Sensory processing of learners in the Western Cape diagnosed with attention-deficit/hyperactivity disorder

Cook, Ray Anne (2011-12)

Thesis (MOccTher)--Stellenbosch University, 2011.

Thesis

ENGLISH ABSTRACT: Background Temperament and sensory thresholds play an important part in how a person processes sensory information. Because people are differently construed, the way we perceive sensory information and act on the information will differ. Any person who suffers from an ailment or condition that interferes with this process of receiving, interpreting and acting on stimuli from our environments may find this process even harder. Behavioural observations that deviate from the "norm" are often found in children with attention-deficit/hyperactivity disorder (ADHD) and sensory processing disorder (SPD). More recent research focused on the relationship between ADHD and SPD. Dunn developed the Sensory Profile Caregiver1 and Sensory Profile School Companion2 (SPSC) measures to identify children’s sensory processing difficulties. Although many studies have been conducted using the Sensory Profile, no studies have been conducted outside the United States of America (USA) to establish whether Dunn’s SPSC will differentiate between children who are considered to be "normal" and those diagnosed with ADHD. Aim The aim of this study was to investigate how learners with ADHD in the Western Cape would perform on Dunn’s Sensory Profile School Companion (SPSC) and the ADHD Rating Scale-IV³ in order to assess the sensory processing problems of learners with ADHD in South Africa (see note end of abstract). Methodology A descriptive study was conducted using a convenience sample (n=108) from learners in the Western Cape between the ages of five and ten years and diagnosed with ADHD. Data collection consisted of a demographical form completed by the parents/legal guardians of the learners, as well as the completion of two questionnaires by the educator of the learners. The first questionnaire, the ADHD Rating Scale-IV, was used to classify the learners into subtypes of ADHD. The second questionnaire was Dunn’s SPSC, which is a teacher-report measure of learners’ responses to sensory input in the school environment. The following statistical analyses were performed: • descriptive statistics to provide means, medians and measurements of dispersion of the learners in the Western Cape on the SPSC; • The Kruskal-Wallis one-way ANOVA probability value to consider if significant differences existed between the medians of the 13 group scores of the SPSC; and • The Welsh T-test to compare learners with ADHD in the Western Cape with SPSC norms and Dunn’s sample of learners with ADHD. Results The results showed that there were significant differences (p=0.000) on all 13 group scores of the SPSC in learners with ADHD in the Western Cape showing significantly more behaviours characterising poorer sensory processing, when compared to Dunn’s normal sample. The comparison to Dunn’s sample of learners with ADHD did not yield significant differences in 11 of the 13 group scores, indicating that learners with ADHD in the Western Cape did not differ from Dunn’s ADHD learners. Avoiding and School Factor 4 showed significant differences, with the Western Cape group showing more extreme behaviours related to sensory input than Dunn’s group. The results using the ADHD Rating Scale-IV were less significant and it was found that the rating scale could not differentiate between the two types of ADHD, although some inferences could be made regarding the use (or not) of medication. There was a significant difference (p < 0.01) on the inattentive, hyperactive-impulsivity and total scores of the ADHD Rating Scale-IV with learners not on medication showing a higher frequency of ADHD behaviours. Conclusion Dunn’s SPSC was found to be a good measure to assess learners with ADHD’s sensory processing problems. The ADHD Rating Scale-IV, on the other hand, could not classify the learners into the subtypes and therefore cannot be used when learners are already using medication. Further investigation is recommended to try to establish a link between the different subtypes of ADHD and the placement of learners on the different quadrants of Dunn’s SPSC as well as the School Factors and Sensory Section Scores.

