Sensory Processing Difficulties, Behavioral Problems, and Parental Stress in a Clinical Population of Young Children

Abstract

This study examined the relationship between sensory processing difficulties, parental stress, and behavioral problems in a clinical sample of young children with developmental and behavioral difficulties. We hypothesized that a high rate of sensory processing difficulties would be found, that there would be a high rate of comorbidity between sensory processing difficulties and behavioral problems, and that children’s sensory processing difficulties and parental stress would be highly correlated. Parents of 59 children ages two to five who attended an out-patient clinic in a low income, urban community completed the Child Behavior Checklist, Parental Stress Inventory-Short Form and the Short Sensory Profile. Children in this clinical population showed a high prevalence (55.9 %) of sensory processing difficulties, a significantly higher rate than previously reported. Sensory processing deficits were correlated with behavioral difficulties and parental stress levels-suggesting that as sensory processing difficulties increase, so do behavioral difficulties and parental stress. Parents of children with sensory processing deficits had significantly higher levels of parental stress than parents of children without sensory deficits. Parenting stress levels were also clinically elevated for the cohort of children in which sensory processing difficulties and behavioral concerns co-existed. These findings suggest that treatment outcomes might improve and parental stress could be reduced if mental health clinicians were trained to identify and address sensory problems. This could result in more children being screened and treated for sensory processing difficulties and an eventual reduction in the rates of parental stress.

This is a preview of subscription content, access via your institution.

References

  1. Abidin, R. R. (1995). Parenting stress index: Professional manual (3rd ed.). Odessa, FL: Psychological Assessment Resources, Inc.

    Google Scholar 

  2. Achenbach, T. M., & Edelbrock, C. (1983). Manual for the child behavior checklist and revised child behavior profile. Burlington, VT: Queen City Printers.

    Google Scholar 

  3. Ahn, R. R., Miller, L. J., Milberger, S., & McIntosh, D. N. (2004). Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy, 58(3), 287–293.

    PubMed  Article  Google Scholar 

  4. Anastopoulos, A. D., Guevremont, D. C., Shelton, T. L., & DuPaul, G. J. (1992). Parenting stress among families of children with attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 20(5), 503–520.

    PubMed  Article  Google Scholar 

  5. Baker, B. L., Blacher, J., Crnic, K., & Edelbrock, C. (2002). Behavior problems and parenting stress in families of three-year-old children with and without developmental delays. American Journal on Mental Retardation, 107(6), 433–444.

    PubMed  Article  Google Scholar 

  6. Baker, B. L., McIntyre, L. L., Blacher, J., Crnic, K., Edelbrock, C., & Low, C. (2003). Pre-school children with and without developmental delay: Behavior problems and parenting stress over time. Journal of Intellectual Disability Research, 47, 217–230.

    PubMed  Article  Google Scholar 

  7. Baranek, G. T., Roberts, J. E., David, F. J., Sideris, J., Mirrett, P. L., Hatton, D. D., et al. (2008). Developmental trajectories and correlates of sensory processing in young boys with fragile X syndrome. Physical and Occupational Therapy in Pediatrics, 28(1), 79–98.

    PubMed  Article  Google Scholar 

  8. Ben-Sasson, A., Carter, A. S., & Briggs-Gowan, M. J. (2009a). Sensory over-responsivity in elementary school: Prevalence and social-emotional correlates. Journal of Abnormal Child Psychology, 37, 705–716.

    PubMed  Article  Google Scholar 

  9. Ben-Sasson, A., Cermak, S. A., Orsmond, G. I., Tager-Flusberg, H., Carter, A. S., Kadlec, M. B., et al. (2007). Extreme sensory modulation behaviors in toddlers with autism spectrum disorders. American Journal of Occupational Therapy, 61, 584–592.

    PubMed  Article  Google Scholar 

  10. Ben-Sasson, A., Hen, L., Fluss, R., Cermak, S. A., Engel-Yeger, B., & Gal, E. (2009b). A meta-analysis of sensory modulation symptoms in individuals with Autism Spectrum Disorders. Journal of Autism Developmental Disorders, 39, 1–11.

    PubMed  Article  Google Scholar 

  11. Cascio, C. J. (2010). Somatosensory processing in neurodevelopmental disorders. Journal of Neurodevelopmental Disorders, 2(2), 62–69.

