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Sensory difficulties are a commonly occurring feature of autism spectrum disorders and are now included as one manifestation of the ‘restricted, repetitive patterns of behavior, interests, or activities’ diagnostic criteria of the DSM5 necessitating guidelines for comprehensive assessment of these features. To facilitate the development of such guidelines, this paper provides an overview of the literature on sensory features in autism spectrum disorder. We summarize the literature pertaining to: terminology, current assessment practices, sensory development, and the relationship of sensory features to core symptoms of autism. The paper concludes with recommendations for clinical assessment of sensory features in Autism.

Distinct sensory processing (SP) subtypes in autism have been reported previously. This study sought to replicate the previous findings in an independent sample of thirty children diagnosed with an Autism Spectrum Disorder. Model-based cluster analysis of parent-reported sensory functioning (measured using the Short Sensory Profile) confirmed the triad of sensory subtypes reported earlier. Subtypes were differentiated from each other based on degree of SP dysfunction, taste/smell sensitivity and vestibular/proprioceptive processing. Further elucidation of two of the subtypes was also achieved in this study. Children with a primary pattern of sensory-based inattention could be further described as sensory seekers or non-seekers. Children with a primary pattern of vestibular/proprioceptive dysfunction were also differentiated on movement and tactile sensitivity.

OBJECTIVE. To measure upper-extremity and gross motor skill development in infants with and without risk factors for autism spectrum disorder (ASD). METHOD. Data were coded retrospectively from 39 infants who participated in longitudinal structured early developmental assessments. Twenty-five infants were at high risk for ASD, and the remaining 14 infants were classified as low risk. Upper-extremity and motor skill development were coded at ages 2, 4, and 6 mo. Five infants went on to receive an ASD diagnosis at age 2–4 yr. RESULTS. Infants at high risk for ASD demonstrated fewer midline behaviors with the upper extremities and delayed motor skill development than the low-risk group. Differences in motor skills were most apparent at age 4 mo. CONCLUSION. Early monitoring for motor delay in infants at high risk for ASD is warranted. Midline control and play with the upper extremities and overall motor skill development are possible assessment and therapeutic targets.

Children with autism are frequently observed to experience difficulties in sensory processing. This study examined specific patterns of sensory processing in 54 children with autistic disorder and their association with adaptive behavior. Model-based cluster analysis revealed three distinct sensory processing subtypes in autism. These subtypes were differentiated by taste and smell sensitivity and movement-related sensory behavior. Further, sensory processing subtypes predicted communication competence and maladaptive behavior. The findings of this study lay the foundation for the generation of more specific hypotheses regarding the mechanisms of sensory processing dysfunction in autism, and support the continued use of sensory-based interventions in the remediation of communication and behavioral difficulties in autism.

Evidence supports a link between handwriting and aspects of literacy, including both reading and writing. Most evidence, however, pertains to children from grade one and above, once foundation skills known to support emerging literacy have been established. The purpose of this systematic review is to synthesise the extant literature concerning measurement of handwriting and literacy and the relationships between these measures for kindergarten students (the first year of formal instruction). Following a systematic search of the literature, 17 studies involving 3343 participants were identified. Handwriting measures could be grouped into two categories—letter writing fluency and perceptual motor skills, while literacy measures addressed one or more of letter name and sound knowledge, phonological skills, word reading, writing composition, and spelling. Strong evidence was found for the impact of letter writing fluency on writing composition, and letter name and sound knowledge. In addition, there was moderate evidence for a relationship between letter writing fluency, spelling, word reading and phonological skills. Weaker evidence was found for the impact of perceptual motor skill proficiency on letter knowledge and spelling, word reading and phonological skills. However, as all intervention approaches focusing on letter forming fluency included perceptual motor skill practice or exposure, an important role for perceptual motor skill in both letter writing fluency and literacy may be inferred. This review has found preliminary evidence to support the facilitating impact of handwriting on the foundations of literacy in kindergarten. Further research into the effects of handwriting interventions on kindergarten literacy is indicated.

The ultimate goal of reading is to comprehend written text, and this goal can only be attained if the reader can decode written words and understand their meanings. The science of reading has provided compelling evidence for the subskills that form the foundation of decoding. Decoding words requires understanding of the alphabetic principle and letter–sound, or grapheme–phoneme, correspondence. In the first year of formal schooling (kindergarten), this same understanding is also required for young learners who are learning to write the letters of the alphabet. In this article, we examine the effectiveness of a handwriting intervention, Write Start–K, that emphasizes the recall, retrieval, reproduction, and repetition (the 4Rs model) of grapheme–phoneme relations. We conducted a two-group, pre/posttest study at two Australian schools across four kindergarten classes (n = 77 students). One school received the intervention, and the other continued with standard teaching. Participants (mean age = 5 years 8.45 months, standard deviation = 4.18 months) at both schools were assessed at baseline, immediately after the eight-week intervention period, and at 12 weeks following the end of the intervention (follow-up). We used linear mixed models to determine the statistical significance of effects over three time intervals. We identified statistically significant Group × Time effects for letter name knowledge and word reading, whereas changes in letter sound knowledge and nonsense word–reading fluency approached statistical significance. These results indicate that a handwriting intervention, incorporating repeated practice in recalling and reproducing letter forms, had a statistically significant impact on early reading skills.

