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Parent ratings of children with autism on the Evaluation of Sensory Processing (ESP)

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PARENT RATINGS OF CHILDREN WITH AUTISM
ON THE EVALUATION OF SENSORY PROCESSING (ESP)
by
Jacy Renee VerMaas-Lee
A Thesis Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In partial Fulfillment of the
Requirements for the Degree
MASTER OF ARTS
(Occupational Therapy)
August 1999
Copyright 1999Jacy Renee VerMaas-Lee
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UM I Number. 1397658
U M I*
UMI Microform 1397658
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U N IV E R S IT Y O F S O U T H E R N C A L IFO R N IA
T H E GRA DUATE SC H O O L
U N IV ER SITY RA R K
LO S A N G ELES. C A L IFO R N IA 1 0 0 0 7
This thesis, written by
under the direction of A_£X— Thesis Committee,
and approved by all its members, has been pre
sented to and accepted by the Dean of The
Graduate School, in partial fulfillment of the
requirements fo r the degree of
Master of Arts
D ee m
T in t* June 14, 1999
THESIS COMMITTEE
Chmins«s
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ii
ACKNOWLEDGMENTS
I would like to express my sincere appreciation and gratitude to m y committee chair, Dr.
L. Diane Parham, for her guidance, encouragement, and wisdom throughout this project,
and most importantly for helping me grow as a clinician and researcher. I am also grateful
for the guidance and insight of my committee chairs, Dr. Diane Hammon Kellegrew and
Dr. Ruth Zemke. A special thank you goes to the people who took time from their busy
schedules to assist with data collection, particularly Cheryl Ecker at Therapy in Action;
Elizabeth Hunter, Gallagher Pediatric Therapy; Pryia Moham, Irvine Therapy Services; and
Susanne Smith Roley, Pediatric Therapy Network.
I also want to thank my parents and family, who taught me anything is possible if you
are willing to w orkfor i t Their continual support and encouragement is only made stronger
by distance. Most especially I want to thank my husband, Damon Lee, who redefined his
role of husband to include everything from data collector to constant supporter and who
now knows more about sensory processing and autism than he ever thought possible. His
love and faith in me has been unfailing.
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TABLE OF CONTENTS
in
ACKNOW LEDGEM ENTS...................................................................................................... n
LTST OF T A B L E S ....................................................................................................................... v
ABSTRACT.................................................................................................................................vi
CHAPTER
I. THE PR O B LEM ............................................................................................................... I
Rationale and R elev an ce.................................................................................................1
Importance of S tu d y ...................................................................................................... 3
Research Design ............................................................................................................4
Research Q uestions......................................................................................................... 4
A ssum ptions................................................................................................................... 4
Limitations........................................................................................................................ 5
II. LITERATURE R EV TEW .............................................................................................. 6
Sensory Processing Difficulties in A utism .................................................................. 6
Research on Sensory Processing and Autism ...........................................................8
Firsthand Accounts of Sensory D ifficulties................................................................ 9
Sensory Histories and A u tism ..................................................................................... 10
Development of the Evaluation o f Sensory Processing............................................12
Comparison of the Sensory Profile and the
Evaluation of Sensory Processing...............................................................................15
T IT . M ETH O D S............................... 17
Participants.......................................................................................................................20
Instrument
Data A nalysis................................................................................................................. 20
IV. R E S U L T S ...................................................................................................................22
Sensory Domains............................................................................................................ 22
Comparison of Results with Johnson’s (1996) S tu d y ............................................ 23
Internal Consistency.......................................................................................................24
Gender A nalysis............................................................................................................ 24
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iv
V. DISCUSSION.............................................................................................................. 27
Comparison of Children with Autism and
Sensory Integrative Dysfunction ...............................................................................29
G e n d e r.......................................................................................................................... 31
Clinical Si gnificance................................................................................................... 32
Limitations and Suggestions forfuture R esearch.................................................... 33
R E FE R E N C E S .................................... 35
APPENDIX
A. Evaluation of Sensory Processing (Research Version 3 ) ........................................39
B. Consent to Participate in a study of Sensory Questionnaire...................................47
Validity for Children with Autism
C. ESP Participant Information S h e e t............................................................................ 50
D. Results of Item Analysis and Frequency D istribution............................................. 51
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V
LIST OF TABLES
1. Breakdown of Demographic Characteristics by G e n d e r.................................................19
2. Sensory Domains which Differentiate between G ro u p s ................................................22
3. Number of Significant Items that Differentiate Groups on the E S P ..............................23
4. Internal Consistency of the ESP (Cronbach’s Alpha C oefficients)..............................24
5. Items that Differentiate Between Boys and G irls .............................................................25
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VI
Abstract
The purpose of this study was to identify items on the Evaluation of Sensory Processing
(ESP), a sensory history questionnaire, that differentiate between children with autism and
typically developing children. The responses of 41 parents of children with autism were
compared with the responses of 41 parents of typically developing children using the
Mann-Whitney U test for each item and for each sensory domain. All sensory domains of
the ESP differentiated between groups. Item analysis revealed 114 of the 185 items
significantly differentiated between groups (p < .05), distributed throughout every sensory
domain. Results of the present study indicate that items representing both under- and
overresponsiveness to tactile, auditory, and vestibular input are relevant to children with
autism. Item ratings indicative of seeking intense proprioceptive input were particularly
prevalent among children with autism.
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Chapter I
Problem Statement
1
The goal of this research project was to identify items on the Evaluation of Sensory
Processing (ESP), a sensoiy history questionnaire, that differentiate between children with
autism and typically developing children. Additionally, this research explored the
performance o f children with autism on sensory domains, examined gender differences on
ESP items, and made comparisons between children with autism and non-autistic children
with sensory integrative dysfunction. This research provided further information on
parents’ perceptions of sensory processing difficulties of children with autism and how
these problems may be manifested in a child’s daily occupations.
Rationale and Relevance
Occupational therapists are primarily concerned with the ability of their clients to actively
participate in meaningful occupations every day. The ability to process and utilize sensory
information is one variable which can potentially affect functional performance in one’s
environment. Standardized assessments, when children are able to complete them, may
give information about how children are processing sensory information, but not
necessarily how this may affect their ability to participate in meaningful occupations in
everyday life (Dunn, 1994; Johnson, 1996). How people process sensory information
affects how they are able to interact with their environments and thus their performance in
daily activities.
It would be inefficient, if not impossible, for an occupational therapist to observe a child
in every environment to gain firsthand knowledge regarding the child’s interactions with
sensoiy stimuli and ability to process information in every situation. Because children are
often unable to report this information themselves, therapists can gather information from a
child’s parents. Typically, parents know their child better than anyone else. They have a
wealth of knowledge about their child and their child’s interactions in various situations,
which is valuable to therapists. Parents can report this information to occupational
therapists through sensory history questionnaires. The questionnaires can help therapists
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identify areas of sensory processing in which the child’s performance may be problematic,
consider how the child’s ability to interact with sensory stimuli may interfere with the daily
life of the child (and possibly the daily life of the family), and decide whether or not
intervention is warranted (Parham & Mailloux, 1996). In addition to giving therapists
insight, sensory history questionnaires can facilitate communication and collaboration
between therapists and parents (LaCroix, 1993; Parham, LaCroix, Johnson, Mailloux,
Roley, 1997), thus contributing to more effective interventions.
The Evaluation of Sensory Processing (ESP) is one example of a sensory history
questionnaire which is in the process of development. The current study is part of a larger
instrument development project involving the ESP. Original items on the ESP (research
version 1) were generated from a literature review and survey of expert clinicians. Strong
content validity was established (LaCroix, 1993). Each item currently in the ESP (research
version 3) was rated by a panel of experts in sensory integration as a “good item” for a
sensory history questionnaire (interrater agreement ^ 75%). Expert ratings further indicated
that each item measures behavior representative of a specific sensory domain (at least .70
item-objective congruence; LaCroix, 1993; Parham, 1997b).
Items were clarified and professional jargon eliminated (yielding research version 2),
then the criterion-related validity was assessed by comparing children with and without
sensory integrative dysfunction (Johnson, 1996). This revealed that 84 of 192 ESP items
distinguished between these two groups of children. Research version 3 of the ESP was
created by eliminating the original gustatory and olfactory items and creating 15 different
items for a new combined gustatory/olfactory domain (Parham, 1997b). Research version
3 is the current version o f the ESP and is the focus of the present study. A complete copy
of this instrument is found in Appendix A.
The ESP (research version 3) has demonstrated good internal consistency as evidenced
by a coefficient alpha of .80 or greater for subscales and total item scores (Parham, 1 997a).
Also on research version 3, Chang (1999) found fair interrater reliability between parents.
Mothers and fathers responded similarly (within one rating level) 72 to 89 percent of the
time. In its current form, the ESP (research version 3) examines parents’ perceptions of the
frequency of specific behaviors across six different sensory systems: auditory,
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gustatory/olfactory, proprioceptive, tactile, vestibular, and visual. The 185 items are
grouped according to the sensory system that each primarily represents. (See Chapter 2 for
more complete information on the development o f the ESP.)
Importance of Study
Past studies have indicated that the ESP is a strong and dependable tool for use in
occupational therapy. If the ESP is to be used confidently in practice, it would be beneficial
for therapists to know if and how well the ESP discriminates between the various
populations that occupational therapists serve, as w ell as between those populations and
typically developing children. This knowledge contributes to its usefulness as a screening
tool and its ability to identify problematic areas. W hen children with different disabilities
are compared using the ESP, it may be possible to see patterns of sensory processing
problems emerge, thus increasing our understanding of how sensory processing problems
specifically affect one population differently, or similarly, from another.
One population with well known and documented sensory processing difficulties is
children with autism. These sensory problems h av e been documented by clinical reports
(e.g., Ayres, 1 979; Huebner, 1992; Omitz, 1974), as well as by multidisciplinary
empirical research (e.g., Baranek & Berkson, 1994; Lincoln, Courchesne, Harms, Sc
Alien, 1995) and first hand accounts (e.g., Cesaroni Sc Garber, 1991; Grandin, 1995;
Stehli, 1991). Theorists and clinicians have specul-ated that children with autism have
deficits in their ability to register, process, and organize sensory information (Ayres, 1979;
Huebner, 1992; Omitz, 1974; Kinnealey, 1973). "These difficulties are thought to be
expressed in unusual responses to environmental sensory stimuli (Ayres, 1979). Such
unusual behaviors can be in response to stimuli in any one sensory modality (vestibular,
auditory, tactile, proprioception, visual, gustatory* or olfactory) or combination of sensory
modalities, and may reflect either hyper- or hyporesponsivity. For example, with respect to
auditory stimuli, one child with autism may run to the far end of the house and begin
rocking back and forth in response to the sound o f an electric mixer (Stehli, 1991), while
others may show no response of any kind to a noise (Rapin, 1991), or have difficulty
screening out background noise or listening to two people talk at the same time (Grandin,
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1995). These types o f responses may interfere with the child’s ability to participate
meaningfully in his or her environment. These children will be the focus o f this research
project.
By comparing parental ratings o f children with and without autism, this study gives
