Evaluating Sensory Integration/Sensory Processing Treatment: Issues and Analysis

When Attempts to Help Backfire: Psychosocial Interventions that May Inadvertently Prolong Anxiety Among Youth

Anxiety disorders are among the most common and impairing mental health conditions in children and adolescents. Although exposure-focused cognitive behavioral therapy (CBT) is a well-established treatment for this population based on decades of psychological science, many available psychosocial interventions are not based on this strong empirical foundation. In some cases, interventions for youth with anxiety disorders have the potential to maintain anxiety in the long run. Grounded in a well-developed cognitive-behavioral theoretical frame, this commentary aimed to discuss popular and emerging psychosocial interventions for anxious youth that may inadvertently prolong anxiety. We argue that (1) although the availability of gold-standard CBT (with an adequate focus on exposure therapy) appears to be increasing, it continues to be difficult to access for many youth, (2) several available interventions prescribe avoidance-based strategies that do not enable a child to experience self-efficacy building and corrective learning experiences related to their fears or anxieties, thereby potentially maintaining anxiety in the long-run, and (3) several available interventions are not based in any clear, empirically-supported theoretical frame or evidence base, and thus have unclear benefits for anxiety. In a time when there is increasing alarm about anxiety disorders among youth, building systems that can support tried-and-true interventions based on strong science is of utmost importance. Future research, intervention deployment, and policy efforts should pay more attention to the harms that could arise from psychosocial interventions.

[Formula: see text] Sensory processing, executive function, and behavior in children with ADHD

The relationship between sensory processing, executive function, and behavior in children with Attention Deficit/Hyperactivity Disorder (ADHD) is far from clear. The aim of this study was to examine the mediating role of executive function in the relationship between sensory processing and behavior in ADHD. Sixty-three children (51 boys), aged between 7 and 14 years participated in this study. Caregivers completed the Sensory Profile 2 (SP-2), the Behavior Rating Inventory of Executive Function 2 (BRIEF-2), and the Child Behavior Checklist (CBCL) to assess sensory processing, executive function, and behavior, respectively. Positive and significant associations were found between sensory processing, executive function, and behavioral problems. In addition, positive indirect effects between sensory processing and behavior were mediated by executive function. These findings add to other evidence on neurodevelopmental disorders, suggesting that sensory processing may be a foundational aspect related to executive function, which in turn affects behavior in ADHD.

Overgrowth-intellectual disability disorders: progress in biology, patient advocacy and innovative therapies

Overgrowth-intellectual disability (OGID) syndromes encompass a group of rare neurodevelopmental disorders that frequently share common clinical presentations. Although the genetic causes of many OGID syndromes are now known, we lack a clear mechanistic understanding of how such variants disrupt developmental processes and ultimately culminate in overgrowth and neurological symptoms. Patient advocacy groups, such as the Overgrowth Syndromes Alliance (OSA), are mobilising patients, families, clinicians and researchers to work together towards a deeper understanding of the clinical needs of patients with OGID, as well as to understand the fundamental biology of the relevant genes, with the goal of developing treatments. In this Review, we summarise three OGID syndromes encompassed by the OSA, namely Sotos syndrome, Malan syndrome and Tatton-Brown-Rahman syndrome. We discuss similarities and differences in the biology behind each disorder and explore future approaches that could potentially provide a way to ameliorate some of the unmet clinical needs of patients with OGID.

Sensory Processing in Individuals With Attention-Deficit/Hyperactivity Disorder Compared With Control Populations: A Systematic Review and Meta-analysis

OBJECTIVE

To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) and atypical sensory processing patterns.

METHOD

For this systematic review and meta-analysis, PubMed, Embase, and Web of Science were searched from their inception until June 30, 2024. Studies examining sensory processing patterns using questionnaires in participants with a diagnosis of ADHD compared with healthy controls were included. The study risk of bias was assessed using a modified Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted using R Version 4.3.1 software, considering sensory modulation severity atypicities as the primary outcome. The risk of publication bias was explored, and sensitivity analyses were conducted to test the robustness of findings.

RESULTS

After screening 10,750 references, 30 studies (reported in 32 publications) encompassing 5,374 participants were included, with 23 studies focusing on children and 7 focusing on adults. Patients with ADHD presented with significantly more severe sensory atypicities than the control group in multiple domains: sensory sensitivity (k = 13, SMD = 1.17, 5% CI [0.75, 1.59], I2 = 87%), sensory avoiding (k = 11, SMD = 1.15, 95% CI [0.66, 1.64], I2 = 92%), low sensory registration (k = 23, SMD = 1.22, 95% CI [0.89, 1.56], I2 = 92%), and sensory seeking (k = 15, SMD = 1.23, 95% CI [0.48, 1.97], I2 = 97%). Heterogeneity was high in all analyses. Only 9 studies were deemed at overall low risk of bias.

CONCLUSION

Even though available ADHD clinical guidelines do not specifically mention the need to assess sensory processing in ADHD, this meta-analysis suggests that this should be systematically explored in the evaluation of children and adults referred for ADHD.

