Classify Sensory Reactivity: Sensory Assessment for Neurodevelopmental Disorders

Disclosure

Brian Syzdek is a co-author of the SAND Manual, receiving no royalties. He is former Product Manager at Stoelting, publisher of the SAND. His attendance at ACRM is sponsored by Stoelting.

Learning Objectives

As a result of attending this presentation, attendees will be able to:

Describe a classification system of sensory reactivity style by predominant modality and behavior
Administer, score, and interpret an assessment to classify sensory reactivity, with completion of manual
Integrate sensory reactivity assessment into treatment planning and provide specific recommendations

Obtaining CME/CEU Credit

Credit is only given to attendees who:

Successfully complete the entire course/session.
Evaluate the course – by completing an online survey.
After you have completed the session evaluations and post-tests, and evaluate the overall program, you will be able to download your certificate from you task page.

The evaluation will close 30 days after the end of the enduring activity.

Outline

https://stoeltingco.com/sand

Sensory reactivity overview
SAND overview
SAND administration
Scoring and Interpretation
Case Study
Psychometrics
Research

Sensory reactivity

DSM-5 criteria
45 to 96 % in ASD
Sensory Processing Disorder (Tavassoli et al. 2018)
Diverse terminology
- Included as ‘restricted, repetitive patterns of behavior, interests, or activities’
- Variations in estimates are likely related to the diversity of assessments utilized and the type of sensory features evaluated. Hypo and hyper-reactivity are included as ‘restricted, repetitive patterns of behavior, interests, or activities’ diagnostic criteria; parents of children with ASD report more difficulties in these areas than parents of typically developing controls and other clinical groups;
- SPD- similar sensory issues as ASD, but more empathy
- Hypo- poor/low registration, under-sensitivity/responsivity, hyporesponsiveness, hypo-reactivity/sensitivity
  
  Hyper- sensory sensitivity/defensiveness, tactile/oral/visual defensiveness, hyper-responsiveness/reactivity, over/hyper-sensitivity

Multiple classification schemes

Reactivity
Perception
Integration
- Reactivity- findings present in ASD, particularly hypo; generally converging around hypo, hyper, seeking predominant styles, and mixed
- Perception- most studies focus on auditory, visual and tactile perception, but there is also emerging data on proprioceptive perception in ASD; measured with questionnaires, but increasingly objective measures–gaze, imaging,
- Integration- evidence suggesting that sensory integration/MSI is both different and inefficient in ASD when compared to typical controls. Further, impairment in MSI impacts the magnitude, latency, and timing of response to sensory stimuli

Why assess?

Sensory integration crucial to many activities
Assessment of ASD
Reactivity : repetitive, restricted behaviors
Reactivity : social communication problems
- sensory integration/MSI is crucial for many simple and complex activities ranging from focusing on the salient aspects of stimuli for attention to the integration of auditory and visual stimuli for speech comprehension
- studies examining early development in infants at-risk for autism suggest that sensory features may be one factor that discriminates ASD in early development- some evidence that sensory differences lessen with age
- Elucidation of the specific impact of sensory features on RRBs is required to guide clinical assessment protocols and to better understand the mechanism by which sensory features affect RRBs in autism
- number of studies explored the relationship between social, language and communication competence, RRB’s, and sensory features in ASD. Although cause and effect has not been established, it appears that performance in these areas is related; in particular that hyporeactivity and unusual sensory interests are related to poor social communication

Is all sensory reactivity the same?

Differences in:

Modality
Behavior

Existing instruments

Questionnaires
- Sensory Processing Measure
- Sensory Profile
- Sensory Experiences Questionnaire
Rely on accurate reporting
Observation
- Test of Sensory Functions in Infants
- Sensory Integration and Praxis Test
Infants only/perception and motor

Assessment needs

Report and observation
Comprehensive- frequency, type, modality
Developmentally sensitive
Inter-professional

(Schaaf and Lane 2014)

Sensory Assessment for Neurodevelopmental Disorders (SAND)

First observation and interview (Siper et al. 2017)
Matrix for classifying by behavior and modality
Low-to-no verbal
Efficient, multi-disciplinary