insight into how sensory processing problems may be expressed in children with autism in
everyday situations. Additionally, this study contributes to the instrument’s validity
through identification o f items that differentiate parent ratings of children with autism from
parent ratings o f children without autism.
Research Design
This study provided information regarding the ability of the individual items of the ESP
to differentiate between parental perceptions of children with autism and typically
developing children. The two groups of children were similar in age, gender, ethnicity, and
geographic location. The parental responses to each item on the questionnaire were
compared to identify those which significantly differentiate between groups.
Research Questions
1. Are there significant differences between the parent ratings of children with autism and
typically developing children on individual items of the ESP?
2. When the items are grouped by sensory domain, are the scores of the children with
autism and those of typically developing children different?
3. How do parent ratings o f children with autism on ESP items compare with results of
other studies? In comparison to previous studies, how many items differentiate? How
many items were significant for both non-autistic children with sensory integrative
dysfunction (Johnson, 1996) and for children in the present study?
4. Do significant gender differences exist on ESP items?
Assumptions
1. The ability to process sensory information can be inferred from a child’s behavior.
2. Children with autism process sensory information differently than typicaily developing
peers.
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5
3. Parents completing the questionnaire can comprehend the items in a way which
generates responses that accurately reflect their child’s behaviors.
4. There are no unknown sensory processing problems in the children considered
“typically developing.”
5. Parents’ responses to the questionnaire prior to initiating occupational therapy
essentially do not change for up to three weeks after initiation of occupational therapy for
their child with autism.
Limitations
1. The results are not generalizable to all children who fall within the autism spectrum
disorder. (Other pervasive developmental disorders were not adequately represented in this
study.)
2. The severity of autism is not taken into account other than noting a diagnosis of autism
or Asperger’s syndrome, which is generally considered less severe.
3. Parental perception may be influenced by variables such as socioeconomic status or
availability of resources which were not assessed.
4. Sensory processing problems may be influenced by developmental age or IQ, which
were not assessed or controlled in this study.
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Chapter IT
Literature Review
6
This chapter begins by reviewing pertinent literature on the sensory problems associated
with autism. It will look at the role abnormal sensory responses play in diagnosing autism,
and will discuss evidence of sensory processing problems in research, firsthand accounts
of sensory experiences, and parental perceptions of sensory responses previously
documented on sensory questionnaires. This will be followed by an overview of the
development of the ESP up to the present, as well as a comparison between the ESP and
similar tools.
Sensory Processing Difficulties in Autism
Autism is a developmental disability which manifests in early childhood and is
behavicrally characterized by severe deficits in language and communication, social
interactions, and repertoire o f activities and interests which are thought to denote
underlying abnormal brain organization and development (Rapin & Katzman, 1998; Rapin,
1997). Ever since autism was first described, there has been some association of this
condition with unusual responses to sensoiy stimuli in the environment Amid Kanner’s
(1943) first clinical description of autism was the characteristic of unusual response to the
child’s environment, such as an oversensitive response to a noise (as cited in Volkmar,
Klin, & Cohen, 1997). Unusual sensory responses were part of the official diagnostic
criteria for autism in the DSM-III (American Psychiatric Association, 1980), but were then
excluded in later editions. The current DSM-IV (American Psychiatric Association, 1 994)
criteria for autism include: impairmentin social interactions, impairment in communication,
and repetitive and stereotyped behavior, interests, and activities. Although abnormal
sensory responses are not expl icitly part of the diagnostic criteria for an autistic disorder,
they are considered an associated feature of autism in the DSMIV.
Atypical sensoiy responses have been deemed crucial and prevalent enough to be
included in checklists and measures designed to assess and help diagnose children with
autism, although the inclusion of sensory components is often brief or obscure. For
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example, the Childhood Autism Rating Scale (CARS; Schopler, Reichler, & Renner,
1988), which is widely used in the diagnosis and treatment of children with autism, has
items related to visual, auditory and tactile responses. DiLalla and Rogers (1994) studied
children with autism (n = 33), pervasive developmental disorder (n = 18), and
nonpervasive developmental disorder (n = 18) using CARS. (The nonpervasive
developmental disorder group included children with oppositional disorder, adjustment
disorder, attachment-related disorders, and mental retardation.) When the items of CARS
were factor analyzed, three factors emerged, one o f which was “distorted sensory
response.” Items that loaded strongly on this factor addressed visual responsivity, auditory
responsivity, and near receptor responsivity. Although this factor accounted for only 8% of
the variance in CARS scores, the authors reported that the distorted sensory response
represented a salient subdomain o f the scale given the strong pattern o f factor loadings.
Another measure, the Autism Behaviors Checklist (ABC; Krug, Arick, & Almond, 1980),
a 57-item screening tool, has a sensory subscale consisting of items such as “frequently has
no visual reaction to ‘new ’ person” or “sometimes shows no ‘startle response’ to loud
noise.” Although not identified as such, other ABC subscales contain items which may be
related to poor sensory processing, such as “whirls self for long periods o f time” and “will
feel, smell, taste objects in the environment” in the body concept subscale and “doesn’t
respond to own name when called among 2 others” in the language subscale. The Autism
Diagnostic Interview-Revised (Lord, Rutter, & Couteure, 1994) contains items which refer
to unusual sensory interests and noise sensitivity. These are just a few o f the many
examples of sensory influenced behavioral items on existing checklists.
Some researchers and clinicians associate certain aspects of the diagnostically relevant
behaviors with underlying sensory abnormalities. For example, social aloofness has been
associated with abnormal sensory responses (as cited in O ’Neill & Jones, 1997).
Stereotyped behaviors (e.g., hand flapping, twirling) have been associated with poor
sensory modulation (Omitz, 1974; Ayres, 1979). Levels of tactile defensiveness have been
shown to positively correlate with rigid behaviors, repetitive verbalizations, visual
stereotypes, and abnormally focused attention (Baranek, Foster, & Berkson, 1997).
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8
Within the frame of reference of sensory integration, the poor sensory processing
abilities of children with autism are believed to be the expression o f poor registration and
modulation (Ayres, 1979; Huebner, 1992; Omitz, 1974; Kinnealey, 1973). If sensory
information is not registered (i.e., not attended to), then it cannot be processed or acted on
appropriately. A child who does not register information, therefore, seems to ignore the
sound of a bell or a puff of air to the neck. Conversely, if the child registers the stimuli, he
or she may demonstrate behaviors which seem overly sensitive. For example, a child might
register the vibrations o f a small vibrator placed on the face, but the vibration may be
perceived by the child as overwhelming. Thus, the child attempts to avoid the sensation.
Another child might also register vibrations placed directly on the face, but may seek that
sensation for a prolonged period of time, almost as though he cannot seem to set enough of
the sensation. This would demonstrate decreased sensitivity. Both under-responding and
over-responding to sensory stimuli, sometimes the same stimuli at different times, occurs
in children with autism.
Research on Sensory Processing and Autism
Children with autism show abnormal sensory responses throughout all sensory
domains, although the extent and behavioral responses are varied between children. Many
published clinical reports and empirical studies have documented these atypical
characteristics associated with autism.
Clinical observations have implicated irregularities in the processing of vestibular
information in autistic children (Clark, 1983). Many clinical accounts and reviews of
empirical literature describe children with autism as liking to watch moving objects such as
moving stripes, rotating fans, and moving lights (Ayres, 1979; Mays & Gillon, 1993;
Rapin, 1991). This type o f stimulation is thought to excite the vestibular nuclei through
optokinetic nystagmus (Ayres, 1979). Many children with autism either seek intense
movement stimulation, or avoid that type of stimuli altogether (Ayres, 1979). Omitz (1974)
hypothesized, based on his laboratory studies of children with autism, that “a dysfunction
of the central vestibular system might be fundamental to this facet [sensorimotor
dysfunction] of the autistic syndrome” (p. 211.)
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Children with autism are also known to have difficulties in the processing of auditory
information. When looking at auditory evoked potentials (AEP), Bruneau, Garreau, Roux,
& Lelord (1987) found that although the average AEP amplitudes did not significantly
differ between controls, the children with autism showed abimodal distribution of AEPs.
One subgroup of children with autism showed a hyper-responsiveness to auditory stimuli
and the other subgroup showed similar ESP’s to the controls at low intensities, but as the
intensity o f the auditory stimuli increased the AEP amplitudes decreased. Lincoln,
Courchesne, Harms, & Allen ( 1995) demonstrated that some children with autism do not
respond to increases in auditory stimuli intensity and hypothesized that they may fail to
regulate or fully process the auditory stimuli. Another study showed that with the repetition
of simple auditory stimuli, children with autism failed to habituate to the sound (Martineau,
Roux, Garreau, Adrein, & Lelord, 1992).
Children with autism may also show abnormal tactile reactions such as sensitivity to
certain textures in food or clothing (Ayres, 1979). Evidence of aversive reactions to tactile
stimuli have been demonstrated in research (Baranek, Foster, & Berkson, 1997a, 1997b;
Baranek & Berkson, 1994; Dunn, 1997; Kinnealey, 1973), but are associated with
developmental age (Baranek & Berkson, 1994). Additionally, some children with autism
reportedly have a decreased sense of taste and smell (Ayres, 1979), or may attempt to lick
or smell all objects (Rapin, 1991).
The responses of children with autism to systematically applied sensory stimuli was
recorded by Ayres and Tickle (1980). They found wide variability within the group of
children with autism, with some children behaviorally over-responding while others under
responded to sensory stimuli. The responsivity to sensory stimuli was then compared to
treatment effectiveness for each child- Hyperresponsivity, especially avoidance of
movement, tactile defensiveness, and orienting to a puff of air, were the best predictors of
good response to sensory integration-based occupational therapy.
Firsthand Accounts of Sensory Difficulties
Besides appearing in research, evidence of sensoiy abnormalities are described in
firsthand accounts of people with autism. Temple Grandin (1995, 1997) potently describes
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10
her hypersensitivity to touch and sounds. Although she craved to be hugged, she could not
tolerate being touched. Shampooing her hair caused pain. Grandin equated the feeling of
scratchy Sunday clothes against her skin to sandpaper on raw nerve endings. It took her
body two weeks to fully adapt between the feeling o f wearing a skirt (bare legs) to the
feeling of long pants. Other people only require seconds to make that same adaptation.
Grandin also describes problems tolerating sounds. “Loud noises were also a problem,
often feeling like a dentist’s drill hitting a nerve. They actually caused pain My
roommate’s hair dryer sounded like a je t plane taking off” (Grandin, 1995, p. 67). In
another case, Jim, a young man with autism, recalled how low frequency sounds in
background music frightened him to the point of refusing to return to school (Cesaroni
&Garber, 1991). For some children fluorescent lights are problematic due to their ability to
see the 60 cycle flicker of the lights (Grandin 1995, 1997). Smells can also cause
problems. Georgie Stehli had trouble with the smell of dogs, cats, and everyday toiletries
used in hygiene. Georgie’s mother, Anabel, recalls a conversation in which Georgie
explains this sensitivity: “smells like deodorant and after-shave lotion, they smell so strong
to me I can’t stand it, and perfume drives me nuts.. . . I can smell hand lotion from the
next room” (p. 187, Stehli, 1991).
Sensory processing problems can affect the entire family. Annabel Stehli (1991)
describes herself as “deprived of a happy, gurgling, affectionate baby” (p. 16), in part
because her daughter with autism avoided cuddling or any type of touch with people.
Grandin’s (1995) scratchy clothes contributed to tantrums in church. Many parents either
stop taking their children out in public in order to avoid these types of tantrums, or need to
plan outings very carefully (Sullivan, 1997). Typical activities such as grocery shopping
become highly challenging endeavors. All of these activities and behaviors contribute to
family stress and interrupt family life (Marcus, Kunce, & Schopler, 1997).
Sensory Histories and Autism
Currently in the literature are questionnaires which have been specifically designed to
focus on behaviors indicative of sensory processing. The questionnaires may encompass a
specific area of sensory processing (such as tactile; Royeen, 1987), or apply only to infants
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11
and toddlers (Provost & Oetter, 1993). A parent sensory history questionnaire that is
similar to the ESP in content as well as intended population is the Sensory Profile (Dunn,
1994). The Sensory Profile consists o f 125 child behavior items which are also grouped
according to sensory categories (auditory, visual, touch, taste/smell, movement, and body
position), with additional behavioral categories (emotional/social and activity level)
included as well. In general, the Sensory Profile is expanded beyond behaviors indicative
of sensory processing. Although this may be useful in some clinical situations, it is not
optimal when clinical assessment aims to identify behavior problems that can be attributed
specifically to sensory processing.
Using the Sensory Profile, Kientz and Dunn (1997) compared a group of children with
autism or pervasive developmental disability (n =32) with typically developing controls (n
= 64). O f the children with autism, 17 children were rated as having “severe” autism and
