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Development of an Adult Sensory Processing

Scale (ASPS)

Erna Imperatore Blanche, Diane Parham, Megan Chang,


Trudy Mallinson

MeSH TERMS This article describes the development of the Adult Sensory Processing Scale (ASPS), a sensory processing
 activities of daily living questionnaire for adults. The ASPS measures self-reported responses to input from distinct sensory systems
and is intended to be sensitive to individual differences in the adult population. ASPS construction involved
 adult
two phases: item development and instrument construction. During item development, content validity of 71
 questionnaires items was assessed by means of expert ratings. During instrument construction, items were evaluated using
 sensation data from an online survey of 491 adults. Exploratory factor analysis and Rasch analysis yielded an optimal
 sensation disorders solution of eight factors representing vestibular overresponsiveness, auditory overresponsiveness, visual
overresponsiveness, social tactile overresponsiveness, proprioceptive seeking, general underresponsive-
ness, vestibular–proprioceptive underresponsiveness affecting postural control, and vestibular overrespon-
siveness–intolerance to movement. The final ASPS contains 39 items and demonstrates acceptable internal
consistency, strong content validity, and adequate construct validity.

Blanche, E. I., Parham, D., Chang, M., & Mallinson, T. (2014). Development of an Adult Sensory Processing Scale (ASPS).
American Journal of Occupational Therapy, 68, 531–538. http://dx.doi.org/10.5014/ajot.2014.012484

Erna Imperatore Blanche, PhD, OTR/L, FAOTA, is


Clinical Associate Professor, Division of Occupational
Science and Therapy, University of Southern California,
S ensory processing refers to a person’s ability to receive and organize sensory
information for use in everyday life (Ayres, 1972, 1979/2005; Miller &
Lane, 2000). The relationship between sensory processing and behavioral pat-
1540 Alcazar Street, CHP 133, Los Angeles, CA 90089;
blanche@osot.usc.edu terns in everyday life has been studied extensively in clinical populations, pri-
marily with children (Koenig & Rudney, 2010). Less understood are the sensory
Diane Parham, PhD, OTR/L, FAOTA, is Professor, processing patterns of adults and how they influence their everyday behavioral
Occupational Therapy Graduate Program, Department of
Pediatrics, School of Medicine, University of New Mexico,
patterns and activity choices.
Albuquerque. Researchers who study the relationship between sensory processing and
the activity choices of adults have concluded that sensory processing across
Megan Chang, PhD, OTR/L, is Assistant Professor,
the life course can affect a person’s quality of life, coping strategies, and activity
Department of Occupational Therapy, San Jose State
University, San Jose, CA. choices. The few existing studies on this topic have focused on sensory
overresponsiveness (SOR), also called sensory defensiveness. SOR is defined as
Trudy Mallinson, PhD, OTR/L, FAOTA, is Visiting a condition in which responses to innocuous sensory stimuli are characterized
Associate Professor, Office for Clinical Practice
Innovation, School of Medicine and Health Sciences, The
by unusually heightened arousal accompanied by feelings of discomfort and
George Washington University, Washington, DC. anxiety (Parham & Mailloux, in press). Kinnealey, Oliver, and Wilbarger
(1995) used qualitative analysis of interviews to study how activity choices and
everyday life patterns are affected by the coping strategies and avoidance
mechanisms used by adults with sensory defensiveness. These authors organized
their qualitative analysis to reflect SOR within specific sensory systems, that is,
tactile, vestibular, auditory, and so forth. Fanchiang’s (1996) qualitative analysis
of the case of Dale revealed that this man’s character, sense of self, and selection
of occupations across his life course were affected by his learning disability and
his sensory processing needs, particularly with regard to tactile processing.
Moreover, significant associations have been reported between measures of SOR
and health-related quality of life, as well as mental health symptoms of

