Relationship Between Context and Sensory Processing

in Children With Autism

Natalie Bennett Brown, Winnie Dunn

KEY WORDS OBJECTIVE. The purpose of the study was to determine the relationship between sensory processing and
! autistic disorder context for children with autism. We examined home and school contexts using the Sensory Profile (Dunn,
1999) and the Sensory Profile School Companion (Dunn, 2006a) questionnaires.
! child behavior
! environment
METHOD. Teachers of 49 students with autism completed the Sensory Profile School Companion, and parents
completed the Sensory Profile. We conducted correlational analyses using the avoiding and seeking quadrant
! sensory processing
scores from the School Companion and corresponding avoiding and seeking quadrant scores from the Sensory
! sensory threshold Profile.
RESULTS. The avoiding quadrant score coefficient (.59) and the seeking quadrant score coefficient (.45)
were statistically significant (p 5 .01) with good and fair correlations, respectively, suggesting that sensory
processing patterns have both universal qualities and context-specific qualities in children with autism.
CONCLUSION. Findings from this study provide initial evidence that sensory processing and context for
children with autism are related.

Brown, N. B., & Dunn, W. (2010). Relationship between context and sensory processing in children with autism. American
Journal of Occupational Therapy, 64, 474483. doi: 10.5014/ajot.2010.09077

Natalie Bennett Brown, MS, OTR/L, is Occupational
Therapist, The Manse, 9 Hamilton Gardens, London NW8
9PU England; tallybennett@yahoo.com. At the time of the
study, she was a graduate student at the University
of Kansas.
Winnie Dunn, PhD, OTR/L, FAOTA, is Professor and
Chair, Department of Occupational Therapy Education,
University of Kansas Medical Center, Kansas City.
I
n the United States, the prevalence of autism is 1 in 150 births, and it affects
more boys than girls (4.8:1; Centers for Disease Control and Prevention
[CDC], 2007). Autism is a neurodevelopmental disorder characterized by im-
pairments in social skills and nonverbal and verbal communication, and it
involves repetitive behaviors and unusual interests (American Psychiatric As-
sociation, 2000; Corsello, 2005; Rapin, 1991). In addition to those core char-
acteristics, many children with autism have unusual ways of learning, attending,
and responding to sensory experiences (Rapin, 1991; Strock, 2004); this area
of consideration has received greater attention in the past decade.

Sensory Processing Concepts

Scholars have continued to advance the study of sensory processing since Sensory
Integration Theory was first developed by Jean Ayres. Dunns (1997) Model of
Sensory Processing is based in knowledge from neuroscience and behavioral
science (Figure 1). The model conceptualizes sensory processings contribution
to a childs behavior. Dunns model hypothesizes that an interaction between
neurological thresholds and behavioral responses exists (Dunn, 1997). In Figure 1,
neurological thresholds (i.e., the vertical axis) indicate the amount of stimuli
needed for a child to notice or react to the stimuli. The behavioral responses (i.e.,
the horizontal axis) indicate the manner in which a child responds to stimuli.
According to Dunns Model of Sensory Processing, neurological thresholds
and behavioral responses fall on a continuum and interact with each other. The
intersection of the two continua results in four sensory processing patterns (i.e.,
registration, seeking, sensitivity, and avoiding) that offer possible interpretations
of a childs behavior (Dunn, 2006a):

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Figure 1. Dunns Model of Sensory Processing.
From The Impact of Sensory Processing Abilities on the Daily Lives of Young
Children and Families: A Conceptual Model, by W. Dunn, 1997, Infants and
Young Children, 9(4), p. 24. Copyright ! 1997 by Aspen Publishers. Reprinted
with permission.
Registration is described as the degree to which a child
misses sensory input (high neurological threshold and
passive response).
Seeking is the degree to which a child obtains sensory
input. Children in the seeking quadrant also have
a high neurological threshold but respond actively.
Children with low neurological thresholds fall into
the sensitivity or avoiding quadrants.