15 were rated as having “mild” to “moderate” autism on the Childhood Autism Rating Scale
(CARS). Kientz and Dunn found that there was no difference between the perceptions of
parents of children with severe autism and the parents of children with mild/moderate
autism on the behaviors listed on the Sensory Profile. In comparing children with autism
with their typically developing peers, significant differences were found in all categories
(taking into consideration both age and gender). Eighty-four o f 99 items, distributed
throughout all categories, contributed to this difference, although the specific items were
not identified in the published paper. At least 50% of parents of children with autism
responded that their child “always” or “frequently” displays the behaviors on 17 of the 99
items, one at least in each category.
A preliminary study using version 2 and version 3 o f the ESP (the instrument to be used
in the present study) compared 12 children with autism and 12 typically developing
children, matched fo r age and gender (Parham, 1997a). Results indicated significant
differences on 19 items. The present study, which uses a larger sample size (n = 80) and
controls for age, gender, ethnicity, and geographic location, may yield a greater number of
discriminating items.
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12
Development of the Evaluation of Sensory Processing
This study utilizes the the Evaluation of Sensory Processing (ESP), a sensory history
questionnaire which has undergone rigorous development in an attempt to provide a valid
and reliable tool. The earliest version of the ESP was created by LaCroix (1993) who
followed the process for instrument development that was described by Benson and Clark
(1982). LaCroix formulated the first table of specifications which delineated the ideal
number of items within each of the seven sensory systems in accordance with the emphasis
placed on various sensory systems in the sensory integration literature: tactile, 25;
vestibular, 22; proprioception, 17; auditory, 13; visual, 13; olfactory, 5; and gustatory, 5.
Next, LaCroix gathered items from existing sensory history questionnaires found in the
literature and from therapists and parents. A total o f679 descriptive behavioral statements
were compiled and then analyzed for content validity by a panel of 21 experts in sensory
integration theory. The experts were asked to evaluate to what extent each item signified a
sensory domain (i.e., not a measure of the domain, undecided as to whether the item
measures the domain, and a definite measure of the domain), and whether or not the
statement was a “good item” for a sensory questionnaire. Each item was independently
evaluated by four to five experts. The percent to which the experts agreed that the item was
a “good item” was calculated for each item. Tn addition, content validity was calculated on
domain ratings using the index of item-objective congruence (Rovinelli & Hambleton,
1997). The result of this was 191 “best items” which had both a 75% or greater inter-rater
agreement that the item was a “good item,” as well as a .70 or greater coefficient on the
item-objective congruence. Most sensory systems, except for the gustatory and olfactory
systems, greatly exceeded the minimum criteria. Because the gustatoiy items did not meet
the criteria, the minimum criteria for these items was changed to include items with only
50% or greater inter-rater agreement that the item was a “good item.” This yielded a total of
200 items in Likert-scale format with strong content validity, which composed the first
version of the sensory questionnaire (research version 1). The items were distributed as
follows: tactile, 60; vestibular, 36; proprioception, 28; auditory, 32; visual, 22; olfactory,
12; and gustatory, 10.
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13
The Evaluation of Sensory Processing (research version I), consisting of these 200
items with good content validity, was distributed to 250 families (LaCroix and Mailloux,
1995). Thirty-seven questionnaires were completed and returned by parents of children
without any known disabilities. The returned questionnaires represented 15 girls and 22
boys with the following ages: 3-year-olds (43%), 4-year-olds (51 %), and 5-year-olds
(5%). O f the 200 items, 116 behavioral statements were rated by at least 75% of the parents
to be behaviors which their children engaged in “rarely” or “never.” This is reflective of
behaviors which may be uncommon in typically developing children and thus potentially
good discriminators. Additionally, at least 50% of the parents indicated that 10 items
described their child “often” or “always.” LaCroix and Mailloux ( 1 995) also conducted
four interviews with mothers of children with sensory integration disorders (two parents)
and without sensory integration disorders (two parents) to gain insight into their experience
and opinions of the questionnaire. They found that mothers of children with sensory
integration disorders found the questionnaire validated their observations of their child,
wished the questionnaire could be used earlier in the intervention process, and helped to
bring about new insights and questions about their children (LaCroix, Johnson, Parham,
1997). Overall, this provided positive feedback with regard to the scope and content of the
questionnaire from a parental perspective.
Johnson (1996) examined the criterion-related validity of the Evaluation of Sensory
Processing. Johnson first examined the clarity of each item as interpreted by parents. This
was important to address because interpretations may differ between parents and therapists
due to different knowledge bases. To accomplish this, she conducted interviews with
parents of four children with sensory integration disorders and the parent of one child with
no known sensory integration disorder. For one parent, English was a second language.
Qualitative analysis showed that limited English vocabulary may influence the interpretation
of questions. As a result of the interviews, eight items were eliminated (due to professional
jargon), and 41 items were rewritten for clarity. This produced research version 2 of the
ESP, consisting of 192 questions. Using this version of the questionnaire, Johnson
obtained 30 questionnaires completed by parents of children with sensory integration
disorder and 59 questionnaires completed by parents of children with no known disorders.
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Analysis o f the questionnaires completed by parents of children without disorders revealed
that 80% or more responded to 112 items in the extremes (i.e., “always/often” or
“seldom/never”). Thirty o f the 59 children without disorders were matched according to
age, gender, location, ethnicity, and socioeconomic status to the 30 children with sensory
integration disorders. Comparing these two groups using the Wilcoxon Signed Rank test
(Pagano & Gauvreau, 1993) revealed a significant difference (p ^ .05) between groups on
84 items, distributed among the domains as follows: tactile, 24; vestibular, 19;
proprioception, 10; auditory, 16; visual, 13; olfactory, 2; and gustatory, 0.
Parham (1997a) analyzed the internal consistency of each sensory system from the
Johnson (1996) study using Cronbach’s alpha. This yielded alphas of .95 for the tactile
system, .92 for the auditory system, .85 for the proprioceptive system, .84 for the visual
system, .83 for the vestibular system, .76 for the olfactory system, 3 2 for the gustatory
system. When the olfactory and gustatory systems were eliminated, an aggregate
coefficient alpha of .97 was computed. This study demonstrated that the ESP has strong
reliability with the exception of the olfactory and gustatory sensory domains. Parham
( 1997b) next eliminated the ori ginal items from the olfactory and gustatory domains and
created a new combined gustatory/olfactory domain, for which 29 new items were created
by a panel of sensory integration experts. Following the same procedures utilized in the
LaCroix (1993) study, a different panel of experts rated the new questions along with 11
intermixed “distracter” items. This yielded 15 gustatory/olfactory items identified as “best
items” (i.e., 75% or greater inter-rater agreement that the item was a “good item” and .80 or
greater coefficient on the item-objective congruence). These “best items” replaced the
original gustatory and olfactoiy items and ESP Research Version 3 was created. This is the
current version of the ESP and is the focus of this study.
The interrater reliability o f the current ESP (version 3) was assessed by Chang (1999)
by comparing the independent responses of mothers and fathers o f 35 children (20 with
typical development and 15 children with sensory integrative dysfunction). Chang found
that although there were differences between parental perceptions, when agreement was
defined as ratings within one response level (e.g., always and often, never and rarely) the
average percent agreement between parents was high for all systems (between 7233% and
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15
88.6%). In the combined group (n =35) consisting of typically developing children and
children with sensory integrative dysfunction), moderate to good reliability was found on
48 items using the intraclass correlation coefficient (ICC). The degree to which the fathers’
and mothers’ scores are related was assessed further by Spearman correlation coefficients.
A total of 43 o f 185 items in the combined group were found to have at least a moderate
correlation (rs ^ .50).
Comparison o f the Sensory Profile and the Evaluation of Sensory Processing
A discussion of the similarities and differences of the Sensory Profile (SP) and the
Evaluation of Sensory Processing is merited to help eliminate any confusion which may
occur when comparing the results of studies using the two tools. Both the ESP and the SP
are questionnaires which assess parental perceptions of children’s sensory processing of
multiple sensory systems. They both target preschool through elementary aged children,
and are designed to be used by occupational therapy clinicians and researchers. However,
important differences between the questionnaires arise from the items and categories
included in the questionnaire.
As a result o f the strong content validity (LaCroix, 1993), all items in the ESP are
specific to the sensory domain they fall under. When problematic behaviors are identified
on the ESP, the therapist can be confident that the behavior is indicative of sensory
processing difficulties in the sensory domain the items fall under. This way the therapist
using the tool will know which sensory systems are most affected, thus contributing to a
more focused intervention which can more directly address specific areas of sensory
processing. The ESP’s sole focus on sensory processing is beneficial to clinicians and
researchers who wish to identify whether sensory functioning is a factor contributing to a
child’s difficulties in daily life.
On the other hand, the Sensory Profile is designed to assess a broader range of
problems, both related to sensory processing as well as problem behaviors associated with
activity level and emotional/social functioning. Additionally, the content validity of the
Sensory Profile has not been formally evaluated in published research, and may be
problematic in that items designated as sensory may be influenced by non-sensory factors.
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For example, item 8 in the visual category, “has trouble staying between the lines when
coloring or when writing,” may be attributed to ataxia, poor motor planning, or cognition,
in addition to visual perception. Another difficulty is that some items which fall under one
sensory category, may be related to multiple sensory modalities. Item 4 in the “taste/smell”
category, “chews/licks nonfood items,” might also be attributed to tactile or proprioceptive
properties. Because of these characteristics, the Sensory Profile may be better suited to
assessing a broader range of problems than sensory processing specifically.
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17
Chapter T IT
Methods
This study compares ESP item ratings assigned by parents of two groups of children:
children with autism and typically developing children. Analysis reveals which items on the
ESP differentiate between the two groups, as well as significant differences when items are
grouped by sensoiy domain and gender differences in individual items.
Participants
Forty-one parents of children with autism or Asperger’s Disorder were recruited from
private occupational therapy clinics in Southern California for this study. Autism, along
with Rett’s Disorder, Childhood Disintegrative Disorder, Asperger’s Disorder, and
Pervasive Developmental Disorder Not Otherwise Specified, falls under the class of
Pervasive Developmental Disorders in the DSM IV (1994). Children who participated in
this study received a diagnosis of Autistic Disorder (n = 39) or Asperger’s Disorder (n = 2)
from a physician or psychologist. The diagnosis was verified by either the researcher or the
child’s therapist by referring to previous reports or inquiring with the parents. To receive a
diagnosis of Autistic Disorder, a child must show a certain number of marked impairments
in social interactions (such as no use of nonverbal communication patterns),
communication (delay or lack of language, unable to sustain conversation, idiosyncratic
language), and repetitive or stereotyped behaviors, interests or activities. Additionally,
delays or abnormal patterns must be present in either social interaction, language, or
symbolic or imaginative play before the age of 3 years. A diagnosis of Asperger’s Disorder
is given when there has been no delay in language or cognitive development, but
impairments in social interaction and repetitive and stereotyped behaviors are present.
The parents of these children were asked to complete the sensory history questionnaire
sometime between the initial occupational therapy evaluation and the first three weeks of
occupational therapy. Data for children who had a completed ESP in their clinical chart that
was completed in the same time frame were also included. Restricting the time frame for
ESP completion to the first three weeks of treatment was done to minimize the amount of
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18
influence therapists might have exerted on the parents’ ratings o f their child’s responses to
sensory stimuli. Through parent education therapists discuss typical abnormal sensory
responses or problems they have observed. This may lead to heightened parental sensitivity
to sensory based behaviors. Since the ESP is primarily intended to be used as an initial
screening tool, it is important that the therapist knows how parents tend to respond to the
questionnaire before such bias can occur. The limited time frame also minimizes the
potential effects on the ESP ratings that intervention may have with respect to the child’s
sensory-related behaviors.
Data collection was completed for the autism group prior to completion of data collection
for the comparison group. Demographic characteristics were summarized for the autistic
group and used to focus the final recruiting efforts in the typically developing group.
Parents of 36 typically developing children were recruited from local day care centers,
preschools, and personal contacts who did not have knowledge of sensory integration
principles (i.e., no children o f occupational therapists were recruited, nor siblings of
children receiving services). Parents o f the typically developing children were asked to
participate based on the age and sex of their child (i.e., parents with boys between the ages
of 2 and 4 were sought due to the higher prevalence of these characteristics in the autism