The American Journal of Occupational Therapy 531


depression and anxiety (Kinnealey, Koenig, & Smith, consistent with Ayres’s (1972, 1979/2005; Ayres & Tickle,
2011; Pfeiffer & Kinnealey, 2003). 1980) original theory of sensory integration.
To date, the most significant contribution to the If shown to be reliable and valid, the ASPS may be
understanding of sensory processing of adults has been a valuable research tool for expanding knowledge of the
made by Brown and Dunn (2002), who developed the relationship between everyday activity choices of adults and
Adolescent/Adult Sensory Profile (AASP), a standardized diverse processing patterns within distinct sensory systems.
self-report questionnaire intended for people ages 11–65 Moreover, the ASPS may also be valuable as a research
yr. The standardization sample consisted of 900 people, tool for characterizing the sensory processing features of
92% White and predominantly living in the midwestern adults with disabilities, such as autism spectrum disorder
United States (Brown & Dunn, 2002). The 60 items of or mental illness. Eventually, the ASPS may possibly
the AASP measure the respondent’s frequency of re- contribute to the development of new clinical assessment
sponses to specific sensations by means of a Likert scale. and intervention strategies that address the occupational
AASP scores are interpreted using a model derived from needs of adults in relation to their individual sensory
factor analysis to classify responses within four quadrants processing characteristics.
of sensory processing: low registration, sensory seeking,
sensory sensitivity, and sensory avoiding. Responses in Method
each quadrant are scored categorically in relation to dis-
tance from the normative mean: much less than most The ASPS is a self-report questionnaire designed to measure
people, less than most people, similar to most people, more behavioral responses that are indicative of sensory pro-
than most people, and much more than most people. The cessing challenges in five systems: tactile, proprioceptive,
quadrants in this model are viewed as emanating from vestibular, auditory, and visual. The original version of this
a combination of neurological threshold and self-regulation questionnaire included 10–14 questions for each system,
patterns that may reflect temperament-related traits that addressing overresponsiveness and underresponsiveness as
affect everyday functioning (Brown & Dunn, 2002; Dunn, well as sensory seeking.
2001; Dunn & Westman, 1997). However, this model The development of the ASPS was conducted in two
does not explicitly address responses within individual phases: item development, which included generation of
sensory systems. AASP users can examine item responses to items and assessment of content validity, and instrument
make inferences about the roles of specific sensory systems construction, which examined validity using factor analysis
in the everyday life of a respondent, but the AASP does not and Rasch analysis, as well as internal consistency of items in
provide standard scores or other guidelines for critically the final factor solution. This research was approved by the
assessing the involvement of specific sensory systems within University of Southern California institutional review board.
each quadrant.
Phase 1: Item Development
The goal of this study was to initiate development of
a new instrument, the Adult Sensory Processing Scale Item Generation. Item development included item
(ASPS), to facilitate further research on the relationship generation and content validity. On the basis of an ex-
between occupational choices and diverse modes of pro- tensive literature review and clinical expertise, we gener-
cessing within specific sensory systems. In contrast to the ated from previous research 59 items thought to be
AASP, the ASPS was designed to measure different patterns influenced by sensory processing and 12 items focusing on
of responsiveness (overresponding and underresponding, as general arousal (Mehrabian, 1995). We later eliminated
well as sensory seeking) with respect to specific sensory the arousal items to focus the instrument specifically on
systems (auditory, visual, tactile, vestibular, and pro- sensory responsiveness as it relates to choices in daily life.
prioceptive). In the ASPS, overresponsiveness is defined as All items focused on the frequency of specific behavioral
a tendency toward heightened sensitivity or aversion in or affective responses to sensory experiences, rated on
response to ordinary sensory input that would not bother a 5-point Likert scale (5 5 always, 4 5 often, 3 5 sometimes,
most people. Underresponsiveness is defined as a tendency 2 5 rarely, and 1 5 never).
toward reduced sensitivity or lack of awareness of sensory Content Validity. Content validity was established using
input that most people would notice. Sensory seeking is the index of item-objective congruence (IIOC). This sta-
defined as a tendency toward initiating behaviors that tistical procedure, developed by Rovinelli and Hambleton
generate sensations with greater intensity or frequency than (1977), is best used in test development to evaluate content
is typical of most people. The emphasis on diverse patterns validity at the item development stage (Thorn & Deitz,
of processing with respect to distinct sensory systems is 1989). It requires two or more judges to rate each test item

