Date Presented 04/04/19
This study examines the relationship between parent stress and sensory processing differences in preschool-age children who were referred to a multidisciplinary pediatric psychiatry clinic. A correlation was found between elevated parent stress and sensory processing differences in their children. These results provide evidence to support the role of the OT in pediatric mental-health settings and encourage collaboration between OTs and mental-health professionals.
Primary Author and Speaker: Kristina Daily
Contributing Authors: Alexis Clyde, Brandon Oscarson
PURPOSE: Literature suggests sensory difficulties in children may be related to more severe behavioral outcomes and greater parental stress1. Parents of children with sensory processing differences report higher levels of parental stress especially when a child has both sensory processing differences and challenging behaviors 1. Mothers of toddlers with sensory differences demonstrate increased stress3and parent stress and child behaviors may have a mutually increasing and reducing effect on one another2. Similarly, caregiver strain increases and daily functioning can be impacted in parents of children who have ASD and sensory challenges4. Additional evidence is needed to support the role of the occupational therapist in pediatric mental health. This study examines the relationship between parent stress and sensory processing differences in young children referred to a pediatric psychiatry outpatient clinic.
DESIGN: Data was collected for clinical purposes for Early Childhood Mental Health Clinic (ECMHC) patients that completed the multidisciplinary evaluation. Children included in this data analysis were 67% male and 60% Caucasian, with a mean age of 4 ½ years. Common diagnoses include communication disorders, anxiety disorders, ADHD, ASD, and mood disorders. ECMHC at Children’s Health in Dallas provides evaluation for children 0-5 experiencing difficulty with behavior, attachment, social-emotional development, and cognitive skills. Evaluation includes clinical interview with psychiatry, psychological testing, and evaluations with a speech and language pathologist and occupational therapist. Parents complete questionnaires including the Parenting Stress Index (PSI), to measure the level of parenting stress (Total Stress), stress the parent reports directly related to parenting (Parental Distress), parent’s perception of the child as not meeting expectations (Parent-Child Dysfunctional Interaction), and behaviors of the child that impact the parent (Difficult Child). Parents also complete the Sensory Profile, to measure a child’s sensory processing patterns in the context of everyday life and determine how a child’s responsiveness to sensory input might be supporting or interfering with functional performance.
METHOD: Data was collected for clinical purposes for 80 ECMHC patients. A One-Way ANOVA was used to determine any correlations between the Sensory Profile and Parenting Stress Index.
RESULTS: Results indicate a correlation between elevated PSI scores in both the areas of Parent-Child Dysfunctional Interaction (P-CDI) and Difficult Child (DC) when differences are present on the Sensory Profile. One-Way ANOVA indicated strong correlation (p-values between 0.00 and 0.03) between higher levels of stress on the PSI P-CDI and definite differences on the Sensory Profile in Emotional Reaction and Poor Registration. A strong correlation was also found between higher levels of stress on the PSI P-CDI and probable differences on the Sensory Profile in Low Endurance/Tone. In addition, strong correlations were found between elevated or higher stress levels on the PSI DC and definite differences in the Sensory Profile Emotional Reaction, Inattention, and Sensory Seeking.
CONCLUSION: Parents of young children with greater sensory processing differences are reporting increased stress levels. They feel their interactions between themselves and their child are less rewarding than expected and the difficult behaviors of their child impact them. These results provide evidence to support the role of the occupational therapist in pediatric mental health settings and encourage collaboration between occupational therapists and mental health professionals in order to best meet the needs of patients and their parents.
References
1. Gourley, L., Wind, C., Henninger, E.M., & Chinitz, S. (2012) Sensory processing difficulties, behavioral problems, and parental stress in a clinical population of young children. Journal of Child and Family Studies, 22(7), 912-921.
2. Neece, C. L., Green, S. A., & Baker, B. L. (2012) Parenting stress and child behavior problems: a transactional relationship across time. American Journal of Intellectual and Developmental Disabilities, 117(1), 48-66.
3. Ben-Sasson, A., Soto, T.W., Martinez-Pedraza, F., & Carter, A.S. (2013) Early sensory over-responsivity in toddlers with autism spectrum disorders as a predictor of family impairment and parenting stress. Journal of Child Psychology and Psychiatry, 54(8), 846-853.
4. Kirby, A.V., White, T.J., & Baranek, G.T. (2015) Caregiver strain and sensory features in children with autism spectrum disorder and other developmental disabilities. American Journal of Intellectual Disabilities, 120(1), 32-45.
