Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
A comparison between children with and without posttraumatic stress (PTS) symptoms found that children with PTS symptoms are at increased risk for sensory processing deficits in various sensory modalities, over and above the core symptoms of posttraumatic stress disorder. These results emphasize that sensory processing should be incorporated into the routine evaluation of this population and point to the importance of OT trauma-informed intervention programs, emphasizing the sensory component of regulation.
Primary Author and Speaker: Aviva Yochman
PURPOSE: A significant number of children develop post-traumatic stress disorder (PTSD) after trauma exposure. Preliminary evidence supports a possible association between PTSD and sensory modulation disorder (SMD). Nevertheless, the research focusing on this relationship in children is notably limited. This study examined children with and without PTS symptoms, by comparing their mothers’ perceptions of their responses to sensory events in daily life. Determining if sensory processing is an additional factor contributing to the child’s difficulties in participating in daily activities is important in order for evaluation and intervention programs to address the multiple needs of children with PTSD.
DESIGN: Mothers of 134 non-referred children, aged 7-11 years, participated in this descriptive study. Inclusion criteria were children exposed to continuous traumatic stress as a result of living in an area with repeated political violence. This information was obtained by means of the ‘exposure to traumatic events questionnaire’ developed for the specific psycho-political context. In addition, none of the children had any history of developmental or neurological deficits.
METHOD: Families were contacted by phone in order to explain the aim of the study. Interested families who met the inclusion criteria were scheduled for an in-home visit by trained research assistants who provided the mothers with the following questionnaires: a) the University of California-Los Angeles Reaction Index (UCLA-RI), a widely used questionnaire, based on the DSM categories for measuring PTSD symptoms b) the Sensory Profile questionnaire, a standard measure of a child’s sensory processing patterns in the context of everyday life. Three subgroups were created based on the scores of the UCLA-RI: 16 children defined with full PTS symptoms, 54 children with partial PTS symptoms, and 64 children without symptoms of PTS. Thus our sample was unique in that it compared children with and without PTS symptoms who were all exposed to the same trauma.
RESULTS: The results of the multivariate analysis of variance revealed a significant group effect on the sensory profile total score (F(14, 250) = 3.88, p < .001, η2 = 0.179). Follow-up univariate ANOVAs showed that all sections, excluding Taste/Smell Sensitivity, were significantly different in children with various levels of PTS symptoms. The effect sizes found for these results were moderate to high. Furthermore half of the children with PTS symptoms had suspected clinically significant deficits in sensory processing. In addition, logistic regression indicated that the overall sensory processing score was a significant predictor of group classification (Odds Ratio = 0.953, R
2 = .199, χ2(1) = 21.640, p < .001).
CONCLUSIONS: These results indicate that children with PTS symptoms may be at increased risk for sensory processing deficits and that these co-occurring deficits are not a marginal phenomenon. Our findings also indicate that the level of PTS symptoms may predict the degree of sensory difficulties. Although the diagnoses of SMD and PTSD share some common behavioral characteristics, the results of the sensory profile pointed to difficulties beyond what might be considered trauma-related stimuli or core symptoms of PTSD. Our results also show that a substantial number of children with PTS symptoms scored within normal ranges of sensory processing, emphasizing the importance of relating to the individual child and not only to the characteristics of a group
References
Yochman, A., & Pat-Horenczyk, R (2019). Sensory Modulation in children exposed to continuous traumatic stress. Journal of Child and Adolescent Trauma. https://doi.org/10.1007/s40653-019-00254-4
Bailliard, A. L., & Whigham, S. C. (2017). Centennial topics-Linking neuroscience, function, and intervention: A scoping review of sensory processing and mental illness. American Journal of Occupational Therapy, 71, 1–18. https://doi.org/10.5014/ajot.2017.024497.
Champagne, T., & Tewfick, D. (2010). Trauma, mental health care & occupational therapy practice. In M. A. Scheinholtz (Ed.), Occupational therapy in mental health: Considerations for advanced practice (pp. 215–230). Bethesda, MD: American Occupational Therapy Association.