Sensitivity is the degree to which a child notices sen-
sory input (passive response).
Avoiding is the degree to which a child is bothered by
sensory input (active response).
The interaction of neurological thresholds and behavioral
responses provides a method for explaining how children
process sensory information and guidance for intervention
planning (Dunn, 1999).
Sensory Processing and Children
With Autism
One of the many difficulties children with autism face
is that they respond to sensory experiences in an unusual
way (CDC, 2007; Rapin, 1991; Strock, 2004). Children
with autism may be sensitive and overreact to auditory
stimulation and withdraw (Case-Smith & Bryan, 1999).
They may also seek proprioceptive and vestibular input
through self-stimulatory, repetitive behaviors such as
rocking, spinning, or flapping their hands (Case-Smith &
Bryan, 1999). The unique sensory processing patterns of
children with autism are associated with dysfunction in
attending, arousal, interactions with others, and goal-
directed play (Case-Smith & Bryan, 1999; Greenspan &
Wieder, 1997; Wieder, 1996).
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Moreover, research has shown that sensory processing
affects a childs ability to learn (Ayres, 1979; Dunn, 2001;
Dunn & Donaldson, 2001). Specifically, children with
autism often fail to notice sensory input that is impor-
tant; at other times, they are overly sensitive to sensory
input and withdraw from stimuli (Ermer & Dunn,
1998; Kientz & Dunn, 1997; Ornitz, 1974; Rapin,
1991; Tomchek & Dunn, 2007; Watling, Deitz, &
White, 2001). This pattern of responding makes it dif-
ficult for a child to learn because he or she misses im-
portant information needed to profit from instruction;
this situation becomes critical in the school context. For
these reasons, education teams need the appropriate tools
to identify and design effective interventions specific to
the educational context.
Evaluation Within the Educational System
With a cause for autism not yet understood, effective
interventions for children with this disorder are in de-
mand. Because of federal laws and the fact that children
spend most of their day at school, the educational system is
expected to provide much of the instruction and in-
tervention for children with autism (Individuals With
Disabilities Education Act of 1990; Individuals With
Disabilities Education Improvement Act of 2004; No
Child Left Behind Act of 2001). Public schools are re-
quired to provide supportive programming to facilitate
childrens success in academics and social interactions.
Including assessment of sensory processing in the edu-
cational assessment plans of children who have autism
may facilitate individualized intervention planning.
A critical factor that the educational system faces
when serving children with autism, however, involves
conducting valid and reliable assessments. Assessments are
used to determine childrens learning strengths and needs.
Many authors have suggested that childrens reaction
to sensation may interfere with both assessment and
educational planning (Ayres, 1979; Case-Smith & Bryan,
1999; Case-Smith & Miller, 1999; Cook, 1991; Kientz &
Dunn, 1997; Larson, 1982). If we are better able to
understand childrens reaction to sensation, particu-
larly their sensory processing patterns, then professionals
will have important information to guide educational
planning.
Methods for Assessing
Sensory Processing
Behavior is influenced by context; therefore, it is im-
portant to consider a persons context when consid-
ering his or her potential to learn (Dunn, Brown, &
475
 McGuigan, 1994). The Sensory Profile (Dunn, 1999),
which is based on Dunns Model of Sensory Processing,
has been used in many interdisciplinary studies to doc-
ument sensory processing patterns in children and
adults with and without disabilities (Brown, Tollefson,
Dunn, Cromwell, & Filion, 2001; Dunn, 1994; Dunn &
Bennett, 2002; Ermer & Dunn, 1998; Kientz & Dunn,
1997; Rogers, Hepburn, & Wehner, 2003; Watling
et al., 2001). However, behaviors assessed by the Sensory
Profile are not specific to behaviors that would occur in
the classroom setting, where a school-age child spends
most of his or her day.