532 September/October 2014, Volume 68, Number 5


relative to a set of objectives or domains. Because the items Table 1. Demographic Characteristics of Respondents
were designed to measure sensory responsiveness within Characteristic Mean (SD) or Frequency (%)
distinct sensory systems, the IIOC was computed for Age, yr, mean (SD) 37.1 (12.8)
each item to measure its congruence with specific Age group, male/female
sensory systems. To compute the IIOC, six experts in 18–25 yr 20/42
sensory integration rated each item for each of the five 26–35 yr 69/129
36–45 yr 44/56
sensory systems using a 3-point scale: 1 (definite in-
46–55 yr 27/37
dicator of responsiveness to a particular sensory domain), 55–64 yr 33/34
0 (undecided), and 21 (not an indicator of responsiveness Marital status, n (%)
to specific sensory system). Unmarried or single 178 (36.2)
An item was considered acceptable if the IIOC for that Married or living with partner 268 (54.6)
item was >.70 (Rovinelli & Hambleton, 1977). Items Divorced 29 (5.9)
Others 16 (3.3)
with an IIOC between .50 and .69 were examined in-
Educational status, n (%)
dividually and accepted, revised and reevaluated, or re- Junior high school 2 (0.4)
jected. Of the original 71 items, 64 produced IIOC High school 37 (7.6)
values ³.70, and 3 of the sensory systems (tactile, ves- Vocational–technical training 26 (5.3)
tibular, and auditory) produced items with strong item– College/bachelor degree 222 (45.3)
objective congruence. Postgraduate degree 188 (38.4)
Others 15 (3.0)
Phase 2: Instrument Construction Note. N 5 491. SD 5 standard deviation.

The 71-item questionnaire with consent form was created


using Qualtrics software (Qualtrics, Provo, UT) on a se- Comrey and Lee’s (1992) recommendations, we also
cure and data-encrypted website hosted by the University deleted items with a factor loading of <.32.
of Southern California. We distributed the link to the Stage 2: Rasch Analysis. We examined item structure,
survey using fliers, community venues, Internet postings, construct hierarchy, and measurement precision using
and personal communications. Participants between ages Rasch analysis (Winsteps Version 3.80.1). Results are
18 and 64 yr who were interested in participating accessed summarized in Table 2. All 71 items resulted in a person
the website. Once the participants affirmed their consent separation reliability (PSR) of .89 (interpreted similarly to
by checking the “agree” box in the consent form, the site a Cronbach’s a), suggesting the survey had good mea-
directed them to a secure web page where they completed surement precision (Bond & Fox, 2007). Six items misfit
the ASPS. Table 1 shows the demographic information (infit mean square [MnSq] > 1.4), and the principal
from 491 respondents between age 18 and 64 yr who components analysis (PCA) indicated an eigenvalue of 6.7,
completed the questionnaire. Data were exported to SAS suggesting the instrument showed some multidimension-
Version 9.1.3 (SAS Institute, Cary, NC) and Winsteps ality (Pesudovs, Gothwal, Wright, & Lamoureux, 2010).
Version 3.80.1 (Linacre, 2014) for statistical analysis. Removal of the 12 arousal items resulted in minimal loss
Sample size was determined on the basis of the sug- of measurement precision (PSR 5 .87). Although the
gestion by Comrey and Lee (1992) that a minimum PCA percentage of variance explained was only about
number of 5 participants per variable is adequate to 10%, the eigenvalue of 6.2 suggested multidimensionality.
represent and evaluate the psychometric properties of We examined the items separately to identify whether
measures; therefore, with 71 items, a sample of 491 was they appeared to reflect overresponsiveness or underrespon-
considered acceptable. siveness to sensory input. The overresponsiveness items
Stage 1: Initial Exploratory Factor Analysis. We per- had a PSR equivalent to the full scale, and the under-
formed exploratory factor analysis (EFA) to identify latent responsiveness items had a somewhat lower PSR of .71,
constructs and the underlying structure of the items. The suggesting these items alone did not capture differences
total number of factors was determined by examining the in participants as well as the full scale or the over-
scree plot as well as the eigenvalues. Following Gorsuch’s responsiveness items. Across the analyses, 6 sensory
(1983) recommendations, we retained factors with an processing items consistently misfit (infit MnSq > 1.4).
eigenvalue >1. Sixteen factors that consisted of homoge- All arousal items and all 6 of the misfit sensory pro-
neous variables originally emerged. To perform data re- cessing items were then removed before further analyses.
duction and simplify data structure, we deleted five Stage 3: Second Exploratory Factor Analysis. We again
factors that included no more than two items. Following performed EFA to determine the stability of factors