STUDY REGISTRATION INFORMATION

Association between ADHD and sensory processing disorder: A systematic review and meta-analysis; https://www.crd.york.ac.uk/PROSPERO/view/CRD42022325271.

DIVERSITY & INCLUSION STATEMENT

We actively worked to promote sex and gender balance in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science.

No significant links between somatognosia, stereognosia, and hypermobility: sensory processing unlikely to drive common complaints in hypermobile population

BACKGROUND

Previous research has demonstrated impaired proprioception and poorer responses to tactile deep pressure, visual-tactile integration, and vestibular stimuli in individuals with generalized hypermobility, potentially leading to sensory processing issues. Therefore, we aimed to explore the influence of hypermobility on somatognosia and stereognosia.

METHODS

Forty-six participants were assessed using the Beighton score and categorized into three groups: non-hypermobile (n = 20), symptomatic hypermobile (n = 13), and asymptomatic hypermobile (n = 13). Somatognosia was evaluated using the shoulder width test in the vertical plane and pelvic width test in the vertical and horizontal planes. Stereognosia was assessed with Petrie's test. Spearman's rank correlation coefficient was examined the relationship between the Beighton score and measures of somatognosia and stereognosia. An unpaired t-test was used to compare variables between hypermobile (both symptomatic and asymptomatic) and non-hypermobile individuals, while a one-way ANOVA was used to compare data between the three groups.

RESULTS

No significant relationship was observed between Beighton scores and measures of somatognosia and stereognosia. The t-test revealed no statistically significant differences between hypermobile and non-hypermobile groups in the shoulder width, two pelvic widths, and Petrie's tests (all p ≥ 0.105). Similarly, one-way ANOVA showed no statistically significant differences between the three groups across these tests (all p ≥ 0.177).

CONCLUSIONS

The results indicate that somatognosia and stereognosia are not significantly related to the Beighton score and do not significantly differ between the groups studied. These sensory processing functions are unlikely to contribute to the common complaints reported by hypermobile individuals.

CLINICAL TRIAL NUMBER

Not applicable.

Outcome Measures in Evaluation of Weighted Blankets: A Scoping Review

Introduction: Weighted blankets are an intervention used in healthcare settings for alleviating anxiety and sleep problems. Selection of appropriate outcome measures that capture relevant effects is important in clinical practice and research. However, outcomes used are diverse and not standardised. Therefore, this scoping review is aimed at identifying, synthesising, and describing available research and used outcome measures in research studies evaluating weighted blankets. Methods: A scoping review was conducted, with a search of four databases. The search included studies published until February 2024. Results were categorized according to target population (adult or child) and primary outcome (sleep or anxiety). A conceptual map was developed to describe outcome measures used in the field. Results: A total of 38 studies were identified, including 12 randomised controlled trials, 13 pre-post-studies, 6 case studies, 3 register studies, and 3 qualitative studies. The State-Trait Anxiety Inventory and the Anxiety Visual Analogue Scale were commonly used outcome measurements in evaluation of weighted blanket effects on anxiety and most commonly conducted in an adult population. There was considerable heterogeneity in the outcomes used, particularly within the domain of sleep. In studies evaluating weighted blankets as a sleep intervention for children, objective measurement methods such as actigraphy were common, as was the use of a sleep diary. Conclusion: Even though there is extensive research available evaluating weighted blanket use and effects, there is a lack of standardised outcome measures and instruments are not adapted to use within occupational therapy practice. More research is necessary, informing clinical practice about which measures to use and when. Furthermore, there is a need to develop an instrument specifically tailored for use within occupational therapy practice to evaluate sleep interventions.

The Relationship Between Attention, Sensory Processing, and Social Responsiveness Among Adults on the Autism Spectrum

This study evaluated attention, sensory processing, and social responsiveness and the relationship between these constructs among autistic and neurotypical adults. Participants included 24 autistic adults (17-30 years) and 24 neurotypical peers who completed the Test of Everyday Attention, Adolescent/Adult Sensory Profile (AASP), and the Social Responsiveness Scale-2. Autistic individuals showed greater attention, sensory processing, and social responsiveness challenges compared to neurotypical peers. Using mediation models, we showed that the relationship between attention and social responsiveness was mediated by sensory processing, specifically the low registration and sensation-seeking AASP quadrants. The relationship between attention, sensory processing, and social responsiveness suggests that adults with greater attention issues may have greater sensory and social challenges. Specifically, having poor attention may lead to poor sensory processing skills which compound poor social responsiveness. Understanding the relationships between these domains is critical for developing effective interventions and support for autistic adults.

Effect of Multicomponent Exercise Program on Pain and Functional Mobility in Antitubercular Drug Therapy-Induced Peripheral Neuropathy in Pulmonary Tuberculosis Survivors

OBJECTIVES

 Exercise therapy is a pivotal component in the multidisciplinary approach to managing tuberculosis (TB)-related peripheral neuropathy (PN). A personalized exercise protocol maximizes therapeutic benefits while minimizing the risk of symptom exacerbation. This study aimed to determine the effect of multicomponent exercise programs on pain and functional mobility in antitubercular drug therapy-induced PN in pulmonary TB survivors.