Home and school contexts are unique, and contex-
tually relevant assessments are therefore essential. Re-
cently, the Sensory Profile School Companion (hereinafter
referred to as the School Companion) has been published
to answer this need (Dunn, 2006a). The School Com-
panion is built on Dunns Model of Sensory Processing
(Figure 1) and coordinates findings with the well-
established Sensory Profile (Dunn, 1999). The School
Companion reflects scores that are grounded in tested
theoretical concepts from the literature (i.e., sensory
processing patterns: seeking, avoiding, sensitivity, and
registration), providing insights into the childs sensory
patterns in the context of school. The School Companion
also offers sensory system scores (i.e., visual, auditory,
touch, movement) and a behavior score. Because teachers
complete this form, it also includes four school factor
scores reflecting teacher and classroom perspectives.
The School Companion is designed for children ages
311. The childs teacher uses a 5-point Likert scale to
complete the 62-item questionnaire regarding the childs
responses to daily sensory experiences in the classroom.
Additionally, the School Companion is designed to be
used in conjunction with the Sensory Profile (Dunn,
1999), which solicits the caregivers input, providing
a comprehensive view of the childs sensory processing
patterns. We used the Sensory Profile and School Com-
panion in this study of home and school contexts because
of their common conceptual basis.
Identifying the Best Source for
Evaluation Information
Research has shown that when teachers and parents are
asked the same questions about a child, the responses are
only slightly correlated, suggesting that each informant has
a unique view and that one view cannot be substituted for
the other (Achenbach, McConaughy, & Howell, 1987;
De Los Reyes & Kazdin, 2005; de Nijs et al., 2004;
Kumpulainen et al., 1999). The low correlations between
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teacher and parent responses to the same questionnaire also
suggest that home and school variables differ and indicate
the need for contextually designed assessments and dif-
ferent interventions and goals (Achenbach et al., 1987).
Questions may be raised about how home and school
versions of sensory processing assessments relate to each
other. If assessment of sensory processing only concerns
childrens reactions, then home and school assessments
will be highly correlated. If, however, the contexts of
childrens reactions are an important factor, then both
similarities and differences will perhaps indicate the
contribution of context to behavior. For this study, we
hypothesized that the greatest difference between parent
and teacher responses would be seen in the two active
behavioral response quadrants from Dunns Model of
Sensory Processing (i.e., avoiding and seeking). Perhaps
the active behavioral response quadrant behaviors would
be more noticeable, making it easier for parents and
teachers to report behaviors.
In summary, a strong need for effective assessment
and intervention for children with autism exists. The
school system is expected to provide specialized instruction
to meet the unique learning needs of all children. Research
has shown that children with autism have unique sensory
processing patterns affecting the way in which they re-
spond in their everyday lives, including at home and at
school (Ermer & Dunn, 1998; Kientz & Dunn, 1997;
Ornitz, 1974; Rapin, 1991; Tomchek & Dunn, 2007;
Watling et al., 2001). Being able to determine how
specific sensory processing patterns might relate to par-
ticipation at home and at school will help professionals
support children, families, and teachers by demonstrating
how therapists might adjust the context to better fit
childrens needs.
The purpose of this study was to determine the re-
lationship between sensory processing and context. To
address this purpose, we examined Sensory Profile and
School Companion findings for the same children, hy-
pothesizing that each assessment would provide contex-
tually specific information about the sensory processing
responses of children with autism at home (Sensory
Profile) and at school (School Companion). If context
(home and school) and sensory processing patterns are
related, then some aspects of sensory processing responses
in children with autism will be unique to school. We
hypothesized (1) a low relationship between seeking
quadrant scores at home and at school and (2) a high
relationship between avoiding quadrant scores at home
and at school. For this study, we focused only on the
seeking and avoiding quadrants. We hypothesized that the
active quadrant behaviors from Dunns Model of Sensory
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 Processing (i.e., avoiding and seeking) would be more
noticeable, making it easier for parents and teachers to
report them, and that these two quadrants would have the
greatest difference in parent and teacher responses.
