Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder.

IMPORTANCE: Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis. OBJECTIVE: To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns. DESIGN: Observational cohort longitudinal design using blinded video analysis. PARTICIPANTS: Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age. RESULTS: Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = -2.29, p < .05, r = .31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD. CONCLUSIONS AND RELEVANCE: Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD.

Occupational Balance Among Parents of Typically Developing Children and Parents of Children With Disabilities.

IMPORTANCE: Parenting may influence perceptions of occupational balance (OB), particularly among parents of children with disabilities (PCWD). OBJECTIVE: To compare OB among PCWD and parents of typically developing children (PTDC), identify potential predictors of OB, and examine the association between OB and family quality of life (FQOL). DESIGN: Cross-sectional group-comparison design. SETTING: Two hospitals under the Hamad Medical Corporation, Doha, Qatar. Data were collected between November 2020 and February 2021. PARTICIPANTS: PCWD attending occupational therapy clinics and PTDC from the hospital staff and their relatives were recruited through convenience sampling. Participants were 89 PCWD and 89 PTDC, of whom 38% spoke Arabic, and 62% spoke English. OUTCOMES AND MEASURES: The revised 11-item Occupational Balance Questionnaire and the short version of the Family Quality of Life Survey-2006 were used to measure outcome variables. An investigator-developed demographic survey was used to collect information on independent variables. All data collection forms were available in English and Arabic. The hypothesis was generated before data were collected. RESULTS: Statistically significant but marginal differences were found in OB between PTDC and PCWD (M difference = 1.87, p = .02; 95% confidence interval [0.331, 3.339]). A moderate association existed between OB and FQOL among PCWD (r = .57, p = .001) and PTDC (r = .31, p = .003). CONCLUSIONS AND RELEVANCE: Occupational therapists working with families of young children may find it helpful to assess OB and address OB-related issues to facilitate better FQOL. What This Article Adds: Parenting young children affects OB regardless of the disability status of the child. Role satisfaction and spousal support are possible intervention targets to improve OB and thereby improve FQOL.

Desempeño de niños típicos entre 5 y 7.11 años de edad en una selección de observaciones clínicas: datos preliminares y propiedades psicométricas en una muestra chilena / The performance of typical children between 5 and 7.11 years in a selection of clinical observations: preliminary data and psychometric properties in a Chilean sample

La utilización de observaciones que proporcionan información acerca del funcionamiento sensorio-motor relacionado a procesamiento sensorial es común en la práctica clínica. Un grupo de observaciones, llamadas observaciones clínicas por A.J. Ayres ayuda a diagnosticar disfunciones sensoriales aunque no existen normas desarrolladas en Chile, ni su validez o confiabilidad establecida estadísticamente para su utilización. Para normar estas pruebas en Chile se entrenaron 4 evaluadores quienes recolectaron datos de niños entre 5 y 7.11 años de edad: 90 típicos y 26 identificados con problemas de procesamiento sensorial. Este estudio proporciona datos preliminares sobre 5 pruebas relacionadas a control postural y planeamiento motor: equilibrio en un pie (ojos cerrados y ojos abiertos), extensión antigravitatoria, flexion antigravitatoria, secuenciación de dígitos, y diadochokinesis. Los resultados indican que estas pruebas se pueden utilizar para diagnosticar niños con disfunciones sensorio-motoras en la práctica clínica e investigación.

Clinical observations that provide information about sensory-motor performance related to sensory processing, are commonly used in clinical practice. A group of these observations, known as clinical observations by A. J. Ayres,help diagnose sensory related dysfunctions even when normative data and statistically established validity and reliability are not available for the Chilean children. In order to develop normative data, we trained 4 independent assessors who collected data on 90 typically developing children 5 to 7.11 years of age and 26 children identified as presenting with sensory processing problems. The present study provides preliminary data about 5 observations that relate to postural control and motor planning: Standing on one foot (eyes open and closed), extensión against gravity, flexion against gravity, sequential finger touching and diadochokinesis. The results of this study indicate that these observations can help diagnose children with sensory-motor dysfunctions and be utilized for clinical applications and research.