METHODS

In the approved experimental study, 110 participants with antitubercular study drug-induced PN were randomly assigned to two groups, and data were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States). The study's purpose was to evaluate the efficacy of a multicomponent exercise program on PN symptoms.

RESULTS

The study assessed a multicomponent exercise regimen's effectiveness in individuals with TB-related PN. The experiment group demonstrated noteworthy pain reduction (p < 0.0001), improvement in neurological symptoms (p < 0.0001), and better functional outcomes in the 12-minute walk test (p < 0.0001) and sit-and-reach test (p < 0.0001). Conversely, the control group exhibited less significant improvements. The low p-values indicate the intervention's effectiveness, emphasizing its impact on pain reduction, neurological symptoms, and functional abilities in comparing the experimental and control groups.

CONCLUSION

The study demonstrated the significant effectiveness of an eight-week multicomponent exercise program in individuals with pulmonary TB-related PN, showcasing notable improvements in pain reduction and functional mobility compared to a conventional single-component regimen in the control group.

Inter-hemispheric somatosensory coherence and parental stress in hypersensitivity at 8 months old: An electroencephalography study

OBJECTIVE

Infant hypersensitivity affects daily challenges and parental stress. Although the crucial role of tactile sensation in infants' brain function has been highlighted, hypersensitive infants and their families lack support. Electroencephalography may be useful for understanding hypersensitivity traits. We investigated the relationship between infant perceptual hypersensitivity and parental stress, somatosensory-evoked potential (SEP), and magnitude-squared coherence (MSC) in the general population.

METHODS

Infants aged 8 months (n = 63) were evaluated for hypersensitivity and parental stress using a questionnaire and for cortical activity using electroencephalography. Vibration stimuli were applied to the infant's left foot. SEP components that peaked around 150 ms (N2) and at 200 ms (P2) after stimulus onset were evaluated by amplitude and latency at the midline electrode (Cz) and MSC between the midline electrodes (C3-C4).

RESULTS

Parental stress was associated with infant hypersensitivity. The latency of Cz was delayed, and C3-C4 delta MSC was high in infants with hypersensitivity.

CONCLUSIONS

Increasing inter-hemispheric MSC synchrony in the stimulated condition in infants with hypersensitivity suggested atypical somatosensory cortical function.

SIGNIFICANCE

These findings contribute to identifying, understanding the mechanisms of, and developing effective coping strategies for early-stage hypersensitivity.

Disentangling the relationship between sensory processing, alexithymia and broad autism spectrum: A study in parents' of children with autism spectrum disorders and sensory processing disorders

BACKGROUND

Autistic features and sensory processing difficulties and their phenotypic co-expression with alexithymia share a transdiagnostic vulnerability. In this work, we explored whether the current concept of broad autism phenotype rather translates altered sensory processing (non-specific to autism), meaning that the characteristics of altered sensory processing should be overexpressed among individuals with heightened vulnerability to sensory processing atypicalities (parents of children with sensorial processing disorder, or SPD parents) and individuals with heightened vulnerability to autistic traits (parents of children with autism spectrum disorders, or ASD parents). In addition, the association between altered sensory processing and alexithymia was inspected.

METHOD

The Adolescent/Adult Sensory Profile, Autism Spectrum Quotient, and Toronto Alexithymia Scale were completed by 31 parents of children with ASD, 32 parents of children with SPD, and 52 parents of typically developed (TD) children.

RESULTS

Extreme sensory patterns were overexpressed both in parents of children with SPD and parents of children with ASD when compared to parents of TD children. In addition, extreme sensory patterns were significantly associated with alexithymia scores. Specifically, sensory avoidance, low registration, and sensory sensitivity were positively correlated with alexithymia. No significant differences were found regarding the proportion of autistic traits and alexithymia between ASD and SPD groups of parents.

CONCLUSIONS

These results challenge the specificity of broad autism phenotype and suggest a neurodevelopmental atypicity with roots in altered sensory and emotional processing.

Relationship between sensory processing patterns and gross motor function of children and adolescents with Down syndrome and typical development: a cross-sectional study

BACKGROUND

Children and adolescents with Down syndrome (DS) may experience impairments in sensory and motor skills that can be interrelated. The purposes of this study were (i) to compare the sensory processing patterns and gross motor function between children and adolescents with DS and with typical development (TD) and (ii) to explore associations between these areas in both DS and TD groups.

METHOD

This cross-sectional study involved a sample size of 25 participants with DS (mean age 10.24 ± 2.04 years) and 25 participants with TD (mean age 10.04 ± 2.82 years). The sensory processing patterns were assessed using the Sensory Profile Second Version questionnaire, and the gross motor function was measured with the Gross Motor Function Measure (GMFM-88) dimensions (D) standing, and (E) walking, running, and jumping. Differences between groups were tested using the Mann-Whitney test, and the relationship between the variables was examined using Spearman's correlation tests, with a significance level set at 5%.

