Sensory Features and Caregiver Accommodations for Children with Autism and Developmental Disorders

Background:  Sensory features are highly prevalent, although not universal, among young children with ASD, and are characterized by at least three patterns of response: hyporesponsiveness, hyperresponsiveness and sensory seeking. Research has shown that caregivers implement accommodations to activities based on their children’s impairments. However, there is a dearth of research on the association of parent adaptations and sensory patterns, as well as how parent accommodations differ among children ASD versus those with other developmental disabilities (DD), or those with typical development (TD).

Objectives:

1) Determine to what extent groups differ on rate of caregiver accommodation for overall sensory features as well as across three sensory patterns.

2) Determine how types of caregiver accommodations qualitatively differ between groups.

Methods:  This mixed methods study used the Sensory Experiences Questionnaire Version 2.1 (Baranek et al., 2006), a 43 item caregiver report that quantifies children’s responses to sensory experiences and qualitatively describes caregivers implementation of accommodations. The sample (n=214) consisted caregivers of children with ASD (n=94), DD (n=62), and TD (n=58). A concurrent triangulation mixed methods approach was used to analyze data (Creswell, 2009). Quantitative data were analyzed using a hierarchical linear model with sensory pattern nested within child. Thematic analysis was used to analyze qualitative data on a subgroup (n=30) to classify common themes into descriptive categories. Qualitative analysis will be available for the full 214 participants by May 2011.

Results:  The three groups significantly differed on main effects of caregiver accommodations to sensory experiences (F[1,183]=58.54, p<.001) and sensory patterns (F[2,368]=34.22, p<.001). Two and three way interactions between diagnosis, caregiver accommodations, and sensory patterns were not found to be significant. Thematic analysis revealed six themes: verbal and physical redirection, verbal and physical attempts to increase or maintain engagement, implementation of rewards and environmental accommodations. Caregivers of children with ASD utilized the most physical attempts to maintain engagement and made the most environmental modifications. Caregivers of children with DD reported the highest rates of verbal attempts to increase engagement.

Conclusions:  The findings suggest that caregivers of children with ASD demonstrate the highest rates of accommodations to sensory activities in the presence of the highest rates of sensory symptoms, as compared to those of DD and typically developing children. The qualitative differences in caregiver accommodations suggest that caregivers of children with ASD utilize strategies that may reflect a transaction with other core features (e.g., communication difficulties) of ASD. Accommodations reported by caregivers of children with ASD are characterized by a combination of strategies, or longer sequences of accommodations to maintain their child’s engagement, as compared to DD and TD.  These results have important clinical implications for assessment and intervention.