the adolescent/adult sensory profile
DESCRIPTION
The Adolescent/Adult Sensory Profile. Tana Brown PhD, OTR FAOTA University of Kansas Medical Center Occupational Therapy Education. Presentation topics. History of the A/ASP Overview of the sensory processing model Taking and scoring the profile Interpreting the profile - PowerPoint PPT PresentationTRANSCRIPT
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The Adolescent/Adult Sensory Profile
Tana Brown PhD, OTR FAOTAUniversity of Kansas Medical CenterOccupational Therapy Education
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Presentation topics
History of the A/ASP Overview of the sensory processing model Taking and scoring the profile Interpreting the profile Intervention guidelines Practice designing environments to support
sensory processing preferences Considerations for specific diagnostic groups
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General information before we get started Not a “sensory integration” presentation
The model applies to all people – not an impairment model
Will provide a framework for assessment and intervention that is applicable regardless of the population
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History of the A/ASP
Statistical analysis of the children’s version of the Sensory Profile
Development of the model of Sensory Processing
Relationship to adult issues Development of the Adult version Revisions to make applicable to
adolescents
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Overview of Dunn’s Model of Sensory Processing
Theoretical framework for interpreting the measure and designing intervention
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Dunn’s Model of Sensory Processing
Behavioral Response Behavioral Responsein accordance to counteractPassiveActive
Low Low Registration Sensation SeekingThreshold
High Sensory Sensitivity Sensation AvoidingThreshold
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Sensory Sensitivity
passive response to a low threshold easily respond to sensory stimuli notice things other people don’t
notice highly aware of their surroundings distractible
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Sensation Avoiding
active counteracting a low threshold intentional withdrawal or blocking of
sensation use of rituals and routines overwhelmed by sensory rich
environments good at creating structured and
supportive environments
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Low Registration
Passive response with a high threshold miss available sensory input spacey, clumsy under-responsive or slow to respond can focus in distracting environments flexible, comfortable in wide range of
environments
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Sensation Seeking
behavioral response to counteract a high threshold
enjoys sensory rich environments creates sensation easily bored trouble tolerating low stimulus
environments
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Adolescent/Adult Sensory Profile measure of sensory processing
preferences Self questionnaire 60 items – 15/quadrant Taste/smell, movement, visual,
tough, auditory, activity level Ages 11 and up
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If/when the A/ASP is revised…
Change the double negative items
Better distinguish sensory sensitivity and sensation avoiding by making sensitivity items focus on detection and not annoyance of sensation
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Who should fill out the A/ASP?
It is designed to be a self-report
Informant reporting should be done cautiously and avoid interpretations based on scores
Best informants would be those that have caretaking responsibilities
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Fill out and score the A/ASP
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Classification System
Based on standardization sample 193 adolescents, 496 adults, 261 older
adults Cut scores for each quadrant Classifications
Much less than most people Less than most people Similar to most people More than most people Much more than most people
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Uses normal distribution
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Support for Reliability
Internal consistency for quadrants range from .65 - .78
Each item on a subscale correlates best with its intended subscale
Standard error of measurement ranges from 3.58 – 4.51
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Validity Evidence
Discriminant Validity with Adult Temperament Questionnaire (Chess & Thomas, 1998)
Sensation seeking scores negatively correlated with withdrawal and dysphoric mood subscales
Sensitivity subscales positively correlated with dysphoric mood and sensory threshold subscales
Sensation avoiding positively correlated with low adaptability, withdrawal and dysphoric mood
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Further support for validity
Physiological data consistent with four quadrants Sensory sensitivity respond intensely and
habituate slowly Sensation avoiding respond intensely but
habituate quickly Low registration respond weakly and
habituate quickly Sensation seeking respond weakly but
habituate slowly
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More support for validity
Distinguished people with and without mental illness
Distinguished younger and older adults
Child version distinguished children with autism and ADHD
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Considerations
Scoring different than child, infant/toddler versions
All preferences have advantages and disadvantages
Consider all quadrants together Consider meaning of low scores
(particularly for seeking and avoiding behaviors)
Consider patterns within sensory categories
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Intervention Strategies
Create a supportive environment
Increase tolerance, rather than change the person’s preference
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Increase tolerance
Graded exposures
Personal commitment, rewards or other external motivators
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Analyzing the environment
Intensity Amount Repetition Competing stimuli Predictability Familiarity Speed
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The Auditory Environment
Intensity – soft/loud Amount – intermittent, constant Repetition – rhythmic Competing stimuli – background noise,