RESULTS

Children with DS showed greater difficulties with sensory processing than TD children in Seeker (P < 0.001), Avoider (P < 0.001), Sensitivity (P < 0.001), Registration (P < 0.001), Auditory (P < 0.001), Touch (P = 0.001), Movements (P = 0.001), Oral (P = 0.028), Conduct (P = 0.005), Socioemotional (P < 0.001), and Attentional (P < 0.001) domains. Additionally, children with DS presented lower gross motor function than TD in GMFM-88, standing (P < 0.001) and walking, running, and jumping (P < 0.001). Correlations were found between greater difficulties with sensory processing in Touch and lower gross motor function in walking, running, and jumping for the DS group.

CONCLUSION

Our results suggest there are more difficulties in sensory processing patterns and gross motor function in children with DS than in TD. Also, there is a single association between more difficulties in sensory processing and less well-developed motor function in the DS group. Therefore, a comprehensive assessment of all these aspects should be performed in children and adolescents with DS, along with the provision of relevant interventions addressing specific needs.

Naturalistic Developmental Behavioral Interventions for Developmental Language Disorder

PURPOSE

Naturalistic-developmental-behavioral interventions (NDBIs) are a widely accepted and validated approach for treating language-related symptoms in autism spectrum disorder, including deficits in vocabulary, social skills, and grammar. The purpose of this article is to define the elements naturalistic, developmental, and behavioral as applied to children with developmental language disorder (DLD) and to provide an example of how this type of intervention can be implemented to teach vocabulary and test cross-modal generalization between expressive and receptive modalities.

METHOD

A vocabulary intervention using hybrid NDBI methods (storybook reading and conversational recast interaction) was provided to three participants with DLD using a single-case design.

RESULTS

The results indicated that all participants successfully learned receptive and expressive vocabulary targets with extensive cross-modal generalization. However, generalization was limited in some of the participants.

CONCLUSIONS

This article provided definitions of key elements of NDBI (naturalistic, developmental, and behavioral) including a rationale for extending NDBI procedures to language intervention for children with DLD. In addition, a single-case design demonstrated that NDBI can be implemented in DLD and that broadly defined naturalistic-developmental applied behavior analysis techniques are applicable to language interventions for children with language disorders. Moreover, diverse naturalistic and developmental procedures meet the highest standards for evidence-based practice to treat DLD.

Preventive effects of resveratrol against early-life impairments in the animal model of autism induced by valproic acid

Background

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by social interaction deficits and repetitive/stereotyped behaviors. Its prevalence is increasing, affecting one in 36 children in the United States. The valproic acid (VPA) induced animal model of ASD is a reliable method for investigating cellular, molecular, and behavioral aspects related to the disorder. Trans-Resveratrol (RSV), a polyphenol with anti-inflammatory and antioxidant effects studied in various diseases, has recently demonstrated the ability to prevent cellular, molecular, sensory, and social deficits in the VPA model. In this study, we examined the effects of prenatal exposure to VPA and the potential preventive effects of RSV on the offspring.

Method

We monitored gestational weight from embryonic day 6.5 until 18.5 and assessed the onset of developmental milestones and morphometric parameters in litters. The generalized estimating equations (GEE) were used to analyze longitudinal data.

Results

Exposure to VPA during rat pregnancy resulted in abnormal weight gain fold-changes on embryonic days 13.5 and 18.5, followed by fewer animals per litter. Additionally, we discovered a positive correlation between weight variation during E15.5-E18.5 and the number of rat pups in the VPA group.

Conclusion

VPA exposure led to slight length deficiencies and delays in the onset of developmental milestones. Interestingly, the prenatal RSV treatment not only prevented most of these delays but also led to the early onset of certain milestones and improved morphometric characteristics in the offspring. In summary, our findings suggest that RSV may have potential as a therapeutic intervention to protect against the negative effects of prenatal VPA exposure, highlighting its importance in future studies of prenatal neurodevelopmental disorders.

Relationships between sensory integration and the core symptoms of attention-deficit/hyperactivity disorder: the mediating effect of executive function

