Beth Pfeiffer

Assessing Sensory Processing Problems in Children With and Without Attention Deficit Hyperactivity Disorder

ABSTRACT Aims: This exploratory study investigated whether children with attention-deficit/hyperactivity disorder (ADHD) are at greater risk than children without ADHD for problems with sensory processing and if certain sensory systems are more closely associated with the core symptoms of ADHD, specifically inattention and hyperactivity/impulsivity. Methods: The sample included 20 children with ADHD and 27 children without ADHD, ages 5 to 10 years. Assessments included the Sensory Processing Measure-Home Form and the Conners 3rd edition-Parent Short Form. Results: After controlling for age, children with ADHD exhibited more sensory processing problems on all scales of the Sensory Processing Measure with small to medium effect sizes observed (η2 = .27 to .61). For children with ADHD, the Social Participation (r = .50) and Planning and Ideas (r = .73) subtests of the Sensory Processing Measure were significantly associated with hyperactivity/impulsivity, but not with inattention on the subtests of the Conners Parent Short Form. Conclusion: The results suggest the importance of assessing sensory processing issues in children with ADHD to guide in the intervention process.

Effectiveness of Cognitive and Occupation-Based Interventions for Children With Challenges in Sensory Processing and Integration: A Systematic Review

&NA; This systematic review examines the evidence for the effectiveness of cognitive and occupation‐based interventions to improve self‐regulation in children and youth who have challenges in processing and integrating sensory information. The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guided the methodology. Five studies identified through a comprehensive database search met the inclusion criteria and were separated into categories of cognitive and occupation‐based interventions. Articles that did not specifically measure sensory integration (SI) or processing challenges were omitted. Synthesis of the articles suggests that self‐regulation (e.g., sensory processing, emotional regulation, executive functioning, social function) improved with cognitive and occupation‐based interventions. Because the number of studies that measured sensory processing or SI challenges was limited, researchers are encouraged to include these measures in future research to understand the impact of a broader range of cognitive and occupation‐based interventions.

Effectiveness of the Size Matters Handwriting Program

The purpose of the research was to study changes in handwriting legibility among kindergarten, first- and second-grade students in response to the Size Matters curricular-based handwriting program. A two-group pre–post-test design was implemented at two public schools with half of the classrooms assigned to receive the Size Matters program and the other continuing to receive standard instruction. All participants completed two standardized handwriting measures at pre-test and after 40 instructional sessions were completed with the classes receiving the handwriting program. Results identified significant changes in legibility in the handwriting intervention group for all three grades when compared with the standard instruction group. The results of this study support the use of a curricular-embedded handwriting program and provide the foundation for future research examining the impact of handwriting legibility on learning outcomes.

Systematic Review of the Effectiveness of Frequency Modulation Devices in Improving Academic Outcomes in Children With Auditory Processing Difficulties

This systematic review describes the published evidence related to the effectiveness of frequency modulation (FM) devices in improving academic outcomes in children with auditory processing difficulties. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were used to identify articles published between January 2003 and March 2014. The Cochrane Population, Intervention, Control, Outcome, Study Design approach and the American Occupational Therapy Association process forms were used to guide the article selection and evaluation process. Of the 83 articles screened, 7 matched the systematic review inclusion criteria. Findings were consistently positive, although limitations were identified. Results of this review indicate moderate support for the use of FM devices to improve childrens ability to listen and attend in the classroom and mixed evidence to improve specific academic performance areas. FM technology should be considered for school-age children with auditory processing impairments who are receiving occupational therapy services to improve functioning in the school setting.

Caregivers’ Perspectives on the Sensory Environment and Participation in Daily Activities of Children With Autism Spectrum Disorder

The purpose of this phenomenological study was to obtain caregivers’ perspectives on the impact of the sensory environment on participation in daily activities of their young children with autism spectrum disorders (ASD). Interviews were completed with 34 caregivers of children with ASD ages 3‐7 yr. Results strongly suggest that parents and caregivers were pivotal in enabling participation for their children through the implementation of specific strategies and a parental decision‐making process. The decision‐making process considered amount of effort necessary to support participation and whether participation in a given activity was perceived as essential or nonessential. Strategies enabled participation and reduced the effort required to support the child’s participation. Strategies either directly related to the sensory factors of the environment or focused on reducing behavioral responses associated with sensory factors. In this study, we identified important considerations to enhance participation in the home and community environments for children with ASD. Pfeiffer, B., Coster, W., Snethen, G., Derstine, M., Piller, A., & Tucker, C. (2017). Caregivers’ perspectives on the sensory environment and participation in daily activities of children with autism spectrum disorder.