    PubMed  Article  Google Scholar 

  12. Davies, P. L., & Gavin, W. J. (2007). Validating the diagnosis of sensory processing disorders using EEG technology. American Journal of Occupational Therapy, 61, 176–189.

    PubMed  Article  Google Scholar 

  13. Donenberg, G., & Baker, B. L. (1993). The impact of young children with externalizing behaviors on their families. Journal of Abnormal Child Psychology, 21(2), 179–198.

    PubMed  Article  Google Scholar 

  14. Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young children and their families: A conceptual model. Infants and Young Children, 9(4), 23–35.

    Article  Google Scholar 

  15. Dunn, W. (1999). Sensory profile: User’s manual. San Antonio, TX: Psychological Corp.

    Google Scholar 

  16. Dunn, W. (2001). The sensations of everyday life: Empirical, theoretical, and pragmatic considerations. American Journal of Occupational Therapy, 55, 608–620.

    PubMed  Article  Google Scholar 

  17. Dunn, W. (2007). Supporting children to participate successfully in everyday life by using sensory processing knowledge. Infants and Young Children, 20, 84–101.

    Article  Google Scholar 

  18. Epstein, T., Saltzman-Benaiah, J., O’Hare, A., Goll, J. C., & Tuck, S. (2008). Associated features of Asperger Syndrome and their relationship to parenting stress. Child: Care, Health and Development, 34, 503–511.

    Article  Google Scholar 

  19. Ermer, J., & Dunn, W. (1998). The sensory profile: A discriminant analysis of children with and without disabilities. American Journal of Occupational Therapy, 52, 283–290.

    PubMed  Article  Google Scholar 

  20. Fox, N. A., & Polak, C. P. (2004). The role of sensory reactivity in understanding infant temperament. In R. DelCarmen-Wiggins & A. Carter (Eds.), Handbook of infant, toddler, and preschool mental health assessment (pp. 105–119). New York: Oxford University Press.

    Google Scholar 

  21. Gavin, W. J., Dotseth, A., Roush, K. K., Smith, C. A., Spain, H. D., & Davies, P. L. (2011). Electroencephalography in children with and without sensory processing disorders during auditory perception. American Journal of Occupational Therapy, 65, 370–377.

    PubMed  Article  Google Scholar 

  22. Gouze, K. R., Hopkins, J., LeBailly, S. A., & Lavigne, J. V. (2009). Re-examining the epidemiology of sensory regulation dysfunction and comorbid psychopathology. Journal of Abnormal Child Psychology, 37, 1077–1087.

    PubMed  Article  Google Scholar 

  23. Greenspan, S. I., & Wieder, S. (1997). An integrated developmental approach to interventions for young children with severe difficulties in relating and communicating. Zero to Three: National Center for Infants, Toddlers, and Families, 17(5), 5–18.

    Google Scholar 

  24. Gunn, T. E., Tavegia, B. D., Houskamp, B. M., McDonald, L. B., Bustrum, J. M., Welsh, R. K., et al. (2009). Relationship between sensory deficits and externalizing behaviors in an urban, Latino preschool population. Journal of Child and Family Studies, 18, 653–661.

    Article  Google Scholar 

  25. Hopkins, J., Gouze, K. R., Sadhwani, A., Radtke, L., Lebailly, S. A., & Lavigne, J. V. (2008). Biological and psychosocial risk factors differentially predict internalizing/externalizing problems in preschoolers. Paper presented at the 20th annual convention of the Association for Psychological Science, Chicago, IL.

  26. Jaegermann, N., & Klein, P. S. (2010). Enhancing mothers’ interactions with toddlers who have sensory-processing disorders. Infant Mental Health Journal, 31(3), 291–311.

    Article  Google Scholar 

  27. Kientz, M. A., & Dunn, W. (1997). A comparison of the performance of children with and without autism on the sensory profile. American Journal of Occupational Therapy, 51, 530–537.

    PubMed  Article  Google Scholar 

  28. Krieger, N., Williams, D. R., & Moss, N. E. (2006). Measuring social class in US public health research: Concepts, methodologies and guidelines. Annual Reviews in Public Health, 18, 341–378.

    Article  Google Scholar 

  29. Mangeot, S. D., Miller, L. J., McIntosh, D. N., McGrath-Clarke, J., Simon, J., Hagerman, R. J., et al. (2001). Sensory modulation dysfunction in children with attention deficit hyperactivity disorder. Developmental Medicine and Child Neurology, 43, 399–406.