Children with autism spectrum disorder frequently present with atypical behavioral responses to sensory stimuli, as well as differences in autonomic nervous system (ANS) and neuroendocrine activity. However, no one consistent pattern appears to explain these differences within this heterogeneous population. To conceptualize more homogenous ASD subgroups, sensory-based subtypes have been explored. One subtyping mechanism groups children by sensory responsivity pattern in addition to sensory domain. Differences in nervous system responsivity to sensory input within this sensory-based subtyping scheme have not yet been investigated. This exploratory study used ANS indices (respiratory sinus arrhythmia [RSA], skin conductance level) and neuroendocrine (salivary cortisol) response to examine patterns differentiating these subtypes. Significant differences in RSA were found during baseline, and during tactile, tone and movement stimuli (p < 0.05). Subtype membership was predicted by RSA changes during auditory stimulation and recovery periods (p < 0.05). Results confirm that children with an adaptive sensory responsivity subtype differ from those children with sensory processing dysfunction, however, physiological variables did not distinguish between children with different patterns of sensory processing dysfunction.

People with autism spectrum disorder (ASD) commonly experience difficulties with social participation, play, and leisure along with restricted and repetitive behaviors that can interfere with occupational performance. The objective of this systematic review was to evaluate current evidence for interventions within the occupational therapy scope of practice that address these difficulties. Strong evidence was found that social skills groups, the Picture Exchange Communication System, joint attention interventions, and parent-mediated strategies can improve social participation. The findings were less conclusive for interventions to improve play and leisure performance and to decrease restricted and repetitive behaviors, but several strategies showed promise with moderately strong supporting evidence. Occupational therapists should be guided by evidence when considering interventions to improve social participation, play, leisure, and restricted and repetitive behaviors in people with ASD. Additional research using more robust scientific methods is needed for many of the currently available strategies.

Asthma during pregnancy is associated with a range of adverse perinatal outcomes. It is also linked to increased rates of neurodevelopmental conditions in the offspring. We aimed to assess whether fractional exhaled nitric oxide ( F ENO )-based asthma management during pregnancy improves child developmental and behavioural outcomes compared to usual care. The Breathing for Life Trial was a randomised controlled trial that compared F ENO -based asthma management during pregnancy to usual care. Participants were invited to the developmental follow-up, the Breathing for Life Trial – Infant Development study, which followed up infants at 6 weeks, 6 months and 12 months. The primary outcomes were measured in infants at 12 months using the Bayley-III: Cognitive, Language and Motor composite scores. Secondary outcomes included Bayley-III social-emotional and adaptive behaviour scores, autism likelihood and sensory and temperament outcomes. The exposure of interest was the randomised intervention group. Two hundred and twenty-two infants and their 217 participating mothers were recruited to the follow-up; 107 mothers were in the intervention group and 113 were in the control group. There was no evidence of an intervention effect for the primary outcomes: Bayley-III cognitive (mean = 108.9 control, 108.5 intervention, p  = 0.93), language (mean = 95.9 control, 95.6 intervention, p  = 0.87) and motor composite scores (mean = 97.2 control, 97.9 intervention, p  = 0.25). Mean scores for secondary outcomes were also similar among infants born to control and F ENO group mothers, with few results reaching p  < 0.05. Conclusion : In this sample, F ENO -guided asthma treatment during pregnancy did not improve infant developmental outcomes in the first year of life. Trial registration : ClinicalTrials.gov Identifier: ACTRN12613000202763. What is Known: • Maternal asthma during pregnancy has been associated with increased rates of neurodevelopmental conditions in offspring, including intellectual disability and autism. What is New: • This is the first study to examine how managing asthma during pregnancy via a F ENO -guided algorithm or usual care affects infant developmental and behavioural outcomes. While the results of the study showed no impact of the intervention, and therefore do not support the integration of F ENO -based management of asthma in antenatal settings for optimal infant development, they do send a positive message about the implications of active asthma management during pregnancy on infant developmental outcomes.

Participation in regular physical activity (PA) provides health, psychological, and physiological benefits for people with and without a physical disability. This study investigated the physical and sedentary activity patterns of adolescents with cerebral palsy (CP). A cross‐sectional, descriptive, postal survey was used, consisting of the Physical Activity Questionnaire for Adolescents (PAQ‐A), self‐reported level of gross motor function (based on the Gross Motor Function Classification System [GMFCS]), and specific questions regarding weekly sedentary activities. Following piloting to determine test‐retest reliability (intraclass correlation [ICC] for PA=0.90; total weekly sedentary time=0.84) and concurrent validity (survey PA score vs pedometry, Pearson's r=0.24; survey PA score vs accelerometry, r=‐0.21; survey weekly sedentary time vs logbook, r=0.38), the survey was mailed to all adolescents with CP in South Australia registered with Novita Children's Services (n=219). One hundred and twelve valid surveys were returned (76 males, 36 females; age range 11‐17y, mean age 13y 11mo [SD 23mo]; GMFCS Level I, n=42; Level II, n=27; Level III, n=10; Level IV, n=17; Level V, n=15; level not reported, n=1). Results were compared with recent normative age‐ and sex‐matched data sets. Key findings were that PA level of adolescents with CP was related to level of gross motor function and inversely related to age, and that adolescents with CP were less physically active than their peers without disability. Comparisons with normative data sets suggested that adolescents with CP tend to participate in less structured and lower intensity PA compared with non‐disabled adolescents, though sedentary activity patterns (TV and computer use) of adolescents with and without CP were similar.