Attention-deficit/hyperactivity disorder (ADHD) is often accompanied by executive function deficits and functional alterations in sensory integration. The present study aimed to investigate the relationship between ADHD core symptoms, executive function, and sensory integration in children with ADHD. A total of 228 children with ADHD were recruited for our study. The Sensory Organization Test (SOT) and Child Sensory Integration Scale (CSIS) evaluated the sensory integration ability from lab-based and scaled-based perspectives, respectively. Three core components of executive functions (inhibition, working memory, and set-shifting) were assessed using both lab-based tests and the relevant factors from the behavior rating inventory of executive function (BRIEF). Partial correlation analysis was performed to explore the correlation of sensory integration with EF and ADHD core symptoms. Based on the observed significant correlation, bootstrap analyses were further conducted to explore the potential mediating effect of EF on the relationship between sensory integration and ADHD core symptoms. ADHD symptoms and EF were significantly correlated with CSIS scores; no factors were significantly correlated with SOT performance. In detail, the vestibular-balance score was negatively correlated with both inattention and hyperactivity/impulsivity symptoms, while the hyper-sensory and proprioception scores were negatively correlated with only inattention symptoms. For the scaled-based EF, vestibular-balance was negatively correlated with inhibition and working memory, and the hyper-sensory score was negatively correlated with shift factor. No correlation was found for the lab-based EF tests. The subsequent mediation analysis found that inhibition partially mediated the relationship between vestibular balance and hyperactivity/impulsivity symptoms. Working memory completely mediated the relationship between vestibular-balance, hyper-sensory, proprioception, and inattention symptoms. These results were well validated in an independent sample. Our present findings demonstrated that the functional alteration in basic sensory integration might be associated with impairments of executive functions and then lead to the behavioral expression of ADHD. The present findings might provide a new perspective to understand the occurrence of ADHD symptoms and potential precise intervention methods.

Cross-Modal Plasticity during Self-Motion Perception

To maintain stable and coherent perception in an ever-changing environment, the brain needs to continuously and dynamically calibrate information from multiple sensory sources, using sensory and non-sensory information in a flexible manner. Here, we review how the vestibular and visual signals are recalibrated during self-motion perception. We illustrate two different types of recalibration: one long-term cross-modal (visual-vestibular) recalibration concerning how multisensory cues recalibrate over time in response to a constant cue discrepancy, and one rapid-term cross-modal (visual-vestibular) recalibration concerning how recent prior stimuli and choices differentially affect subsequent self-motion decisions. In addition, we highlight the neural substrates of long-term visual-vestibular recalibration, with profound differences observed in neuronal recalibration across multisensory cortical areas. We suggest that multisensory recalibration is a complex process in the brain, is modulated by many factors, and requires the coordination of many distinct cortical areas. We hope this review will shed some light on research into the neural circuits of visual-vestibular recalibration and help develop a more generalized theory for cross-modal plasticity.

EEG Correlates of Cognitive Functions in a Child with ASD and White Matter Signal Abnormalities: A Case Report with Two-and-a-Half-Year Follow-Up

This research aimed to examine the EEG correlates of different stimuli processing instances in a child with ASD and white matter signal abnormalities and to investigate their relationship to the results of behavioral tests. The prospective case study reports two and a half years of follow-up data from a child aged 38 to 66 months. Cognitive, speech-language, sensory, and EEG correlates of auditory-verbal and auditory-visual-verbal information processing were recorded during five test periods, and their mutual interrelation was analyzed. EEG findings revealed no functional theta frequency range redistribution in the frontal regions favoring the left hemisphere during speech processing. The results pointed to a positive linear trend in the relative theta frequency range and a negative linear trend in the relative alpha frequency range when listening to and watching the cartoon. There was a statistically significant correlation between EEG signals and behavioral test results. Based on the obtained results, it may be concluded that EEG signals and their association with the results of behavioral tests should be evaluated with certain restraints considering the characteristics of the stimuli during EEG recording.

Early psychomotor therapy in very preterm infants does not improve Bayley-III scales at 2 years

AIM

To assess the efficacy of post-hospital psychomotor therapy in the development of very preterm infants at nine and 24 months.

METHODS

We conducted a randomised controlled study at Toulouse Children's Hospital between 2008 and 2014 among preterm infants aged under 30 weeks. All infants in both groups could benefitt from physiotherapy to prevent motor disorders. The intervention group received 20 early post-hospital psychomotor therapy sessions. The development was assessed by the Bayley Scale Infant Development at nine and 24 months.

RESULTS

The intervention and control group contained 77 and 84 infants, respectively, with 57 infants in each group undergoing assessment at 24 months. Boys accounted for 56% of the population. Median gestational age was 28 weeks, range 25-29. The development scores at 24 months did not significantly differ between the randomisation groups. At 9 months, we observed improvements in global motricity (mean difference 0.9 point, p = 0.04) and fine motricity for the subgroup containing educationally underserved mothers (mean difference 1.6 point, p = 0.008). There was no significant difference in neuromotor functioning between the two groups.

CONCLUSION

The benefits of psychomotor therapy were short-lived and did not persist post-intervention. Our results and this organisational model encouraged us to persevere towards similar multi-professional care.

Exploring the Prognosis: A Longitudinal Follow-Up Study of Children with Sensory Processing Challenges 8-32 Years Later

Sensory integration and processing challenges have been long recognized in children and, more recently, in adults. To understand the long-term prognosis of these challenges, more research is needed on what children with sensory integration and processing challenges look like as adults. Using the Adult/Adolescent Sensory History, researchers followed up with 102 adults who had known sensory integration and processing challenges as children to examine the following questions: What is the current sensory processing status of adults who received sensory-integration-based occupational therapy services as children? And how has the sensory processing status of adults who received sensory-integration-based services changed since childhood? This study compared performance on sensory processing measures completed as children and as adults for a follow-up group of adults. The results revealed that the severity of sensory integration and processing challenges experienced by the follow-up group decreased from childhood, with 51% of the follow-up group now scoring in the "typical" range of sensory processing. Our findings suggest that those children with sensory integration and processing challenges who are recognized and seek occupational therapy services using an ASI approach are likely to have a good long-term prognosis regarding the severity of their sensory processing functioning.