group). Additionally, the typically developing children were not taking any medications nor
did they have any known medical conditions or diagnoses which could affect their
responses to sensory input.
An additional nine typically developing children were drawn from the participants of
research with Chang (1999) who was collecting ESP inter-parent agreement data in
Southern California during the same time period. Four of these participants replaced four of
the typically developing children who had been recruited specifically for the present study
in order to balance the ethnicity of the autism group with the typically developing group.
The other five participants were imported from Chang’s study to make the comparison
groups equivalent in size to the autism group. The ESP questionnaires that were completed
by the mother were used for all nine children taken from Chang’s sample because the
majority of parents completing the ESP in this study were mothers.
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19
Each participant was asked to complete an ESP (research version 3), if she had not
already done so, and a consent form (see Appendix B). The researcher contacted parents by
phone to obtain missing data and clarify responses. Parents of children with autism were
contacted to fill in missing items only if no more that three months had passed from the
time therapy began. Missing data could not be obtained for 121 items, which represented
.8% of the total data. These items were left blank for the analysis.
Both the typical development group and the autism group were similar in demographic
characteristics (see Table 1). The typical development group contained one more female
than male. A t-test confirmed that the groups did not differ in mean ages (t = .037; p =
.971). In the autism group, the “other” ethnicity category represents participants who
consider themselves M iddle Eastern (n = 1), Black (n=l), Tndian (n = I), and 2 participants
for whom ethnicity could not be obtained. The 2 participants in the “other” category in the
typical development group represent Middle Eastern ethnicity. In cases where dual
ethnicities were reported by the parent (n = 7), the minority ethnicity was recorded. One
participant listed her child as having dual minority ethnicities. In this case, the ethnicity of
the parent who filled out the form was used in the summary o f demographic data presented
in Table 1.
Table 1
Breakdown of Demographic Characteristics by Gender
Age Ethnicity
n Range Mean S.D. White Asian Hispanic Other
Children with Autism
Male 34 2 .1 7 -1 1 .0 8 4.63 1.92 22 5 4 3
Female 7 2 .3 3 - 6.11 4.35 1.57 3 2 0 2
Total 41 2 .1 7 -1 1 .0 8 4.58 1.85 25 7 . 4 5
Children with Typical Development
Male 33 2.00 - 9.75 4.62 1.78 24 4 4 I
Female 8 2.08 - 7.92 4.50 1.44 4 3 0 I
Total 41 2 .0 0 -1 1 .9 2 4.59 1.70 28 7 4 2
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Instrument
A brief intake form was used to ensure that the typically developing children do not have
any medical conditions or diagnoses which could potentially influence their responses to
sensory stimuli (see Appendix C). The sensory history questionnaire utilized was the
Evaluation of Sensory Processing, research version 3. This instrument was described in
chapters I and 2.
Data Analysis
Prior to data analysis, items marked “not applicable” were recoded as “never.” Johnson
(1996) found through interviews with parents that when parents marked “not applicable”
on the questionnaire, the true intended response nearly all the time was “never.” This
misuse of the “not applicable” response was confirmed in the present study through the
follow up calls to obtain missing data.
The responses of parents of children with autism were compared with the responses of
typically developing children using the Mann-Whitney U test to determine if the two groups
responded differently on the questionnaire items. The Mann-Whitney U test is a
nonparametric test used to evaluate the difference between two independent groups
(children with autism and typically developing children) on an ordinal scale (always, often,
sometimes, rarely, never). Because the study was initiated with the expectation that
children with autism would be perceived by parents as having more behaviors indicative of
sensory processing problems, one-tailed tests were used in these analyses.
First each item was independently analyzed using the Mann-Whitney U test to ascertain
whether or not parent ratings differentiated between children with autism and typically
developing children. Next, the items from each sensory domain were grouped together and
summed to obtain a total score for each sensory domain. The Mann-Whitney U test was
then used to determine whether the groups differed in total domain scores.
The internal consistency of each sensory domain was established using Cronbach’s
alpha. An aggregate coefficient for the entire questionnaire was also computed. Data for all
participants were used in these analyses.
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21
The Mann-Whitney U test was also used to determine which items on the ESP may
exhibit significant gender differences. Gender differences were analyzed for the entire
sample (n =82), as well as children with autism (n =41) and typically developing children
(n =41) separately.
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Chapter IV
Results
Analysis with the Mann-Whitney U test showed that a total o f 114 of 185 (61 %)
individual items discriminated between groups (see Appendix D). These items were
distributed throughout each sensory domain as follows (presented in order from highest to
lowest percentage of significant items within each domain): auditory, 26 of 3 1 (84%);
proprioception, 20 o f25 (80%); visual, 14 of 20 (70%); tactile, 35 of 61 (57%)
gustatory/olfactory, 6 o f 15 (40%); vestibular, 13 o f 33 (39%).
Sensory Domains
Items were summed within each sensory domain to obtain a score for each domain.
Analysis with Mann-Whitney U test showed that parents of children with autism responded
significantly differently (p < .05) on all six sensory domains of the ESP (see Table 2).
Table 2
Sensory Domains which Differentiate between Groans
Sensory
Domain p value
Auditory <.001
Gustatory/ .009
Olfactory
Proprioceptive <.001
Tactile <.001
Vestibular <.001
Visual <.001
Note. All participants were used in a Mann-Whitney analysis (n = 82).
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23
Comparison of Results with Johnson’s (1996) Study
O f the 185 ESP items, 62 were found to significantly differentiate groups both in the
present study and in Johnson’s (1996) study comparing children with sensory integrative
dysfunction (SID), excluding children with autism, cerebral palsy, mental retardation or
seizures, and typically developing children (see Table 3). Seventy-six items were
significant in one study, but not the other. In ail sensory domains except vestibular, more
items were significant in the present study than in Johnson’s study.
Table 3
Number of Significant Items that Differentiate Groups on the ESP
Content
Domains
Children
with Autisma
Non-autistic
children with
STDb
Both Children
with SID
and Autism
Auditory 26 16 14
Gustatory/
Olfactory
6 0/2 NA
Proprioception 20 10 8
Tactile 35 24 19
Vestibular 13 19 10
Visual 14 13 11
Total 114 84 62
Note. “NA” = not applicable because different items were used in this domain in the
present study versus Johnson’s study.
a The present study.
b Johnson (1996).
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24
Internal Consistency
Because the present study offered an opportunity to reevaluate the reliability o f the ESP,
Cronbach’s coefficient alpha was computed and compared to results of previous studies
(see Table 4). Cronbach’s alpha coefficients for the six sensory domains ranged between
.78 (vestibular) and .96 (tactile). The coefficient for the entire questionnaire was .98. These
findings taken together indicate that the ESP has strong internal consistency, particularly
for the total score and tactile domain.
Table4
Internal Consistency of the ESP (Cronbach’s Alpha Coefficients)
Content
Domains
Research
Version 2
(Parham, 1997a)
Research
Version 3
(Chang, 1999)a
Research
Version 3
(Current Study)
Auditory .92 .89 .94
Gustatory/
Olfactory
3 2 me .78 .81
Proprioception .85 .91 .90
Tactile .95 .95 .96
Vestibular .83 .77 .78
Visual .84 .98 .88
Total ESP .98 .98
Note. All coefficients were obtained using all participants from each study.
a Alpha coefficients for the mother’s ratings
Gender Analysis
Significant differences between the ratings of parents with female children and with
male children were found (see Table 5). Twelve items significantly differentiated between
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25
male and female children with autism. One item discriminated between typically developing
males and females. Nine items were found to discriminate between gender groups when
both children with autism and typically developing children were taken into account.
Table5
Items that Differentiate Between Bovs and Girls
Gender p values Gender in which
Behavior is more
Prevalent
Autism Control Combined
Group Group Group
(n = 41) (n = 41) (n = 82)
Auditory #1:
Bothered by sound of
toilet flushing*
.048 Females
NS
.034 Females
Auditory #4:
Hear sounds that others
do not notice
.037 Males
NS
NS
Auditory #6:
Bothered by
background noises
NS
.017 Female
NS Female
Gustatory #5:
Resist new flavors of
pureed food
.021 Female
NS
NS
Gustatory #6:
Prefer salty foods*
.023 Female
NS
NS
Proprio #3:
Grind teeth*
.045 Male
NS
.037 Male
Proprio #18:
Frequently hit, bump,
push other children*
NS
NS
.037 Male
Proprio #22:
Taste/chew on toys,
cloths, other objects*
.018 Female
NS
NS
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T able 5 (continued)
Gender p values Gender in which
Autism Control Combined
Group Group Group
(n = 41) (n = 41) (n = 82)
Behavior is more
Prevalent
Proprio#23: .027 Male
crave hugging/ NS
rough play* .022 Male
Tactile#6: .041 Male
Resist/dislike clothes NS
of certain textures NS
Tactile #7: .038 Male
React negatively to NS
feel o f new clothes* NS
Tactile #43: NS
Ask for tags/labels NS
removed from clothes .037 Male
Tactile #44: .014 Male
Irritated by tags
N S
on clothes .029 Male
Vestib#19: .010 Female
get car sick NS
NS
Visual #2: .011 Male
Sensitive to NS
bright light* .037 Male
Visual #7: NS
Rubs eyes, complains NS
ofheadaches .017 Male
Visual #19: NS
makes reversal in NS
words or letters .054 Male
T otal # Significant 12 I 9
Note. NS = Not significant, p > .05.
*Item differentiated significantly between children with and without autism (px .05).
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Chapter V
Discussion
The sensory processing problems of children with autism were reflected throughout all
sensory domains o f the ESP. Examination o f the content o f significant items indicated that
behaviors representing both under- and over-responding were reported more frequently for
children with autism than in children without disabilities.
In the auditory domain, significant items pertained to children becoming easily startled,
scared, or distracted by sounds, as well as items asking parents if their child underacts to
loud noise or whether their child is seemingly confused about the location of sounds. Both
o f these extremes are represented in the literature though self reports (Cesaroni & Garber,
1991; Grandin, 1995, 1997; Stehli, 1991), as well as through the research that measures
brain potentials in response to auditory stimulation (Bruneau et al., 1987; Kinnealey, 1973;
Lincoln etal., 1995).
Items on the ESP which indicated hyperresponsivity to odors and tastes, and items
which referred to hyporesponsivity (e.g., preference for salty foods) also differentiated
between groups. This sensory domain is much less conspicuous in the literature, although
possible sensitivity to smells or tastes have been suggested in other questionnaire studies
(Baranek et.al., 1997a; Kientz & Dunn, 1997) and in clinical reports (Ayres, 1979; Rapin,
1991).
In the proprioceptive system, ESP results show that children with autism may have
difficulty modulating the amount of force needed to manipulate objects (either using too
much or too little). Many o f the proprioceptive items indicate that children with autism tend
to seek strong input, as in seeking out activities that involve jumping, crashing into things,
pushing, pulling, or falling. Children who are seeking this type of intense stimulation may
be doing so in order to help modulate sensory input from other areas (Koomar & Bundy,
1991; Parham & Mailloux, 1996). An alternative explanation is that, through these
behaviors, the children may be seeking augmented proprioceptive input in order to
compensate for limited or inaccurate proprioceptive feedback.
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28
Tactile items involving hypersensitivity included pulling away from people to avoid
touch, irritation from clothes or parts o f clothes (e.g., clothing tags), or being bothered by
everyday activities such as hair brushing and face washing. These findings are consistent
with the autism literature in which tactile defensive behaviors are well documented in self-
reports (Cesaroni & Garber, 1991; Grandin, 1995, 1997; Stehli, 1991) as well as in
research (Baranek et al, 1997a; 1997b). However, evidence of tactile underresponding was
also present in the results o f the current study. Examples of significant items representing
hyporesponsiveness were lack of awareness of being touched and craving to touch
different textures. Parents of children with autism also reported that their children had a
high tolerance of pain.
Accordingto parental responses on the questionnaire, some children with autism
avoided or were fearful of movement or balance activities, while other children sought
more intense movement experiences such as spinning and whirling. In some cases, clear
patterns of seeking or avoiding movement experiences were absent. For example, one child
both sought and avoided certain vestibular activities. Research has not provided definitive
evidence suggesting which explicit mechanisms are involved in atypical vestibular
processing in children with autism. Response to vestibular stimulation has been examined
by measuring postrotary nystagmus. Decreased duration and time constant aspects of
nystagmus are thought to be indicators of central vestibular processing dysfunction (Fisher,
1991). Research has revealed variability in the duration of the nystagmus between children
with autism (Nelson, Nitzberg, & Hollander, 1980), which may be reflective of atypical
processing of vestibular input. Future empirical research is needed to link vestibular
processing mechanisms with under- and overresponse to vestibular stimuli.
Finally, unusual responses to visual stimuli were also noted on the ESP. Children with
autism were more likely to focus on only parts of pictures, have difficulty maintaining a
visual focus, and have a hypersensitivity to light. Kemner, Verbaten, Cupenes,
Camfferman, & VanEngeland (1994) reported in their study that children with autism
differed statistically from normal children with respect to occipital amplitudes in response to
visual stimuli. This may help to explain some of the atypical visual processing of children
with autism.
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29
Comparison of Children with Autism and Sensory Integration Dysfunction
Not all items on the questionnaire which differentiated between children with autism and
typically developing children were shown in an earlier study to differentiate betw een
children with sensory integrative dysfunction (excluding autism) and typically deweloping
children (Johnson, 1996). These contrasting findings indicate that there may be differences