Uses

Detailed individual sensory profile
Diagnostic battery
Assess change over time
Assess family insight

Structure

SAND Organization

Modality x Domain

Modality x Domain Matrix
Domain \| MODALITY	VISUAL	TACTILE	AUDITORY
Hyperreactivity	Visual-Hyperreactivity	Tactile-Hyperreactivity	Auditory-Hyperreactivity
Hyopreactivity	Visual-Hyporeactivity	Tactile-Hyporeactivity	Auditory-Hyporeactivity
Seeking	Visual-Seeking	Tactile-Seeking	Auditory-Seeking

Observation/Interview

Hyperreactivity Assessment
Source	Visual	Tactile	Auditory
Observation	Squints, covers, or closes eyes in response to bright or flickering visual stimuli	Bothered by certain textures	Startles or bothered in response to sounds
Interview	Does your child ever show an aversive reaction to bright or flickering visual stimuli (e.g., bright or flickering lights) by squinting, covering, or closing his/her eyes?	Does your child appear bothered by certain textures (e.g., refuses to wear clothes with tags or of certain texture, resists the feel of water or sand)?	Does your child startle or appear bothered in response to certain sounds (e.g., vacuum cleaner, hand/hair dryer, blender)?

Observation Record Form Sample

Observation Visual Hyperreactivity

Interview Record Form Sample

Interview Visual Hyperreactivity

Coding

Visual-Hyperreactivity Criteria
Criteria	Observation	Interview
Squints, covers, or closes eyes in response to bright or flickering visual stimuli	If a light-up Manipulative is presented and the Examinee turns away from or covers his/her eyes in response to the light, code a 1. If the Examinee turns away because the Flashlight shines right into his/her eyes code 0 as this is an expected response.	Report of avoidance or discomfort with certain types of lighting (e.g., fluorescent lights, dimmed lights) is coded a 1. Sensitivity to direct sunlight in young children is expected and is coded a 0, unless it interferes with daily living (e.g., Caregivers must carry around sunglasses or make other modifications to the environment)

Summary Form

Modality

Visual
Tactile
Auditory

Visual

The Visual Scale references reactivity to stimuli perceived visually. Manipulative items on this scale stimulate visual activity using flashing lights, motion, and titillating images. Visual stimuli correspond to specific aspects of the environment that our visual system can process. For example motion (moving object), color (brightly colored objects), and light of different levels of brightness.

Tactile

The Tactile Scale involves the reactions of an individual to sensations perceived by touch. The objects in the Tactile Scale have different textures including soft (weighted stuffed animal), vibrating (vibrating dog), and unusual (inside-out ball) textures as well as warm and cold packs to assess response to different temperature thresholds.

Auditory

The Auditory Scale examines reactions to various sounds. Manipulative items on this scale produce noise that can be loud, soothing, musical, or otherwise excitatory. Stimuli correspond to different aspects of what our auditory system can process. For example we can hear loudness/amplitude, pitch and complexity of sounds. Therefore some stimuli are loud or noxious (buzzer, siren), some complex (musical instruments), and each elicits a different frequency.

Domain

Hyperreactivity
Hyporeactivity
Seeking

Hyperreactivity

Hyperreactivity refers to responses to sensory stimuli that are more extreme than what is observed in typically developing individuals. Someone who displays hyperreactive behavior shows aversion towards ordinary stimuli. Individuals may engage in avoidance behavior (i.e., turning away, covering ears/eyes), use nonverbal cues (i.e., startled facial expression), or verbally express their dislike of a stimulus. For example, individuals who are visually hyperreactive might squint or turn away from bright light (i.e., fluorescent lights). Individuals who are hyperreactive to touch might avoid wearing clothes of certain material or avoid eating food of certain texture or temperature. Individuals who are hyperreactive to sound might cover their ears or put their fingers in their ears in response to everyday sounds such as a vacuum cleaner, blowdryer, or food processor. Sensory hyperreactivity can impair daily functioning when certain environments must be avoided or modified due to an overload of sensory stimulation.

