How Can We Robustly Measure Sensory Reactivity; A New DSM-5 Criterion for Autism Spectrum Disorder

Background:

Sensory reactivity abnormalities are a new criterion for Autism Spectrum Disorder (ASD) in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Yet a consensus on how we can reliably measure sensory reactivity in clinical and research settings is missing.

Objectives:

The current study set out to compare existing methods in order to identify robust measures of sensory reactivity.

Methods:

To assess sensory reactivity in children with ASD (n=35) and without (n=27), three measures were employed: two sensory questionnaires (Short Sensory Profile and Sensory Processing Scale Inventory) and one sensory observation (Sensory Processing Scale Assessment). ADOS and ADI-R were used for ASD diagnosis.

Results:

Children with ASD showed more sensory reactivity abnormalities on all three sensory measures compared to typically developing children. Sensory reactivity abnormalities were present in 47% of cases on the two questionnaires and in 64% of cases on the observation. The three sensory reactivity measures overlap in identifying abnormalities, and they also correlate moderately with one another. Inter-rater reliability ranked from .52 to .74, with the highest agreement between both parent-reports.

Conclusions:

We confirmed that a significant amount of children with ASD (47-64%) have sensory reactivity issues using three sensory measures, two parent-reports and one observation. The three measures overlap between 52% and 74% of the time in classifying individuals as having sensory reactivity difficulties, which is important for clinical and research settings wanting to examine the new DSM-5 criteria of sensory reactivity.  Given that the overlap is only moderate the three different sensory measures seem to measure different aspects of sensory reactivity. Therefore we recommend using at least one sensory parent report and in addition a sensory observation.