Method
Research Design
We conducted correlational analyses to explore the re-
lationship between sensory processing and context for
children ages 311 yr. The avoiding and seeking quadrant
scores from the School Companion (school) were corre-
lated with the corresponding avoiding and seeking
quadrant scores from the Sensory Profile (home). The
teachers of 49 students with autism completed the School
Companion, and parents completed the Sensory Profile.
Participants in this study were part of a larger study
conducted from September 2005 to March 2006 to es-
tablish validity and reliability for the School Companion.
This parent study was approved by the institutional review
board of the University of Kansas Medical Center, and
participating parents and teachers provided informed
consent.
Participant Selection
The sample for this study included 56 students with
autism (49 boys and 7 girls) located across the United
States and their public school teachers (n 5 56); teachers
completed the School Companion on participating stu-
dents. To participate, students were required to have
a diagnosis of autism as designated by the educational
system. Children with multiple diagnoses were excluded
from the data set. As a result of missing data, 49 pairs of
teachers and children with autism had complete data sets
for the analyses in this study.
Instruments
The Sensory Profile (Dunn, 1999) is a caregiver ques-
tionnaire consisting of 125 items that describe a childs
response to sensory experiences. The items are divided
into three main sections: (1) sensory processing, (2) mod-
ulation, and (3) behavioral and emotional responses. The
questionnaire items also form nine meaningful groups, or
factors, that characterize children by their responsiveness
to sensory input. The Supplement Summary Score Sheet
to the Sensory Profile (Dunn, 2006b) provides four
quadrant scores (registration, seeking, sensitivity, and
avoiding) that correspond to Dunns (1997) Model of
Sensory Processing (Figure 1). According to the model,
registration is the level at which a child misses sensory
input, seeking is the level at which a child obtains sensory
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input, sensitivity is the level at which a child notices
sensory input, and avoiding is the level at which a child is
bothered by sensory input. Parents respond to each
statement by reporting the frequency with which their
child engages in a behavior on a 5-point Likert scale (i.e.,
1 5 always, 100% of the time; 2 5 frequently, 75% of the
time; 3 5 occasionally, 50% of the time; 4 5 seldom, 25%
of the time; and 5 5 never, 0% of the time). The Caregiver
Questionnaire and the Summary Score Sheet require
approximately 30 min to complete. We calculated the
Supplement Summary Score Sheet in SPSS 16 (SPSS,
Inc., Chicago) using the raw scores.
We estimated the Sensory Profiles reliability using
internal consistency. Internal consistency indicates the ex-
tent to which the items in each section measure a single
construct. The value of Cronbachs a for each of the
various sections ranged from .47 to .91 (Dunn, 1999).
Validity refers to the extent to which a test measures
what it is designed to measure. Dunn (1999) compared
scores from the Sensory Profile with scores obtained on
the School Function Assessment (Miller-Kuhaneck,
Henry, Glennon, & Mu, K. (2007). Both high and low
correlations were found, providing evidence of conver-
gent and discriminant validity. Convergent and dis-
criminant validity are types of construct validity, which is
the ability of an instrument to measure an abstract con-
cept or construct (Portney & Watkins, 2000).
Convergent validity indicates that two assessments are
believed to reflect the same concept (high correlation).
Conversely, discriminant validity indicates that two as-
sessments assess different characteristics (low correlation).
For example, correlations were higher between the behav-
ioral regulation section of the School Function Assessment
and the modulation sections of the School Companion.
Lower correlations were found between the more detailed
performance items on the School Factor Assessment (e.g.,
manipulating small objects in art class) and items on the
Sensory Profile (Dunn, 1999).
Other researchers have provided additional validity
data for the Sensory Profile. For example, researchers have
shown that children with autism have significantly dif-
ferent sensory processing patterns from those of their peers
(Kientz & Dunn, 1997; Tomchek & Dunn, 2007;
Watling et al., 2001), children with Asperger syndrome
(Myles, Hagiwara, Dunn, Rinner, & Reece, 2004), and
children with attention deficit hyperactivity disorder (Er-
mer & Dunn, 1998). In addition, Rogers et al. (2003)
reported sensory processing differences among children
with autism, fragile X syndrome, and developmental delays
and children without disabilities, suggesting that the short
Sensory Profile can discriminate among these groups.
