differentiated from each other based on degree of SP dysfunction, taste/smell sensitivity and vestibular/proprioceptive processing. Further elucidation of two of the subtypes was also achieved in this study. Children with a primary pattern of sensory-based inattention could be further described as sensory seekers or non-seekers. Children with a primary pattern of vestibular/proprioceptive dysfunction were also differentiated on movement and tactile sensitivity.

Activity participation of children with complex communication needs, physical disabilities and typically-developing peers

Objective: To describe and compare the context of participation of children with physical disabilities and complex communication needs (Group CCN) in out-of-school activities with children with physical disabilities only (Group PD) and typically-developing peers (Group TD). Method: A cross-sectional, matched, multi-group design was used. Thirty-nine participants between 10–15 years of age were administered the Childrens Assessment of Participation and Enjoyment. Results: Kruskall-Wallis analyses revealed that there were significant differences among the three groups for overall location, enjoyment of the activities and with whom they did the social and self-improvement activities with. Mean trends showed that Group CCN participated in activities closer to home rather than in the community, were restricted in social participation and reported higher levels of enjoyment in activity participation than the other two groups. Conclusions: Group CCN appeared to experience differences in participation when compared to peers with and without disability.

An internet‐based physical activity intervention for adolescents with cerebral palsy: a randomized controlled trial

Aim  To determine the effectiveness of an 8‐week internet‐based, lifestyle physical‐activity intervention for adolescents with cerebral palsy (CP).

Self-reported quality of life in adolescents with cerebral palsy.

Health Related Quality of Life (HRQOL) is an important outcome in the delivery of health care. Research on the HRQOL in young people with cerebral palsy (CP) has relied on proxy-reports from parents. The purpose of this study was to investigate the self-reported HRQOL of young people with CP. A survey was mailed to 229 adolescents with CP in South Australia, of which 118 responded (51.5%). Seventy-one participants 11 to 17 years of age, self-reported HRQOL on the Pediatric Quality of Life Inventory 4.0 (PedsQL). Thirty-eight youth were deemed by their parent/guardian as having insufficient cognitive ability to self-report HRQOL and nine respondents returned their surveys incomplete. The mean PedsQL Physical Function score was 57.3 (SD = 24.3), the mean Psychosocial Function score was 64.5 (SD = 15.9), and the Overall PedsQL score was 62.0 (SD = 16.7). Compared to norms for children without disabilities, 67% of participants had an Overall PedsQL score greater than 1 SD below the mean. PedsQL scores were related to gross motor function classification level (Spearmans rho = −0.54), number of health issues (rho = −0.51), and socioeconomic status (rho = 0.28), but not age, gender, quality of sleep, or whether parent assistance was needed to complete the PedsQL. The results have implications for policy and efforts to identify and address barriers to full and satisfying participation in mainstream schools and community activities.

Toward a Best-Practice Protocol for Assessment of Sensory Features in ASD

Sensory difficulties are a commonly occurring feature of autism spectrum disorders and are now included as one manifestation of the ‘restricted, repetitive patterns of behavior, interests, or activities’ diagnostic criteria of the DSM5 necessitating guidelines for comprehensive assessment of these features. To facilitate the development of such guidelines, this paper provides an overview of the literature on sensory features in autism spectrum disorder. We summarize the literature pertaining to: terminology, current assessment practices, sensory development, and the relationship of sensory features to core symptoms of autism. The paper concludes with recommendations for clinical assessment of sensory features in Autism.

Effect of a coteaching handwriting program for first graders: one-group pretest-posttest design.

We examined the effects of a cotaught handwriting and writing program on first-grade students grouped by low, average, and high baseline legibility. The programs aim was to increase legibility, handwriting speed, writing fluency, and written expression in students with diverse learning needs. Thirty-six first-grade students in two classrooms participated in a 12-wk handwriting and writing program cotaught by teachers and an occupational therapist. Students were assessed at pretest, posttest, and 6-mo follow-up using the Evaluation Tool of Childrens Handwriting-Manuscript (ETCH-M) and the Woodcock-Johnson Writing Fluency and Writing Samples tests. Students made large gains in ETCH-M legibility (η² = .74), speed (η²s = .52-.65), Writing Fluency (η² = .58), and Writing Samples (η² = .59). Students with initially low legibility improved most in legibility; progress on the other tests was similar across low-, average-, and high-performing groups. This program appeared to benefit first-grade students with diverse learning needs and to increase handwriting legibility and speed and writing fluency.

Measuring activity and participation in children and adolescents with disabilities: a literature review of available instruments.

BACKGROUND/AIM This article aims to (1) identify instruments available to measure activity and participation in children with disabilities; (2) describe the reliability and validity of these instruments; and (3) consider whether the available instruments capture the extent of involvement, as well as the difficulty and satisfaction/enjoyment associated with performance in all life areas. METHOD A literature review was completed by undertaking an electronic search to identify instruments that measure activity and participation in children with disabilities. A further electronic search was conducted to obtain an adequate description of the instruments, including psychometric properties. RESULTS The search identified 20 instruments purporting to measure activity and participation, however, no single instrument measured extent of involvement, difficulty and satisfaction/enjoyment in all life areas. There were instances in which each of these aspects was captured, but not within the one instrument. Instruments assessed combinations of frequency, difficulty, assistance, environment and satisfaction across varying contexts, for example, school, domestic life, recreational tasks, leisure tasks or all life areas. CONCLUSIONS Although a large number of instruments exist to measure varying aspects of activity and participation, there is currently no single instrument available to measure the extent of involvement, difficulty and satisfaction/enjoyment in all life areas. This finding indicates that there is the opportunity to develop a single instrument to measure activity and participation across all life areas.