in the way these clinically defined groups of children respond to sensory stimuli im
everyday situations. Although statistical analysis comparing these two clinical populations
was not performed, comparison of results from the present study and results from* Johnson
(1996) is suggestive o f the kinds of behaviors that may characterize children with autism in
contrast to non-autistic children with SID.
Some caution must be drawn in comparing results from these two studies. T h e children
with autism and the children with SID were contrasted with different sets of typically
developing children using different nonparametric tests. The sample sizes were somnewhat
larger in the autism study. Because no statistical item analysis was done directly b«etween
children with autism and children with SID, comparisons were made based on the specific
items which differentiated each group (autism and STD) from the typically developing
children in their respective study.
Examination of the percentages of children with autism and with SID who w ere rated at
the extremes (i.e., “always” and “often,” or “rarely” and “never”) revealed that som e items
were not significant for the autism group, yet the percentages of these parents w h o
responded in the extreme ends of the scale were similar to or even higher than the
percentages o f parents o f children with SID. For example, the item which asks “D oes your
child like giving bear hugs?” was rated as “rarely” or “never” by 30% of the parenrts of
children with autism and 27% of parents with children with SID. This item was no»t
significant in the autism study, but was a significant item for differentiating STD from
typically developing children in the Johnson (1996) study. These discrepant results seemed
to be caused by differences in the distributions of parent ratings of typically developing
children in each study. In the autism study (where the item was not significant) 38*36 of
parents of typically developing children reported that their children liked to give b e a r hugs
“rarely” or “never” while in the Johnson study, only 6% rated their typically developing
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30
children this way. Also, a larger proportion of the parents (67%) o f typically developing
children in the Johnson study than in the present study (44%) rated their child as liking to
give bear hugs “always” or “often.” This example underscores how misleading it may be
two simply focus on which items were significant in the present study versus the Johnson
study. T n light o f this, the remainder of this section discusses only the significant items for
which a meaningful contrast in ratings for children with autism versus SID was identified
by the researcher.
In the auditory system, items which represented hypersensitivity to noises, such as
being fearful of the sounds of a flushing toilet, vacuum, hair dryer, or fan, appear to be
more characteristic o f children with autism than children with STD. Two items which
represented auditory underreactivity were significant in the present study, but not in
Johnson’s study: children with autism reportedly appeared not to hear certain sounds or
seemed to underreact to loud noises. Perhaps both extremes of under- and overresponding
to auditory stimuli are more prevalent in children with autism than in non-autistic children
with STD.
A greater number of items which involved aversi ve reactions to tactile input were
significant in the present study than in Johnson’s study. A higher proportion of parents of
children with autism rated their children as having difficulty interacting with messy
activities (e.g., disliking playing with gritty things, glue, or glitter, or eating messy foods
with their hands) “always” or “often” than parents of children with SID. Children with
autism also were reported to be driven to touch various textures more than children with
SID. Items which involved preference for continually wearing long sleeve shirts or long
pants were only significant for the SID group.
Other discrepancies between children with SID and autism were evident in vestibular
items. In general, children with SID were significantly differentfrom typical children on a
larger number o f items which referred to avoidance or fear of movement. Items which were
significantly different for children with autism, but not for children with SID, were items
which represented vestibular underresponsiveness, such as the child not seeming to
become dizzy or the child engaging in spinning and whirling. It is important to note that
items which represented overresponsiveness were significant for both clinical groups (e.g.,
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31
disliking fast carnival rides, showing stress when on riding equipment), however no items
which represented seeking o f movement were significant in the study of non-autistic
children with SID.
In the visual system, only three items were significant for children with autism that did
not differentiate children with sensory integrative dysfunction without autism. These items
involved greater sensitivity to bright light, difficulty distinguishing figure ground from
foreground, and focusing more on pattern or details instead of the entire picture.
Overall, more items reflecting hyper-responsivity were significant for children with
autism compared to the earlier study of children with SID. Perhaps this finding is related to
the concomitant finding that a large number of items involving proprioceptive-seeking
behaviors were also significant in the present study. Proprioception is thought to help
modulate input from other sensory modalities (Koomar & Bundy, 1991; Parham &
Mailloux, 1996). Examples o f significant proprioceptive seeking items included grinding
teeth, chewing non food objects, jumping, crashing, pulling, and craving rough play. For
these items, a higher percentage of children with autism were rated as exhibiting these
behaviors more often than children with SID.
Much overlap was noted in the two studies with respect to items which differentiated
between groups. In most sensory domains, items which related to overresponding and
underresponding to sensory stimulation were significantly different in both studies.
However, salient differences between children with autism and children with SID do
emerge in their responses to everyday sensory experiences as measured by the
questionnaire. T n general, children with autism appear to have a higher prevalence of
extreme or atypical responses to sensory input, especially with regards to the auditory and
tactile systems, and also they tend to seek more proprioceptive and vestibular input than
children with SID.
Gender
When comparing the gender differences for this study, it is important to keep in mind
that the number of female participants available for analysis was small (n = 15), and that
only a small number of items discriminated between genders. Most of the items which
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32
discriminated between boys and girls were significant only when considering children with
autism. The content o f these items represents a hypersensitivity to gustatory, auditory and
vestibular input for girls, and a underresponsivity to auditory stimuli, overresponsivity to
tactile and visual stimuli, and a seeking o f proprioceptive activities for boys.
Proprioceptive-seeking as a characteristic of boys is consistent with the literature on
rough-and-tumble play. In Pellegrini and Smith’s (1998) review of play, gender
differences emerge in both exercise play (e.g., running, jumping, pushing, pulling,
climbing) and in rough-and-tumble play (e.g., wrestling, kicking). A higher prevalence of
these behaviors are found in boys in the general population. However, in the present study,
these behaviors were only significantly more prevalent when looking at children with
autism, not when looking at children with typical development. Future research should
further explore the possibility of gender differences among disability groups.
Clinical Significance
The present study provides new evidence supporting the criterion-related validity of the
ESP. This should increase therapists confidence in the ESP as an instrument that is
sensitive to sensory-based problem behaviors in children with autism. Sensory based
behaviors are of concern to occupational therapists because they can negatively impact a
child’s ability to participate in meaningful occupations such as grooming, education, and
play.
Many normal everyday activities can cause distress and discord in family life. By
accurately identifying these problematic areas, therapists can begin to work with the family
to alleviate, or at least decrease, some of the problematic responses. To illustrate this
process, take the example of Ryan.1 Ryan is a five year old boy with autism. His mother’s
response to items on the ESP questionnaire indicate that Ryan is hypersensitive to noises.
T n the home, activities such as vacuuming, drying one’s hair, or a toilet flushing are noises
which are particularly upsetting for Ryan, causing him to run away or hold his hands over
his ears.
1 Name has been changed.
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33
Ryan also reacts aversively to many forms of tactile input. He is bothered by the feeling
of new clothes. He dislikes the everyday activities o f brushing his hair and washing his
face. He also avoids “messy” activities like finger paint, mud, sand, glue, glitter, or clay.
In kindergarten, Ryan is probably expected to participant in activities which involved these
mediums. These “messy” activities may overwhelm a him and result in an outburst of
inappropriate behavior. Ryan also dislikes being touched by others. When lining up to go
to recess, or lunch, or gym class, an accidental touch from a fellow classmate may send
him out o f control. These episodes disrupt the class and a certain amount of education is
lost for the day, both for the child, and for the class.
Ryan’s mother also reported an excessive fear o f movement of several items of the
questionnaire. So, when Ryan does go to the playground, he may avoid playing on the
jungle gym, slides, swings or teeter-totter because of poor balance or fear o f these
movement based activities. But these are the activities of his peers. When he avoids them,
he is isolated from his classmates and the chance of socializing with them dwindles even
further.
Knowing Ryan’s sensory difficulties may lead to more positive school experiences. His
teachers, as well as parents, may interpret outbursts of inappropriate behaviors simply as
poor behavior, when many of these behaviors may be expressions o f underlying sensory
based problems. It is possible that for many children with autism, Ryan included, these
episodes of negative behavior may be eliminated or reduced, both through direct
remediation of sensory processing problems, and through preparation for or avoidance of
situations which are likely to bring them on. The occupational therapist can also work with
the teacher and parents to increase their understanding of the child with autism.
Limitations and Suggestions for Future Research
This study had several limitations. The high number of items used in analysis may have
created significant results which were the effect of chance. However, the high significance
of the domain scores increase confidence that there are truly differences between the
children with autism and typically developing children. The full spectrum of Pervasive
Developmental Disorders and the level of functioning of children considered autistic was
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34
not adequately represented. This, and the child’s developmental age or cognitive level,
could have influenced the child’s response to sensory experiences. Also, parents raising
children with autism may be dealing with different amounts of stress which may influence
their perceptions. Parents’ biases regarding stereotyped gender behaviors (e.g., boys are
rougher by nature, girls are neater with activities) may also influence the ways sensory
histories are completed.
The sensory items contained in the ESP may not be exhaustive. Children with autism
may have other areas of atypical sensory processing which are not covered by the existing
items.
More research is needed to determine possible influences on the ESP of stress, cultural
expectations, temperament of the parent, and level of functioning of the child. Future
research on the ESP with larger samples may examine possible gender differences, explore
age differences, and provide a normative sample from which atypical sensory responses
can be inferred. Children with different disorders may perform differently on the ESP, and
more accurate comparisons could be made if they were statistically analyzed in direct
contrast with each other. Additionally, since the ESP is based on parent perceptions, it
would be interesting to see how these perceptions correlate with more observation-based
measures of sensory functioning, and with evidence of physiological functioning o f the
child. For example, tactile hypersensitivity may correspond with greater skin conductance
indicating an increase in arousal following the application of light touch stimuli.
It may be beneficial to see which items or areas of the ESP are strongly linked together.
This would give insight into typical patterns of sensory processing of the clinic population.
Test-retest reliability has not yet been performed to determine if parent perceptions of their
child remain constant over short time periods. Additionally, research is needed to determine
whether or not the ESP is sensitive to changes in parents’ perceptions of sensory-related
behaviors of children over time and whether these perceptions are congruent with
therapists’ assessments of child progress.
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35
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Appendix A
ESP
Evaluation of Sensory Processing
R esearch Version 3
Instructions: Please read each question carefully and answ er each a s
accurately and honestly a s you can. Indicate only one answ er for each
question by checking the appropriate box, using the key below:
A = Always,
O = Often,
S = Som etim es,
R = Rarely,
N = Never,
N/A = Not applicable.
The key is also printed on the first page of the questionnaire.
Please keep in mind that we are trying to find out which of th ese
questions pick up on unusual behaviors, and which o n e s relate to
behaviors that m any children dem onstrate. Your honest answ er,
therefore, is very important to us. None of the questions are intended to
be "trick" questions.
Som etim es parents are not sure when to check "Never" versus "N/A."
The N/A option should only be used if the child h as never been exposed
to the situation in question. For exam ple, for the item "Is your child
bothered by loud background noise such a s construction work nearby or
sounds of m achinery operating?” the N/A response should be checked
only if the child h a s never been exposed to background noises such a s
construction work or m achinery operating. If you are not sure of the
m eaning of a particular item, or if you are unsure of how to answ er it.
please call the primary investigator. Dr. Diane Parham , a t the University
of Southern California, for clarification. S h e can be reached by
telephone a t 213-342-2879.
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4 0
ESP Research Version 3 A ALWAYS
Child’s name O OFTEN
Child’s age years months S SOMETTMIES
Name o f adult completing this form R RARELY
Relationship to child N NEVER
Date N/A NOT
APPLICAIBLE
ITEM
1 A 1 o
1 s R N 1 N/A
Auditory System
i. Is your child bothered by or fearful o f the sound made by a toilet flushing?
2. Does your child startle or become distressed by loud or unexpected sounds?
