Abstract
Sensory reactivity is a diagnostic criterion for Autism Spectrum Disorder (ASD), and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. Yet, there is little consensus on best practice approaches to assessing sensory processing dysfunction in adolescents and adults with ASD. Despite growing evidence that sensory symptoms persist into adolescence and adulthood, there is a lack of norms for older age groups, and pediatric assessments may not target appropriate functional outcomes or environments. This review identified approaches used to measure sensory processing in the scientific literature, and to describe and compare these approaches to current best practice guidelines that can be incorporated into evidence-based practice. Method and Analysis: A search of scientific databases and grey literature (professional association and ASD society websites), from January 1987–May 2017, uncovered 4769 articles and 12 clinical guidelines. Study and sample characteristics were extracted, charted, and categorized according to assessment approach. Results: There were 66 articles included after article screening. Five categories of assessment approaches were identified: Self- and Proxy-Report Questionnaires, Psychophysical Assessment, Direct Behavioral Observation, Qualitative Interview Techniques, and Neuroimaging/EEG. Sensory research to date has focused on individuals with high-functioning ASD, most commonly through the use of self-report questionnaires. The Adolescent and Adult Sensory Profile (AASP) is the most widely used assessment measure (n = 22), however, a number of other assessment approaches may demonstrate strengths specific to the ASD population. Multi-method approaches to assessment (e.g., combining psychophysical or observation with questionnaires) may have clinical applicability to interdisciplinary clinical teams serving adolescents and adults with ASD. Contribution: A comprehensive knowledge of approaches is critical in the clinical assessment of a population characterized by symptomatic heterogeneity and wide-ranging cognitive profiles. This review should inform future development of international interdisciplinary clinical guidelines on sensory processing assessment in ASD across the lifespan.
Highlights
Since the incorporation of sensory reactivity into the Diagnostic and Statistical Manual of MentalDisorders (5th ed.; DSM-5), identifying the presence of sensory processing dysfunction has become a key component of diagnosing Autism Spectrum Disorder (ASD)
Objectives of Scoping Review: This review sought to answer the question: What approaches to assessing sensory processing dysfunction have been applied to date in scientific research with adolescents and adults with ASD and how do they compare to what tools, approaches and rationale for assessment are recommended in clinical guidelines? This scoping review provides a framework from which to compare and critique a wide transdisciplinary literature, and will assist clinicians to consider both the evidence base and potential practicality of using certain approaches
Three overarching clinical recommendations were identified through qualitative content analysis: (1) assess sensory processing dysfunction when diagnosing ASD or when sensory processing dysfunction is thought to be related to difficulty with adaptive behavior and/or contributing to maladaptive behavior; (2) if possible, engage in interdisciplinary collaboration when assessing sensory processing, and (3) utilize multiple techniques to assess sensory processing
Summary
Since the incorporation of sensory reactivity into the Diagnostic and Statistical Manual of MentalDisorders (5th ed.; DSM-5), identifying the presence of sensory processing dysfunction has become a key component of diagnosing ASD. Clinicians who are directly involved in the assessment of the functional, affective, and social impact of sensory processing dysfunction include occupational therapists, psychologists, behavioral analysts, and psychiatrists who may use a range of assessment tools and techniques [4,5,6]. In this age of evidence-based practice (EBP), clinicians face mounting pressure to utilize research evidence when selecting an assessment approach [7]. Three major obstacles to implementing EBP when assessing sensory processing provided the impetus for conducting this scoping review
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