477
 The School Companion (Dunn, 2006a) is a 62-item
teacher questionnaire; items describe a students response
to common sensory experiences in the school context.
Because the School Companion is designed to be used in
conjunction with the Sensory Profile, the School Com-
panion uses the same 5-point Likert scale and scoring
procedures as the Sensory Profile. The Teacher Ques-
tionnaire provides the same four quadrant scores (regis-
tration, seeking, sensitivity, and avoiding) corresponding
to Dunns Model of Sensory Processing, four school
factor scores (School Factors 1, 2, 3, and 4), and section
scores for four sensory groups and one behavior group
(auditory, visual, movement, touch, and behavior).
Teachers required approximately 15 min to complete the
Teacher Questionnaire, and we calculated the scoring
summary using the raw scores within SPSS 16.
Dunn (2006a) used Cronbachs a coefficient to re-
port reliability of the School Companion. Correlations
ranged from .83 to .95, which are considered to be in the
adequate reliability range (DePoy & Gitlin, 1994). Dunn
also reported testretest reliability coefficients ranging
from .80 to .95, reflecting good to excellent stability of
scores from the teachers first rating on a child to the
teachers second rating on the same child (Dunn, 2006a).
To test the validity of the School Companion, we
correlated the scores from the teacher responses on the
School Companion with scores from the parent responses
on the Sensory Profile and indicated contrasting high and
low correlations, providing evidence of convergent and
discriminant validity. For example, the parent and teacher
ratings for the avoiding quadrant score had the highest
correlation (.62), and the parent and teacher ratings for
the seeking quadrant score had the weakest correlation (.34).
In addition, teachers completed a demographic data
sheet that included educational level and degree attained,
frequency of teacher contact with students, years of teacher
contact with students, and years of teaching experience.
Teachers also reported parents educational level.
Procedures
To prevent conflict of interest, an independent testing
company sent packets to teachers and parents of children
with autism. The packets included a cover letter with
instructions, a demographic data sheet, a consent form,
and the Sensory Profile and School Companion
questionnaires. Teachers completed the demographic
data sheet, consent form, and the School Companion,
and parents completed the Sensory Profile. Participants
returned the material to the testing company within 2
months of receipt of packet materials. The testing com-
pany compiled the data into deidentified files and for-
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warded them to us. We calculated summary scores using
raw scores and conducted statistical analyses using SPSS 16.
Data Analysis
To determine the relationship between home and school
reports of sensory processing patterns in children with
autism, we conducted correlational analyses using the
avoiding and seeking quadrant scores from the School
Companion and the corresponding avoiding and seeking
quadrant scores from the Sensory Profile. We hypothe-
sized that the schools context may restrict seeking pat-
terns that are demonstrated at home, whereas behaviors
associated with avoiding patterns may be more likely to
occur in both the home and the school contexts. We
conducted one-tailed Spearman rank order correlations
with a bivariate correlation design. We chose Spearman
rank order correlations because data from a Likert scale
are nonparametric. We set the p value at the standard
level of .05. We used SPSS 16 to complete the cor-
relational analyses and frequency distributions of the
demographics.
Results
The 49 students (43 boys and 6 girls) ranged in age from
3 yr 3 mo to 11 yr 11 mo (Table 1). Five of the children
received one service (i.e., occupational therapy, physical
therapy, speechlanguage therapy, special education, or
counseling), 10 children received two services, and 34
students received more than two services (Table 2).
Of the children, approximately 18% were from various
ethnic backgrounds (4 African-American, 2 Asian, 1
Hispanic, 2 othermultiracial), and approximately 82%
were White (n 5 40).