3. Does your child have trouble understanding what other people mean when
they sav something?
4. Does your child seem to hear sounds that other people tend to not notice?
5. Do you notice your child being bothered by any sounds which occur during
daily life tasks, such as tasks of personal hygiene, dressing, eating, home
making, school work, play/leisure?
6 . Is your child bothered by loud background noise such as construction work
nearbv or sounds of machinery operating?
7. Does your child seem to have trouble remembering what is said to him/her?
S. Is your child bothered by any household or ordinary sounds, such as
squeaky shoes, the vacuum, the blow dryer, dog barlring, etc.?
9. Does your child seem to understand oral directions?
10 Does your child fail to act upon a request to ao something, or fail to
understand directions?
1 1 Does your child respond negatively to loud noises as in running away,
crying, or holding hands over ears?
i
i
12 Is your child distracted by subtle sounds, such as fluorescent light bulbs,
heaters, fans, refrigerators?
1
13 Is your child bothered by the sound o f the vacuum?
14 Is your child bothered by the sound made by certain accessories such as
bracelets and necklaces?
15 Does your child appear to not hear certain sounds?
1 6 Is your child distracted by sounds not normally noticed by other people?
17 Does your child mind the sound of the hairdryer?
;
18 Does your child mind the sound o f squeaky shoes?
19 Is your child frightened of sounds which do not usually convey alarm to
other children the same age?
20 Does your child hear sounds other people don't nonce or have trouble
tuning out certain sounds, such as. a clock or watch ticking?
2! Does your child ask others not to talk or sing or make noise?
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4 1
ITEM A O s R N N/A
22 Does your child appear to make noise for noise's sake?
-
23 Compared to other children the same age does your child seem to under
react to loud noises?
24 Does your child have trouble interpreting the meaning of simple or common
words?
25 Does your child respond negatively or seem bothered by unexpected sounds
or noises, as in running away, crying, or holding hands over ears?
26 Does your child seem confused as to the direction from where sounds are
coming?
27 Does your child have difficulty paying attention when there are other noises
nearby?
28 Is your child easily distracted by irrelevant or background noises such as a
lawn mower outside, children talking in the back o f the room, crinkling
paper, air conditioners, refrigerators, fluorescent lights?
29 Does your child seem too sensitive to sounds?
30 Does your child ask “what?” a lot, or need to have words, especially
directions repeated?
31 Does your child like to sing or dance to music?
Gustatory/ Olfactory System
i. Does your child gag. vomit, or complain of nausea when smelling odors
such as soap, perfume, or cleaning products?
2
Does your child respond to odors that other people do not notice?
3. Does your child complain that foods are too bland or refuse to eat bland
foods?
4. Does your child season his/her food heavily or indicate a desire for heavy
seasoning, such as excessive salt, ketchup, or other spices?
5. As an infant did your child resist eating when new flavors of pureed baby
foods were introduced?
6. Does your child prefer very salty foods?
7. Does your child complain o f being hurt by a taste or a smell?
8. Does your child like unusual combinations o f flavors such as ketchup with
ice cream or salt in orange iuice?
9. Does your child like to taste non-food items such as glue or paint?
10 Does your child gag when smelling food odors such aa cooked broccoli or
garlic?
1 1 Docs your child gag when anticipating an unappealing food such as cooked
spinach?
12 Does your child gag at a sound associated with an unpleasant odor such as
the sound of a can o f cat food being opened
1 3 Does your child prefer to eat spicy foods?
14 Does your child prefer to eat sour foods or candies?
15 Is your child distracted by smells on his/her hands?
.
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42
| ITEM
1 A 1 o 1 s 1 * 1' N I n/a
Proprioception System
i. Does your child grasp objects so tightly that it is difficult to use the object?
2. Does your child tire easily after sitting or lying in the same position for
awhile?
3. Does your child grind his/her teeth?
4. Does your child seem driven to seek activities such as pushing, pulling,
draughts. lifting, and tumping?
S. Does your child climb high into trees, jump off tall walls o r furniture, etc.?
6. Does your child like giving bear hugs?
7. Does your child seem unsure of how for to raise or lower the body during
movement such as sitting down or stepping over an object?
8. Does your child not notice falling?
9. Does your child like to be under heavy blankets, covers or pillows?
10. Does your child tend to break toys?
11. Does your child chew on pens, straws, etc.?
12. Does your child grasp objects so loosely that it is difficult to use the
object?
13. Does your child chew on nonfood objects?
14. Does your child seem to exert too much pressure for the task, for example,
walks heavily, slams doors, or presses too hard when using pencils or
cravons?
15. Does your child jump a lot?
16. Does your child have difficulty playing with animals appropriately, such as
petting them with too much force?
17. Does your child have difficulty positioning hira/herselfin a chair?
18. Does your child frequently hit. bump, and/or push other children?
19. Does your child seem generally weak?
20. Compared with other children the same age. does your child seem to seek
out activities that involve jumping, crashing into things, pushing, pulling or
falling?
21. Does your child like getting bear hugs?
22. Does your child taste or chew on toys, clothes, or other objects more than
other children?
23. Does your child crave hugging or rough playing?
24. Does your child like to chew on hard candy?
25. Does your child have difficulty sitting erect, or choose to lie down instead
of sitting up?
Tactile System
l. Does your child dislike going barefoot, not like to take his/her shoes off or
insist on always wearing shoes?
2
Does it bother your child to play games with bare feet?
3. Is your child irritated by the feel of certain clothing?
4 Does your child pull away from light touch?
5
Does your child seem to lack the normal awareness of being touched?
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43
ITEM A O S R N N/A
6. Docs your child resist or dislike wearing clothing of certain textures? •
7. Does your child react negatively to the feel of new clothes?
8. Does your child tend to prefer to wear long sleeve shirts and long pants
regardless of the weather, for instance prefers to wear long sleeves even
when it is warm outside?
9. Does your child seem excessively ticklish?
10. Does your child like to cuddle up with a blanket or stuffed animal or
special pillow?
11. Does your child enjoy tickling as a form of play?
12. Does your child avoid playing with "messy* things such as finger paint,
mud. sand. glue, glitter, or clay?
13. Does your child show an unusual dislike for naving his/her hair combed,
brushed or styled?
14. Do rough bedsheets bother your child?
IS. Does wearing turtieneck shirts bother your child?
16. Does your child prefer to touch rather than be touched?
17. Does your child seem driven to touch different textures?
18. Does your child prefer to go barefoot?
19. Does your child refuse to wear hats, sunglasses, or other accessories?
20. Does wearing fuzzy shirts bother your child?
21. Does your child dislike wearing pants or complain about the feel of them
brushing against his/her legs?
22. Does your child tend to wear coats or sweaters when they are not needed?
23. Does your child appear to lack the normal awareness of being touched?
24. Does your child prefer the textures of certain clothing?
25. Does your child overreact to minor hquries?
26. Does your child complain about irritating bumps on the bedsheets?
27. Does it bother your child to have his/her finger or toe nails cut?
28. Does your child struggle against being held?
29. Does your child dislike playing games with his/her bare feet?
30. Does your child have a tendency to touch things constantly?
31. Does your child dislike getting his/her hands messy or ask to wash hands
when using things like glue and glitter?
32. Does your child avoid or dislike playing with gritty things?
33. Do tags or collars on clothing bother your child?
34. Does your child demonstrate an aversion to any form of clothing?
35. Does your child prefer certain textures of clothing or particular fabrics?
36. •Does it bother your child to have his/her face touched?
37. Does it bother your child to have his/her face washed?
38. Does your child object to being touched by familiar people?
39. Does it bother your child if he/she can not see who is touching him/her
when among familiar people at home or school?
40. Does the feel o f new clothes bother your child?
41. Does your child resist or dislike wearing short sleeved shirts or short
pants?
42. Does your child seem to lack awareness of being touched by others?
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44
r i m A O s R N N /A
43.
Poes your child ask you to take the tags and libels out o f clothing or only
wear clothes which have had the tags and labels removed?
-
44. Is your child irritated by tags on clothing?
45. Is your child bothered by hair brushing against his/her free?
46. Does your child dislike the feeling o f certain clothing?
47. Does your child have an unusually high tolerance for pain?
48. Does your child demonstrate an excessive need to touch?
49.
Does your child display an unusual need for touching certain textures,
surfaces, objects o r toys?
50.
Does your child startle easily when being touched unexpectedly?
51.
Does wearing fuzzy socks bother your child?
52. Does your child dislike eating messy foods with his/her hands?
-
53. Does your child tend to fed pain less than others?
54. Does it bother your child when a familiar person at home or school is close
ov?
55. Does your child avoid touching different textures?
56. Does your child appear to resist eating certain foods because o f their
texture?
57. Does your child strongly dislike being tickled?
58. Does your child avoid foods o f certain textures?
59. Does your child avoid getting his/her hands in finger paint, paste, sand,
day. mud. glue. etc.?
60. Does your child seek messy play activities?
61 Does it bother your child to have his/her hair cut?
Vestibular System
1. Does your child rock while sitting?
2.
Does your child seem excessively fearful of movement, as in going up and
down stairs or riding swings, teeter totters, slides, or other playground
eauipment?
3. Does your child get nauseous or vomit due to movement experiences?
4. Does your child like to swing?
5. Does your child demonstrate distress when he/she is moved or riding on
moving eauipment?
6. Does your child's head move along with his/her eyes in activities such as
reading, following along with a parent reading or playing a computer
game?
7. Is your child frequently and easily confused about his/her location for
example, gets lost in stores, or cant find the way to a fiuniliar classroom?
8. Does your child have good balance?
9. Does your child have to exert more effort to move than others, tire easily
from exertion and o r require more sleep than others?
10. Does your child avoid balance activities such as walking on curbs or on
uneven ground?
11.
Is your child fearful o f heights, such as escalators, glass elevators, stairs,
etc.?
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
45
ITEM A O S R N N/A
12. Does your child like fast movements, such as being whirled about or
tossed in the air bv an adult?
13. Does your child like to climb very high?
14. Does your child like fast spinning carnival rides, such as merry-go-rounds?
15. Is your child fearful o f activities which require good balance?
16. When your child shifts his/her body does he/she fall out o f his chair?
17. Is your child unable to catch him/herself when falling?
18. Does your child seem to not get dizzy when others usually do?
19. Does your child get car sick?
20. Does your child seem generally weak?
21. Does your child spin and whirl more than other children?
22. Does your child rock himself/herself when stressed?
23. Does your child like to be inverted or tipped upside down or enjoy doing
activities that involve inversion, such as hanging upside down or doing
somersaults?
24. Is your child fearful o f swinging or bouncing, or was fearful of this as an
infirm?
25. Does your child experience discomfort, nausea, or dizziness following
movement, especially rotation?
26. Does your child tend to need movement in order to "get going,* for
example, after waking up from a nao?
27. Does your child dislike sudden or quick movement such as suddenly
stopping or going over a bump while riding in the car?
28. Compared with other children the same age does your child seem to ride
longer or harder on certain playground equipment for example, swing,
merry-go-round?
29. Does your child avoid rapid or spinning movement?
30. Is your child fearful o f activities in which he/she moves through space?
31. Does your child demonstrate distress when his/her head is in any other
position than upright or vertical such as having the head tilted backward or
upside down?
32. Does your child react negatively to. dislike, appear threatened by, or
exhibit a fear reaction to movement?
33. Does your child enjoy excessive spinning and twirling?
Visual System
1. Does your child have trouble telling the difference between printed figures
that appear similar, for example, differentiating b with p. or + • with x?
2. Is your child sensitive to or bothered by light, especially bright light
(blinks, squints, cries, or closes eyes, etc.)?
3. When looking at pictures, does your child focus on patterns or details
instead o f the main pictures?
4. Is your child able to look at something far away?
5. Does your child have difficulty keeping his/her eyes on the task or activity
at hand?
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
46
ITEM A O S R N N/A
6. Does your child have trouble maintaining his/her visual focus on one task
or obiect for very Iona?
7. Does your child rub his/her eyes, complain ofheadaches, or have eyes
which water after reading or looking at books?
8. Does your child have difficulty with visually focusing on things far away?
9. Does your child become easily distracted by visual stimuli?
10. Does your child have trouble locating things laying on top of other things,
especially things of the same color, or have trouble finding an object when
it is amidst a group o f other things?
11. Does your child close one eye and/ortip his/her head back when looking
at something or someone?
12. Does your child have difficulty with unusual visual environments such as a
bright colorful room or a dimlv lit room?
13. Does your child have difficulty with visually focusing on things close?
14. Does your child have difficulty controlling eye movements during activities
such as following objects like a ball with eyes, keeping place while reading,
or copying from blackboard to the desk?
15. Compared to other children the same age does your child seem to be easily
distracted bv visual stimuli?
16. Does your child have trouble following objects with his/her eyes?
17. Does your child have difficulty naming, discriminating, or matching colors,
shapes or sizes?
18. Did your child make reversals in words or letters when writing or copying
or read words backwards (such as reading saw for was) after the first
grade?
19. Does your child lose his/her place on a page while reading, copying,
solving problems, or performing manipulations?
20. In school does your child have difficulty shifting gaze from the board to
the paper when copying from the board?
