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Start studying The Adolescent/Adult Sensory Profile ppt- edited by TM. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Jul 01, 2012 The purpose of this study was to (1) validate the Hebrew version of the Adolescent/Adult Sensory Profile (AASP); (2) screen sensory processing difficulties, as expressed in daily living in a vast range of ages of healthy Israeli adolescents, adults and older people; and (3) examine gender effect on sensory processing in the different age groups.
The Adolescent/Adult Sensory Profile August 2015 Overview The Adolescent/Adult Sensory Profile (Brown & Dunn, 2002) is a standardized assessment that measures sensory processing among adolescents and adults, ages 11 years and up. It elicits information about the adolescent’s or adult’s responsiveness to. Oct 08, 2019 Assessment Tools Sensory profile: user's manual Search this Guide Search. Adolescent/adult sensory profile: user's manual. CINAHL and PubMed searches on the reliability and validity for the Sensory profile: user's manual. Click on the database link to run the search.
Abstract
[Purpose] The present study aimed to understand characteristics of sensory processing inpatients who have experienced a stroke using the previously established, self-diagnosticAdolescent/Adult Sensory Profile (AASP). [Subjects and Methods] Data from 180 total Koreanpatients who had been diagnosed as having experienced a stroke were collected and analyzedbetween May and August of 2015. [Results] Average scores for each sensory processingdomain were as follows: low registration (32.1), sensation seeking (34.3), sensorysensitivity (36.7), and sensation avoiding (34.0). Study participants exhibited similarscores to healthy controls (data obtained from previous studies) with the followingfrequencies: low registration (65%), sensation seeking (77.2%), sensory sensitivity (65%),and sensation avoiding (62.2%). Significant differences were observed between control dataand scores obtained for study participants in all domains except that of sensorysensitivity. [Conclusion] The results of the present study indicate that therapeuticintervention following the experience of a stroke should account for individualdifferences in sensory processing abilities to provide the environment most conducive tothe patient’s overall cognitive and physical improvement.
INTRODUCTION
Following a stroke, the majority of patients experience alterations in a variety ofbehavioral patterns, ranging from physical disability to psychological impairment. Among thesecondary cognitive impairments observed are deficits in speech and memory, as well asemotional disturbance or dysregulation1).Sensory processing is the neural process by which information regarding the environment istransmitted to the brain via the peripheral nervous system, ultimately allowing theindividual to select actions and responses appropriate to the immediate environment2). As many cognitive functions aresignificantly affected by an individual’s ability to process sensory information, sensoryprocessing difficulties following stroke may lead to further cognitive and behavioralimpairments3). Further, individualdifferences are observed in both perception and cognitive processing of this peripheralinformation, resulting in differential responses to changing sensory information4). The strength of a given stimulus withrespect to any individual does not necessarily correlate with the actual, measured intensityof the stimulus. For example, individuals adopting a strategy of avoidance may do so becauseof heightened sensitivity to changes in environmental stimuli. Such levels of sensoryinformation processing vary from individual to individual, with different patterns ofsensory processing resulting in apparent differences in behavior, ). The choices onemakes regarding action are therefore dependent on the individual’s experience and ability toprocess the situation, with such choices accumulating over time to eventually exert effectson the individual’s quality of life4).
Brown and Dunn theorized that difficulties in social functioning such as delayed responsetimes, unintended actions, and failure to grasp the social atmosphere in a given situationmay be due to impairments in sensory processing7). A previous study comparing the sensory processing capabilities ofchildren with developmental disabilities to those of typically-developing adults revealedthat adults exhibited sensory defensiveness in four of six areas of behavior, similar toresults obtained for children with developmental delays. Some authors have furtheremphasized the need for research regarding sensory processing in adults8). Previous research has also described the relationshipbetween reactions to sensory stimuli and associated behavioral responses, proposing aframework for adult sensory defensiveness). Kinnealey et al. have further advocated for research regardingsensory processing in adults based on observations that 15% of adults exhibit sensorydefensiveness10). Korean researchershave similarly observed the significant impact of sensory processing ability on overallfunction. Park et al. investigated the ability of non-traditional methods to improve avariety of cognitive functions, including sensory processing, in the elderly, who tend toexhibit decreased cognitive performance across numerous domains that appears resistant toimprovement with more traditional methods aimed at direct improvement of specific functions(i.e., memory, speed, etc.)11). Also, Kimet al. reported that adults begin to exhibit passive behavioral patterns as the culturalbackground and social environment exert influence on their individual sensory processingabilities12). Though these adults havenot experienced structural damage that would indicate decreases in function, a lack ofopportunity to experience various, enriching environments may still result in difficultiesin sensory processing similar to those observed when actual structural damage hasoccurred13). In this way, the sensoryprocessing of basic characteristics determines behavior for all individuals, not just thoseaffected by diagnosed neurological impairments. The present study aims to identifyalterations in sensory processing patterns following the experience of a stroke, with thegoal of providing information regarding the roles of environment, culture, and physicalcondition with respect to physical and occupational therapeutic interventions. Suchinformation may then allow for improvements in quality of life in addition to functionalrecovery.