Hyporeactivity

Hyporeactivity describes behavioral responses to sensory stimuli that are less reactive (sometimes referred to as underreactive) than what is observed in typically developing individuals. People who respond less, slower, or do not respond at all to stimuli others would notice are considered hyporeactive. For example, individuals who are hyporeactive to visual stimuli might not notice a flashing emergency vehicle light or might require frequent prompting to notice items in their surroundings. Individuals who are hyporeactive to touch might display a high threshold for hot or cold temperatures or pain (sometimes referred to as pain or temperature insensitivity). Individuals who are hyporeactive to sound might not notice or may show a delayed reaction time to a loud alarm or everyday sounds such as a phone ringing. Sensory hyporeactivity can impair daily functioning due to safety concerns (e.g., delayed response to a car passing by, failure to notice extreme temperatures or alarms/sirens).

Seeking

Seeking describes behavioral responses to sensory stimuli that manifest as unusual interests in sensory aspects of the environment. Children who repeatedly seek out the same stimulus over and over again, at least 3 times, and/or play with it for an extended period. The frequency or intensity of the seeking behavior must be taken into account for young children as sensory seeking is a typical developmental stage during infancy and toddlerhood (e.g., mouthing of objects is often observed in children up to age three, although the frequency of mouthing objects begins to decline as early as 12 months old).

Individuals who seek visual stimuli might inspect parts of objects close to their eyes (sometimes referred to as visual inspection).Individuals who seek tactile stimuli might rub or feel certain textures of interest repeatedly (i.e., the feel of a person’s skin or water). Individuals who seek sounds might put objects that make sounds close to their ears and/or activate noisemaking objects continuously. Even though sensory seeking is sometimes described as beneficial and enjoyable by autistic individuals, it can also impair daily functioning when an individual’s interest interferes with his or her participation in everyday activities (i.e., personal care, socialization).

Administration

Preparation
Kit and Record Form
Background and Introduction
Observation
Free Play
Multi-sensory manipulatives
Stimulus Presentation
Present items for ~2 min and code response
Free Play II
Interview
Ask if symptom present within past month/examples
If item endorsed, ask severity question

Preparations prior to testing

Materials needed

SAND Kit (see Appendix for list of manipulatives)- Ensure manipulatives are clean and prepared to be used properly
Record Form with clipboard and pencil
Table and chairs

Background information

Ensure background information on the Record Form cover is all know, including history of any sensory issues, seizures, or epilepsy. If these are present, see Accommodations section for ways to address.
Introduce the testing session to Caregiver and Examinee

Free Play I (1-2 min)

Place the three multisensory free play materials on the table: rainmaker, school bus, light up textured wand.
Allow the Examinee to explore the stimuli for 1-2 minutes.
If the Examinee does not independently explore any object, provide direct exposure (e.g., hold up and shake the rainmaker and then offer it to the Examinee).

Observation

Stimulus Presentation

Present each object for a minimum of 5-10 seconds. For cause and effect stimuli, demonstrate the use of the item and then place the item on the table or hand it to the Examinee. For all other items, place stimuli on the table one by one or hand the the stimulus to the Examinee.
Observe how the Examinee engages with and explores material throughout the duration of the observation

Coding Behavior Items

Score all observed behavior
Code behavior observed during any activity (free play I, direct presentation of toys, and free play II) and in response to any stimulus in the appropriate domain
A response to a given stimulus can be coded in any Modality (e.g., hyperreactivity, hyporeactity, seeking) and any Sensory Domain domain (e.g., visual, tactile, auditory).

For example:

Covering ears while feeling a tactile toy gets coded under auditory Hyperreactivity.
Placing a buzzer close to one’s eyes gets coded under visual seeking.

Coding Severity Items

For Severity Items:
- Do not circle a response if no Behavior Items were endorsed for that Subscale. Thus, 0 points will be awarded.
- Circle “Mild” and score a 1 if at least one item was scored and if the behavior was occasional or mild in intensity

Circle “Moderate to Severe” and score a 2 if at least one item was scored a 1 and if behavior was frequent or moderate or severe in intensity

Free Play II

Present the Examinee with the SAND kit and allow the Examinee to explore materials of his or her choosing for up to 2 minutes.
The SAND administration ends when the Examinee does not show interest in further exploration or when 2 minutes has elapsed. If the Examinee chooses not to re-visit any stimuli, end the observation.

