Patricia L. Davies, Rebecca Tucker; Evidence Review to Investigate the Support for Subtypes of Children With Difficulty Processing and Integrating Sensory Information. Am J Occup Ther 2010;64(3):391-402. doi: 10.5014/ajot.2010.09070.
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We investigated the evidence for subtypes in children with difficulty processing and integrating sensory information. Fifty-seven articles were incorporated into a systematic literature review; only 4 articles provided direct evidence for subtypes. These studies did not provide a comprehensive assessment of all sensory functions and sensory-based motor functions (i.e., praxis) and included different diagnostic groups. Therefore, generalized conclusions about subtypes could not be drawn. The other 53 studies reviewed provided meaningful information about strengths and challenges that children with difficulty processing and integrating sensory information demonstrate, but these studies were limited in scope. A principal theme was the importance of conducting comprehensive assessments of sensory-based functions, including multiple measures of sensory integrative functions such as praxis, sensory modulation, and sensory discrimination in children and adolescents with various clinical disorders. In addition, more consistency in the use of specific assessment tools will allow for synthesis of data across studies.
The Sensory Questionnaire, designed for this study, using 60 items from the Sensory Profile
A question about exceptional memory
DSM–IV checklist for autism symptoms
Kinsbourne Overfocusing Scale
Vineland Adaptive Behavior Scale.
Cluster 1 (n = 17) featured overreactivity to sensory stimuli, perseverative behavior, high overfocusing, and an exceptional memory.
Cluster 2 (n = 36) members were relatively high functioning, were not seriously impaired, and exhibited few sensory problems.
Cluster 3 (n = 44) members were low functioning with prominent undersensitivity and sensory-seeking behaviors.
Cluster 4 (n = 47) members were low on autistic symptoms and high on adaptive functioning and sensory overreactivity but not as high as Cluster 1 in overfocusing and had an exceptional memory. When a 3-cluster solution is forced, Cluster 4 combines with Cluster 1, but this finding obscures the overfocusing of Group 1. Cluster 4 members were significantly older than the other clusters.
Cluster 1 included 11.2% of the sample and showed generalized sensory dysfunction and dyspraxia–severe.
Cluster 2 included 29.6% of the children and was labeled dyspraxia. Z-scores were higher than for Cluster 1, although many were still in the dysfunctional range.
Cluster 3 included 8.4% of all the children and was labeled generalized sensory dysfunction and dyspraxia–moderate. Many of the tests were in the dysfunctional range, not as low as in Cluster 1.
Cluster 4 was labeled low-average bilateral integration and sequencing and included 36.6% of all the children. This cluster represents children functioning at an average level but with specific difficulties.
Cluster 5 was labeled average sensory integration and praxis and included 14.2% of all the children. All children in this cluster scored within the average range on the SIPT.
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