    PubMed  Article  Google Scholar 

  30. McIntosh, D. M., Miller, L. J., Shyu, V., & Dunn, W. (1999a). Overview of the short sensory profile. In W. Dunn (Ed.), Sensory profile: User’s manual (pp. 59–73). San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  31. McIntosh, D. M., Miller, L. J., Shyu, V., & Hagerman, R. (1999b). Sensory-modulation disruption, electrodermal responses, and functional behaviors. Developmental Medicine and Child Neurology, 41, 608–615.

    PubMed  Article  Google Scholar 

  32. Miller, L. J., McIntosh, D. N., McGrath, J., Shyu, V., Lampe, M., Taylor, A., et al. (1999). Electrodermal responses to sensory stimuli in individuals with fragile X syndrome: A preliminary report. American Journal of Medical Genetics, 83(4), 268–279.

    PubMed  Article  Google Scholar 

  33. Miller, L. J., Nielsen, D. M., & Schoen, S. A. (2012). Attention deficit hyperactivity disorder and sensory modulation disorder: A comparison of behavior and physiology. Research in Developmental Disabilities, 33, i804–i818.

    Article  Google Scholar 

  34. Miller, L. J., Robinson, J., & Moulton, D. (2004). Sensory modulation dysfunction: Identification in early childhood. In R. DelCarmen-Wiggins & A. Carter (Eds.), Handbook of infant, toddler, and preschool mental health assessment (pp. 247–270). New York, NY: Oxford University Press.

    Google Scholar 

  35. Rescorla, L. A. (2005). Assessment of young children using the Achenbach system of empirically based assessment (ASEBA). Mental Retardation and Developmental Disabilities Research Reviews, 11, 226–237.

    PubMed  Article  Google Scholar 

  36. Roberts, S. (2011, September 22). As effects of recession linger, growth in city’s poverty rate outpaces the nations. New York Times, p. A23.

  37. Rodriguez, C. (2010). Association between independent reports of maternal parenting stress and children’s internalizing symptoms. Journal of Child and Family Studies, 19(6), 762–770.

    Article  Google Scholar 

  38. Schaaf, R. C., Benevides, T., Blanche, E. I., Brett-Green, B. A., Burke, J. P., Cohn, E. S., et al. (2010). Parasympathetic functions in children with sensory processing disorder. Frontiers in Integrative Neuroscience, 4, 1–11.

    Article  Google Scholar 

  39. Talay-Ongan, A., & Wood, K. (2000). Unusual sensory sensitivities in autism: A possible crossroads. International Journal of Disability, Development, and Education, 47(2), 201–212.

    Article  Google Scholar 

  40. Van Hulle, C. A., Schmidt, N. L., & Goldsmith, H. H. (2012). Is sensory over-responsivity distinguishable from childhood behavior problems? A phenotypic and genetic analysis. Journal of Child Psychology and Psychiatry, 53(1), 64–72.

    PubMed  Article  Google Scholar 

  41. Walker, L. O., & Cheng, C. (2006). Maternal empathy, self-confidence, and stress as antecedents of preschool children’s behavior problems. Journal for Specialists in Pediatric Nursing, 12(2), 93–104.

    Article  Google Scholar 

  42. Yeo, R. A., Hill, D. E., Campbell, R. A., Vigil, J., Petropoulos, H., Hart, B., et al. (2003). Proton magnetic resonance spectroscopy investigation of the right frontal lobe in children with attention deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 303–310.

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank the Bronx CREED project funded by NIH’s National Center for Minority Health & Health Disparities (grant # P60 MD000514) for their help with language translational services, Paraic Kenny, PhD for his generous assistance with statistical analysis, Sarah A. Schoen, PhD, OTR for her prompt attention in solving a SSP scoring question, Emily Fried, LMSW, MSEd for her assistance, and the clinicians and families of the Early Childhood Center who participated in this study. Financial support for this project was provided in part by a Leadership Education in Neurodevelopmental Disabilities (LEND) fellowship to the second author.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Lauren Gourley.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Gourley, L., Wind, C., Henninger, E.M. et al. Sensory Processing Difficulties, Behavioral Problems, and Parental Stress in a Clinical Population of Young Children. J Child Fam Stud 22, 912–921 (2013). https://doi.org/10.1007/s10826-012-9650-9

Download citation

Keywords

  • Sensory processing disorder
  • Short sensory profile
  • Parental stress
  • Behavioral difficulties
  • Preschool aged children