Teachers experience ranged from 0 to 26 yr, and
educational levels ranged from no degree to a doctoral
degree (no degree 5 1, bachelors degree 5 22, masters
degree 5 23, doctoral degree 5 2, missing 5 1; see Table
3). Seven teachers had contact with students 2 days
a week, 17 teachers had contact with students 34 days
a week, and 25 teachers had contact with students daily
(Table 4). Most teachers had only 1 year of contact with
Table 1. Distribution of Children With Autism by Age and Gender
Male (n 5 43) Female (n 5 6)
Age (yr.mo) n % of Sample n % of Sample
3.05.11 20 40.82 2 4.08
6.08.11 12 24.49 1 2.04
9.011.11 11 22.45 3 6.12
Total 43 87.76 6 12.24
Note. N 5 49.
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 Table 2. Distribution of Children With Autism by Race or Ethnicity Table 4. Distribution of Frequency by Teacher Contact With
and Number of Services Received Students and Years of Teacher Contact With Students
Race/Ethnicity and Services n % of Sample Teachers of Students With
Race or ethnicity Autism (N 5 49)
African-American 4 8.16 Teacher Contact With Students n % of Sample
Asian 2 4.08 Frequency of contact
Hispanic 1 2.04 2 days/week 7 14.29
White 40 81.63 34 days/week 17 34.69
Othermultiracial 2 4.08 Daily 25 51.02
Total 49 100.00 Total 49 100.0
Services received Years of contact
1 5 10.20 1 yr 30 61.22
2 10 20.41 >1 yr 19 38.78
>2 34 69.39 Total 49 100.00
Total 49 100.00
Note. N 5 49. Percentages may not total 100 because of rounding.
As a result of missing data, only 49 of the 56 pairs of
students (n 5 30), but some teachers had multiple years teachers and students with autism were eligible for the
of contact (8 had 2 yr, 4 had 3 yr, 2 had 4 yr, 5 had study. In addition, we excluded cases pairwise in the
5 yr). correlations to minimize the effect of missing data. For this
In addition, parents of the same children completed reason, the number of participants reported in Table 6
the Sensory Profile Caregiver Questionnaire. Mothers varies.
and fathers education levels (based on teacher report) When data were plotted, both the seeking and
ranged from 11 yr of school (mother 5 0, father 5 2) avoiding results had outliers (Figures 2 and 3). When
to 16 yr of school; with most parents had 16 yr outliers were excluded, the correlation strength improved.
of school (mother 5 21, father 5 21; see Table 5). The demographics, however, indicated no reason to ex-
Other education levels included 12 yr of school or clude the outliers from the results; thus, the reported
a GED (mother 5 12, father 5 10), and 1315 yr of results include data from outliers.
school (mother 5 16, father 5 15); one parent was
unreported (mother 5 0, father 5 1).
Discussion
Table 6 summarizes the results of the correlations
using the avoiding and seeking quadrant scores from the In this study, we examined the relationship between
Sensory Profile (parent report) and School Companion sensory processing patterns at home and school in children
(teacher report). The avoiding quadrants correlated at .59 with autism. Specifically, we correlated the seeking
(p 5 .01). The seeking quadrants correlation was also quadrant scores from the Sensory Profile (completed by
positive (.45, p 5 .01). parents) and the School Companion (completed by
teachers). We also correlated the avoiding quadrant scores
from each of the assessments. Data analysis revealed sta-
Table 3. Distribution of Teachers by Education Level or Degree tistically significant correlations, with both good and fair
Attainment and Years of Teaching Experience correlations suggesting that sensory processing patterns
Teacher Education and Experience n % of Sample have both universal qualities (i.e., the impact is the same
Education level or degree
No degree 1 2.04
Bachelors degree 22 44.90 Table 5. Distribution of Parents of Children With Autism by
Masters degree 23 46.94 Education Levels
Doctoral degree 2 4.09
Mother (n 5 49) Father (n 5 49)
Missing 1 2.04
Education Level n % of Sample n % of Sample
Total 49 100.00
Years of teaching 11 yr of school 0 0.00 2 4.08
010 18 36.73 12 yr of school or GED 12 24.49 10 20.41
1120 18 36.73 1315 yr of school 16 32.65 15 30.61
>20 13 26.53 16 yr of school 21 42.86 21 42.86
Total 49 100.0 Not reported 0 0.00 1 2.04
Total 49 100.00 49 100.00
Note. N 5 49. Percentages may not total 100 because of rounding.