multiple conversations Predictability - startle Familiarity – accents or garbled speech Speed – rate of speech
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The Visual Environment
Intensity – brightness, colors Amount – number of objects to process Repetition – clean lines, patterns Competing stimuli - clutter Predictability – organized, movement Familiarity – visual input is recognizable, known
vs. unknown setting Speed – how much time to process information
(static environment versus moving {driving})
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The Tactile Environment
Intensity – light versus deep pressure, degree of irritability
Amount – body surface Repetition – constant or intermittent Competing stimuli – consider ambient
environment – temperature, wind, fans Predictability – handshake versus being
touched from behind Familiarity – recognize what you are touching
(stepping on something unfamiliar) Speed – fast/slow
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The Gustatory Environment
Intensity – spices, temperature Amount – how much is taste a part of the
experience Repetition – different tastes or lots of the same Competing stimuli – eat everything separately,
mix foods together Predictability – taste surprises (e.g. plantains
not bananas) Familiarity – eaten before Speed – how quickly you eat and therefore
taste
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The Olfactory Environment
Intensity – strength of the smell Amount – e.g. bath stores, restaurants Repetition – less relevant Competing stimuli – unpleasant smells can be
especially distracting Predictability – can detect when and where Familiarity – can detect what Speed – tends to be more constant, smells
generally do not come and go quickly
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The Vestibular/Proprioceptive Environment Intensity – large, pounding movements Amount – activity level Repetition – rhythmic, cadenced Competing stimuli – mostly when not executing
movements on own, - car, rides, elevator Predictability – can anticipate movement and
body in space Familiarity – established motor patterns Speed – slow versus quick movements
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Let’s analyze an environment
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Low Registration
↑ Intensity ↑ Amount ≈ Consistency ≈ Competing (↑ intensity of salient stimuli) ↓ Predictability ↓ Familiarity ↓ Speed
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Other Low Registration Considerations There could be safety issues related to
not noticing Will probably have a high level of
tolerance for different types of environments so capitalize on flexibility
Cues are an essential strategy because it increases accessibility of salient/important information
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Sensation Seeking
↑ ↑ Intensity ↑ Amount ↓ ↓ Consistency ↑ Competing ↓ Predictability ↓ ↓ Familiarity ↑ Speed
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Other sensation seeking considerations Incorporate additional sensations into
daily routines What may be distracting for others, may
help increase arousal/promote attention for sensation seekers
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Sensory Sensitivity
↓ Intensity ↓ Amount ↑ Consistency ↓ ↓ Competing ↑ Predictability ↑ Familiarity ↓ Speed
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Other sensory sensitivity considerations How capable is person of assimilating
multiple stimuli (may be sensitive but able to handle/process information effectively)
Otherwise remove distractors and create organizational systems
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Sensation Avoiding
↓ ↓ Intensity ↓ Amount ↑ Consistency ↓ ↓ Competing ↑ Predictability ↑ Familiarity ↓ Speed
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Other sensation avoiding considerations Be sure to distinguish low registration
and avoiding because approaches are often contradictory
When possible give the individual control over the environment when introducing sensory input
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Other strategies……
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Distress tolerance
Idea comes from dialectical behavior therapy
There are times when will have to tolerate an uncomfortable situation
Develop coping mechanisms for managing those times
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Information is part of the intervention Awareness of personal preferences
increases self-awareness and is reassuring
Provide information to relevant others – spouses, employers, parents, teachers, so that they can understand
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Incorporate breaks
Avoider may need to leave the party and retreat to the kitchen
Seeker may need to leave a long lecture and go outside for a run
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Meet needs internally/self-soothing Self talk Meditation Chew gum Rock
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Use others as intervention
To help focus attention To provide feedback about behavior To reassure To distract
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Design an environment for each quadrant around a specific occupation
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Findings related to specific populations
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Individuals with schizophrenia
Low scores on sensation seeking High scores on sensation avoiding and
low registration
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People with bipolar disorder
Average scores on low registration High scores on sensation avoiding and
low scores on sensation seeking
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Older adults
Low scores on sensation seeking High scores on low registration with
cumulatively higher scores as age from 60 – 70 - 80
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Autism/Asperger
More likely to exhibit behaviors in Sensation seeking, low registration and
sensory sensitivity Especially sensitive to auditory and oral
motor input
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Attention Deficit Hyperactivity Disorder Differences across all quadrants – may
be more reflective of a modulation problem
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Adults with brain injury
High scores on sensory sensitivity Low scores on sensation avoiding