Sensory Response Patterns As Predictors of Adaptive Outcomes in Children with ASD or Other Developmental Disabilities

Background:   Sensory response patterns of hyperresponsiveness, hyporesponsiveness, and sensory seeking are highly prevalent in children with autism spectrum disorder (ASD) (Baranek et al, 2006; Ben-Sasson et al., 2009; Wiggins et al, 2009). Among children with ASD and other developmental disabilities (DD), significant concurrent negative correlations have been found between hyporesponsiveness and social adaptive skills as measured by the Vineland Adaptive Behavior Scales (Watson et al., 2011). Hypothetically, disruptions of sensory processing impact the development of adaptive skills; longitudinal research on associations between early sensory patterns and later adaptive outcomes can provide support for this hypothesis.    

Objectives:   (1) to determine the predictive association between earlier sensory response patterns and later adaptive behavior outcomes among children with ASD and DD; (2) to determine whether these associations differ by group. 

Methods:  The study included 57 children with ASD and 34 with DD. At Time 1 (ages 2 – 12 years), two parent report measures (Sensory Experiences Questionnaire, Sensory Profile) and two observed measures (Sensory Processing Assessment, Tactile Defensiveness and Discrimination Test-Revised) were used. Adaptive outcomes were measured at Time 2 (3-5 years later) with the Vineland Adaptive Behavior Scales (VABS). Separate general linear models were run for the two parent report measures (combined) and the two observed measures (combined) to examine the predictive association between Time 1 hyporesponsiveness, hyperresponsiveness, and sensory seeking and Time 2 VABS Daily Living, Communication, Socialization and Adaptive Behavior Composite (ABC) scores. An interaction term for diagnosis (ASD/DD) and covariates (child’s age, IQ, gender, time between assessments, mother’s education and income) were included in each model.

Results:   Parent-reported hyporesponsiveness and sensory seeking at Time 1 were significantly negatively related to VABS Communication, Socialization and ABC scores at Time 2 when accounting for all covariates. Behaviorally observed sensory response patterns at Time 1 did not predict Time 2 VABS scores. A significant interaction emerged between Time 1 observed hyperresponsiveness, diagnosis, and Time 2 VABS Socialization scores; for children with DD, as Time 1 hyperresponsiveness increased, Time 2 VABS Socialization scores decreased, whereas children with ASD showed the opposite linear trend. 

Conclusions:  The results suggest that earlier patterns of heightened sensory hyporesponsiveness and sensory seeking negatively impact later adaptive behavior outcomes, especially in the domains of communication and socialization skills, both for children with ASD and those with other DD. However, heightened sensory hyperresponsiveness at Time 1 is only associated with poorer adaptive outcomes for children with other DD. The finding that only parent-reported measures, but not observational measures, of sensory response patterns predicted adaptive outcomes in most models supports the importance of involving parents in the assessment process, in order to get more complete information on an array of sensory responses that may be difficult to fully elicit and observe in a clinical setting.