Sensory Processing in Children and Adolescents with Neurofibromatosis Type 1

Despite the evidence of elevated autistic behaviors and co-occurring neurodevelopmental difficulties in many children with neurofibromatosis type 1 (NF1), we have a limited understanding of the sensory processing challenges that may occur with the condition. This study examined the sensory profile of children and adolescents with NF1 and investigated the relationships between the sensory profiles and patient characteristics and neuropsychological functioning. The parent/caregivers of 152 children with NF1 and 96 typically developing children completed the Sensory Profile 2 (SP2), along with standardized questionnaires assessing autistic behaviors, ADHD symptoms, internalizing symptoms, adaptive functioning, and social skills. Intellectual functioning was also assessed. The SP2 data indicated elevated sensory processing problems in children with NF1 compared to typically developing children. Over 40% of children with NF1 displayed differences in sensory registration (missing sensory input) and were unusually sensitive to and unusually avoidant of sensory stimuli. Sixty percent of children with NF1 displayed difficulties in one or more sensory modalities. Elevated autistic behaviors and ADHD symptoms were associated with more severe sensory processing difficulties. This first detailed assessment of sensory processing, alongside other clinical features, in a relatively large cohort of children and adolescents with NF1 demonstrates the relationships between sensory processing differences and adaptive skills and behavior, as well as psychological well-being. Our characterization of the sensory profile within a genetic syndrome may help facilitate more targeted interventions to support overall functioning.

PROTOCOL: The effectiveness of sensory interventions targeted at improving occupational outcomes, quality of life, well-being and behavioural and psychological symptoms for older adults living with dementia: A systematic review and meta-analysis

This is the protocol for a Campbell systematic review. The objectives are as follows: The primary objective is to systematically review the available evidence of the effects of sensory interventions on quality of life, well-being, occupational participation, and behavioural and psychological symptoms of older adults living with dementia.

Experiences of Using Weighted Blankets among Children with ADHD and Sleeping Difficulties

Introduction

Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children's individual needs in connection with sleep and daytime functioning.

Aim

To explore how children with ADHD and sleeping difficulties experience the use of weighted blankets.

Methods

An explorative qualitative design in which 26 children with ADHD and sleeping difficulties, 6-15 years old, were interviewed about a sleep intervention with weighted blankets. Four categories emerged from qualitative content analysis.

Results

Children's experiences revealed that the use of weighted blankets 1) requires a commitment, by adjusting according to needs and preferences and adapting to the environment; 2) improves emotional regulation by feeling calm and feeling safe; 3) changes sleeping patterns by creating new routines for sleep and improving sleep quality; and 4) promotes everyday participation by promoting daily function and balancing activity and sleep.

Conclusions

Using weighted blankets promoted children's management of daily life with ADHD and sleeping difficulties. Occupational therapists can improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves.

Preparation of a Regioselective Quercetin-3-palmitate and Its Using for Boosting Cooking Oil Stability

Due to over worldwide use of frying oil, and due to its oxidation and deterioration after the usage for short time, huge oil amounts are wasted. So, most attempts are aimed to increase oil stability. Quercetin is a common name for the lipophobic strong natural phenolic antioxidant 2-(3,4-Dihydroxyphenyl)-5,7-dihydroxy-4H-1-benzopyran-4-one. Thus, its solubility had been improved by converting it to a lipophilic compound via its appending to a fatty acid residue. So, regioselectively 2-(3,4-Dihydroxyphenyl)-5,7-dihydroxy-3-[Hexadecanyl]oxychromen-4-one commonly named as (Quercetin-3-palmitate) was synthesized. The formed compound was confirmed based on its elemental analysis and spectral data (IR, ¹H NMR and MS). The partition coefficient of Quercetin-3-palmitate in octanol/water (k) was determined and compared to that of palmitic acid and quercetin individually to prove its solubility enhancement. Its radical scavenging activity was then tested. The effect of this new antioxidant compound on the oil stability was studied through the frying process. All physical and chemical parameters of this oil were considered before and after the frying process compared to another reference antioxidant (TBHQ) and control sample. The safety of this compound was determined by acute oral toxicity using albino mice. The liver and kidney functions of these mice were also examined. The results showed non-significant change. A sensory evaluation of the fried potato chips has been done. The results showed that the properties of the potato chips were improved by adding Quercetin-3-palmitate to the oil. Thus, good protection against frying oils oxidation was achieved via the addition of Quercetin-3-palmitate. The Quercetin-3-palmitate effectiveness is mainly attributed to its stability at high temperatures. Moreover, Quercetin-3-palmitate was found to be a safe compound according to an acute lethal toxicity test. Consequently, it can be used as a food additive.