El desarrollo de un cuestionario para padres para la medición de la responsividad sensorial en niños con diagnóstico de autismo (CMRS) / The development of a parental questionnaire to measure sensory responsivity in children with a diagnosis of autism (QMSR)

Este estudio presenta el desarrollo de un Cuestionario para Padres para la Medición de la Responsividad Sensorial en Niños con Diagnóstico de Autismo (CMRS). Se llevaron a cabo una revisión sistemática de la literatura internacional en el período 2000-2015 y tres estudios Delphi. Los estudios Delphi examinaron prospectivamente a ochenta y siete (N=87), setenta y tres (N= 73) y sesenta (N= 60) Terapeutas Ocupacionales certificados en Integración Sensorial en Argentina. Los profesionales clasificaron 62 ítems en los rótulos de “mantener”, “modificar” o “eliminar” los ítems del CMRS y proporcionaron cambios en su estructura y redacción. Adicionalmente, determinaron su inclusión en cuatro categorías: “hipo-responsividad”, “hiperresponsividad”, “planificación motriz” y “social” y dentro de seis escalas de responsividad sensorial: “visual”, “auditiva”, “vestibular”, “gusto/olfato”, “propioceptiva” y “táctil”. Se presenta la versión final del CMRS y la retroalimentación profesional en todos sus ítems, categorías y escalas así como también sugerencias para estudios futuros que podrían proporcionar información adicional para su aplicación clínica y en investigación.

This study presents the development of a Parental Questionnaire for the Measurement of Sensory Responsivity in Children with a Diagnosis of Autism (QMSR). A systematic review of the international literature in the 2000-2015 period and three Delphi studies were conducted. The three Dephi studies prospectively examined eighty-seven (N=87), seventy-three (N=73) and sixty (N=60) Argentine Occupational Therapists certified in Sensory Integration. These professionals classified all 62 items of the QMSR with three labels that included “maintain” “modify” and “eliminate” and provided written suggestions for changes in their structure and composition. Additionally, they determined their inclusion in four categories: “Hypo-responsivity”, “Hyper-responsivity”, “Motor Planning” and “Social” and six sensory responsivity scales: “Visual”, “Auditory”, “Vestibular”, “Taste/Smell”, “Proprioceptive” and “Tactile”. The final version of the QMRS and professional feedback on all its items, categories and scales is presented, together with suggestions for future studies that could potentially clarify its clinical utility and research applications.

Development of the comprehensive observations of proprioception (COP): validity, reliability, and factor analysis.

OBJECTIVE: We developed an observational tool, the Comprehensive Observations of Proprioception (COP), for identifying proprioceptive processing issues in children with developmental disabilities. METHOD: Development of the COP underwent three phases. First, we developed items representing proprioceptive functions on the basis of an extensive literature review and consultation with occupational therapists. We then established interrater reliability and content, construct, and criterion validity. Finally, we completed a factor analysis of COP ratings of 130 children with known developmental disabilities. RESULTS: Adequate validity and reliability were established. Factor analysis revealed a four-factor model that explained the underlying structure of the measure as it was hypothesized. CONCLUSION: The COP is a valid criterion-referenced short observational tool that structures the clinician's observations by linking a child's behaviors to areas identified in the literature as relevant to proprioceptive processing. It takes 15 min to administer and can be used in a variety of contexts, such as the home, clinic, and school.

Proprioceptive processing difficulties among children with autism spectrum disorders and developmental disabilities.

OBJECTIVE. Sensory processing difficulties among children with autism spectrum disorders (ASD) have been extensively documented. However, less is known about this population's ability to process proprioceptive information. METHOD. We used the Comprehensive Observations of Proprioception (COP; Blanche, Bodison, Chang, & Reinoso, in press) to describe the proprioceptive difficulties experienced by children with ASD. A sample of 32 children with ASD, 26 children with developmental disabilities excluding ASD, and 28 typically developing control children were studied using the COP. RESULTS. Children with ASD present with proprioceptive processing difficulties that are different from those of children with developmental disabilities and their typically developing counterparts. Specific data, potential clinical applications, and directions for future research are described. CONCLUSION. Results suggest that the COP has useful clinical research applications. Further assessment of psychometric properties, clinical utility, and meaningful differences among diverse clinical populations are needed.

Revisión de la literatura: déficit de procesamiento sensorial en el espectro del autismo / Literature review: sensory processing deficits in autism spectrum disorder

En muchas oportunidades los problemas sensoriales presentados por niños con autismo son confundidos con conductas aprendidas sin base biológica. Este artículo es una revisión de la literatura que trata con el tema de déficit sensoriales en individuos con autismo. La literatura que describe estos déficits sensoriales se puede dividir en tres tipos de estudios: colección de conductas a través de cuestionarios, estudios neuro-fisiológicos y autobiografías. El déficit sensorial en individuos con autismo esta presente en la mayoría de los casos e incluye múltiple sistemas sensoriales. Este déficit debe ser identificado y tratados en el proceso de intervención.

In many opportunities the sensory processing deficits presented by children with autism are misinterpreted as behavioral issues with no biological base. This article is a review of the literature describing sensory processing deficits in children with autism. The literature reviewed can be divided into three types of studies: data collection through questionnaires, studies focusing on the neurofisiological aspects of sensory processing, and autobiographical accounts. The majority of individuals diagnosed with autism present sensory processing deficits that cut across many sensory systems. These deficits need to be identified and addressed in the intervention process.