• Research in progress
• Research published or in press
• SPDF research staff

Research in progress

Researchers at the SPD Foundation are currently at work studying the following topics.

• Multisensory integration in typically developing children
  We have completed the first study of multisensory integration in children, representing an important and fundamental step toward our goal of understanding multisensory integration in children with Sensory Processing Disorder.
• Multisensory integration in children with SPD compared to typically developing children
  Research related to determining whether the different subtypes of children with SPD show evidence of atypical multisensory integration at the cortical level is ongoing. To date, we have collected data on 18 children with the Sensory Over-Responsivity (SOR) subtype of SPD, and 3 children with the Sensory Under-Responsivity (SUR) subtype. Preliminary inspection of the data suggests that unisensory processing (auditory, tactile) as well as multisensory (audio-tactile) integration is atypical in children with SOR. We currently are increasing our sample size and analyzing the statistical differences between children with SPD and those who are typically developing.
• Treatment effectiveness
  Two studies on treatment effectiveness using OT with a sensory integration framework have been completed. Their findings were published in the March-April 2007 issue of the American Occupational Therapy Journal.

  Planned is a new treatment effectiveness study measuring multisensory integration and electrodermal activity before and after treatment. The purpose will be to obtain behavioral data and determine if any variables in these measures will be useful outcome measures of treatment effectiveness. To date we have pre- and post-case study data on 10 subjects.

• Gold standard for diagnosis of SPD
  Our work on the Sensory Processing Disorder Scale (e.g., measuring Sensory Over- and Under-Responsivity and Sensory Seeking/Craving) continues. These scales are performance measures administered directly to the child (not parent-report measures as are currently used). A manuscript has been accepted for publication by the American Journal of Occupational Therapy with research from two separate samples on the SPD scale (Sensory Over-Responsive subtest (n > 200). The Sensory Under-Responsive and Sensory Seeking/Craving subscales are under construction. Having a performance measure for SOR, SUR, and SS is critical for collecting a homogeneous sample in research, for clinical precision in identifying children who need services, and for designing appropriate treatment services.
• Prader-Willi Syndrome (PWS) study
  The aim of this study is to characterize the sensory functioning of individuals with PWS using behavioral and physiologic measures. Specifically, we are using an extensive parent interview and parent-report measures. We are also measuring autonomic nervous system function in individuals with PWS in reaction to sensory stimuli using the Sensory Challenge Protocol as was used in our previous studies with children who have SPD, ADHD, autistic spectrum disorders, and Fragile X Disorder. We have completed parent interviews, physiologic testing, and parent report measures of sensory behaviors on 12 children with PWS. Preliminary findings were presented at the Foundation for Research in Prader-Willi annual conference 2007.

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Research published or in press

The following peer-reviewed research by the SPD Foundation has been published or is currently in press. Click on a title to read the article in Our Library.

Miller LJ, Schoen SA, James K, Schaaf RC. Lessons Learned: A Pilot Study of Occupational Therapy Effectiveness for Children with Sensory Modulation Disorder. American Journal of Occupational Therapy, 61, 161-169.

A one-group pre-test/post-test pilot study designed in preparation for a randomized controlled study of the effectiveness of occupational therapy using a sensory integration approach.

Miller LJ, Coll JR, Schoen SA. A Randomized Controlled Pilot Study of the Effectiveness of Occupational Therapy for Children with Sensory Modulation Disorder. American Journal of Occupational Therapy, 61, 228-238.

A randomized controlled pilot study comparing three treatment conditions for children with Sensory Modulation Disorder: OT SI , Activity Protocol, and No Treatment. Significant gains were reported on goal attainment scaling and on the attention subtest and the cognitive social composite of the Leiter International Performance Scale – Revised.

Miller LJ, Anzalone ME, Lane SJ, Cermak SA, Osten ET. Concept Evolution in Sensory Integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61, 135-140.

A discussion of the new taxonomy for Sensory Processing Disorder that describes three primary patterns of dysfunction: Sensory Modulation Disorder, Sensory Discrimination Disorder and Sensory-Based Motor Disorder.

Schoen, SA, Miller, LJ, Brett-Green, K. (in press). Psychophysiology of Children with Autism Spectrum Disorder, Research in Autism

A study characterizing the electrodermal activity in a group of 40 children with high functioning Autism and Asperger's Syndrome.

Schoen SA, Miller LJ, Green K. (in press). A Pilot Study of the Sensory Over-Responsivity Scales: Assessment and Inventory . American Journal of Occupational Therapy

Preliminary data on the reliability and validity of an examiner- administered scale and a report measure of one subtype of Sensory Processing Disorder (Sensory Over-Responsivity).

Numerous additional peer-reviewed articles and other publications of SPD Foundation researchers are filed by topic area in Our Library.

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SPDF research staff

Barbara Brett-Green, Ph.D.

Title: Director, Psychophysiology Research
Institution: SPD Foundation
Mailing Address: 5655 S. Yosemite Street, Ste. 305
                      Greenwood Village, CO 80111
Phone: (303) 794-1182

Research Interests
Dr. Brett-Green has a long-term program of research studying multi-sensory integration in animal models and currently in children.