NOTE: Object exploration is expected on the SAND, however, children should transition easily, and generally spontaneously, from one item to the next.

Interview

Materials needed

Record Form

Interview administration

Read the instructions on the interview: “I am going to ask you several ‘yes’ and ‘no’ questions about your Examinee’s sensory preferences. We are interested in hearing about your Examinee’s responses to vision, hearing and touch stimuli. The word”stimuli” refers to any objects or toys that your Examinee may come across on during everyday life.”
Introduce each domain to the Caregiver as stated on the interview: “I will ask you a series of ‘yes’ and ‘no’ questions. Answer ‘yes’ if the Examinee has shown this behavior in the last month. Also, let me know if the Examinee showed the behavior in the past, but not now. The first set of questions is about sensory responses in the visual domain.” “This second set of questions is about sensory responses in the tactile domain.” “This last set of questions is about sensory responses in the auditory domain.”
Read the questions verbatim and provide examples as needed. Ask the Caregiver to provide examples if you are unsure how to code a response.
- If the sensory symptom was present at all over the past month, circle yes.
Caregivers should rate severity based on the frequency and intensity of a behavior and its impact on functioning.

Only ask Severity Items if a Caregiver endorses an item within the section (e.g., visual hyperreactivity, tactile seeking, auditory hyporeactivity, etc.). When asking about severity, restate the behavior endorsed by the parent. For example, “You stated that your Examinee peers at objects close to his/her eyes. How severe would you rate your Examinee’s visual sensory seeking? Mild, moderate or severe? Consider how often your Examinee engages in the behavior and whether it impacts his/her functioning.” Circle mild if the behavior occurs occasionally and score moderate-to-severe if the Examinee engages in the behavior frequently.

Observation Example

Administration Video Example

Scoring

Scoring Summary Scoring app

Interpretation

Validity
Total Score
Observation v. Interview
Domain, Modalities, Subscales

Case Study–Overall

Juan–7-year-old boy, referred for neuropsych eval for behavior
Case Study Valid

Case Study–Specific

Case Study–Specific (cont’d)

Case Study Subscales

Case Study–Information

Aversive reaction to stimuli
Interview
- Bothered by tactile stimuli
- Startles from auditory sounds–upset

During the observation, Jonny frequently covered his ears. He displayed an aversive reaction when touched by with a cotton ball and immediately turned his head away from certain objects (e.g., inside out ball). During the interview, Jonny’s father reported that Jonny is bothered by fluorescent lights, tags in his clothing, warm food, and many sounds. He startles in response to everyday sounds such as a vacuum and blowdryer and becomes extremely upset and at times aggressive when he is unable to stop these sounds. Occasional sensory seeking behaviors were present, such as visual peering (observed) and repetitive noise making (reported). Overall, Jonny’s scores on the SAND indicate clinically significant levels of tactile and auditory hyperreactivity which are impacting his ability to function optimally across home and academic environments. Sensory symptoms are also interfering with Jonny’s independence in activities of daily living. Environmental modifications and the integration of a behavior plan that incorporates Jonny’s sensory needs are warranted.

Case Study–Conclusions

Clinically significant tactile and auditory hyperreactivity
Impacting functioning at home and school
Environmental modifications
Behavior plan

Case Study–Recommendations

Treatment team awareness of sensory profile
- Minimize uncomfortable stimuli
- Prepare Juan ahead
Involve Juan in managing environment
Long-term: Gain awareness of sensory needs and advocacy skills
Increased tolerance

Hyperreactivity: Those working with Jonny should be aware of his sensory clinically significant hyperreactivity which is impacting functioning in everyday environments. Caregivers, teachers, therapists, and physicians should be made aware of Jonny’s sensory needs to (1) adapt environments to minimize stimuli that may be uncomfortable for Jonny (e.g., adjusting lighting, volume) and (2) to set expectations about various sensations Jonny may experience ahead of time so Jonny knows what to expect (e.g., preparing him for a fire alarm or the feel of a stethoscope). When possible, allow Jonny to participate in modifying his environment (e.g., dimming bright lights or turning on a vacuum). Over time, Jonny should work with his team of clinicians to gain awareness of his own sensory preferences, increase his tolerance for sensory stimuli that may interfere with his daily life, and ultimately, learn how to advocate for his sensory needs.