SUBJECTS AND METHODS
Participants for the present study were selected from among those patients receivingphysical, occupational, and speech therapy following the experience and subsequent diagnosisof stroke at a number of general and university hospitals located in South Korea. Prior toparticipation in the study, 240 patients who had experienced a stroke and fulfilled theselection criteria received written information regarding the study and subsequentlyprovided their written informed consent. Patients were required to meet the followingselection criteria for inclusion in the study: 1) diagnosis of stroke by a specialist; 2)score of more than 75 points on the Modified Barthel Index (MBI); 3) a score of more than 20points on the Korean version of the Mental State Examination (K-MMSE); 4) no history ofheart disease; 5) no severe visual impairments; 6) no severe auditory impairments; 7) noorthopedic conditions; 8) no history of psychological disorders; 9) no other impairment thatwould significantly affect ability to participate in the study. This study was approved bythe Institutional Review Board of Kangwon National University (numberKWNUIRB-2015-03-005-001), in accordance with the ethical standards of the Declaration ofHelsinki (1975, revised in 1983). Questionnaires were distributed to patients themselves,though those with visual disabilities were assisted by their protectors/therapists inreading the questions. Additional information was collected by an experienced therapistusing a recording sheet. A total of 480 questionnaires were collected out of the 550 thathad been initially distributed. A reliability test was conducted using data from 340collected questionnaires to assess the degree to which the AASP produced stable andconsistent results. After excluding for vote and illegible writing, information from 180questionnaires was used for further analyses. The total data collection period extended fromMay to August 2015. The frequency of each questionnaire item was calculated, and dataregarding general, medical, and functional participant characteristics were analyzed usingfrequency analysis. A one-sample t-test was performed to evaluate differences in thedistribution of scores between patients who had experienced stroke and healthy controls ofprevious studies. A χ2 test was used to evaluate statistically significantdifferences in each of four areas of Dunn’s model of sensory processing with respect tobehavioral responses, general clinical and functional patient characteristics, and theneurological threshold. For all analyses, the level of statistical significance was set atp<0.05.
RESULTS
The average AASP score of 180 patients who had experienced a stroke was analyzed toinvestigate the sensory processing patterns of the patient group (Tables 1 and and2Table2). The average score on the low registration domain, which may indicate apattern of passive behavioral responses in which the individual requiresstronger-than-normal stimuli to elicit a response, was 32.1 points. The average score on thedomain of sensation seeking, indicative of a pattern of active behavioral responsesassociated with enjoying or creating sensory-rich environments, was 34.3 points. The averagescore on the domain of sensory sensitivity, indicative of a pattern of active behavioralresponses associated with hyper-awareness of surroundings and easy distractibility, was 36.7points. The average score on the sensation avoiding domain, indicative of an active,intentional withdrawal from or blocking of sensation, was 34.0 points. The results of theanalysis of sensory processing patterns according to the frequency of particular sensoryprocessing domain scores are presented in Table3. Of the 180 participants, 65% appeared to accept the low registration sensorystimulus, a result similar to that observed for healthy controls. With regard to thesensation seeking domain, 77.2% of study patients appeared to accept the sensory stimulus,and 14.4% ± 1.6% exhibited a higher than average neurological threshold, with the exceptionof passive behavioral responses on stimulus searching items. With regard to the sensorysensitivity domain, 65% of the 180 subjects exhibited typical patterns of sensoryprocessing, while 16.7% ± 1.7% were more sensitive and 14.2% ± 2.2% were less sensitive thanaverage. With regard to the sensation avoiding domain, 62.2% of patients responded similarlyto healthy control subjects, 21.6% exhibited fewer avoidant responses, and 12.7% exhibitedmore avoidant responses than average. Average sensory processing scores for studyparticipants with respect to each domain are presented in comparison to scores obtained forhealthy Korean adults in Table 4. The comparison of average sensory processing scores between studyparticipants and healthy controls revealed significant differences in the low registration,sensation seeking, and sensation avoiding domains (p<0.05, p<0.001). No significantdifference was observed between the scores of study participants and control data withrespect to sensory sensitivity (p>0.05) (Table5).
