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Update on Development of the Sensory Processing Scales

Sarah A. Schoen, PhD, OTR

By Sarah A. Schoen, PhD, OTR
Assistant Director of Research, SPD Foundation
Clinical Services Advisor, STAR (Sensory Therapies And Research) Center

The development of a reliable and valid scale for identifying subtypes of sensory processing disorder is proceeding. The Sensory Processing Scale is designed to assess sensory functioning in children with Sensory Processing Disorder (SPD) or other childhood disorders (e.g., Autism, ADHD, and Anxiety). There is overwhelming evidence that sensory processing problems are widespread in children with developmental disorders. The ability to properly assess sensory processing problems is critical as symptoms of sensory over-responsivity (SOR), sensory under-responsivity (SUR) and sensory seeking/craving (SS/C) have been associated with academic underachievement as well as social, emotional and behavioral problems. To date, there is no gold standard for identification of sensory processing deficits. Currently the identification of SOR, SUR and SS/C are based on caregiver reports rather than direct observation. No examiner administered performance scale exists that assesses sensory processing across all seven sensory domains (visual, auditory, taste, smell, touch, proprioceptive, and vestibular) for all three subtypes (SOR, SUR, and SS/C).

The Sensory Processing (SP) Scale consists of a performance assessment as well as a caregiver questionnaire. The SP Scale is theoretically linked to the proposed diagnostic classification system (Miller, et al. 2007) and is designed to assist in treatment planning as well as identifying homogenous samples for clinical research. Both measures reflect sensory activities or components of daily life activities in each of the seven sensory domains. The assessment attempts to capture typical behaviors that are seen at home or in the clinic in the form of specific test items; while the inventory is similar to other parent/caregiver report measures and requires the person filling it out to indicate whether a particular statement describes their child's response to varied sensory experiences.

The research edition of the Sensory Processing Scale only includes the SOR sub-scale, which is in use in multi-site collaborative research. Preliminary data on the Sensory Over-Responsivity (SOR) Scale show moderately strong internal reliability and discriminant validity (Schoen, Miller & Green, 2008). The items and subtests within the scale appear to be measuring the same construct and the scale discriminates between groups with and without sensory over-responsivity at meaningful and statistically significant levels.

Since the time of when the preliminary data were published in 2008, work has continued to develop and expand the scale so that it would assess all areas of sensory modulation, not only over-responsivity. The new updated scale includes items already tested for reliability and validity from the Sensory Over-Responsivity Scale as well as new items to tap sensory under-responsivity and sensory seeking/craving. The Sensory Processing Scale is designed to be a comprehensive assessment of all sensory modulation subtypes.

This past summer, the primary focus of scale development was on refinement of the scoring system. The SPD Foundation research team was fortunate to have the assistance of three interns: Vicki McQuiddy, completing a research residency in partial fulfillment of her doctoral degree at Southeastern Nova; Lisa Porter, completing a fellowship at the STAR Center; and Maura Monneyham, a second year occupational therapy student at Winston-Salem State University. Data were collected on 10 typically developing children and 10 children with known sensory deficits. Behavioral responses of each individual were coded as typical or atypical. Similar responses were grouped together and only those responses that differentiated between the clinical and typical groups were retained. The new scoring system contains 9 descriptors of behaviors that are recorded before, during or after a sensory activity in each of the seven sensory domains. Sensory processing is complex, so multiple behaviors may be observed at one time. In addition, a single behavior may reflect more than one subtype of sensory processing disorder. Examiners need to interpret the possible reason for the demonstrated behavior (e.g., Does the child make noises to dampen other noises in the environment (SOR) or to obtain additional sensory input (SS/C)). The scoring system was tested first by scoring videotapes of test administration and then during live administration sessions. A study of inter-rater reliability resulted in several revisions to the scoring system as well as re-wording of the operational definitions until an adequate level was established amongst the three interns.

Efforts are currently underway to use the SP Scales in clinical assessments, to assist researchers in characterizing clinical samples and to identify more homogenous samples. Our overall goal is to develop the Sensory Processing Scale for use in a nationwide standardization project. This scale will contribute significantly to the global health of children by providing a tool that can be widely used for improved identification so that appropriate treatments can be provided.

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