SPD Research Summary
For the past several years, Dr. Brett-Green has investigated EEG activity in children with Sensory Processing Disorder (SPD) compared to those with Attention Deficit disorder (ADHD) and Autistic Spectrum Disorder. In addition, Dr Brett-Green is undertaking EEG (event-related potential) research evaluating the effect of multi-sensory stimulation at the cortical level on typically developing children and adults compared to those with SPD and Autism. Her article on multi-sensory integration in typically developing children is the first to study MSI in pediatrics and has recently been accepted to the journal Brain Research.

Lucy Jane Miller, Ph.D., OTR

Title: Executive Director
Institution: SPD Foundation
Mailing Address: 5655 S. Yosemite Street, Ste. 305
                      Greenwood Village, CO 80111
Phone: (303) 794-1182

Research Interests
Dr. Miller has a program of research in Sensory Processing Disorder (SPD). She has developed a psychophysiologoical lab that has collected electrodermal activity (with Dr. Sarah A. Schoen), vagal tone (with Dr. Schaaf), and EEG/Event Related Potentials (ERP) (with Dr. Barbara Brett-Green) as well as data on children with SPD, autistic spectrum disorders, Attention-Deficit Disorder (ADHD), and Prader-Willi Syndrome in response to sensory stimulation. She has developed the Short Sensory Profile (with Dr. Willie Dunn and others) and is currently working on a SPD performance assessment and parent checklist that evaluates all subtypes of SPD.

In addition to spearheading the push for psychophysiologic research on SPD, Dr. Miller focuses on treatment effectiveness studies for remediation of SPD. She has obtained a National Institutes of Health (NIH) grant to plan a multi-site treatment study and has engaged a team of leading occupational therapists to collaborate. In addition, she started the SPD Scientific Work Group in 2000 and is active in recruiting new members.

Her summary of SPD research was submitted to the DSM-V committee for consideration in January 2007. Amended with additional research data in early 2008, the application is under active consideration by the committee, which is revising the DSM.

Dr. Miller also has a 30+ year career developing norm-referenced, nationally standardized scales. Her tests include: the Miller Assessment for Preschoolers (MAP), the Japanese MAP, the First STEP, Primer Paso (First STEP in Spanish), the Toddler and Infant Motor Evaluation, the Leiter International Performance Scale – Revised, the Short Sensory Profile, the Miller Function and Participation Scale, and the Goal-Oriented Assessment of Lifeskills (in process).

Dr. Miller's peer-reviewed publications include the first reports of significant differences between SPD and typically developing children through development and analysis of the Sensory Challenge Protocol. She continues to spearhead an intensive program of research in SPD including studies related to SPD differential diagnostic specification, treatment effectiveness and neuropathology. She is convinced that effective SPD research must be multi-site and multi-disciplinary and to this end has started several SPD collaborative research groups.

Sarah A. Schoen, PhD, OTR

Title: Director, Applied Research
Institution: SPD Foundation
Mailing Address: 5655 S. Yosemite Street, Ste. 305
                      Greenwood Village, CO 80111
Phone: (303) 794-1182

Research Interests
Dr. Schoen has a program of research studying electrodermal activity and vagal tone in children with Sensory Processing Disorder (SPD) compared to those with Attention-Deficit/Hyperactivity Disorder (ADHD) and Autistic Spectrum Disorder. She is also collaborating with Dr. Lucy Jane Miller on the development of a Sensory Processing Disorder (SPD) performance measure and parent checklist that evaluates all subtype of SPD.

SPD Research Summary
Can a reliable performance assessment be developed to characterize sensory over-responsivity?

Dr. Schoen, Dr. Miller, and colleagues are focusing on the development of reliable and valid scales that can be used to diagnose each of the six subtypes of SPD. Each scale has two components: 1) an Assessment that is an examiner-administered performance evaluation and an Inventory that is a caregiver/self-rated symptom checklist. The purpose of the Sensory Processing Disorder Scales is to accurately diagnose SPD for clinical purposes and to identify homogeneous populations for research purposes. Existing measures are not based on the theoretical conceptualization of SPD and therefore are inadequate for the diagnosis of subtypes of Sensory Processing Disorder.

The measure of Sensory Over-Responsivity (SOR) is most fully developed and has been validated on a sample of 125 participants with and without SOR. Data has been collected on another cohort of 97 individuals with and without SOR. Preliminary findings from both samples support the internal reliability, discriminant validity, and test-retest reliability of the scales. A classification analysis of the sensitivity and specificity of the SPD SOR scales will be conducted to define "at risk" and "disordered" cut-points for SOR that can be used by members of the SPD Scientific Work Group to identify children for research.

A caregiver/self-rated symptom checklist exists for all of the other subtypes of SPD. The checklists are currently being piloted at sites across the country in order to determine which items best discriminate each subtype. Also in the process of development are items for an examiner-administered performance evaluation for Sensory Modulation Disorder: Sensory Under-Responsivity and Sensory Seeking. Test items will be administered to typically developing children as well as children with each disorder so as to determine which items best discriminate between groups.

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