Anne V. Kirby

Sensory experiences of children with autism spectrum disorder: In their own words:

First-person perspectives of children with autism spectrum disorder are rarely included in research, yet their voices may help more clearly illuminate their needs. This study involved phenomenological interviews with children with autism spectrum disorder (n = 12, ages 4–13) used to gain insights about their sensory experiences. This article addresses two study aims: determining the feasibility of interviewing children with autism spectrum disorder and exploring how they share information about their sensory experiences during the qualitative interview process. With the described methods, children as young as 4 years old and across a broad range of autism severity scores successfully participated in the interviews. The manner with which children shared information about their sensory experiences included themes of normalizing, storytelling, and describing responses. The interviews also revealed the importance of context and the multisensory nature of children’s experiences. These findings contribute strategies for understanding the sensory experiences of children with autism spectrum disorder with implications for practice and future research.

Caregiver Strain and Sensory Features in Children with Autism Spectrum Disorder and Other Developmental Disabilities.

Caring for children with disabilities contributes to increased levels of parent stress or caregiver strain. However, the potential relationship of sensory features to strain among caregivers of children with autism spectrum disorder (ASD) and other developmental disabilities (DD) is unknown. Sensory features include overreactions, underreactions, and unusual interests in sensations, which may negatively impact family functioning. This descriptive study confirmed three caregiver strain types (i.e., objective, subjective internalized, subjective externalized) and explored differences among ASD (n  =  71) and DD (n  =  36) groups, with the ASD group reporting higher levels. Furthermore, this study explored the contribution of sensory features to caregiver strain, finding differential contributions to strain in the ASD group and covariate contributions (i.e., child cognition, mothers education) in the DD group.

Beyond Independence: Introducing Deweyan Philosophy to the Dialogue on Occupation and Independence

The concept of independence is often explicitly stated or subtly implied to be a human ideal in occupational science literature. While that assumption has been critiqued as culturally-specific, scholars of occupation have yet to firmly critique independence as an ideal within Western culture. There is a taken-for-granted assumption that independence is good because it is traditionally valued in Western societies. Drawing on the philosophy of John Dewey, this paper introduces a critique of the valuation of independence within Western culture as it relates to occupational science and argues that (a) idealizing independence undercuts the connected nature of life, (b) independence is not an end that can be achieved and maintained, and (c) independence and interdependence in fact co-exist in occupation. This argument extends recent trends in occupational science towards a transactional perspective. Deweys concepts of freedom and growth—when framed as occurring through occupation—can provide guidance for moving beyond independence.

Falling through the Cracks: Challenges for High School Students with Autism Spectrum Disorder

High school students with autism spectrum disorder (ASD) often struggle in the complex social and academic secondary environment. Current literature suggests postsecondary success is limited for adults with ASD, but little is known about the high school experiences of individuals with ASD that may be impacting their postsecondary outcomes. Focus groups with multiple stakeholders were used to examine challenges facing high school students with ASD and their service providers. Through qualitative analysis, three themes emerged that illuminate challenges posed in the high school setting for students with ASD: (1) inconsistencies, many of which are intrinsic to the secondary environment, (2) difficulties with interpersonal connections, and (3) knowledge/process breakdowns. The findings demonstrate the misalignment or “crack” that exists between the nature of high schools and the needs of students with ASD as they prepare for success in postsecondary environments.

Sensory and repetitive behaviors among children with autism spectrum disorder at home

Atypical sensory and repetitive behaviors are defining features of autism spectrum disorder and are thought to be influenced by environmental factors; however, there is a lack of naturalistic research exploring contexts surrounding these behaviors. This study involved video recording observations of 32 children with autism spectrum disorder (2–12 years of age) engaging in sensory and repetitive behaviors during home activities. Behavioral coding was used to determine what activity contexts, sensory modalities, and stimulus characteristics were associated with specific behavior types: hyperresponsive, hyporesponsive, sensory seeking, and repetitive/stereotypic. Results indicated that hyperresponsive behaviors were most associated with activities of daily living and family-initiated stimuli, whereas sensory seeking behaviors were associated with free play activities and child-initiated stimuli. Behaviors associated with multiple sensory modalities simultaneously were common, emphasizing the multi-sensory nature of children’s behaviors in natural contexts. Implications for future research more explicitly considering context are discussed.