AFRIKAANSE OPSOMMING: Agtergrond Temperament en sensoriese drempels speel 'n belangrike rol in die wyse waarop 'n persoon sensoriese inligting verwerk. Omdat mense verskillend is, sal die manier waarop ons sensoriese inligting waarneem en dan daarop reageer, verskil. Enige persoon wat aan 'n kwaal of toestand ly wat inmeng met hierdie proses van hoe sensoriese insette uit die omgewing opgeneem, geïnterpreteer en dan op gereageer word, sal dit moeilik vind. Gedrag wat afwyk van die "norm" word dikwels in kinders met aandagafleibaarheid/hiperaktiwiteitsteuring (AAHS) en sensoriese prosesseringsdisfunksie (SPD) waargeneem. Meer onlangse navorsing fokus op die verhouding tussen AAHS en SPD. Dunn het die Sensory Profile Caregiver4 en die Sensory Profile School Companion5 (SPSC)-skale ontwikkel om kinders se sensoriese prosesseringsprobleme te identifiseer. Alhoewel baie studies gedoen is wat die Sensory Profile gebruik het, is daar geen studies buite die VSA gedoen om te bepaal of Dunn se SPSC tussen kinders wat as normaal beskou word en dié wat met AAHS gediagnoseer is, kan differensiëer nie. Doelstelling Die doel van hierdie studie was om ondersoek in te stel na hoe leerders met AAHS in die Wes- Kaap op Dunn se Sensory Profile School Companion (SPSC) en die ADHD Rating Scale-IV6 sou presteer om die sensoriese prosesserings probleme van leerders met AAHS te assesseer. Metodiek 'n Beskrywende studie is gedoen met 'n gerieflikheidsteekproef (n=108) van leerders tussen die ouderdomme vyf en tien jaar oud in die Wes-Kaap wat met AAHS gediagnoseer is. Datainsameling het bestaan uit 'n demografiese vorm wat deur die ouers/wettige voogde van die leerders ingevul is, sowel as die voltooiing van twee vraelyste deur die opvoeder van die leerders. Die eerste vraelys, die ADHD Rating Scale-IV, is gebruik om die subtipes van AAHS te klassifiseer. Die tweede vraelys was die Sensory Profile School Companion (SPSC) wat 'n meting met behulp van die onderwyser se verslag is wat die leerders se reaksie ten opsigte van sensoriese insette in die skoolomgewing meet. Die tweede vraelys (Dunn se SPSC) is deur onderwysers ingevul ten einde leerders se response op sensoriese insette in die skoolomgewing te bepaal. Die data is aan die volgende ontledings onderwerp: beskrywende statistiek wat die gemiddelde, mediane en metings van die verspreiding van leerders in die Wes-Kaap op die SPSC verskaf; • die Kruskal-Wallis-eenrigting-ANOVA waarskynlikheidswaarde om vas te stel of daar beduidende verskille tussen die mediane van die 13 groeptellings van die SPSC is; en • die Welsh T-Toets om leerders met AAHS in die Wes-Kaap te vergelyk met die SPSCnorme en Dunn se steekproef van leerders met AAHS. Resultate Die resultate het beduidende verskille getoon (p=0.000) op al 13 groeptellings van die SPSC by leerders met AAHS in die Wes-Kaap, wat dui daarop dat hierdie groep aansienlik meer probleme kenmerkend aan sensoriese verwerking toon as wat in Dunn se normale steekproef waargeneem is. Die vergelyking met Dunn se steekproef met AAHS het in 11 van die 13 groeptellings nie beduidende verskille getoon nie wat aandui dat leerders met AAHS in die Wes-Kaap nie veel verskil het van Dunn se AAHS-leerders nie. Avoiding en School Factor 4 het beduidende verskille getoon met leerders in die Wes-Kaapse groep wat meer uiterstes in gedrag getoon het ten opsigte van sensoriese insette as dié van Dunn se groep. Die resultate waar die ADHD Rating Scale gebruik is, was minder beduidend en daar is bevind dat die skaal nie kon differensiëer tussen die twee tipes AAHS nie, alhoewel daar afleidings gemaak kon word ten opsigte van die gebruik (of nie) van medikasie. Daar was 'n beduidende verskil (p < 0.01) in die onoplettende, hiperaktief-impulsiwiteit en totale tellings van die ADHD Rating Scale-IV met leerders nie op medikasie nie, wat 'n hoër frekwensie van AAHS-gedrag getoon het. Slot Daar is bevind dat Dunn se SPSC 'n goeie maatstaf is om die sensoriese verwerkingsprobleme van leerders met AAHS te assesseer. Die ADHD Rating Scale-IV aan die ander kant kon nie die leerders in die verskillende subtipes klassifiseer nie en kan dus nie gebruik word wanneer die leerders reeds medikasie gebruik nie. Verdere ondersoek word aanbeveel in ’n poging om 'n skakel te kry tussen die verskillende subtipes AAHS en die plasing van leerders op die verskillende kwadrante van Dunn se SPSC sowel as die School Factors- en Sensory Section-tellings.

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