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
47
Appendix B
C o n s e n t t o P ar t i ci p ate in a St ud y o f
S en so ry Q u e s ti o n n a i r e V al i di t y f or C h i l d ren w i t h A u ti sm
P r in c ip a l In v est i g a t o r; D i a n e P a r h a m , F h . D .
D e p a r tm e n t: O c c u p a ti o n a l S ci en c e a n d O c c u p a ti o n a l T h e r a p y
2 4 -h o u r T elep h o n e N u m b er ( 3 2 3 ) 4 4 2 - 2 8 7 9
Purpose o f Study:
Y o u a r e i nv i t e d t o p art i ci p at e i n a U n i v e r sit y of S ou t h ern C a l i f o rn i a resea rch p r o jec t. I n t h i s p r o je c t,
w e a r e d ev el o p i n g a p aren t q u esti o n n a i re t h a t wi l l b e s e ns i t i v e t o t h e sp eci a l sen sory p ro ce ssi n g
c h a ra cte rist i c s of chi l d ren w i t h au t i sm . W e h o p e t o l e a m w h ic h , i t e ms o n ou r q u e sti o n n a i re p i ck u p
o n t h e spe c i al p r o b l e m s of ch i l d ren wi t h a u t i sm , an d w h i ch i t e ms si m p l y d es cr i b e b e h a v io r s t h a t a re
ty p i ca l of m ost n o rm a l l y d e v el o p i n g c h i l d r e n . T h i s wi l l e ve nt ual l y l e a d t o a short er a n d m o r e
ef f i ci e n t q u est i on n ai re t h a t can b e u s ed b y p m f i i eti n n a l s w o rk i n g wi t h ch i l d re n - T h e i t em s h a v e
a lr e a d y bee n eval u at ed f or t he i r re l e v a n c e t o s eve n sen sory ca t eg o r i e s : a u d i t o ry (h e a r i n g ), g u st a t o ry
( t ast e) , o l fa c to r y ( s m e l l ) , p r o p r io c e p ti o n ( s ense o f m u scle co n t ra ct i on a n d b o d y p osi t i on ) , t ac t i l e
(to u c h ), ve s t i bul ar ( aw aren ess of h ea d m o v e m e n t a n d . gravi t at i on al f ar ce s) , an d v is u a L
Y o u a r e i nv i t e d a s a p os s i bl e p a rti cip a n t i n t h i s s t udy b ec a u se e i t h e r ( 1) y o u r c h i l d has re ce i v ed a
d ie g u n in e of a u t i sm or p erv a si v e d e v e lo p m e n ta l d i so rd er fro m a psyc hi at ri s t or p sy ch o l o g i st , a n d is
a g e d b etw een 2 ye ar s 6 m o n th s t h r o u g h 8 y ea rs 1 1 m o n th s Q R ( 2) y o u r c hi l d is b etw een 2 y e a r a 6
m o n th s th r o u g h . 8 ye ar s 1 1 m o n th s of a g e ; h as n o hi s t or y of di s a bi l i t y , d e v e l o p m e n ta l d elay , o r
le a r n i n g or b e h a v i o r p r o b l e m s ; a n d is i n g o o d he al t h.
P r o c e d u r e :
If y o u d e c i d e to p art i ci p at e, p l eas e fill o u t t h e att ac h ed q u est i o n n a i re a n d m ai l it i n t he e n c l o se d
s ta m p e d a n d a d d r e sa e d en ve l o p e. 'D ie q u esti o n n a i re as ks 2 00 q u es t i on s r e l a t e d t o ch i l d b e h a v i o r s
t h a t a r e r e l at e d t o d i f f er ent t ype s of se n so ry p ro ce ssi n g . R e m e m b e r , t h e s e b eh a v i o rs d o n o t
n ec essa ri l y i n d i ca t e p r o b l e m s ; w e a r e t ryi n g t o f i nd out w h i ch o n e s o f t e n o c c u r in t he d e v e lo p m e n t
o f t y p i ca l ch i l d ren , a n d w h i c h o n es se em t o o c c u r p ri m a ri l y i n chi l d re n w i t h aut i s m , b u t n o t in o th e r
c h ild r e n . Y o u w i l l hel p u s t o d i sc o v e r t h i s if y o u a re a s hone s t a s p os s i bl e i n a n sw eri n g t he
q u e sti o n s. T h e q u est i o n n a i re s h o u l d t ak e a b o u t 30 — t o co m p l ete.
Risks-
T h e r e a r e n o r i s k s ass oci at ed w i t h f i l l i n g ou t t h e q u est i on n ai re, o t he r t han t h e i n c o n v e n ie n c e
in v o lv e d in t aki ng t h e t i m e t o c o m p l e te it. Y o u r c hi l d w i l l not b e ex a m i n ed or o b se r v e d i n an y w a y a s
p a r t o f t h i s st u d y .
Benefits:
Y o u m a y rec ei ve n o p erso n a l bene f i t s f r o m p a rti c ip a t i o n in t h i s st ud y. H o w e v e r , it is p ossi b l e t hat
i n f i l l i n g ou t t he q u esti o n n a i re y o u gai n n e w i ns i g ht s a b o u t y o u r c hi l d. A l th o u g h y o u r ch i l d m a y n ot
b e n e fi t p erson al l y f r o m y o u r p a rti ci p a t i o n i n t he st u d y, t h e k n o w l ed g e gai ned m a y h e l p us l e a m
m o r e a b o u t h o w sen so ry p ro cessi n g af f ects b e h a v io r in t he da i l y li v e s of chi l d ren w i t h au ti sm , as
w ell a s ch i l d ren w h o a re t yp i cal l y d e v e lo p in g : T h i s k n o w l e d g e w i l l he l p u s d o a b et t er jo b o f
i d en t i fy i n g an d hel p i n g ch i l d ren w h o h a v e u n u su a l senso ry ch aracteri s t i cs .
Revised 1/99
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
48
A l t e r n a ti v e t o P arti ci p a t i on :
Y o u a r e f r e e t o ch o o se n o t t o part i ci pat e in f i l l i n g out t h e q u es t i on n ai re .
C o n f i d en t i al i t y flh r tflm ftn t;
A n y i n f orm at i on t h a t is o bt ai ne d i n co n n ecti o n w i th , t h i s s t udy an d t h a t c an be i dent i f i e d w i t h you
o r y o u r c hi l d w i l l rem a i n s t r i c t l y con f i d ent i al . B e s u l t s of t his s t ud y m ay b e pre s ent ed a t pr of e s s i onal
c o n fer e n c e s an d in publ i cat i ons , b u t t h e par t i c i pat i ng ch i l d ren a n d pa re n t s w i l l n o t b e n a m ed o r
o th e r w i se i de nt i f i a b l e .
Offer to Answer Questions:
If y o u hav e a ny q ue s t i o ns re lati n g t o t he st u d y, pl e a s e feel f r e e t o contact t h e P ri n ci p a l I nve s t i gat or
at t he 2 4 - h o u r t e l e ph one n u m b er l i s t e d on t h e f i r s t p a g e of t hi s f or m . If you h a v e a n y qu es t i ons
r e g a r d i n g yo ur r i g h t s a s a s t ud y su b j ect, you m a y c o n ta c t t h e I n s t i t u t i o n a l R ev i ew B o a r d O ffi c e a t
3 2 3 - 2 2 3 - 2 3 4 0 . E n cl osed is a c o p y of t h i s fo r m f o r you t o kee p.
C o e r c io n a n d W i th d r a w a l S t at em ent :
Y o u r de c i s i on w h et h er or no t t o p a rt i ci p a t e wi l l n o t i n t erf ere w i t h y o u r f u t u re ca r e in t h i s f a c i l i t y . If
y o u d e c i d e t o part i c i pat e , y o u a re f r e e t o w i th d r a w y o u r c ons e nt and t o riiiwi t i m i n p art i ci p at i on a t
a n y t i m e.
Tnnirv Statainant-
I f y o u o r yo ur c hi l d req u i re m e d i c a l t reat m en t a s a r e s u l t of i n j u ry d u ri n g y ou r p a rti ci p a t i o n in th i n
s tu d y , t h e f i nanci al r e s po ns i bi l i t y f o r su c h ca re w i l l b e y o u r s.
California Law require* that you must be infnranad a h m w -
1 . T h e n at ure an d p u rp o se of t h e st u d y .
2 . T h e p ro ced u res i n t h e s t udy an d an y d r u g or d ev i ce t o b e u s e d .
3 . D isc o m fo r ts an d r i s ks t o b e expect ed fr o m t h e stu d y .
4 . B en ef i t s t o b e expect ed fro m t he stu d y .
5 . A l t ern a ti v e p ro c e d u r e s, d r u g B or d ev i ces t h a t m i g h t b e h e l p f u l an d t h e i r r i s k s a n d b en ef i t s.
6. Availability of m e d i c a l t r e at m ent sh o u l d co m p l i ca ti o n s o c c u r .
7 . T h e o p p o r tu n i t y t o a s k ques t i ons a b o u t t h e s t udy o r t h e p r o c e d u r e .
8 . T h e o p p ortun i t y to w i t h d ra w a t a n y t i m e w i t h ou t af f ect i n g you r f u t u re ca re a t t h i a i ns t i t ut i on .
9. A c o p y of t h e w r i t t e n co ns e nt fr o m f o r t he st u d y .
1 0 . T h e op p ort u n i t y to c ons e nt f r e e l y t o t h e s t udy w i t h o u t t h e u s e of c o e r c io n .
1 1 . St at e m ent reg a rd i n g l i a b i l i t y f o r p hysi cal i n j u ry , if a p p l i cab l e.
Revised 1/99
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
49
A g r p g n w TitT
Y O U R S I G N A T U R E I N D I C A T E S T H A T Y O U H A V E D E C I D E D T O P A R T I C I P A T E , H A V I N G
R E A D T H E I N F O R M A T I O N P R O V I D E D A B O V E .
S i gn at u re of P a ren t D at e
S i gn at u re of w i t ne s s ~ D at e
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ch e e k o n e : [ ] au t i sm
C h i l d ' s n a m e ' [ ] t ypi cal d e v e lo p m e n t
C h i l d 's b i rth d a te: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ch e c k o n e : [ ] b o y
[ I gi r l
S i gn at u re of r ese a r ch er
Form Valid For Enrollment From
J A N 2 1 B 9 9 Tft Q E C 1 6 S99
Institutional Review Board
Revised 1/99
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
50
Appendix C
ESP Participant Information Sheet
C hild’s Name: _________________________
Sex: ____________________
E th n icity :_______________
D ate o f B irth :_____________
M edical Condition or D iagnosis (if a n y ):__________________
Nam e o f person com pleting form : ________________________
Relationship to child: _____________________
Address: ______________________________
Phone N um ber:__________________________
(All answers and inform ation you provide will be kept confidential. You will only be
contacted to clarify your responses if questions arise from the com pleted ESP.)
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
51
Appendix D
R esults o f Item A nalysis and Frequency D istribution
Auditory Domain
Item # p value G roup n A O S R N
1* 0.049 Typical 41 0 .0 % 2.4% 7 3 % 2.4% 87.8%
A utism 41 2.4% 7 3 % 7 3 % 9.8% 73.2%
2* 0 .024 Typical 41 0 .0 % 2.4% 24.4% 48.8% 24.4%
A utism 40 12.5% 12.5% 30.0% 17.5% 27.5%
3* 0.000 Typical 41 2.4% 0 .0 % 22 .0% 41.5% 34.1%
A utism 40 17.5% 27.5% 40.0% 12.5% 2.5%
4 0.097 Typical 41 0 .0 % 2.4% 22 .0 % 34.1% 41.5%
Autism 41 7.3% 14.6% 22.0 % 14.6% 41.5%
5* 0.002 Typical 41 0 .0% 0 .0 % 2.4% 22 .0 % 75.6%
A utism 41 0 .0 % 7 3 % 22 .0 % 2 2 .0 % 48.8%
6 0.169 Typical 41 4.9% 0 .0 % 14.6% 39.0% 41.5%
Autism 41 12.2% 7.3% 17.1% 22 .0 % 41.5%
7* 0.000 Typical 41 0 .0 % 2.4% 12.2 % 43.9% 41.5%
A utism 41 12.2% 29.3% 22 .0 % 22 .0% 14.6%
8 * 0.000 Typical 41 2.4% 4.9% 7.3% 19.5% 65.9%
Autism 41 12.2% 9.8% 31.7% 22 .0 % 24.4%
9 *
0.000 Typical 41 56.1% 39.0% 4.9% 0 .0 % 0 .0 %
A utism 41 7 3 % 41.5% 41.5% 4.9% 4.9%
10* 0.000 Typical 41 0 .0 % 4.9% 31.7% 53.7% 9.8%
A utism 41 9.8% 36.6% 43.9% 9.8% 0 .0 %
11* 0.005 Typical 40 0 .0 % 7.5% 15.0% 17.5% 60.0%
A utism 41 12.2% 9.8% 22 .0 % 22 .0 % 34.1%
12* 0.000 Typical 41 0 .0 % 2.4% 0 .0 % 7.3% 90.2%
Autism 40 2.5% 10.0% 22.5% 15.0% 50.0%
13* 0.001 Typical 41 4.9% 7 3 % 4.9% 9.8% 73.2%
A utism 41 12.2% 17.1% 17.1% 17.1% 36.6%
N ote. Ns differ from 41 due to m issing data. A = Always; O = O ften; S = Som etim es;
R = Rarely; N = N ever. N um bers in the “A ,0,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
52
Auditory Domain (continued)
Item # p value G roup n A O S R N
14 0.112 Typical 41 0 .0 % 0 .0 % 0 .0 % 4.9% 95.1%
Autism 41 0 .0 % 2.4% 2.4% 7.3% 87.8%
15* 0.000 Typical 41 0 .0 % 0 .0 % 7.3% 17.1% 75.6%
Autism 40 5.0% 17.5% 30.0% 15.0% 32.5%
16* 0.001 Typical 41 0 .0 % 2.4% 4.9% 9.8% 82 9%
A utism 40 5.0% 17.5% 30.0% 15.0% 32.5%
17* 0.002 Typical 41 0 .0 % 4.9% 4.9% 12.2 % 78.0%
Autism 41 9.8% 7 3 % 19.5% 14.6% 48.8%
18 0 3 1 6 Typical 41 0 .0 % 0 .0 % 0 .0 % 7 3 % 92.7%
A utism 41 0 .0 % 2.4% 4.9% 2.4% 90.2%
19* 0.000 Typical 41 0 .0 % 0 .0 % 2.4% 2.4% 95.1%
Autism 40 5.0% 10.0% 22.5% 15.0% 47.5%
20* 0.003 Typical 41 0 .0 % 0 .0 % 0 .0 % 17.1% 82.9%
A utism 39 5.1% 5.1% 17.9% 12.8 % 59.0%
21 0.281 Typical 41 0 .0 % 9.8% 36.6% 26.8% 26.8%
Autism 41 7 3 % 17.1% 31.7% 4.9% 39.0%
22* 0.008 Typical 41 0 .0 % 9.8% 58.5% 19.5% 12.2 %
Autism 41 17.1% 24.4% 34.1% 12.2% 12.2%
23* 0.001 Typical 41 0 .0 % 0 .0 % 4.9% 31.7% 63.4%
A utism 41 2.4% 9.8% 26.8% 26.8% 34.1%
24* 0.000 Typical 41 0 .0 % 0 .0 % 2.4% 19.5% 78.0%
A utism 40 12.5% 30.0% 27.5% 20 .0 % 10.0 %
25* 0 .004 Typical 41 2.4% 4.9% 9.8% 22 .0 % 61.0%
Autism 40 10.0% 7.5% 27.5% 20.0 % 35.0%
26* 0.001 Typical 41 0 .0 % 0 .0 % 0 .0 % 41.5% 58.5%
A utism 39 0 .0 % 5.1% 28.2% 33.3% 33.3%
27* 0.000 Typical 41 0 .0 % 0 .0 % 14.6% 56.1% 29.3%
Autism 41 9.8% 24.4% 39.0% 19.5% 7.3%
N ote. Ns differ from 41 due to m issing data. A = Always; O = O ften; S = Som etim es;
R = Rarely; N = N ever. N um bers in the “A ,0,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p :£ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
53
Auditory Domain (continued)
Item # p value G roup n A O S R N
28* 0.000 Typical 41 0 .0 % 0 .0 % 4.9% 34.1% 61.0%
Autism 41 7.3% 12.2% 26.8% 29.3% 24.4%
29* 0.000 Typical 41 2.4% 4.9% 2.4% 29.3% 61.0%
Autism 40 1 3 % 15.0% 15.0% 45.0% 17.5%
30* 0.027 Typical 41 0 .0 % 7 3 % 9.8% 56.1% 26.8%
Autism 41 7 3 % 22.0% 26.8% 9.8% 34.1%
31* 0.001 Typical 41 36.6% 46.3% 12.2% 4.9% 0 .0 %
Autism 40 20.0 % 25.0% 32.5% 17.5% 5.0%
N ote. Ns differ from 41 due to m issing data. A = Always; O = O ften; S = Som etim es;
R = Rarely; N = N ever. N um bers in the “A ,0,S,R ,N ” column indicate frequency
distribution percentages.
*p < . .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
54
Gustatory/Olfactory Domain
Item # p value G roup n A o S R N
I* 0.046 Typical 41 0 .0 % 0 .0 % 4.9% 7 3 % 87.8%
Autism 41 0 .0 % 2.4% 9.8% 14.6% 73.2%
2 0.259 Typical 41 0 .0 % 2.4% 9.8% 12.2 % 75.6%
Autism 40 2.5% 7.5% 5.0% 15.0% 70.0%
3* 0.031 Typical 41 0 .0 % 0 .0 % 2.4% 26.8% 70.7%
Autism 40 2.5% 7.5% 17.5% 15.0% 57.5%
4 0.287 Typical 41 2.4% 4.9% 12.2% 24.4% 56.1%
Autism 40 2.5% 15.0% 5.0% 10.0 % 67.5%
5 0.080 Typical 41 2.4% 4.9% 22.0% 39.0% 31.7%
Autism 40 5.0% 20.0 % 20.0 % 27.5% 27.5%
6* 0.027 Typical 40 0 .0 % 10.0% 10.0% 35.0% 45.0%
Autism 40 2.5% 22.5% 27.5% 10.0 % 37.5%
7 0.244 Typical 41 0 .0 % 0 .0 % 0 .0 % 12.2 % 87.8%
Autism 41 0 .0 % 4.9% 0 .0 % 12.2 % 82.9%
8 0.351 Typical 41 0.0 % 0 .0 % 2.4% 17.1% 80.5%
Autism 41 2.4% 2.4% 4.9% 4.9% 85.4%
9*
0.003 Typical 41 0 .0 % 0 .0 % 0 .0 % 9.8% 90.2%
Autism 41 2.4% 9.8% 7 3 % 14.6% 65.9%
10 0.166 Typical 41 0 .0 % 0 .0 % 2.4% 7.3% 90.2%
Autism 41 0 .0 % 0 .0% 4.9% 12.2 % 82.9%
11* 0.006 Typical 41 0 .0 % 0 .0% 7.3% 4.9% 87.8%
Autism 40 7.5% 5.0% 12.5% 10.0 % 65.0%
12 0 3 4 2 Typical 41 0 .0 % 0 .0 % 2.4% 4.9% 92.7%
Autism 40 0.0 % 2.5% 2 3 % 7.5% 95.0%
N ote. Ns differ from 41 due to m issing data. A = Always; O = Often; S = Som etim es;
R = Rarely; N = Never. N um bers in the “A ,0,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T e st
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
55
Gustatory/OIfactoiy Domain (continued)
Item # p value G roup n A O S R N
13 0 3 5 4 Typical 41 0 .0 % 7 3 % 22 .0% 19.5% 51.2%
A utism 40 0 .0 % 10.0 % 17.5% 15.0% 57.5%
14 0.269 Typical 41 2.4% 12.2 % 39.0% 17.1% 29.3%
A utism 39 12.8 % 17.9% 20.5% 17.9% 30.8%
15* 0.051 Typical 41 0 .0 % 2.4% 7 3 % 26.8% 63.4%
A utism 41 4.9% 7.3% 17.1% 19.5% 51.2%
N ote. Ns differ from 41 due to m issing data. A = A lw ays; O = Often; S = Som etim es;
R = Rarely; N = N ever. Num bers in the “A ,O .S,R,N ” colum n indicate frequency
distribution percentages.
*p < , .05, M ann-W hitney U Test
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
56
Proprioceptive Domain
Item # p value G roup n A O S R N
1* 0.000 Typical 41 0 .0 % 0 .0 % 2.4% 193% 78.0%
A utism 39 2 .6 % 12.8% 25.6% 30.8% 28.2%
2 * 0.002 Typical 41 0 .0 % 4.9% 4.9% 29.3% 61.0%
A utism 41 2.4% 9.8% 19.5% 36.6% 31.7%
3* 0.007 Typical 41 0 .0 % 4.9% 19.5% 22 .0% 53.7%
A utism 40 10.0 % 10.0 % 32.5% 12.5% 35.0%
4 *
0.003 Typical 41 7.3% 17.1% 34.1% 24.4% 17.1%
Autism 40 22.5% 32.5% 22.5% 17.5% 5.0%
5 0.061 Typical 41 9.8% 9.8% 36.6% 22.0 % 22.0 %
A utism 40 25.0% 27.5% 10.0 % 10.0 % 27.5%
6 0.306 Typical 41 17.1% 26.8% 36.6% 17.1% 2.4%
A utism 41 12.2 % 34.1% 24.4% 24.4% 4.9%
7* 0.000 Typical 41 0 .0 % 0 .0 % 2.4% 31.7% 65.9%
A utism 41 4.9% 12.2 % 22 .0 % 17.1% 43.9%
8* 0.001 Typical 40 0 .0 % 0 .0 % 5.0% 25.0% 70.0%
Autism 41 4.9% 12.2 % 22.0 % 17.1% 43.9%
9 0.068 Typical 41 7 3 % 9.8% 34.1% 22.0 % 26.8%
A utism 41 12.2 % 24.4% 26.8% 14.6% 22.0 %
10* 0.002 Typical 41 0 .0 % 0 .0 % 17.1% 46.3% 36.6%
A utism 40 5.0% 12.5% 25.0% 40.0% 17.5%
11* 0.008 Typical 41 2.4% 7.3% 17.1% 26.8% 46.3%