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 Table 6. Correlations Between the School Companion and
Sensory Profile Avoiding and Seeking Quadrant Scores for
Children With Autism
Sensory Profile Quadrants
School Companion Quadrants Avoiding
Avoiding
r .59**
n 31
Seeking
r .46**
n 37
Note. The ns vary as a result of missing data.
pp < .05 level (one-tailed). ppp < .01 level (one-tailed).
everywhere) and context-specific qualities (i.e., the impact
is specific to a situation or activity) in children with autism.
The avoiding quadrant had a moderate to good
correlation coefficient (.59), suggesting that a childs
reactions of being overwhelmed by sensory experiences
might sometimes be similar at home and at school. Per-
haps children with autism are universally overwhelmed
and avoid sensations across contexts. For example, both
teachers and parents may report that students with autism
hold their hands over their ears to protect against sound,
avoid eye contact, or withdraw in response to changes in
routine. The context has the potential to provide multiple
sensory experiences. Children with avoiding patterns can
become easily overwhelmed; stimuli that trigger avoiding
reactions can occur anywhere and at any time. However,
because the correlation between context and sensory
processing was not perfect, data suggest that the home
and school contexts also reflect sensory circumstances that
are unique to each environment. For example, a family
with one child may have a home context that is quieter
than the school context. Such parents would likely ob-
serve fewer auditory reactions than would the childs
Figure 2. Scatterplot for seeking quadrant score.
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teacher, who observes the child amid a classroom full of
students.
For practitioners, these findings can be helpful in
intervention planning. Both parents and teachers can
Seeking implement strategies that could minimize sensory expe-
riences to reduce a childs need to use avoiding behaviors.
.42*
Situations in both home and school contexts may be
30
especially overwhelming (i.e., school assemblies, fire
.45** drills, shopping at a department store with a parent, or
36 receiving a haircut). Therapists should ask additional
questions about these high-risk situations when children
have avoiding patterns so that strategies can be created to
prevent challenging behaviors. Encouraging parents and
teachers to discuss a students sensory preferences across
contexts can provide additional information that will
assist in determining which situations are most over-
whelming for a student and in planning more effective
interventions.
The seeking quadrant correlation (.45) was in the fair
range. For seeking responses, expectations and limitations
of a particular context may contribute to the fair corre-
lation between home and school. For example, when
a child sings out loud at home, such behavior might be
considered delightful. This behavior would be considered
disruptive when exhibited in the classroom setting,
resulting in a difference in reporting by parents and
teachers. Some parents may observe their children in
multiple unstructured contexts in which seeking behaviors
are acceptable and encouraged. Other parents might
provide greater amounts of structure that guide the childs
responses. By contrast, teachers may be more likely to
notice seeking behaviors during structured classroom
activities (such as seatwork, a time when students are
expected to be more controlled) and less likely to take
note of seeking behaviors during recess when all students
Figure 3. Scatterplot for avoiding quadrant score.
May/June 2010, Volume 64, Number 3
 are more active. Alternatively, a child with seeking pref-
erences may maintain self-control during the school day
but exhibit more seeking behaviors when at home. As
a result, the seeking patterns at home and school may
require special attention to understand the impact of
seeking on a childs ability to participate in daily life.
Discussion between parents and teachers provides a more
comprehensive understanding of a students unique sen-
sory processing needs related to seeking.