Deficits of Sensory Integration and Balance as Well as Scoliotic Changes in Young Schoolgirls

The aim of this study was to assess the relationship between sensory integration and balance deficits as well as scoliotic changes in young schoolgirls. The study comprised 54 girls aged 11 years with scoliotic changes. The Clinical Test of Sensory Integration and Balance of the Biodex Balance System platform were used to analyze the deficits in sensory integration and balance. Scoliotic changes were assessed using the Diers Formetric III 4D optoelectronic method. In the present study, there was a significant relationship between sensory integration and balance deficits as well as spine curvature angle (°) (p = 0.01), vertebral surface rotation (°) (p = 0.03), pelvic tilt (°) (p = 0.02), and lateral deviation (mm) (p = 0.04). The integration of the sensory systems has a positive effect on the structure of the intended and controlled movement as well as body posture and the development of the spine. In the treatment of scoliotic changes, one should also consider exercises that improve sensory integration as well as position and balance reactions.

"Sensory in-Service": An Exploratory Evaluation of a Group-Based, Caregiver Intervention for Children with Sensory Processing Difficulties

AIMS

To describe and evaluate the effectiveness of a group-based, caregiver education intervention on: (1) functional concerns for children with identified sensory processing difficulties, (2) caregiver knowledge of sensory processing and strategies to support their child, and (3) resources required.

METHODS

Ninety-five caregivers of children referred to therapy because of sensory processing difficulties [72% male, mean age (SD) = 6.0 (2.3) years] participated in a structured, two-hour, group-based, caregiver education intervention, which included didactic information, group discussion, worksheets, and written resources. Canadian Occupational Performance Measure (COPM) performance and satisfaction scores evaluated changes in child function. A Caregiver Knowledge Questionnaire evaluated changes in caregivers' knowledge of sensory processing and strategies. Resources required were based on the total number of hours required for 1:1 versus group-based intervention.

RESULTS

Statistically significant and clinically meaningful improvements were found for COPM performance (W = 108, p < .001; EF = 0.95) and satisfaction scores (W = 119.5, p < .001; EF = 0.94) and caregiver knowledge (W = 0.00, p<.001; EF = 1.00). Group-based intervention used 62% less time than 1:1 intervention.

CONCLUSIONS

Group-based, caregiver education can be an effective way for therapists to meet demand and improve caregiver self-efficacy related to sensory processing difficulties.

Effectiveness of feedback-based technology on physical and cognitive abilities in the elderly

Aging raises a social and health challenge because the passing of time causes changes in cognitive and physical functions that impair functionality and quality of life. In addition, advancements in technology and information technology have led to the development of new techniques for retraining based on the feedback technology provides. To solve the negative consequences of aging, a randomized clinical trial was carried out to assess the effectiveness of a protocol using feedback-based technology to improve physical and cognitive functions in older adults. For the purpose of this study, 200 patients were selected from a Social and Community Services Center in the province of Seville and only 46 of them became participants of the study (after applying the inclusion criteria). These patients were divided into two groups: control and experimental. Physical and cognitive abilities were assessed using the Miniexamen cognoscitivo Test (an adaptation of the MiniMental examination test), Yesevage's Depression Scale, Oddball Test, Attention Network Test, Berg Scale, Tinetti Scale, and Timed Up and Go Test. The intervention applied to the experimental group consisted of a supervised protocol using the Nintendo® Wii video game console and the Wii-Fit© video game during 16 sessions, 2 times a week with a duration of 30 min per session. The control group did not receive any treatment. The experimental group showed statistically significant improvements in all the physical variables (balance, gait, autonomy, and fall risk), as other authors had proven, and in memory and reaction times; there were no improvements in attention networks. The control group (placebo) even showed a decrease in their functions, with worse results on the Timed up and Go test Scale. The intervention using feedback-based technology has been proven effective in improving physical and cognitive abilities and in preventing and promoting healthy aging.

Review of Sensory Integration Therapy for Children With Cerebral Palsy

Cerebral palsy (CP) refers to a group of non-progressive brain disorders. Several different approaches are used to treat cerebral palsy children like neurodevelopmental therapy (NDT), sensory integration therapy (SIT), and hippotherapy. Sensory integration therapy is a clinically based approach that places an emphasis on the relationship between the therapist and the child and uses play-based sensory and motor activities to encourage analysis and integration. SIT seems to offer a lot of therapeutic prospects. It uses various interventions. According to sensory integration therapists, some impacts of SIT include an improved ability to concentrate in academic, therapeutic, and social settings. Sensory integration treatment is successful in enhancing gait, balance, and gross motor function.