Interventions

Interventions Video Example

Development Research

Criterion Referenced

Sensory Difference: SSP elevated or NDD/ASD

SES, ID status, sex, race, age controlled for

Sensory Difference Characteristics
Sensory Difference Probable	n	FSIQ	VIQ	NVIQ
None	70	0.89	0.87	0.9
Sensory Difference	236	-1.48	-1.70	-1.1

SAND Differences

Results

Sensory Difference SAND
Sensory Difference Probable	Total	Observed	Interview	Hyperreactivity	Hyporeactivity	Seeking	Visual	Tactile	Auditory
None	7.8	5.31	2.49	2.56	1.34	3.90	1.96	3.2	2.64
Sensory Difference	29.5	12.40	17.10	6.32	9.29	13.89	8.80	11.1	9.60

Model

Model of Sensory Difference

*Table* 1: Total Results of the linear regression indicated that there was a significant effect between predictor variables ssp_probable_ndd_w_na, intellectual_disability, viq, nviq and the outcome variable Total X2(1), p = 0.018
Coefficients	Estimate	Std. Error	t value	Pr(>\|t\|)
1	7.075	1.444	4.901	0.000
2	16.333	1.790	9.126	0.000
3	7.722	1.732	4.458	0.000
4	-1.494	0.597	-2.503	0.013
5	1.284	0.543	2.363	0.019

SAND Across Age

Test-Retest Reliability

SAND 12 Week Retest Reliability
SAND Composite Score	ICC	95% CI Range	Sig
Total Score	0.857	.746-.920	<.001
Hyperreactivity	0.751	.555-.860	<.001
Hyporeactivity	0.832	.700-.906	<.001
Seeking	0.913	.945-.951	<.001
Visual	0.738	.531-.853	<.001
Tactile	0.776	.601-.874	<.001
Auditory	0.858	.747-.921	<.001

Observed-Reported Reliability

Average Observation and Interview Scores
Method	N	Mean	SD	SEM
Observed	306	10.78	5.16	0.29
Reported	306	13.75	9.32	0.53

Controlling for Sensory Difference, greater Reported (X2(1) = 46.23, < .001

Observed-Reported Interaction

Interaction effect: (X2(1) = 62.28, < .001

Inter-rater Reliability

Matching Interview and Observation items:

Kappa = 0.25 (p < .001), 95% CI (0.22, 0.27)

::: notes Item-level agreement between raters was assessed using Cohen’s Kappa. To fulfill assumptions of independent variables, the Behavioral items and not dependent Severity items were included. A Cohen’s Kappa statistic was calculated to measure agreement between Observation and Interview scores for each participant, resulting in 5400 total pairs of scores. Kappa = 0.25 (p < .001), 95% CI (0.22, 0.27) , suggesting a significant, though low, correlation on item-level reliability between raters.

The agreement between Observation and Interview Total Scores was examined. The relationship between scores was monotonic, and appeared related, based on examination of the scatterplot.

The relationship between Observation and Interview Total scores was calculated using a Spearman correlation coefficient, appropriate for assessing inter-rater agreement with ordinal data. :::

Internal Consistency

Note: V = Visual, T = Tactile, A = Auditory, Hyper = Hyperreactivity, Hypo = Hyporeactivity, Seek = Seeking; *p < .05. **p < .01. ***p < .001
Subscales	V_Hyper	V_Hypo	V_Seek	T_Hyper	T_Hypo	T_Seek	A_Hyper	A_Hypo	A_Seek
V_Hyper	1.00
V_Hypo	0.16**	1.00
V_Seek	0.19**	0.19***	1.00
T_Hyper	0.25***	0.11	0.21***	1.00
T_Hypo	0.11	0.59***	0.18**	-0.02	1.00
T_Seek	0.12*	0.34***	0.51***	0.11	0.40***	1.00
A_Hyper	0.30***	0.05	0.34***	0.27***	0.08	0.24***	1.00
A_Hypo	0.03	0.62***	0.01	-0.06	0.57***	0.21***	-0.16**	1.00
A_Seek	0.18**	0.28***	0.52***	0.13*	0.33***	0.59***	0.21***	0.13*	1.00