As shown in Table 6, the correlations using the
corresponding seeking and avoiding quadrant scores were
significant. However, we also found significant correla-
tions between the School Companion avoiding quadrant
score and the Sensory Profile seeking quadrant score (.42,
p 5 .05), as well as between the School Companion
seeking quadrant score and the Sensory Profile avoiding
quadrant score (.46, p 5 .01). Both correlations fell in
the fair range. Perhaps we found significant correlations
across these quadrants because, according to Dunns
Model of Sensory Processing (Figure 1), both avoiding
and seeking patterns are active self-regulation patterns.
Self-regulation is on a continuum and is defined as the
strategy a person uses to manage his or her own needs and
preferences (Dunn 2006a). Perhaps childrens need to
control their own sensory input, whether it be to receive
more (i.e., seeking) or less (i.e., avoiding), is reflected in
these fair correlations.
The literature on multiple informants indicates that
when parents and teachers are asked the same question, the
answers are only slightly correlated, suggesting that each
informant has a unique view (Achenbach et al., 1987;
De Los Reyes & Kazdin, 2005; de Nijs et al., 2004;
Kumpulainen et al., 1999). This literature also reiterates
the importance of receiving information from both pa-
rents and teachers during the assessment process and the
necessity of using context-specific assessments (Achen-
bach et al., 1987). In addition, having both home and
school information provides an opportunity to identify
successful strategies from parents and teachers that may
be useful in the other context. Furthermore, using con-
text-specific assessments (home and school versions) can
provide a way to respectfully discuss what is happening at
home and school without suggesting that either parents
or teachers are providing an inaccurate perspective.
We know from the literature that children with autism
have unique sensory processing patterns (Ermer & Dunn,
1998; Kientz & Dunn, 1997; Ornitz, 1974; Rapin, 1991;
Tomchek & Dunn, 2007; Watling et al., 2001) when
compared with those of typically developing peers. This
study illustrates that for children with autism, behavioral
responses to sensory experiences seem to be context re-
The American Journal of Occupational Therapy
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lated, suggesting that simply knowing a childs sensory
processing patterns without considering contextual fac-
tors would be insufficient information for comprehensive
intervention planning.
Implications for Occupational Therapy Practice
This studys results support the need to assess sensory
processing patterns in children with autism across con-
texts. The School Companion may be a valuable addition
to the Sensory Profile measure in accomplishing this goal.
Because both measures are built on the same conceptual
foundation, therapists can examine the impact of sensory
processing in everyday life from parents (using the Sen-
sory Profile) and from teachers (using the School Com-
panion). Having more pieces of the autism puzzle may
help to provide more effective and individualized inter-
ventions. Having data to support the concept that the
context may be a factor in ones sensory processing pro-
vides a respectful way of discussing the similarities and
differences between home and school as unique settings
in which children can thrive.
Limitations and Future Research
This studys small sample size limits its generalizability.
However, the sample included children with a distribu-
tion of age, race, involvement in special education (i.e.,
number of services, frequency of teacher contact), and
parental educational levels, increasing the confidence
that results are relevant to a larger population of children
with autism. Future studies should investigate additional
patterns of sensory processing. In addition, future re-
search using other samples of children and adolescents
with disabilities would provide further information re-
garding the relationship between context and sensory
processing.
Conclusion
This studys findings provide initial evidence for the ex-
istence of a relationship between sensory processing and
context for children with autism. Both similarities and
differences in childrens reactions to sensory stimuli may
indicate the influence of context on behavior. The rela-
tionships between home and school sensory processing
patterns found in this study suggest that therapists must
consider the context when assessing and treating the be-
haviors of children with autism. Comprehensive assess-
ment should include information about behaviors both at
home and at school to plan the most effective in-
tervention strategies. s
481
 Acknowledgments
We thank Lisa Mische-Lawson, MEd, PhD, CRTS, and
Jeff Radel, PhD, for their assistance with statistical analyses
and editing. We also acknowledge the Psychological Cor-
poration, which assisted with the data collection process.
This study was completed in partial fulfillment of Natalie
Bennett Browns requirements for a master of science
degree in occupational therapy.
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