The American Journal of Occupational Therapy 533


Table 2. Rasch Summary Statistics
No. of Person, No. of No. of PCA Eigenvalue,
Analysis Items Mean (SD) RMSE Adjusted SD Separation Reliability Misfitting Items Misfitting People First Contrast (%)
1. All items 71 20.29 (0.38) .12 .36 2.86 .89 6 72 6.7 (9.5)
2. Arousal items removed 59 20.35 (0.37) .14 .35 2.56 .87 6 80 6.2 (10.5)
3. Underresponsiveness 35 20.38 (0.53) .19 .50 2.68 .88 4 82 3.5 (10.0)
items only
4. Overresponsiveness 24 20.37 (0.42) .23 .35 1.57 .71 2 91 3.1 (12.9)
items only
5. Misfit items removed 53 20.36 (0.39) .15 .36 2.46 .86 0 76 5.8 (11.0)
Note. PCA 5 principal components analysis; RMSE 5 root-mean-square error; SD 5 standard deviation.

indicated in the first exploratory analysis. The same eval- 2000). The average a value of the 11 factors was .67, and
uative criteria for item inclusion were applied at this stage. as for the items making up each factor ranged from .6
The final set of items with exploratory factor analysis to .8, which is considered to be acceptable. However,
loadings is presented in Table 3. Results indicated 11 two factors, Underresponsiveness to Tactile Input
factors: Overresponsiveness to Vestibular Input (Factor (Factor 9) and Overresponsiveness to Touch Involving
1), Overresponsiveness to Auditory Input (Factor 2), Textures (Factor 11) fell below .6 and were sub-
Overresponsiveness to Visual Input (Factor 3), Over- sequently removed. Factor 8 (Auditory Seeking) con-
responsiveness to Social Touch (Factor 4), Proprioceptive tained only 2 items and was also removed from the final
Seeking (Factor 5), Overall Underresponsiveness (Factor version. The final version of the scale contains 40 items
6), Underresponsiveness to Proprioceptive–Vestibular In- and 8 factors (Table 4).
put Affecting Postural–Motor Abilities (Factor 7), Auditory
Seeking (Factor 8), Underresponsiveness to Tactile Input
Discussion
(Factor 9), Intolerance to Movement (a type of vestibular
overresponsiveness; Factor 10), and Overresponsiveness to The ASPS is a unique instrument for measuring adult
Touch Involving Textures (Factor 11). sensory processing, because it was designed to measure
In summary, as a result of the series of factor and responsiveness within specific sensory systems. Four key
Rasch analyses, we removed 23 items (12 arousal, 4 tactile, findings indicate that it has the potential to make important
4 proprioceptive, 1 visual, 1 vestibular, and 1 auditory) contributions to sensory integration theory and practice: It is
reducing the scale to 48 items. Table 3 shows the mean a valid tool for identifying patterns of sensory responsiveness
and standard deviation of item ratings within each factor linked to distinct sensory systems in adults; it identifies
for these 48 items. specific patterns of underresponsiveness, sensory seeking,
Stage 4: Internal Consistency. Internal consistency was and overresponsiveness within sensory systems; it replicates
established by computing Cronbach’s a reliability co- sensory processing patterns previously identified in research
efficient for each factor and all retained items of this on children; and it links specific sensory systems to particular
questionnaire. The overall internal consistency for the entire responsiveness patterns in combinations that have not
set of 48 items was .87, which is considered strong (Kline, previously been reported.

Table 3. Mean Item Scores and Internal Consistency of Factors


Factor Interpretation Mean ± SD Cronbach’s a
Factor 1: Overresponsiveness to Vestibular Input (6 items) 3.47 ± 0.70 .60
Factor 2: Overresponsiveness to Auditory Input (8 items) 3.19 ± 0.70 .79
Factor 3: Overresponsiveness to Visual Input (6 items) 3.28 ± 0.87 .80
Factor 4: Overresponsive to Social Touch (4 items) 3.39 ± 0.90 .78
Factor 5: Proprioceptive Seeking (4 items) 2.93 ± 0.88 .75
Factor 6: Overall Underresponsiveness (5 items) 3.79 ± 0.60 .61
Factor 7: Underresponsiveness to Proprioceptive–Vestibular Input Affecting 3.55 ± 0.77 .67
Postural–Motor Abilities (4 items)
Factor 8: Auditory Seeking (2 items) 3.23 ± 1.02 .80
Factor 9: Underresponsiveness to Tactile Input (3 items) 3.33 ± 0.78 .56
Factor 10: Intolerance to Movement (3 items) 3.38 ± 0.90 .66
Factor 11: Overresponsiveness to Touch Involving Textures (3 items) 3.37 ± 0.87 .40
Note. SD 5 standard deviation.