Structure

*Table* 2: Subscales that Most Strongly Load for Each Component
Seeking	Hyporeactivity	Hyperreactivity
A_Seek	A_Hypo	V_Hyper
T_Seek	V_Hypo	T_Hyper
V_Seek	T_Hypo	A_Hyper

The relationship between scales was examined. Results of the Bartlett’s correlation indicated the correlation of Subscales was significantly different than zero, (χ2(36)= 773.44, p < .001). The determinant of the correlation matrix was 0.0767, of sufficient value to conduct further analysis of the factor structure of the items.

Examining the variance of the contrasts of models with increasing factors, it can be seen that the greatest amount of variance is in the model with 1 factor. This is the model represented by Total Score. However, additional models should be evaluated because SAND items are intended to comprise multiple Scales.

Examination of the scree plot reveals that the “bend” in the line, the number of components of eigenvalues above 1 and above the mean, number of factors in parallel analysis, and number of optimal coordinates (identified in plot legend) occurs where there are three components, suggesting that a three-component model is optimal for conceptualizing the items.

To consider how the Subscales were related, a Principal Components Analysis was conducted with those Subscales, assuming a three-component model.

Structural Equation Modeling

Composite reliability 0.89

The model was found to be of significantly good fit (χ2(24)=84.82, p < .001).

Composite reliability of this model was 0.8855.

Summary

Overall, individual items on the SAND converge around constructs represented in the Subscales and these Scales significantly load into Domains and Total Scores. The most salient way to interpret sensory symptoms on the SAND is by Domain (Hyperreactivity, Hyporeactivity, Seeking).

Concurrent Validity

Concurrent Validity
SSP	SAND	Correlation
SSP Total	SAND Total	r = -0.72, p < .001, 95% CI[-0.776,-0.654]
SSP Total	Total Observed	r = -0.422, p < .001, 95% CI[-0.521,-0.313]
SSP Total	Total Interview	r = -0.773, p < .001, 95% CI[-0.819,-0.716]

Normative

Total
Domain	NDD	n	Mean	SD	SEM
Total	TD	80	8.010	3.95	0.44
	NDD	226	30.380	9.85	0.65
NA	TOTAL	306	8.427	4.06	NA

Domain
NDD	n	Mean	SD	SEM
	M+1SD	12.49	M+2SD	16.55

Predict Sensory Reactivity

Accuracy

The Area Under the Curve (AUC), or concordance-statistic (c-statistic) was calculated and found to be 0.9773, which is very high, a reflection of very high Sensitivity and Specificity.

The SAND has high accuracy across a range of Total Scores. A score of 12 provided the greatest accuracy. A score of 14 provided the most equitable balance of sensitivity and specificity and a score of 16 provided the highest sum of the two measures (modified Youden Index). The above metrics will inform cutoff score selection, described below.

While a score of 16 reflects optimal summation of sensitivity and specificity, users may define their own cutoff scores based on their needs. A more thorough description of the process of adjusting cutoff scores is described in Appendix G.

The ROC plot illustrates the sensitivity and specificity correspondence. The ROC plot is zoomed in where accuracy is highest and includes labeled scores.

Logistic models were used to generate tables with the probability of having a sensory difference at given scores and are presented in Appendix E. Tables of accuracies of classifying Sensory Difference Present at given scores for SAND Domains, Modalities, and Subscales were generated and follow.

Cutoff Scores The above information was used to create cutoff scores for Scales. There were several sources of information upon which to base cutoff scores:

Highest average of sensitivity and specificity
Highest accuracy
Standard deviation from the mean
Meaningful metrics (e.g., majority of individuals likely to be identified)

