Journal Club Discussion #16: Identifying the Risk of Sensory Processing Difficulty in Infants

Hey readers! I was perusing the American Journal of Occupational Therapy today and this study stood out to me. You probably know by now that I am interested in all things sensory…so clearly an article titled “Early Identification of Sensory Processing Difficulties in High-Risk Infants” would catch my eye! This article is by Joanne E. Flanagan, Sarah Schoen, and Lucy Jane Miller. AOTA members can access the article here. Let’s talk about it!

Background Info

The purpose of this study was to determine whether there are differences in sensory, motor, cognitive, and language abilities among high-risk infants compared to low-risk infants. The authors defined high-risk infants as those who have older siblings who have sensory processing difficulties and low-risk infants as those who have no siblings with or family history of sensory difficulties or neurological conditions.

According to Flanaga, Schoen, and Miller (2019), 5-16.5% of school-aged children have difficulties with sensory processing, which may affect motor planning, play skills, ADLs, social participation, academic achievement, and emotional well-being. The researchers hypothesized that there may be signs of sensory processing difficulties early in an infant’s life, which may lead to earlier early intervention services and therefore prevent sensory processing difficulties from developing further.

Methods & Participants

This was a single-blind pilot study (researcher was blinded to risk status) in which an OT conducted developmental assessments on two groups of infants, high-risk (n=13) and low-risk (n=16). The infants were between the ages of 4-24 months and all had older sibling(s) with confirmed sensory processing difficulty or confirmed no sensory processing difficulty.

Read more about the specific methods in the article! The outcome measures used were:

  • Bayley Scales of Infant and Toddler Development, Third Edition – assessed cognition, language, and motor skills
  • Three subtests from the T.I.M.E. – Motor Organization Subtest, Mobility Subtest, Atypical Position Subtest
  • Parent report measures – Bayley Social-Emotional and Adaptive Behavior Questionnaire-Parent Caregiver Rating Form, Infant/Toddler Sensory Profile-2, Toddler Sensory Profile-2, Communication and Symbolic Behavior Scales Developmental Profile Infant Toddler Checklist, SP3D

The Results

  • The high-risk group had significantly lower scores on the Bayley-III Cognition, Receptive Communication, and Language Composite
  • The high-risk group had “more statistically significant” scores on the T.I.M.E. for atypical positions (Flanagan, Schoen, & Miller, 2019, n.p.)
  • The high-risk group had a significant difference in sensory-seeking behaviors, engaging less than the low-risk group
  • “A moderate correlation was found between risk status and Bayley-III Cognition…,Receptive Communication…, and Language Composite…. A fair correlation was observed between risk status and motor organization” (Flanagan, Schoen, & Miller, 2019, n.p.).

FAME Score

The results from this study suggest that there may be differences in cognition, language, atypical movements, and sensory processing among infants at high risk for sensory processing difficulties compared to infants at low risk (Flanagan, Schoen, & Miller, 2019). I am scoring these findings (whether or not this information us useful and applicable for future research and OT practice) using the FAME scale. If you need a reminder about what the FAME scale is, check out my blog post here!

Feasibility: B

Appropriateness: A

Meaningfulness: B

Effectiveness: C

What I Think

I think that this information is very useful! It may not warrant immediate transfer into practice, but it is a great indicator of a need for future research. It also tells practitioners to be on the lookout for these signs in infants who are at high risk for developing sensory processing difficulties. The authors concluded that it is possible to differentiate infants at high-risk for sensory processing difficulties from those at low risk. This is important because early identification may lead to earlier access to OT services. The sooner a child receives OT services, the more we can optimize occupational performance and participation! The authors provide limitations and directions for further research, so be sure to check that out in the article!

Question of the Week: If you are an OT practicing in pediatrics, do you ever see a family component in sensory processing difficulties? Meaning, if a child has an older sibling who has sensory processing difficulties, do you often find that the younger sibling does too? Comment down below!

Citation: Flanagan, J. E., Schoen, S., Miller, L. J. (2019). Early identification of sensory processing difficulties in high-risk infants. American Journal of Occupational Therapy, 73.


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