534 September/October 2014, Volume 68, Number 5


Table 4. Factor Analysis Including 11 Factors
Factor
Interpretations and Items 1 2 3 4 5 6 7 8 9 10 11
Factor 1: Overresponsiveness to Vestibular Input
The mere idea of bungee jumping makes me anxious (I avoid .849 .046 .063 2.058 2.054 .019 2.013 .023 .040 2.138 .069
activities that provide intense movement experiences).
I tend to avoid activities that involve spinning or turning, such as .716 2.091 2.005 .015 .051 .002 2.155 2.090 .023 .277 .068
riding on a rollercoaster, etc.
I am bothered by escalators, elevators, or looking down from high .615 .095 .076 2.042 2.046 2.035 .108 .073 2.026 2.019 .036
places.
I am distressed by sudden movements over which I have no .542 .110 2.035 .192 2.031 2.016 .009 .144 .082 .201 .030
control (being bumped in a crowd, turbulence in an airplane).
I tend to change position slower than others to avoid getting dizzy. .445 .043 2.055 .038 .087 .140 2.008 .011 2.022 .222 2.027
I seek activities that provide me with intense movement experi- 2.493 2.029 .032 .096 .274 .065 2.013 .131 .082 2.011 .070
ences (roller coasters, motorcycles, skydiving).
Factor 2: Overresponsiveness to Auditory Input
I have low tolerance to innocuous ordinary environmental sound. .166 .650 2.037 2.125 2.063 .013 .012 .152 2.078 2.013 .075
I become more irritated by certain sound due to lack of sleep. .021 .639 .054 2.005 .020 2.100 .119 .090 2.041 2.037 2.016
I am bothered by unexpected car alarms, ambulance siren, .038 .636 2.066 .059 .084 .030 2.027 2.068 2.006 .008 .052
speaker feedback noise.
I can pick up the slightest sound far away (leaf rustling, fluo- 2.021 .594 .017 .026 .086 2.343 2.065 .085 .053 2.010 2.046
rescent light, etc.).
I am easily distracted by ordinary background noise or music 2.026 .561 2.015 2.051 .031 2.085 .151 2.057 .049 2.008 .136
(people talking, TV on, etc.).
I avoid situations where there will be loud or unexpected sounds .058 .448 2.026 .152 2.047 .240 2.157 2.365 2.012 2.147 2.068
(rock concerts, athletic events in gymnasiums).
I startle easily at unexpected or loud noises. .241 .398 2.019 .114 .124 .159 .000 2.023 2.029 .020 2.173
I am bothered by restaurants that have loud ambient noises. .001 .381 .079 .112 2.103 .150 2.051 2.207 .027 2.039 .031
Factor 3: Overresponsiveness to Visual Input
I carry sunglasses with me wherever I go. .105 2.107 .764 2.093 .084 .012 2.069 2.014 2.068 2.007 2.063
I wear dark glasses even if it is not sunny outside. .031 2.190 .724 .055 .079 .112 .019 .021 .001 2.018 2.075
I often find myself squinting in ordinary daylight. 2.008 .117 .685 .022 .000 .022 .123 .017 2.058 2.004 2.010
I often complain that the lighting is too bright. 2.003 .218 .587 .075 .015 2.092 .061 2.018 .065 .042 .006
I notice artificial light when I enter a room. 2.063 .188 .412 .128 .047 2.047 2.033 2.021 .097 .035 .183
I tend to look for the shade or stay in the shade if I am outside. 2.113 .224 .397 .008 2.210 .201 2.199 .097 2.012 .102 .018
Factor 4: Overresponsiveness to Social Touch
I don’t like people touching me unexpectedly. .039 2.112 .033 .939 .019 2.119 .017 .002 2.037 2.018 .029
I am startled and may be irritated when I am touched .037 .118 .016 .715 .001 2.022 .005 .063 2.104 2.007 2.088
unexpectedly.
I avoid large crowds or being close to other people where I may .065 .130 .020 .631 .044 2.036 .059 2.074 .047 2.093 .072
experience incidental touch.
I do not like to wear turtlenecks. 2.109 2.032 .017 .431 2.048 2.027 .036 .042 2.002 .011 .164
Factor 5: Proprioceptive Seeking
I seek activities where I have to exert muscle force, even when I 2.104 .051 2.006 .017 .746 .101 2.021 2.037 2.001 .032 .053
can only do them for a short time (i.e., weightlifting, jumping,
rock climbing).
When I am stressed, I like to engage in activities like running, .073 2.005 .087 .001 .715 2.036 .028 2.097 2.030 .009 2.065
walking, or rock climbing to calm me down.
I tend to be overly active as compared with others. .051 2.057 .026 .013 .570 .079 2.117 2.011 .122 2.089 .185
The idea of rock climbing or boxing appeals to me; I wish I could 2.315 .179 .015 2.071 .496 .059 .048 .042 2.026 .127 .012
do it.
Factor 6: Overall Underresponsiveness
I don’t hear certain background noises (dripping faucets, others .033 2.331 .033 2.015 .021 .775 2.029 .088 .074 2.025 2.018
approaching).
I tend to ask people to repeat what they say. 2.003 .097 .109 2.149 .013 .468 .163 .009 2.046 .022 2.017
I am not good at tasks that require fine motor manipulation (small .102 2.035 2.034 2.055 .113 .405 .136 .066 2.100 2.101 .083
buttons, sewing, etc.).
I have difficulty grading the amount of pressure I exert on an object .040 .015 2.096 .017 .179 .396 .197 .105 2.034 .022 2.016
(e.g., pencils, doors, hammering a nail, cracking an egg, etc.).
I don’t respond immediately when my name is called. 2.107 2.016 .099 .099 .009 .370 2.010 2.041 .033 .068 .018

