Occupational Therapy Information

• Cohort design
• Controls matched on race, gender, gestational age (within 3 wks), birth weight (within 500 gm), parity level, SES· Assessed every 6 months, from birth to 3 years on measures of neuromotor and organizational capabilities, sensory processing, and fine and gross motor development; comparison to controls done only at 12 months

There were results in multiple areas; only those related to vestibular are below:

• 21% of the sample scored below normal limits on the Reactivity to Vestibular Stimulation subtest at 6 months.
• 27% of the sample scored below normal limits on the Reactivity to Vestibular Stimulation subtest at 12 months.
• 42% of the sample scored below normal limits on the Reactivity to Vestibular Stimulation subtest at 18 months.

At 12 months, comparison to controls showed that the only significant difference was for the Adaptive-Motor subtest, with the prenatally substance exposed group scoring lower.

Clinical implications:

• Cocaine and alcohol exposure do appear to have a negative impact on performance on the TSFI, especially the adaptive-motor and visual-tactile integration subtests.
• The TSFI is useful in assessing prenatally substance-exposed infants. Deficits in sensory functions were clearly prevalent in this population

• Question reliability of TSFI subtests
• Subjects selected based on prenatal substance exposure, rather than prematurity/low birth weight, but many were low birth weight and/or premature
• The authors reported difficulty scoring the postrotary nystagmus test, as infants often closed their eyes
• Sample size small
• Evaluator unmasked

• Cohort design
• 3 different ages groups tested once (cross-sectional data)
• Assessed using measures of sensory processing

• The infants’ mean scores were in the “at risk” range on the Reactivity to Vestibular Stimulation subtest at 7-9 months and 10-12 months.
• The infants’ mean scores were in the “deficit” range on the Reactivity to Vestibular Stimulation subtest at 13-18 months.
• The mean total test scores were in the “at risk” range for infants born prematurely at 10-12 months and 13-18 months only.
• The infants born prematurely scored worse than the normal controls in Reactivity to Tactile Deep Pressure and Reactivity to Vestibular Stimulation at 7-9 months and 10-12 months, as well as overall sensory processing in all age groups.

Clinical implications:

• Infants with prematurity have sensory processing problems at each of the three age groupings. Difficulties with vestibular processing were noted in infants born prematurely at 7-9 months, 10- 12 months, and 13-18 months.
• Vestibular processing problems may be related to neuromotor status, i.e., delayed equilibrium responses and/or tone abnormalities, which cause them to react differently to vestibular input.

• Unmasked tester
• Question reliability of the TSFI subtests
• Premies not evaluated for regulatory disorders
• Subjects not matched for SES, ethnicity, maternal education

• Case-control design
• Assessed using a measure of sensory responsiveness (Sensory Rating Scale)

• Infants born prematurely scored significantly higher than full-term infants on the summary SRS scores and the sensitivity to touch section (i.e., they demonstrated greater frequency of defensive behaviors).

Clinical implications:

• Mean SRS scores reflect minimal meaningful differences in behaviors between the two groups. (A degree of touch hypersensitivity is suggested, but the differences are not large and it has questionable clinical relevance.)
• Only 2 movement items were scored higher for infants born prematurely. It may be that they seek out movement that they missed out on in utero.

• Some of the infants were specifically low birth weight
• Survey used, possible recall bias (but sufficient reliability and validity of Sensory Rating Scale established)
• Limitations included small sample size, use of a convenience sample, lack of extensive research on the SRS, differences in the site of testing, and lack of discrimination of SES in the samples

• Case study design
• One-time assessment of sensory processing using the SIPT

• 26% (8/27) had dysfunctional SIPT cluster
• 89% had low scores in 1 or more SIPT domains
• 41% had 1 or more low scores in all 4 domains
• largest percentage of low scores for total group was praxis (74%), then somatic and vestibular processing (66%), ten form and space (55%), then bilateral integration and sequencing (48%)
• 81% of VLBW had one or more low scores in praxis domain
• 83% of triplets had 1 or more low scores in praxis and somatosensory and vestibular processing
• VLBW (N = 11) group at greatest risk for SID (45%); 4/5 had generalized dysfunction; 63% had low somatosensory and vestibular processing scores

• Small sample
• No control group
• Included more than premie/LBW
• Variables of amount of intervention and environment weren’t controlled for

• Case study design
• One-time assessment of sensory processing using the TSFI

33% (5/15) at risk or deficient scores on the TSFI; scored lowest on Adaptive Motor Functions and Ocular-motor Skills and highest on Reactivity to Vestibular Stimulation

• No significant difference in those scoring normal vs. those at risk/deficient on prematurity variable
• More VLBW (not LBW or SGA) in the group scoring normal
• LBW, prematurity, and low Apgars did not discriminate between those with and without sensory processing disorders

• Question reliability of the TSFI subtests
• Included more than premie/LBW
• No control group
• Small sample