The Sensory Environment and Participation of Preschool Children With Autism Spectrum Disorder

Sensory processing is recognized as impacting participation for preschool children with autism spectrum disorder (ASD). Little research exists to examine the impact of the sensory environment on the participation patterns of children with ASD, specifically from a contextual standpoint. The researchers in this study examined the viewpoint of teachers and occupational therapists on the sensory-related environmental barriers to participation within the preschool context. Qualitative descriptive methodology was used for data collection and analysis. Thirteen preschool teachers and occupational therapists were interviewed. Sensory aspects of the environment both inhibited and enhanced participation. Physical and temporal components of the environment are identified as being the most influential. Modifications of the environment are identified as increasing participation. It is important to consider the sensory aspects of the environment, in addition to the sensory processing patterns of the person in assessment and intervention planning within the preschool environment.

Developmental Test of Visual–Motor Integration (VMI): An Effective Outcome Measure for Handwriting Interventions for Kindergarten, First-Grade, and Second-Grade Students?

We determined whether a widely used assessment of visual-motor skills, the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), is appropriate for use as an outcome measure for handwriting interventions. A two-group pretest-posttest design was used with 207 kindergarten, first-grade, and second-grade students. Two well-established handwriting measures and the VMI were administered pre- and postintervention. The intervention group participated in the Size Matters Handwriting Program for 40 sessions, and the control group received standard instruction. Paired and independent-samples t tests were used to analyze group differences. The intervention group demonstrated significant improvements on the handwriting measures, with change scores having mostly large effect sizes. We found no significant difference in change scores on the VMI, t(202)=1.19, p=.23. Results of this study suggest that the VMI may not detect changes in handwriting related to occupational therapy intervention.

Using a Multifaceted Approach to Working With Children Who Have Differences in Sensory Processing and Integration

Pediatric occupational therapy practitioners frequently provide interventions for children with differences in sensory processing and integration. Confusion exists regarding how best to intervene with these children and about how to describe and document methods. Some practitioners hold the misconception that Ayres Sensory Integration intervention is the only approach that can and should be used with this population. The issue is that occupational therapy practitioners must treat the whole client in varied environments; to do so effectively, multiple approaches to intervention often are required. This article presents a framework for conceptualizing interventions for children with differences in sensory processing and integration that incorporates multiple evidence-based approaches. To best meet the needs of the children and families seeking occupational therapy services, interventions must be focused on participation and should be multifaceted.

State of the Science of Sensory Integration Research With Children and Youth

&NA; Many children and youth with and without disabilities are affected by challenges in processing and integrating sensations. Occupational therapy practitioners serve a pivotal role in the evaluation and treatment of this population. This special section of the American Journal of Occupational Therapy includes articles that elucidate the relationship between sensory processing and participation in valued occupations as well as articles that guide best practice, including systematic reviews on common occupational therapy interventions for children and youth with challenges in processing and integrating sensation. This editorial elaborates on key issues for future research.

Effectiveness of a Handwriting Intervention With At-Risk Kindergarteners

OBJECTIVE We examined the effectiveness of an occupational therapist-led handwriting intervention for special education and at-risk kindergarteners. METHOD We incorporated a two-group, pretest-posttest design. Both groups consisted of kindergarteners receiving individualized education program (IEP) or Response to Intervention (RtI) support. An occupational therapist provided biweekly group handwriting instruction using the Size Matters Handwriting Program to students in the intervention group (n = 23). The control group (n = 12) received the standard handwriting instruction. RESULTS Students in the intervention group demonstrated significantly greater gains in handwriting legibility than students in the control group. Students in the intervention group also demonstrated significantly greater gains in the prereading skills of uppercase letter recognition, lowercase letter recognition, and letter sound recognition. CONCLUSION This study provides preliminary support for an occupational therapist-led handwriting intervention to improve writing legibility and letter recognition in kindergarteners receiving RtI and IEP supports.