(Continued )

The American Journal of Occupational Therapy 535


Table 4. Factor Analysis Including 11 Factors (cont. )
Factor
Interpretations and Items 1 2 3 4 5 6 7 8 9 10 11
Factor 7: Underresponsiveness to Proprioceptive–Vestibular Input
Affecting Postural–Motor Abilities
I tend to slump or have poor balance (I rest my head on my 2.056 .023 2.006 .040 2.032 .031 .822 2.020 2.015 2.050 2.086
hand when sitting).
I tend to lean on furniture or other people. 2.021 2.049 .013 .024 2.020 .168 .506 .007 .044 .076 .082
I lose my balance easily or feel unsteady (worried about .149 .049 2.047 .056 2.051 .246 .359 2.069 .036 .096 2.057
losing balance) walking on unstable ground (loose gravel,
tall grass, etc.).
I don’t enjoy games that involve interacting with balls and .059 .051 .038 .032 2.292 .040 .325 2.146 .136 .066 .067
other people moving at the same time (i.e., soccer,
ice hockey).
Factor 8: Auditory Seeking (deleted from final instrument)
I like to attend events with loud music or put the music up .008 2.075 .072 .007 2.022 2.003 .036 .846 2.016 2.053 .031
when I am alone.
I tend to enjoy music at a higher-than-average volume. .036 .160 2.040 .042 2.072 .124 2.084 .826 .046 2.042 .010
Factor 9: Underresponsiveness to Tactile Input (deleted from final
instrument)
I don’t seem to be bothered by tactile experiences that bother .036 2.094 2.060 .005 2.003 2.030 .056 .029 .702 2.052 2.101
others.
I like the feeling of clay, gritty tactile material, or other .076 .119 .038 2.142 .145 2.134 2.002 2.003 .501 .059 2.094
substances on my hands or body.
I don’t notice or care when my hands or face are dirty. 2.063 2.011 2.003 2.002 2.035 .257 .049 .012 .457 2.086 2.029
Factor 10: Intolerance to Movement
I get motion sickness easily (on cars, boats, rides). .219 2.129 .003 2.057 .069 2.049 .070 2.114 2.112 .725 2.065
I tend to select the front seat when I’m on a vehicle, such as .222 .068 .094 2.046 .000 .020 2.056 .041 .058 .414 .049
riding in a bus, car, etc.
I become distressed when tilted backward unexpectedly (such .245 .118 2.017 .087 2.141 .024 .121 .048 .028 .401 .038
as sitting on an office chair that tilts back).
Factor 11: Overresponsiveness to Touch Involving Textures (deleted
from final instrument)
I remove tags on my clothes because they bother me. .114 .078 2.057 .089 .090 .027 2.114 .109 2.087 2.029 .515
I am bothered by the feeling of certain fabrics (synthetics, wool, .066 .049 .053 .074 .006 .054 .198 2.070 2.235 2.024 .451
chalk, sand, glue, etc.).
I don’t like the feeling of loose jewelry or loose fabrics around 2.099 .125 2.116 .246 2.002 .122 2.023 .014 2.019 .104 .332
my waist or wrists.
Note. Items in bold highlight the factor loading of each item for its corresponding factor.

