The Development of a Clinical Measure of Sensory Processing Behaviors for Toddlers with Autism Spectrum Disorders

Background: Toddlers with autism spectrum disorders (ASD) exhibit a range of responses to sensory stimuli, from sensitivity to seeking behaviors, with varying degrees of impact on participation in activities. There are no assessments for toddlers that directly measure the presence of sensory behaviors in learning and play contexts. 

Objectives: (1) Investigate the reliability and validity of a clinician-based measure of sensory processing behaviors. (2) Examine the concordance between parent report and clinicians’ observations of sensory behaviors. Methods: This study included 48 toddlers with ASD with a mean age of 28 months, 76% boys, and a mean Mullen developmental quotient of 62. The Sensory Processing Impact Child Evaluation (SPICE; Ben-Sasson & Kadlec), an observational measure designed for the current study, included 21 sensory behavioral responses grouped into three scales: Seeking, Under-responsivity, and Over-responsivity. The presence of behaviors was coded from videos during a battery of assessments in the laboratory. Parent data were collected from the Infant Toddler Sensory Profile (ITSP; Dunn, 2002).
Results: Inter-rater reliability ICC_(2,2) on the SPICE was 0.83 for the Total score, 0.62 for Seeking, 0.89 for Under-responsivity, and 0.80 for Over-responsivity. For comparable items, Seeking was observed for toddlers an average of 64% on the SPICE compared with 55% on the ITSP, Under-responsivity was 26% on the SPICE compared to 60% on the ITSP, and Over-responsivity was 17% on the SPICE versus 59% on the ITSP. Although Seeking was the most frequently coded sensory behavior, a higher percentage of toddlers had extreme (>2SD above age norms) ITSP Under- and Over-responsivity scores (77% and 29% respectively) than extreme Seeking scores (0%).
Conclusions: Findings highlight the need for valid and reliable methods to assess sensory behaviors in multiple contexts through parent and clinician’s perspectives so that interventions can match the demands required for children’s participation in the various contexts.