A utism 40 12.5% 10.0 % 32.5% 17.5% 27.5%
12* 0.000 Typical 40 0 .0 % 0 .0 % 0 .0 % 15.0% 85.0%
Autism 39 0 .0 % 7.7% 17.9% 35.9% 38.5%
13* 0.001 Typical 40 0 .0 % 5.0% 17.5% 35.0% 42.5%
A utism 41 12.2 % 19.5% 22 .0% 24.4% 22.0%
14* 0.000 Typical 41 0 .0 % 0 .0 % 7 3 % 41.5% 51.2%
A utism 41 7 3 % £L43? 24.4% 22.0 % 22.0 %
N ote. Ns differ from 41 due to m issing data. A = Always; O = Often; S = Som etim es;
R = Rarely; N = N ever. N um bers in the “A ,0,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
57
Proprioceptive Domain (continued)
Ite m # p value Group n A O S R N
15* 0.008 Typical 41 4.9% 22 .0 % 26.8% 36.6% 9.8%
Autism 41 31.7% 17.1% 24.4% 17.1% 9.8%
16* 0.001 Typical 41 0 .0 % 0 .0 % 12.2 % 26.8% 61.0%
Autism 41 9.8% 17.1% 22.0 % 17.1% 34.1%
17* 0.001 Typical 41 0 .0 % 0 .0 % 14.6% 22 .0 % 63.4%
Autism 41 7 3 % 9.8% 22.0% 26.8% 34.1%
18* 0.001 Typical 41 0 .0 % 0 .0 % 9.8% 51.2% 39.0%
Autism 41 2.4% 17.1% 22.0 % 41.5% 17.1%
19* 0.016 Typical 41 0 .0 % 0 .0 % 0 .0 % 19.5% 80.5%
Autism 40 5.0% 7.5% 7.5% 17.5% 62.5%
20* 0.000 Typical 41 2.4% 12.2 % 19.5% 39.0% 26.8%
Autism 40 17.5% 37.5% 20.0 % 12.5% 12.5%
21 0.234 Typical 41 26.8% 24.4% 29.3% 12.2% 7.3%
Autism 41 24.4% 36.6% 2 9 3 % 7 3 % 2.4%
22* 0.000 Typical 41 0 .0 % 0 .0 % 4.9% 26.8% 68.3%
Autism 41 12.2% 24.4% 7 3 % 24.4% 31.7%
23* 0.000 Typical 41 7 3 % 12.2 % 31.7% 26.8% 22.0%
Autism 41 19.5% 26.8% 43.9% 9.8% 0 .0 %
24 0.092 Typical 41 4.9% 17.1% 31.7% 17.1% 29.3%
Autism 41 4.9% 7.3% 29.3% 17.1% 41.5%
25* 0.012 Typical 41 0 .0 % 0 .0 % 7.3% 31.7% 61.0%
Autism 41 4.9% 17.1% 14.6% 17.1% 46.3%
N ote. Ns differ from 41 due to m issing data. A = A lways; O = Often; S = Sometimes;
R = Rarely; N = N ever. Numbers in the “A ,0,S ,R ,N " column indicate frequency
distribution percentages.
*p s .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
58
Tactfle Domain
Ite m # p value G roup n A O S R N
1 0.125 Typical 41 0 .0 % 2.4% 2.4% 26.8% 68.3%
Autism 41 2.4% 4.9% 0 .0 % 36.6% 56.1%
2 0.117 Typical 41 0 .0 % 2.4% 2.4% 29.3% 65.9%
Autism 41 0 .0 % 4.9% 4.9% 36.6% 53.7%
3* 0.032 Typical 41 0 .0 % 2.4% 31.7% 34.1% 31.7%
Autism 41 9.8% 12.2% 31.7% 19.5% 26.8%
4*
0.000 Typical 41 2.4% 0 .0 % 4.9% 14.6% 78.0%
Autism 41 12.2 % 7 3 % 26.8% 17.1% 36.6%
5* 0.001 Typical 41 0 .0 % 0 .0 % 0 .0 % 12.2 % 87.8%
Autism 41 2.4% 14.6% 9.8% 17.1% 56.1%
6 0.067 Typical 41 0 .0 % 0 .0 % 26.8% 39.0% 34.1%
Autism 41 12.2 % 7 3 % 22 .0 % 2 9 3 % 29.3%
7* 0.042 Typical 41 0 .0 % 0 .0 % 14.6% 34.1% 51.2%
Autism 41 7.3% 12.2% 14.6% 24.4% 41.5%
8 0.312 Typical 41 0 .0 % 0 .0 % 4.9% 14.6% 80.5%
Autism 41 4.9% 0 .0 % 9.8% 7 3 % 78.0%
9 0.089 Typical 41 4.9% 4.9% 9.8% 24.4% 56.1%
Autism 40 5.0% 10.0 % 17.5% 25.0% 42.5%
10 0.496 Typical 41 9.8% 31.7% 39.0% 12.2% 7.3%
Autism 41 19.5% 24.4% 2 9 3 % 9.8% 17.1%
11* 0.002 Typical 41 14.6% 26.8% 56.1% 2.4% 0 .0 %
Autism 41 29.3% 48.8% 17.1% 0 .0 % 4.9%
12* 0.000 Typical 41 0 .0 % 2.4% 7 3 % 26.8% 63.4%
Autism 40 10.0 % 27.5% 22.5% 25.0% 15.0%
13* 0.000 Typical 41 0 .0 % 9.8% 9.8% 36.6% 43.9%
Autism 40 20.0% 17.5% 27.5% 20.0 % 15.0%
N ote. N s differ from 41 due to m issing data. A = Always; O = O ften; S = Som etim es;
R = R arely; N = Never. N um bers in the “A ,0,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T e st
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
59
Tactile Domain (continued)
Item # p value Group n A o S R N
14 0.189 Typical 41 0 .0 % 0 .0 % 4.9% 19.5% 75.6%
Autism 41 7.3% 4.9% 7.3% 9.8% 70.7%
15 0.102 Typical 41 1 3 % 2.4% 22.0 % 19.5% 48.8%
Autism 40 1 3 % 10.0 % 5.0% 10.0 % 67.5%
16* 0.001 Typical 40 2.5% 5.0% 15.0% 20.0 % 57.5%
Autism 40 5.0% 25.0% 27.5% 17.5% 25.0%
17* 0.025 Typical 41 0 .0 % 9.8% 24.4% 22.0 % 43.9%
Autism 41 12.2 % 17.1% 19.5% 22.0 % 2 9 3 %
18 0.133 Typical 41 1 3 % 29.3% 36.6% 22 .0% 4.9%
Autism 41 19.5% 24.4% 39.0% 7.3% 9.8%
19* 0.000 Typical 41 0 .0 % 14.6% 22.0 % 31.7% 31.7%
Autism 41 22 .0 % 29.3% 36.6% 2.4% 9.8%
20 0.311 Typical 40 0 .0 % 0 .0 % 12.5% 25.0% 62.5%
Autism 40 10.0 % 2.5% 5.0% 10.0% 72.5%
21 0.108 Typical 41 0 .0 % 2.4% 1 3 % 19.5% 70.7%
Autism 41 4.9% 9.8% 1 3 % 17.1% 61.0%
22 0.312 Typical
Autism
41
40
0 .0 %
0 .0 %
0 .0 %
2.5%
1 3 %
12.5%
14.6%
10.0%
78.0%
75.0%
23* 0.000 Typical 40 0 .0 % 0 .0 % 0 .0 % 5.0% 95.0%
Autism 40 2.5% 5.0% 17.5% 22.5% 52.5%
24 0.330 Typical 41 4.9% 0 .0 % 43.9% 17.1% 34.1%
Autism 39 10.3% 12.8 % 20.5% 23.1% 33.3%
25 0.062 Typical 41 4.9% 4.9% 19.5% 46.3% 24.4%
Autism 41 1 3 % 2.4% 19.5% 19.5% 51.2%
26 0.230 Typical 41 0 .0 % 0 .0 % 0 .0 % 12.2 % 87.8%
Autism 41 0 .0 % 0 .0 % 0 .0 % 7.3% 92.7%
N ote. Ns differ from 41 due to m issing data. A = Always; O = O ften; S = Som etim es;
R = Rarely; N = Never. N um bers in the “A ,0 ,S ,R ,N ” column indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
60
Tactile Domain (continued)
Item # p value G roup n A o S R N
27* 0.003 Typical 41 4.9% 4.9% 24.4% 34.1% 31.7%
Autism 41 26.8% 7 3 % 34.1% 7.3% 24.4%
28* 0.000 Typical 41 0 .0 % 2.4% 17.1% 31.7% 48.8%
Autism 41 4.9% 26.8% 31.7% 22 .0 % 14.6%
29* 0 .024 Typical 41 0 .0 % 0 .0 % 2.4% 36.6% 61.0%
Autism 40 0 .0 % 7.5% 20.0% 25.0% 47.5%
30* 0.001 Typical 41 2.4% 4.9% 22.0% 29.3% 41.5%
Autism 40 22.5% 15.0% 22.5% 20 .0 % 20.0%
31* 0.000 Typical 41 2.4% 0 .0 % 22 .0 % 34.1% 41.5%
Autism 41 14.6% 24.4% 26.8% 19.5% 14.6%
32* 0.001 Typical 41 0 .0 % 0 .0 % 2.4% 43.9% 53.7%
Autism 40 5.0% 15.0% 22.5% 25.0% 32.5%
33 0 3 8 9 Typical 41 7 3 % 19.5% 36.6% 22 .0 % 14.6%
Autism 40 5.0% 15.0% 22.5% 25.0% 32.5%
34 0.084 Typical 41 0 .0 % 2.4% 26.8% 29.3% 41.5%
Autism 40 7.5% 15.0% 15.0% 30.0% 32.5%
35 0.330 Typical 41 2.4% 4.9% 26.8% 29.3% 36.6%
Autism 41 12.2 % 12.2% 17.1% 14.6% 43.9%
36* 0.000 Typical 41 0 .0 % 0 .0 % 4.9% 48.8% 46.3%
Autism 41 4.9% 22.0 % 26.8% 22 .0% 24.4%
37* 0.000 Typical 41 0 .0 % 4.9% 34.1% 31.7% 29.3%
Autism 40 22.5% 35.0% 17.5% 15.0% 10.0 %
38* 0.001 Typical 41 0 .0 % 0 .0 % 4.9% 43.9% 51.2%
Autism 41 0 .0 % 12.2% 29.3% 31.7% 26.8%
39* 0.001 Typical 40 0 .0 % 0 .0 % 5.0% 27.5% 67.5%
Autism 41 4.9% 14.6% 19.5% 19.5% 41.5%
N ote. Ns differ from 41 due to m issing data. A = Always; O = Often; S = Som etim es;
R = Rarely; N = N ever. N um bers in the “A ,0,S,R ,N ” column indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
61
Tactile D om ain (continued)
Item # p value Group n A O S R N
40* 0.049 Typical 41 0 .0% 0 .0 % 14.6% 24.4% 61.0%
Autism 41 4.9% 2.4% 22 .0 % 24.4% 4 6 3 %
41 0.111 Typical 41 0 .0 % 0 .0 % 0 .0 % 14.6% 85.4%
Autism 41 2.4% 0 .0 % 4.9% 17.1% 75.6%
42* 0.001 Typical 41 0 .0 % 0 .0 % 0 .0 % 12.2 % 87.8%
Autism 41 0 .0% 2.4% 17.1% 24.4% 56.1%
43 0.118 Typical 41 4.9% 7 3 % 36.6% 22.0 % 29.3%
Autism 40 12.5% 7.5% 10.0% 25.0% 45.0%
44 0.190 Typical 41 1 3 % 12.2% 36.6% 26.8% 17.1%
Autism 40 15.0% 5.0% 25.0% 25.0% 30.0%
45 0.154 Typical 41 0 .0 % 4.9% 0 .0 % 48.8% 46.3%
Autism 40 10.0% 5.0% 10.0 % 30.0% 45.0%
46 0.378 Typical 41 0 .0% 0 .0 % 31.7% 36.6% 31.7%
Autism 40 10.0% 7.5% 22.5% 17.5% 42.5%
47* 0.002 Typical 41 2.4% 0 .0 % 12.2 % 48.8% 36.6%
Autism 40 15.0% 1 3 % 25.0% 32.5% 20.0%
48* 0.000 Typical 41 0 .0 % 1 3 % 7.3% 41.5% 43.9%
Autism 40 10.0% 17.5% 35.0% 17.5% 20.0%
49* 0.000 Typical 41 0 .0% 0 .0 % 9.8% 26.8% 63.4%
Autism 41 19.5% 9.8% 34.1% 9.8% 26.8%
50* 0.002 Typical 41 0 .0 % 0 .0 % 14.6% 39.0% 46.3%
Autism 40 5.0% 12.5% 2 0 .0% 40.0% 22.5%
51 0.219 Typical 41 0 .0 % 0 .0 % 4.9% 17.1% 78.0%
Autism 40 5.0% 7.5% 0 .0 % 15.0% 72.5%
52* 0.010 Typical 41 4.9% 1 3 % 9.8% 34.1% 43.9%
Autism 40 12.5% 17.5% 20 .0 % 22.5% 27.5%
N ote. Ns differ from 41 due to m issing data. A = Alw ays; O = O ften; S = Sometimes;
R = Rarely; N = Never. N um bers in the “A ,0,S,R ,N ” colum n indicate frequency
distribution percentages.
*p s .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
62
Tactile Domain (continued)
Item # p value G roup n A O S R N
53* 0.000 Typical 41 0 .0 % 2.4% 2.4% 29.3% 65.9%
Autism 39 12.8 % 15.4% 20.5% 25.6% 25.6%
54* 0.000 Typical 41 0 .0 % 0 .0 % 2.4% 14.6% 82.9%
Autism 41 2.4% 7 3 % 24.4% 2 9 3 % 36.6%
55* 0.000 Typical 41 0 .0 % 0 .0 % 4.9% 29.3% 65.9%
A utism 41 4.9% 9.8% 22 .0% 31.7% 31.7%
56* 0.006 Typical 41 2.4% 4.9% 36.6% 22.0 % 34.1%
Autism 41 22.0 % 14.6% 22.0% 24.4% 17.1%
57 0.058 Typical 41 0 .0 % 0 .0 % 2.4% 41.5% 56.1%
A utism 41 2.4% 2.4% 2.4% 17.1% 75.6%
58* 0.003 Typical 41 2.4% 4.9% 31.7% 24.4% 36.6%
Autism 41 22.0 % 12.2% 24.4% 24.4% 17.1%
59* 0.000 Typical 41 0 .0 % 0 .0 % 9.8% 22.0 % 68.3%
A utism 41 7.3% 19.5% 19.5% 31.7% 22.0%
60 0.096 Typical 41 2.4% 17.1% 46.3% 26.8% 7.3%
Autism 40 15.0% 5.0% 22.5% 45.0% 12.5%
61* 0.000 Typical 41 4.9% 2.4% 12.2% 24.4% 56.1%
Autism 41 36.6% 24.4% 17.1% 14.6% 7.3%
N ote. Ns differ from 41 due to m issing data. A = A lw ays; O = O ften; S = Som etim es;
R = Rarely; N = N ever. N um bers in the “A ,0,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
63
Vestibular Domain
Item # p value G roup n A O S R N
1 0 3 8 4 Typical 41 0 .0 % 2.4% 0 .0 % 31.7% 65.9%
A utism 41 2.4% 0 .0 % 9.8% 22.0 % 65.9%
2 * 0 .004 Typical 41 0 .0 % 0 .0 % 4.9% 19.5% 75.6%
Autism 41 0 .0 % 14.6% 12.2 % 22.0% 51.2%
3 0.296 Typical 41 0 .0 % 0 .0 % 2.4% 14.6% 82.9%
A utism 41 0 .0 % 4.9% 0 .0 % 7 3 % 87.8%
4 0.062 Typical 41 29.3% 41.5% 22 .0 % 4.9% 2.4%
Autism 40 55.0% 22.5% 2.5% 12.5% 7_5%
5* 0.001 Typical 41 0 .0 % 0 .0 % 4.9% 19.5% 75.6%
A utism 41 2.4% 7.3% 24.4% 22.0 % 43.9%
6 0.399 Typical 41 17.1% 12.2% 12.2% 34.1% 24.4%
Autism 37 8 . 1% 18.9% 35.1% 8 . 1% 29.7%
7 0.212 Typical 41 0 .0 % 0 .0 % 2.4% 43.9% 53.7%
A utism 41 2.4% 4.9% 14.6% 24.4% 53.7%
8 * 0.004 Typical 41 56.1% 39.0% 4.9% 0 .0 % 0 .0 %
Autism 41 36.6% 29.3% 26.8% 4.9% 2.4%
9 0.076 Typical 41 2.4% 2.4% 2.4% 26.8% 65.9%
A utism 41 7 3 % 4.9% 9.8% 24.4% 53.7%
10* 0.042 Typical 41 2.4% 0 .0 % 2.4% 29.3% 65.9%
Autism 41 7 3 % 2.4% 12.2% 26.8% 51.2%
11 0.137 Typical 41 0 .0 % 0 .0 % 7.3% 19.5% 73.2%
A utism 41 2.4% 4.9% 7.3% 22.0 % 63.4%
12 0.245 Typical 41 29.3% 41.5% 22.0% 4.9% 2.4%
Autism 40 40.0% 32.5% 20.0 % 2.5% 5.0%
13 0.350 Typical 41 9.8% 34.1% 34.1% 12.2 % 9.8%
A utism 40 25.0% 17.5% 32.5% 17.5% 7.5%
N ote. Ns differ from 41 due to m issing data. A = Always; O = Often; S = Sometimes;
R = Rarely; N = N ever. N um bers in the “A ,0,S,R ,N ” colum n indicate frequency
distribution percentages.
*p s .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
64
Vestibular Domain (continued)
Item # p value G roup n A o S R N
14* 0.003 Typical 41 31.7% 31.7% 31.7% 4.9% 0 .0 %
Autism 40 20.0 % 20.0 % 22.5% 15.0% 22.5%
15 0.125 Typical 41 0 .0 % 2.4% 17.1% 29.3% 51.2%
Autism 40 7.5% 10.0 % 10.0 % 30.0% 42.5%
16* 0.005 Typical 41 0 .0 % 0 .0 % 2.4% 24.4% 73.2%
Autism 40 0 .0 % 2.5% 15.0% 35.0% 47.5%
17* 0.009 Typical 41 0 .0 % 7.3% 12.2% 48.8% 31.7%
Autism 39 5.1% 7.7% 30.8% 41.0% 15.4%
18* 0.000 Typical 41 0 .0 % 2.4% 2.4% 26.8% 68.3%
Autism 39 7.7% 12.8 % 41.0% 12.8% 25.6%
19 0.413 Typical 41 0 .0% 2.4% 0 .0 % 12.2 % 85.4%
Autism 41 2.4% 2.4% 2.4% 4.9% 87.8%
20* 0.001 Typical 41 0 .0 % 0 .0 % 0 .0 % 4.9% 95.1%
Autism 41 4.9% 2.4% 17.1% 7.3% 68.3%
21* 0.001 Typical 41 2.4% 2.4% 7.3% 31.7% 56.1%
Autism 41 7.3% 19.5% 19.5% 24.4% 29.3%
22* 0.040 Typical 41 0 .0 % 2.4% 0 .0 % 12.2% 85.4%
Autism 41 2.4% 7.3% 7.3% 12.2% 70.7%
23 0.478 Typical 41 9.8% 24.4% 51.2% 12.2% 2.4%
Autism 40 17.5% 20.0 % 42.5% 10.0% 10.0%
24 0.145 Typical 41 0 .0 % 0 .0 % 4.9% 34.1% 61.0%
Autism 41 7.3% 14.6% 4.9% 14.6% 58.5%
25 0.466 Typical 41 0 .0 % 0 .0 % 12.2 % 22.0% 65.9%
Autism 40 0 .0 % 1 3 % 10.0 % 12.5% 70.0%
26 0.060 Typical 41 0 .0 % 2.4% 7.3% 31.7% 58.5%
Autism 1 39 2 .6 % 12.8 % 15.4% 20.5% 48.7%
N ote. Ns differ from 41 due to m issing data. A = Always; O = Often; S = Som etim es;
R = Rarely; N = Never. N um bers in the “A ,0,S,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
65
Vestibular Domain (continued)
Item # p value G roup n A O S R N
27 0.285 Typical 41 0 .0 % 0 .0 % 7.3% 31.7% 61.0%
Autism 40 0 .0 % 2.5% 10.0% 17.5% 70.0%
28* 0.001 Typical 41 0 .0 % 2.4% 19.5% 39.0% 39.0%
Autism 41 19.5% 19.5% 22.0% 14.6% 24.4%
29 0.268 Typical 41 2.4% 0 .0 % 4.9% 41.5% 51.2%
Autism 40 2.5% 5.0% 17.5% 22.5% 52.5%
30 0.176 Typical 41 0 .0 % 0 .0 % 12.2 % 31.7% 56.1%
Autism 38 0 .0 % 5 3 % 18.4% 2 6 3 % 50.0%
31 0.243 Typical 41 0 .0 % 0 .0 % 2.4% 41.5% 56.1%
A utism 40 0 .0 % 5.0% 10.0% 32.5% 52.5%
32* 0.011 Typical 41 0 .0 % 0 .0 % 0 .0 % 31.7% 68.3%
Autism 41 2.4% 2.4% 14.6% 31.7% 48.8%
33 0.137 Typical 41 4.9% 4.9% 39.0% 24.4% 26.8%
Autism 38 13.2% 13.2% 28.9% 21. 1% 23.7%
N ote. Ns differ from 41 due to m issing data. A = A lw ays; O = Often; S = Som etim es;
R = R arely; N = N ever. N um bers in the "A ,0 ,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
6 6
Visual Domain
Item # p value G roup n A o S R N
1 0.055 Typical 41 2.4% 9.8% 9.8% 26.8% 51.2%
A utism 40 2.5% 5.0% 7.5% 15.0% 70.0%
2* 0.003 Typical 41 0 .0% 4.9% 12.2 % 34.1% 48.8%
Autism 41 2.4% 17.1% 31.7% 19.5% 29.3%
3* 0.000 Typical 41 2.4% 2.4% 12.2 % 46.3% 36.6%
A utism 40 5.0% 30.0% 32.5% 17.5% 15.0%
4* 0.000 Typical 41 68.3% 26.8% 2.4% 2.4% 0 .0 %
Autism 41 19.5% 26.8% 34.1% 4.9% 14.6%
5* 0.000 Typical 41 0 .0 % 2.4% 26.8% 36.6% 34.1%
A utism 41 19.5% 24.4% 26.8% 26.8% 2.4%
6* 0.000 Typical 41 2.4% 2.4% 22 .0 % 41.5% 31.7%
Autism 40 17.5% 32.5% 17.5% 20 .0 % 12.5%
7 0 3 9 1 Typical 41 0 .0 % 2.4% 0 .0 % 22 .0 % 75.6%
A utism 41 0 .0% 2.4% 12.2 % 9.8% 75.6%
8* 0.030 Typical 41 0 .0% 0 .0 % 4.9% 31.7% 63.4%
Autism 40 5.0% 10.0 % 12.5% 22.5% 50.0%
9*
0.000 Typical 41 0 .0 % 4.9% 26.8% 36.6% 31.7%
A utism 3 7 16.2% 43.2% 27.0% 8 . 1% 5.4%
10* 0.012 Typical 41 0 .0 % 0 .0 % 17.1% 36.6% 46.3%
Autism 3 9 0 .0% 17.9% 25.6% 23.1% 33.3%
11* 0.000 Typical 41 0 .0% 0 .0 % 0 .0 % 9.8% 90.2%
A utism 39 5.1% 5.1% 23.1% 12.8 % 53.8%
12* 0.002 Typical 41 0 .0 % 0 .0 % 7.3% 12.2 % 80.5%
Autism 3 8 5 3 % 5 3 % 13.2% 26.3% 50.0%
13 0.212 Typical 41 0 .0 % 0 .0 % 2.4% 22.0 % 75.6%
A utism 40 0 .0 % 5.0% 7.5% 17.5% 70.0%
N ote. Ns differ from 41 due to m issing data. A = Always; O = O ften; S = Som etim es;
R = Rarely; N = Never. N um bers in the “A ,0,S,R ,N ” colum n indicate frequency
distribution percentages.
*p ^ .05, M ann-W hitney U T est
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
67
Visual Domain (continued)
Item # p value G roup n A O S R N
14* 0.000 Typical 41 0 .0 % 0 .0 % 0 .0 % 24.4% 75.6%
A utism 38 2 .6 % 10.5% 21 . 1% 26.3% 39.5%
L5* 0.000 Typical 41 0 .0 % 0 .0 % 1 3 % 39.0% 53.7%
Autism 38 10.5% 34.2% 26.3% 18.4% 10.5%
16* 0.000 Typical 41 0 .0 % 0 .0 % 4.9% 17.1% 78.0%
Autism 41 0 .0 % 7 3 % 34.1% 29.3% 29.3%
17* 0.000 Typical 41 0 .0 % 2.4% 4.9% 22.0 % 70.7%
Autism 41 2.4% 19.5% 12.2% 36.6% 293%
18 0.458 Typical 41 0 .0 % 0 .0 % 2.4% 12.2 % 85.4%
A utism 41 2.4% 2.4% 2.4% 7.3% 85.4%
19 0.078 Typical 41 0 .0 % 2.4% 14.6% 17.1% 65.9%
Autism 41 4.9% 2.4% 1 3 % 2.4% 82.9%
20 0.441 Typical 41 0 .0 % 0 .0 % 2.4% 12.2% 85.4%
A utism 1 41 2.4% 4.9% 2.4% 2.4% 87.8%
N ote. Ns differ from 41 due to m issing data. A = Always; O = O ften; S = Som etim es;
R = Rarely; N = N ever. N um bers in the “A ,0,S ,R ,N ” colum n indicate frequency
distribution percentages.
*p .05, M ann-W hitney U Test
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

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Asset Metadata

Creator VerMaas-Lee, Jacy Renee (author)

Core Title Parent ratings of children with autism on the Evaluation of Sensory Processing (ESP)

Degree Master of Arts

Degree Program Occupational Therapy

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag education, special,health sciences, rehabilitation and therapy,OAI-PMH Harvest,Psychology, clinical,psychology, developmental,psychology, psychometrics

Language English

Contributor Digitized by ProQuest (provenance)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c16-33167

Unique identifier UC11336864

Identifier 1397658.pdf (filename),usctheses-c16-33167 (legacy record id)

Legacy Identifier 1397658.pdf

Dmrecord 33167

Document Type Thesis

Rights VerMaas-Lee, Jacy Renee

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA