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Description and measurement of sensory symptoms in autism spectrum
Örebro University, School of Medical Sciences.
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Unusual responses to sensory stimuli have been reported in nearly all children with autism spectrum conditions (ASC). A few studies on adults indicate that the sensory and perceptual problems persist into adulthood. Sensory symptoms have not been included in the diagnostic criteria for ASC but in the new diagnostic manual (DSM-5, 2013) hyper- or hyporeactivity or unusual sensory interests were included in the diagnostic criteria for ASC. Sensory phenomena are mostly investigated in studies involving children and the scales used to measure sensory reactivity have been constructed on the basis of the scientific literature and parents’ reports. The experiences of adults with ASC are not well understood and have not been systematically used to develop measures.

The overall aim of the thesis was to capture the first-hand experiences of and perspectives on sensory reactivity and translate them into a self-rating scale. To fulfil this overarching aim the personal sensory experiences of adults with ASC were investigated and the variations and range of atypical sensory phenomena explored and described in two qualitative studies (study I and II). The analyses of the firstperson descriptions enabled the development of items for a scale. These were reduced in steps and the final scale which was named the Sensory Reactivity in Autism Spectrum scale (SR-AS) comprised 32 items in four subscales: high awareness/ hyperreactivity, low awareness/hyporeactivity, strong sensory interests and sensory/motor. The SR-AS was validated using content and factor analyses. Its discriminative validity was then investigated as well as its reliability in the form of internal consistency (study III). In the final step the scale was used to identify clusters of atypical sensory functioning in adults with ASC by hierarchical cluster analysis (study IV). Three different sensory clusters were found.

The main contribution of this thesis is its presentation of individual experience and perspectives and the creation of an clinical tool to measure atypical sensory reactivity frequently experienced by people with ASC. The ways in which the SR-AS can be used comprise assessment of individual sensory patterns for self-knowledge and awareness, to enable the development of coping strategies and to provide information on environmental adjustments required. In diagnostic processes where other criteria for ASC are fulfilled the SR-AS can be used for assessing sensory symptoms according to the DSM-5.

Place, publisher, year, edition, pages
Örebro: Örebro university , 2016. , p. 85
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 139
Keyword [en]
Autism spectrum, sensory, perception, qualitative research, scale development, scale validation, sensory clusters
National Category
General Practice
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-48130ISBN: 978-91-7529-129-1 (print)OAI: oai:DiVA.org:oru-48130DiVA: diva2:901740
Public defence
2016-04-22, Universitetssjukhuset, hörsal C3, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-02-09 Created: 2016-02-09 Last updated: 2018-01-10Bibliographically approved
List of papers
1. Autobiographical Accounts of Sensing in Asperger Syndrome and High-Functioning Autism
Open this publication in new window or tab >>Autobiographical Accounts of Sensing in Asperger Syndrome and High-Functioning Autism
2012 (English)In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 26, no 5, p. 420-429Article in journal (Refereed) Published
Abstract [en]

Sensory experiences in Asperger syndrome (AS) or high-functioning autism (HFA) were explored by qualitative content analysis of autobiographical texts by persons with AS/HFA. Predetermined categories of hyper- and hyposensitivity were applied to texts. Hypersensitivity consists of strong reactions and heightened apprehension in reaction to external stimuli, sometimes together with overfocused or unselective attention. It was common in vision, hearing, and touch. In contrast, hyposensitivity was frequent in reaction to internal and body stimuli such as interoception, proprioception, and pain. It consists of less registration, discrimination, and recognition of stimuli as well as cravings for specific stimuli. Awareness of the strong impact of sensitivity is essential for creating good environments and encounters in the context of psychiatric and other health care.

Place, publisher, year, edition, pages
Philadelphia, USA: Elsevier, 2012
National Category
General Practice
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-49474 (URN)10.1016/j.apnu.2011.10.003 (DOI)000309437700011 ()22999038 (PubMedID)2-s2.0-84866446577 (Scopus ID)
Available from: 2016-03-29 Created: 2016-03-24 Last updated: 2018-01-10Bibliographically approved
2. Too much or too little: hyper- and hypo-reactivity in high-functioning autism spectrum conditions
Open this publication in new window or tab >>Too much or too little: hyper- and hypo-reactivity in high-functioning autism spectrum conditions
2013 (English)In: Journal of Intellectual & Developmental Disability, ISSN 1366-8250, E-ISSN 1469-9532, Vol. 38, no 3, p. 232-241Article in journal (Refereed) Published
Abstract [en]

Background: Sensory reactivity in people with autism spectrum conditions (ASC) has been found to differ in comparison to reactivity in people without ASC. In this study sensory experiences of high-functioning individuals with ASC were explored and described.

Method: Interview data from 15 participants with a diagnosis of ASC were analysed by content analysis.

Results: Seven aspects of sensory experiences were identified: Being hyper- and hypo-reactive, reacting to general overload, having strong stimuli preferences, managing attentiveness to stimuli, managing sensory/motor stimuli, and dealing with consequences of sensory reactions in daily life.

Conclusions: The categorisation of sensory reactivity in this study can guide clinicians on how to pose questions about sensory issues to individuals with ASC. The assessment of spectrum-specific sensory experiences in high-functioning ASC and their association with other social and nonsocial features of ASC are goals for further research.

Place, publisher, year, edition, pages
Taylor & Francis, 2013
Keyword
Autism spectrum disorder, sensory reactivity, qualitative research
National Category
Nursing
Research subject
Occupational therapy; Caring sciences
Identifiers
urn:nbn:se:oru:diva-30899 (URN)10.3109/13668250.2013.815694 (DOI)000323729700005 ()23984882 (PubMedID)2-s2.0-84883442689 (Scopus ID)
Available from: 2013-09-26 Created: 2013-09-20 Last updated: 2017-12-06Bibliographically approved
3. Development and pilot validation of a sensory reactivity scale for adults with high functioning autism spectrum conditions: Sensory Reactivity in Autism Spectrum (SR-AS)
Open this publication in new window or tab >>Development and pilot validation of a sensory reactivity scale for adults with high functioning autism spectrum conditions: Sensory Reactivity in Autism Spectrum (SR-AS)
2016 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 2, p. 103-110Article in journal (Refereed) Published
Abstract [en]

Background: Unusual reactions to sensory stimuli are experienced by 90-95% of people with an autism spectrum condition (ASC). Self-reported sensory reactivity in ASC has mainly been measured with generic questionnaires developed and validated on data from the general population. Interest in sensory reactivity in ASC increased after the inclusion of hyper- and hypo-reactivity together with unusual sensory interest as diagnostic markers of ASC in the DSM-5.

Aims: To develop and pilot validate a self-report questionnaire designed from first-hand descriptions of the target group of adults diagnosed with high functioning ASC. Psychometric properties of the questionnaire were evaluated on a sample of participants with ASC diagnoses (N = 71) and a random sample from the general population (N = 162).

Results: The Sensory Reactivity in Autism Spectrum (SR-AS is intended to be used as a screening tool in diagnostic processes with adults and for support in adapting compensating strategies and environmental adjustments. The internal consistency was high for both the SR-AS and its subscales. The total scale Cronbach's alpha was 0.96 and the subscales alphas were 0.80. Confirmatory factor analysis (CFA) showed best fit for a four-factor model of inter-correlated factors: hyper and hypo-reactivity, strong sensory interest and a sensory/motor factor. The questionnaire discriminated well between ASC-diagnosed participants and participants from the general population.

Conclusions: The SR-AS displayed good internal consistency and discriminatory power and promising factorial validity.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keyword
Autism spectrum, Psychometric validation, Scale development, Sensory reactivity
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:oru:diva-47286 (URN)10.3109/08039488.2015.1053984 (DOI)000366184300004 ()26158770 (PubMedID)2-s2.0-84949437448 (Scopus ID)
Note

Funding Agencies:

Research Committee of Örebro County Council

Uppsala-Örebro Regional Research Council

Available from: 2016-01-07 Created: 2016-01-04 Last updated: 2017-12-01Bibliographically approved
4. Sensory clusters of adults with and without autism spectrum conditions
Open this publication in new window or tab >>Sensory clusters of adults with and without autism spectrum conditions
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
General Practice
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-49580 (URN)
Available from: 2016-03-29 Created: 2016-03-29 Last updated: 2018-01-10Bibliographically approved

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