Sensory Modulation Dysfunction (SMD) is characterized by an inability to consistently and accurately grade responses to sensory information. SMD, and specifically sensory over-responsivity (SOR), has been correlated with stress and anxiety in some developmentally delayed populations and has been associated with structures and functions of the hypothalamic-pituitary adrenal (HPA) axis. Recent attention has been given to HPA functioning in children with Attention Deficit Hyperactivity Disorder (ADHD), with a majority of studies identifying blunted or diminished cortisol patterns. In contrast, elevated cortisol has been associated with anxiety and anxious behaviors in both animal and human studies. The purpose of this study was to determine if SOR may be a contributing factor in determining stress reactivity patterns in children with ADHD or related to elevated levels of anxiety in this population.Twenty four children between the ages of six and ten with ADHD and 24 children without ADHD were recruited for this study. Parents completed a Revised Children's Manifest Anxiety Scale (RCMAS) with their child. Children in the ADHD group were divided into SOR (ADHDs) and non-SOR (ADHDt) groups using the Sensory Over-Responsivity Inventory (SensOR). All children participated in a Sensory Challenge Protocol. Two pre-challenge and seven post-challenge measures of salivary cortisol were taken. The relationship between SOR and anxiety was examined using an Analysis of Variance (ANOVA) and a Fishers exact test to look for differences among group medians and compare scores to clinical cut-off standard. Cortisol patterns were examined using a mixed-effects ANOVA to determine if stress reactivity was significantly different between groups.No baseline differences in salivary cortisol were found between groups. In response to a sensory challenge, there was a borderline significant difference found between the ADHDt and ADHDs group (p=0.056) and a significant difference between ADHDt and the typical (p=0.014) group; with cortisol levels being significantly lower in the ADHDt group. Scores for total anxiety indicated that the ADHDs group was significantly more anxious than both the ADHDt and control group. These results indicate that SOR may alter the stress response in children with ADHD and contribute to increased anxiety in this population.

M.Sc.(Occupational Therapy), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Title: The agreement found between the sensory profiles of children 3-10 years and their parents Author: Elsje Geyser Promoter: Denise Franszen School: Therapeutic Sciences Faculty: Health Sciences Degree: MSc.OT Key Concepts: Sensory modulation dysfunction, sensory processing disorder, high threshold, low threshold, sensory profile, low registration behaviour, sensory seeking behaviour, sensory sensitive behaviour, sensation avoiding behaviour. In order to treat a child with sensory modulation disorder (SMD), the impact of SMD on the child’s occupational sphere should be taken into account. This includes the effect of SMD in the parent on the child’s development and behaviour. This study determined the probability of agreement between the parent and child’s sensory profiles. A quantitative, cross sectional study design established the sensory profiles of 81 children and their parents. Results indicated a moderate probability that a child with SMD may have a parent with SMD. A moderate to high probability existed for a parent with SMD to have a child with SMD. This supports the supposition that there is a hereditary component to SMD, with learned sedentary behavioural patterns. The treatment implications include considering the parent’s reaction to their own sensory thresholds and the influence this has on the child’s treatment and learnt behaviour.

Developmental Dyspraxia and Sensory Modulation Dysfunction are Sensory Integration Disorders that are widely known to occupational therapists practicing in the paediatric occupational therapy field. These disorders have been the subject of numerous research studies that have managed to clarify and explain relations of these disorders with sensory processing as well as their prevalence in different diagnostic groups. Such a clarified relationship is between Developmental Dyspraxia and Sensory Discrimination, while Sensory Modulation Dysfunction is reported to occur in various diagnostic groups. Developments over the past decade in the field of Sensory Integration proposed that Developmental Dyspraxia and Sensory Modulation Dysfunction be regarded as two patterns of a Sensory Processing Disorder and suggested that these two disorder patterns occurred concomitantly. Clinical experience, however, resulted in the researcher questioning the above proposed concomitant relationship and hypothesised that there was a specific relation between Developmental Dyspraxia and Sensory Responsivity (Sensory Modulation Dysfunction). This study was directed at investigating the relationship between Developmental Dyspraxia and Sensory Responsivity. A review of the literature that described these two disorder patterns yielded reference to theories that underpin Developmental Dyspraxia and Sensory Responsivity. From these theories it was possible to identify some common ground between Developmental dyspraxia and Sensory Responsivity that could potentially support a relation. The Sensory Profile, Sensory Profile School Companion and the Sensory Integration and Praxis Tests were used to assess and identify Developmental Dyspraxia and Sensory Responsivity. Obtained data were statistically analysed and compared and did not produce a statistically significant positive relation between Developmental Dyspraxia and Sensory Responsivity, but yielded some weak correlations in supplementary analysis. These weak correlations have value in terms of sensory responsiveness tendencies in the presence of types of dyspraxia. Clinical analyses of the data set were performed to examine the incidence of types of dyspraxia in the sample with sensory over- or under responsiveness. These analyses demonstrated a greater presence of Developmental Dyspraxia in the population with Sensory Under-responsivity. The clinical analyses provided the researcher with additional information that was taken into account when conclusions were made. It also contributed to the recommendations that were made at the end of Chapter 5. Discussion of results was directed at explaining correlations and interpreting the implications of those correlations. A discussion of possible problems included considering possible flaws in the method and procedure that could have contributed to the research outcome. Recommendations were directed at proposals for future research and recommendations for clinical practice. Copyright / Dissertation (MOccTher)--University of Pretoria, 2010. / Occupational Therapy / unrestricted