No abstract

We used a grounded theory approach to data analysis to discover what effect, if any, children's sensory experiences have on family occupations. We chose this approach because the existing literature does not provide a theory to account for the effect of children's sensory experiences on family occupations. Parents of six children who were typically developing and six children who had autism were interviewed. We analyzed the data using open, axial, and selective coding techniques. Children's sensory experiences affect family occupations in three ways: (1) what a family chooses to do or not do; (2) how the family prepares; and (3) the extent to which experiences, meaning, and feelings are shared.

Background Sensory features are highly prevalent and heterogeneous among children with ASD. There is a need to identify homogenous groups of children with ASD based on sensory features (i.e., sensory subtypes) to inform research and treatment. Methods Sensory subtypes and their stability over one year were identified through latent profile transition analysis (LPTA) among a national sample of children with ASD. Data were collected from caregivers of children with ASD ages 2-12 years at two time points (Time 1 N=1294; Time 2 N=884). Results Four sensory subtypes (Mild; Sensitive-Distressed; Attenuated-Preoccupied; Extreme-Mixed) were identified, which were supported by fit indices from the LPTA as well as current theoretical models that inform clinical practice. The Mild and Extreme-Mixed subtypes reflected quantitatively different sensory profiles, while the Sensitive-Distressed and Attenuated-Preoccupied subtypes reflected qualitatively different profiles. Further, subtypes reflected differential child (i.e., gender, developmental age, chronological age, autism severity) and family (i.e., income, mother's education) characteristics. Ninety-one percent of participants remained stable in their subtypes over one year. Conclusions Characterizing the nature of homogenous sensory subtypes may facilitate assessment and intervention, as well as potentially inform biological mechanisms.

This study describes children’s “sensory experiences”, generates parents’ perceptions and explanations of these experiences, and compares these experiences across children with and without autism. Parents of 66 preschoolers (29 typically-developing; 37 with autism) were interviewed using a Critical Incident Technique. Parents described a situation where their child had a “good” sensory experience, a situation where their child had a “bad” sensory experience, and their own perception of how these situations felt to the child. The most common unpleasant experiences for both groups related to sound; the most common pleasant experiences involved touch and movement. Children with autism were reported to have more extreme and/or unusual experiences, and negative food-related experiences than typically-developing peers. Parental explanations for children’s responses focused on qualities of the child, stimulus, and/or context. Many parents had difficulty understanding the concept of sensory experiences. Parents of children with autism were more likely to recognize elements in their children’s experiences as being sensory, and likely to attribute these responses to aspects of autism. Parents’ positive response to the interview itself was an unexpected result with clinical relevance.

These findings are complementary to the three-track mind discussed in the clinical reasoning study and contribute further to our understanding of the experience of doing occupational therapy.