Table 1.
| General characteristics | N (%) | Mean ± SD | |
|---|---|---|---|
| Gender | Male | 96 (53.3) | |
| Female | 84 (46.7) | ||
| Age (years) | <30 | 4 (2.2) | 57.63 ± 13.87 |
| 30–39 | 11 (6.1) | ||
| 40–49 | 40 (22.2) | ||
| 50–59 | 46 (25.6) | ||
| >60 | 79 (43.9) | ||
| Marital status | Single | 16 (8.9) | |
| Married | 164 (91.1) | ||
| Family relatives living together | Yes | 162 (90.0) | |
| No | 18 (10.0) | ||
| Caregivers | Spouse | 49 (27.2) | |
| Children | 12 (6.7) | ||
| Parents | 14 (7.8) | ||
| Caregivers | 78 (43.3) | ||
| None | 27 (15.0) | ||
| Job type before the onset | Blue-collar Job | 24 (13.3) | |
| Office workers | 28 (15.6) | ||
| Tech job | 23 (12.8) | ||
| Service industry | 31 (17.2) | ||
| Unemployed | 74 (41.1) | ||
| Return to work | Yes | 5 (2.8) | |
| No | 171 (96.6) | ||
| Job desires | Yes | 94 (53.1) | |
| No | 80 (45.2) | ||
| Education | No education | 12 (6.7) | |
| Elementary school | 19 (10.6) | ||
| Middle school | 26 (14.5) | ||
| High school | 52 (29.1) | ||
| College | 13 (7.3) | ||
| University or higher | 57 (31.8) | ||
| Average monthly income | <100 | 25 (15.8) | |
| 100–199 | 31 (19.6) | ||
| 200–299 | 35 (22.2) | ||
| 300–399 | 33 (20.9) | ||
| >400 | 34 (21.5) | ||
| Total | 180 (100.0) | ||
Mean ± SD: mean and standard deviation
Table 2.
| Quadrant | Raw score | Much less than most people | Less than most people | Similar to most people | More than most people | Much more than most people |
|---|---|---|---|---|---|---|
| (−) | (−) | (=) | (+) | (++) | ||
| 1. Low registration | /75 | 15–17 | 18–22 | 23–39 | 40–52 | 53–75 |
| 2. Sensation seeking | /75 | 15–19 | 20–26 | 27–41 | 42–51 | 52–75 |
| 3. Sensory sensitivity | /75 | 15–19 | 20–26 | 27–45 | 46–55 | 56–75 |
| 4. Sensation avoiding | /75 | 15–19 | 20–24 | 25–44 | 45–55 | 56–75 |
| Score distribution | 2% | 14% | 68% | 14% | 2% | |
Table 3.
| Quadrant | Mean ± SD | Score analysis |
|---|---|---|
| 1. Low registration | 32.11 ± 8.64 | Similar to most people |
| 2. Sensation seeking | 34.26 ± 7.48 | Similar to most people |
| 3. Sensory sensitivity | 36.56 ± 9.36 | Similar to most people |
| 4. Sensation avoiding | 34.79 ± 9.29 | Similar to most people |
Mean ± SD: mean and standard deviation
Table 4.
| Quadrant | Much less than most people | Less than most people | Similar to most people | More than most people | Much more than most people | Total |
|---|---|---|---|---|---|---|
| N (%) | ||||||
| 1. Low registration*** | 10 (5.6) | 43 (23.9) | 117 (65) | 9 (5) | 1 (0.5) | 180 (100) |
| 2. Sensation seeking* | 3 (1.6) | 26 (14.4) | 139 (77.2) | 11 (6.1) | 1 (0.6) | |
| 3. Sensory sensitivity* | 4 (2.2) | 26 (14.4) | 117 (65) | 30 (16.7) | 3 (1.7) | |
| 4. Sensation avoiding*** | 2 (1.1) | 39 (21.6) | 112 (62.2) | 23 (12.7) | 4 (2.2) | |
| Control distribution | 2% | 14% | 68% | 14% | 2% | (100) |
*p<0.05 ***p<0.001
Table 5.