Research

Unique Phelan–McDermid syndrome profile (Tavassoli et al. 2021)
Autistic preschoolers—Externalizing : seeking; internalizing : hyperreactivity (Rossow, MacLennan, and Tavassoli 2021)
Activity dependent neuroprotective protein show sensory symptoms, w/o ASD (Siper et al. 2021)
- PMS- Children with PMS demonstrated significantly greater hyporeactivity symptoms and fewer hyperreactivity and seeking symptoms compared to children with iASD and TD controls.
- in autistic preschoolers, externalizing mental health symptoms, such as hyperactivity, are related to sensory seeking (seeking out or being fascinated with sensory stimuli), and internalizing mental health symptoms, such as depression, are related to sensory hyper-reactivity (sensitivity to sensory stimuli)

References

Rossow, Timothy, Keren MacLennan, and Teresa Tavassoli. 2021. “The Relationship Between Sensory Reactivity Differences and Mental Health Symptoms in Preschool-Age Autistic Children.” Autism Research 14 (8): 1645–57. https://doi.org/10.1002/aur.2525.

Schaaf, Roseann C., and Alison E. Lane. 2014. “Toward a Best-Practice Protocol for Assessment of Sensory Features in ASD.” Journal of Autism and Developmental Disorders 45 (5): 1380–95. https://doi.org/10.1007/s10803-014-2299-z.

Siper, Paige M., Alexander Kolevzon, A. Ting Wang, Joseph D. Buxbaum, and Teresa Tavassoli. 2017. “A Clinician-Administered Observation and Corresponding Caregiver Interview Capturing DSM-5 Sensory Reactivity Symptoms in Children with ASD.” Autism Research 10 (6): 1133–40. https://doi.org/10.1002/aur.1750.

Siper, Paige M., Christina Layton, Tess Levy, Stacey Lurie, Nurit Benrey, Jessica Zweifach, Mikaela Rowe, et al. 2021. “Sensory Reactivity Symptoms Are a Core Feature of ADNP Syndrome Irrespective of Autism Diagnosis.” Genes 12 (3): 351. https://doi.org/10.3390/genes12030351.

Tavassoli, Teresa, Christina Layton, Tess Levy, Mikaela Rowe, Julia George-Jones, Jessica Zweifach, Stacey Lurie, Joseph D. Buxbaum, Alexander Kolevzon, and Paige M. Siper. 2021. “Sensory Reactivity Phenotype in PhelanMcDermid Syndrome Is Distinct from Idiopathic ASD.” Genes 12 (7): 977. https://doi.org/10.3390/genes12070977.

Tavassoli, Teresa, Lucy Jane Miller, Sarah A. Schoen, Jennifer Jo Brout, Jillian Sullivan, and Simon Baron-Cohen. 2018. “Sensory Reactivity, Empathizing and Systemizing in Autism Spectrum Conditions and Sensory Processing Disorder.” Developmental Cognitive Neuroscience 29 (January): 72–77. https://doi.org/10.1016/j.dcn.2017.05.005.

ACRM

ACRM Title

ACRM Chicago

Classify Sensory Reactivity: Sensory Assessment for Neurodevelopmental Disorders

Disclosure

Learning Objectives

Obtaining CME/CEU Credit

Outline

Sensory reactivity

Multiple classification schemes

Why assess?

Is all sensory reactivity the same?

Existing instruments

Questionnaires

Rely on accurate reporting

Observation

Infants only/perception and motor

Assessment needs

Sensory Assessment for Neurodevelopmental Disorders (SAND)

Uses

Structure

Modality x Domain

Observation/Interview

Observation Record Form Sample

Interview Record Form Sample

Coding

Summary Form

Modality

Domain

Administration

Preparation

Observation

Free Play

Stimulus Presentation

Free Play II

Interview

Observation Example

Scoring

Interpretation

Case Study–Overall

Case Study–Specific

Case Study–Specific (cont’d)

Case Study–Information

Case Study–Conclusions

Case Study–Recommendations

Interventions

Development Research

Criterion Referenced

SAND Differences

Results

Model

Model of Sensory Difference

SAND Across Age

Test-Retest Reliability

Observed-Reported Reliability

Observed-Reported Interaction

Inter-rater Reliability

Internal Consistency

Structure

Structural Equation Modeling

Concurrent Validity

Normative

Predict Sensory Reactivity

Accuracy

Research

References

ACRM

ACRM Chicago

ACRM Associations

Classify Sensory Reactivity:
Sensory Assessment for
Neurodevelopmental Disorders