Findings showed that 5 of the 11 factors identified unacceptably few items or indicated poor internal consis-
by the final EFA reflect responses to individual sensory tency, they are interesting in their specificity to very particular
systems (vestibular, tactile, auditory, visual, and pro- types of sensory responses within particular sensory systems.
prioceptive). The first four of these factors represent over- The congruence of the factors in this study with some
responsiveness. Specifically, Factor 1 contains items that of the sensory integration patterns previously identified in
indicate overresponsiveness to rotary and linear vestibular research on children is noteworthy. For example, Ayres
input; Factor 2, overresponsiveness to auditory input; Factor (1964, 1965, 1966) identified tactile defensiveness as
3, overresponsiveness to visual input; and Factor 4, over- a specific factor in her early studies and later described
responsiveness to tactile experiences that have a social postural control problems in children with vestibular and
component, such as being touched unexpectedly. The next proprioceptive processing difficulties (Ayres, 1972, 1979/
five factors (5–9) reflect underresponsiveness or sensory 2005, 1989). Mailloux et al. (2011) used the Sensory
seeking. Factor 5 represents proprioceptive seeking; Factor 6, Integration and Praxis Test (Ayres, 1989) and the Sensory
underresponsiveness in several sensory systems, including Processing Measure Home Form (Parham & Ecker, 2007)
auditory, proprioceptive, and visual; and Factor 7, under- in a factor analysis that identified several patterns that are
responsiveness to proprioceptive–vestibular input influ- similar to those revealed in the current study. Specifically,
encing movement and posture. Factor 8 represents auditory the vestibular–proprioceptive underresponsiveness pat-
seeking, and Factor 9 indicates underresponsiveness to tern found by Mailloux et al. (2011) corresponds to
nonsocial touch. Although these last two factors contained Factor 7 in the current study (Underresponsiveness to

536 September/October 2014, Volume 68, Number 5


Proprioceptive–Vestibular Input Affecting Postural–Motor • Research involving the ASPS may eventually lead to
Abilities), and Mailloux et al.’s Tactile Defensiveness factor the development of precisely tailored interventions
corresponds with Factor 4 in the current study (Over- that support health and wellness.
responsiveness to Social Touch). Moreover, Mailloux et al.’s • As a research tool, the ASPS may be useful in studying
pattern of somatosensory discrimination shows similarities the relationships between distinct sensory processing
to Factor 9 in the current study (Underresponsiveness to patterns of adults and indicators of well-being, such as
Tactile Input). activity choices and quality of life. s
The consistency of these patterns across age groups
raises the question of whether they persist from childhood
Acknowledgments
into adulthood. Although developmental continuity cannot
be presumed from the results of cross-sectional studies, it is We thank Thomas Decker, Cheryl Ecker, Susan Knox,
plausible that these sensory processing patterns persist over Zoe Mailloux, Gustavo Reinoso, Aneeta Sagar, and
time. If future longitudinal research confirms this suggestion, Susanne Smith Roley, who helped with content validity
it would indicate that children do not simply “outgrow” early ratings. We also greatly appreciate the assistance of Annika
sensory processing patterns, underscoring the potential role Buck and Denise Duran for computing the index of item-
of intervention to prevent or minimize lifelong stress related objective congruence for all items. Last, we thank the
to sensory characteristics. participants who answered the questionnaire on Qualtrics.
Additional findings from the ASPS suggest that Without their help, the study would not have been possible.
meaningful subgroups of sensory processing differences
may exist that have not previously been quantified. Spe- References
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