| N | Low registration*** | Sensation seeking*** | Sensory sensitivity | Sensation avoiding* | |
|---|---|---|---|---|---|
| Mean ± SD | |||||
| Hemiplegic patients | 180 | 32.1 ± 8.6 | 34.3 ± 7.5 | 36.6 ± 9.4 | 34.8 ± 9.3 |
| Healthy control12 | 300 | 34.6 ± 6.9 | 39.8 ± 7.1 | 35.3 ± 8.0 | 37.0 ± 7.7 |
Mean ± SD: mean and standard deviation *p<0.05, ***p<0.001
DISCUSSION
Early physical and occupational therapists assessed individual differences in sensoryprocessing ability using separate measures for each area. However, sensory processing is notcharacterized by isolated analysis of information from specific areas; rather, itencompasses a vast array of sensory information14). Stable trends in sensory processing capabilities are moreindicative of the complex cognitive processes involved in the analysis of and response tosensory information than individual measures alone. Therefore, research regarding thismultidimensional processing of sensory information should encompass both the sensoryexperience and the individual response to environmental conditions, focusing onhow the sensation is processed rather than how well itis processed. Though research regarding sensory processing patterns has been conducted usingactive instruction directed at children, insufficient data exist regarding these patterns inadult subjects. For patients who have experienced a stroke, the pathological characteristicsof the central nervous system result in secondary difficulties in both perception andcognition, though some decline occurs as part of the normal aging process. Difficulty inconnecting accepted sensory information to motor function is influenced not just byneurological damage but also by internal factors such as personality and geneticcharacteristics, as well as by external factors such as familial and environmentalcharacteristics15). Therefore, thepresent study utilized the AASP to explore the sensory processing patterns exhibited bypatients who have experienced a stroke.
Average scores for each quadrant of the AASP were as follows: low registration (32.1points), sensation seeking (34.3 points), sensory sensitivity (36.7 points), and sensationavoiding (34.0 points). Also, the results of the analysis of sensory processing patterns instroke patients showed that 65.0% of the 180 people (117 patients) showed a similar patternin low registration. Analysis of sensory processing patterns in study participants revealedthat 65% of the 180 patients (n=117) exhibited patterns of low registration similar to thoseobserved in controls, while 23.9% (n=43) exhibited higher responses to environmentalstimuli. Very high attention to such stimuli was observed in 5.6% of patients (n=10). Theaforementioned results may indicate that alterations in sensory threshold caused by braindamage and the resultant cognitive instability cultivate passive behavioral patterns thatcontribute to increased responses to stimuli. Dunn et al. observed that individuals withelevated sensory registration capabilities more quickly react to stimuli and exhibit apassive behavioral pattern). Brown andDunn further revealed that the sensation seeking domain has a high neurological thresholdand necessitates an active pattern of behavioral response as individuals attempt to createor seek out enriched sensory environments7). Individuals scoring high on this domain would therefore benefit fromsensory rich environments and experience difficult in low sensory environments, particularlyin therapeutic settings. In the present study, similar patterns were observed with respectto the sensation seeking domain for both study participants (77.2%, n=138) and healthycontrols. However, 14.4% of study patients were observed to have lower scores thanpreviously studied controls. This difference may be attributed to difficulties in navigatingand participating in the external environment in daily life. Patients experiencing suchdifficulties may benefit from the non-traditional therapeutic interventions previouslyproposed by Brown and Dunn7). Suchinterventions account for the sensory-seeking nature of the individual patient, utilizingsensation of the environment as an interactive strategy and allowing for frequent exposureto environmental stimuli, such as changes in food or the arrangement of furniture. Withregard to sensory sensitivity, 65% of participants (n=117) exhibited similar patterns ofsensory processing to those observed for healthy controls, while 16.7% (n=30) were observedto be more sensitive than controls. Such a result may be related to decreases in sensorythreshold and the presence of unstable cognitive states following the experience of stroke.For individuals scoring high on the sensory sensitivity domain, these aspects should beconsidered, and intervention should focus on reducing patterns of sensitivity throughrepeated training and task consistency, with the ultimate goal of reducing difficulties inperformance related to inability to block irrelevant stimuli, 7). Though 62.2% (n=112) ofpatients exhibited sensation avoiding patterns similar to those observed for healthycontrols, 21.6% (n=39) reported greater patterns of sensory avoidant behavior with respectto the control population. Decreases in sensory sensitivity and impaired ability to evaluatevarious situations are considered to result from losses in cognitive function and mayaccount for patterns of sensory avoiding behavior, according to Dunn’s model of sensoryprocessing). Consequently, differencesin sensory processing scores were observed between stroke patients and healthy controls.With respect to the low registration, sensory sensitivity, and sensation avoiding domains,scores obtained for study participants ranged from 1.2 to 3.7 points below those of healthycontrols, with scores as much as 2.6 points lower for the sensory sensitivity domain. Such ahigh sensory threshold may be the result of impaired perception and cognitive functioningcaused by stroke-related neurological damage, and expectations of physical recovery mayfurther actively heighten the response. In conclusion, an average of 67% of studyparticipants exhibited similar patterns of sensory processing to healthy controls on mostaspects of processing, while the remaining 32% showed a pattern divergent from that observedin the same control population. Further research is required to assess the correlation amongsensory processing, psychological factors, and motor function in patients who haveexperienced a stroke.