Treatment of Misophonia with Risperidone in a Patient with Autism Spectrum Disorder

We report the case of a 32-year-old male with autism spectrum disorder (ASD) suffering from severe misophonia. After titrating risperidone to 2 mg twice a day, the patient reported a significant reduction in his symptoms and his Amsterdam misophonia scale-revised (AMISOS-R) score dropped by from 31 to 5. Upon discharge, the patient was noted to have decreased irritability and overall improved behavior and effect. This significant symptomatic improvement was likely not explained by inpatient admission alone or other simultaneous pharmacologic treatments, as the effect was seen during an isolated titration of risperidone with other treatments remaining constant. Although, unfortunately, follow-up findings indicated that the treatment was not curative for the patient, risperidone’s potential for treating misophonia may warrant systematic investigation.

The “Primitive Brain Dysfunction” Theory of Autism: The Superior Colliculus Role

A better understanding of the pathogenesis of autism will help clarify our conception of the complexity of normal brain development. The crucial deficit may lie in the postnatal changes that vision produces in the brainstem nuclei during early life. The superior colliculus is the primary brainstem visual center. Although difficult to examine in humans with present techniques, it is known to support behaviors essential for every vertebrate to survive, such as the ability to pay attention to relevant stimuli and to produce automatic motor responses based on sensory input. From birth to death, it acts as a brain sentinel that influences basic aspects of our behavior. It is the main brainstem hub that lies between the environment and the rest of the higher neural system, making continuous, implicit decisions about where to direct our attention. The conserved cortex-like organization of the superior colliculus in all vertebrates allows the early appearance of primitive emotionally-related behaviors essential for survival. It contains first-line specialized neurons enabling the detection and tracking of faces and movements from birth. During development, it also sends the appropriate impulses to help shape brain areas necessary for social-communicative abilities. These abilities require the analysis of numerous variables, such as the simultaneous evaluation of incoming information sustained by separate brain networks (visual, auditory and sensory-motor, social, emotional, etc.), and predictive capabilities which compare present events to previous experiences and possible responses. These critical aspects of decision-making allow us to evaluate the impact that our response or behavior may provoke in others. The purpose of this review is to show that several enigmas about the complexity of autism might be explained by disruptions of collicular and brainstem functions. The results of two separate lines of investigation: 1. the cognitive, etiologic, and pathogenic aspects of autism on one hand, and two. the functional anatomy of the colliculus on the other, are considered in order to bridge the gap between basic brain science and clinical studies and to promote future research in this unexplored area.

Behavioural Differences in Sensorimotor Profiles: A Comparison of Preschool-Aged Children with Sensory Processing Disorder and Autism Spectrum Disorders

Sensory Processing Disorders (SPDs) define dysfunctions in modulating, organising, and using information from several sensory channels for regulating motor, behavioural, emotional and attention responses. Although SPD can be identified also as an isolated condition in young children, its presence in Autism Spectrum Disorder (ASD) population is really frequent. The study purpose is to explore the SPD clinical expression and the putative correlation with several behavioural aspects both in children with ASD and in those with isolated SPD. Therefore, 43 preschool-aged children (25 ASD vs. 18 SPD) were recruited, and their parents completed three questionnaires (Developmental Profile-3, Sensory Processing Measure–Preschool, Repetitive Behaviour Scale-Revised) to evaluate behavioural alterations and developmental levels. The main result is that both ASD and SPD groups had significantly sensory-related behavioural symptoms, although ASD children seem to be more impaired in all areas. Several significant correlations were found between sensory processing difficulties and repetitive behaviours, but in the SPD group a specific relationship between Body Awareness and Ritualistic/Sameness Behaviour was found. Conversely, in the ASD group, more diffuse interlinks between sensory processing difficulties and motor behaviours were significant. In conclusion, the present study confirms the key role of sensory–motor skills in early diagnosis and intervention among children at risk for neurodevelopmental disorders.

Exploration of Relationships among Clinical Gastrointestinal Indicators and Social and Sensory Symptom Severity in Children with Autism Spectrum Disorder

Autism Spectrum Disorders (ASD) are associated with co-morbidities such as gastrointestinal (GI) symptomatology, which in the absence of known causes are potential indicators of gut microbiota that may influence behavior. This study's purpose was to explore relationships among clinical GI indicators-diet, abdominal pain, and stool status-and ASD symptom severity, specifically social and sensory symptoms. Participants were 33 children with ASD, 3 to 16 years. The Social Responsiveness Scale (SRS-2) and the Child Sensory Profile Scale (CSP-2) were used to appraise social and sensory symptomatology. Significant difference was found in overall SRS-2, t(31) = -3.220, p = 0.003 when compared by abdominal pain status using independent samples t-tests. Significant difference was observed for overall CSP-2, t(31) = -2.441, p = 0.021, when grouped by stool. The three clinical GI variables predicted overall SRS-2 score using multiple linear regression, F(3, 32) = 3.257, p = 0.036; coefficient for abdominal pain significantly contributed to the outcome. Findings contribute to the growing literature signaling the need to understand occurrence of GI symptomatology more deeply, and in consideration of diet status and its implications in the children's everyday lives, behaviors, and symptom severity.