Observational characterization of sensory interests, repetitions, and seeking behaviors

Sensory interests, repetitions, and seeking behaviors (SIRS) are common among children with autism spectrum disorder (ASD) and other developmental disabilities (DD) and involve unusual actions that intensify or reinforce a sensory experience. Researchers and practitioners typically use parent-report measures or informal clinical observations to understand the presence and nature of SIRS. In this study, we used a scoring supplement to the Sensory Processing Assessment for Young Children, an observational measure, to characterize SIRS across three groups of children-those with ASD (n=40), DD (n=37), and typical development (n=39). Group differences were identified in frequency and intensity of overall SIRS, complexity of SIRS, and incidence of particular types of SIRS (i.e., posturing, sighting, proprioceptive seeking, spinning). Facial affect was also explored and found to be primarily neutral during engagement in SIRS across groups. Implications for practice and future research are discussed.

Longitudinal Predictors of Outcomes for Adults With Autism Spectrum Disorder Systematic Review

To generate an evidence-based understanding of longitudinal predictors of social outcomes (i.e., employment, social relationships/participation, independent living) of adults with autism spectrum disorder (ASD), we conducted a systematic literature review of publications since 2000. Twelve publications deriving from eight study samples fit inclusion/exclusion criteria for the review. In these publications, statistically significant predictors of social outcomes fell into five categories: (a) personal characteristics, (b) individual functioning, (c) family context, (d) services, and (e) other factors (i.e., peer influence, health status). However, only two studies demonstrated high methodological quality, and only one category of predictors—individual functioning—was identified across multiple study samples. To inform practices for youth with ASD, there remains a need for high-quality outcome research related to adults with ASD to better understand predictors, especially related to environmental factors such as related to the family and services received.

Developmental sequelae and neurophysiologic substrates of sensory seeking in infant siblings of children with autism spectrum disorder

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Characteristics of Students Receiving Occupational Therapy Services in Transition and Factors Related to Postsecondary Success

OBJECTIVE. This study had a twofold purpose: (1) identify the characteristics of people with disabilities who received occupational therapy services during their transition to adulthood and (2) determine factors associated with their successful postsecondary transition. METHOD. This study was a secondary analysis of National Longitudinal Transition Study–2 data. Data analyses include descriptive statistics, binary logistic regression, and simple linear regression. RESULTS. Autism, cerebral palsy, and intellectual disability were the most commonly reported disability classifications. Participation in postsecondary education was significantly associated with functional use of arms and hands. Postsecondary employment was significantly associated with verbal comprehension. Participation in community activities was significantly related to students’ health status, and participation in community service was significantly related to students’ functional use of arms and hands. CONCLUSION. Providing transition services to students with disabilities remains an emerging area of practice. Occupational therapy practitioners may contribute to transition teams by intervening to improve functional abilities and health status.

Sensory features as predictors of adaptive behaviors: A comparative longitudinal study of children with autism spectrum disorder and other developmental disabilities

BACKGROUND Children with autism spectrum disorder (ASD) and other developmental disabilities (DD) exhibit sensory features that differ from their typically developing peers. Prior cross-sectional research has demonstrated significant associations between elevated sensory features and lower adaptive behavior scores, yet there is limited prospective research examining longitudinal associations. AIMS To examine the longitudinal prediction of early sensory response patterns (i.e., hyperresponsiveness, hyporesponsiveness, and sensory interests, repetitions, and seeking behaviors) to later adaptive behavior outcomes in children with ASD and DD. METHODS AND PROCEDURES Children with ASD (n = 51) and DD (n = 30) were seen at two time points (Time 1: M(SD) = 5.6(2.5) years; Time 2: M(SD) = 9.0(2.2) years). We used a series of regression models with both observational and parent-report measures of sensory response patterns, and including group interactions. OUTCOMES AND RESULTS All three sensory response patterns significantly predicted aspects of adaptive behaviors, with some differences based on assessment format and diagnostic group. Across groups and sensory patterns, we found some evidence that elevated sensory features early in childhood predicted lower adaptive behavior skills later in childhood. CONCLUSIONS AND IMPLICATIONS Sensory features may interfere with development of adaptive behaviors, suggesting a need for effective interventions addressing sensory features early in development.