Running head: TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS. Exploration of the Relationships Between Temperament and Sensory-Processing

Running head: TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS Exploration of the Relationships Between Temperament and Sensory-Processing Behaviors ...
Author: Ralf Robertson
5 downloads 2 Views 9MB Size
Running head: TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

Exploration of the Relationships Between Temperament and Sensory-Processing Behaviors in Parent-Child Dyads

Dissertation Submitted to Northcentral University Graduate Faculty of the School of Behavioral and Health Sciences in Partial Fulfillment of the Requirements for the Degree of

DOCTOR OF PSYCHOLOGY

by RACHEL B. DIAMANT Prescott Valley, Arizona April 2011

UMI Number: 3458588

All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion.

UMI Dissertation Publishing

UMI 3458588 Copyright 2011 by ProQuest LLC. All rights reserved. This edition of the work is protected against unauthorized copying under Title 17, United States Code.

uest ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346

2011 Rachel B. Diamant

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

APPROVAL PAGE

Exploration of the Relationships Between Temperament and Sensory-Processing Behaviors in Parent-Child Dyads

by Rachel B. Diamant

Approved by:

Chair: Max Stanky-Chartrand, Ph.D

ate

Member: Jill Keller, Ph.D.

Member: Miguel Fernandez, Ph.D.

Certified

\Q,acA\ School Dean: Heather Frederick, Ph.D

ate

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

Abstract The fields of psychology and occupational therapy have engaged in separate lines of research (e.g., temperament and sensory-processing behaviors, respectively) to explore child behavior styles related to social and activity engagement. These two constructs imply that a goodness-of-fit between the child's behavior styles and demands of contextual experiences is critical for optimal task and social engagement. The purpose of this correlational study was to examine whether relationships existed between temperament and sensory-processing behavior patterns in parent-child dyads. Through convenience sampling, 59 healthy adults, 19 years or older, who were the primary caregiver of a healthy child between the ages of 3 to 7 years, were recruited for this study. Three self-report, standardized questionnaires were utilized to evaluate sensoryprocessing behavior patterns (e.g., low sensory registration, sensory seeking, sensory avoiding, and sensory sensitivity), and temperament characteristics (e.g., negative affectivity, extraversion/surgency, effortful control) and subcategories. Pearson productmoment correlation statistics revealed statistically significant positive associations between effortful control and typical behavior responses for auditory, visual, vestibular, touch sensory-processing, sensory sensitivity, and sensory seeking. Statistically significant associations were also found between atypical, extreme expression for subcategories of sensory-processing behaviors (i.e., auditory, visual, tactile, and vestibular sensory processing) and negative affectivity and extraversion/surgency. Three multiple regression analyses controlling for child age were completed to discover whether sensory-processing behaviors predicted temperament characteristics. Results revealed that atypical, extreme responses for sensory avoiding behaviors were

iv

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

significantly related to negative affectivity, F(5, 53) = 6.36,p < .001, and atypical, extreme responses for sensory seeking behaviors were significantly related to extraversion/surgency, F(5, 53) = 6.58, p < .001. Results imply that children who can adapt and modulate behavior responses to sensory experiences may be better able to selfregulate behaviors for effortful control (e.g., increased inhibitory control, increased focus and attention), whereas, children who are less able to adapt to sensory experiences are more likely to demonstrate negative, difficult temperament characteristics. An understanding of sensory processing behaviors and its relationships with temperament becomes critical in the analysis of goodness-of-fit between child, caregiver, and context. Outcomes suggest the potential for behavior management strategies when both temperament and sensory-processing behavior patterns are considered.

v

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

Acknowledgements I dedicate this project to the memory of my mother, Dora Diamant, who valued education and dearly tried to hold on to her health long enough to witness one of her children receive a doctorate.

I wish to thank my husband, John Volk, and my grown daughters, Rebecca, Samantha, and Sarah, for their support, encouragement, and patience. Additional thanks to Bernadette Mineo, PhD, Christina Griffin, PhD, and Mary Greer, PhD, my colleagues in the occupational therapy program at A. T. Still University, who guided me through this process and made sure that I did not give up. Final thanks goes to Max Chartrand, PhD, and my dissertation committee for the excellent feedback.

VI

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

Table of Contents List of Tables

ix

Chapter 1: Introduction

1

Background

2

Problem Statement

6

Purpose

7

Theoretical Framework

8

Research Questions

12

Nature of the Study

14

Significance of the Study

15

Definitions

16

Summary

23

Chapter 2: Literature Review

25

The Transactional Model of Development and Parent-Child Relationships

27

Temperament: Definition and History

33

Temperament and Its Influences on Social Interaction, Social Competence, and AdultChild Relationships 42 Model of Sensory Processing

66

Sensory-Processing Behaviors and Context

69

Neurophysiological Components of Sensory-Processing Behaviors and Temperament 80 Links Between Temperament and Sensory-Processing Behavior Patterns

95

Summary

99

Chapter 3: Research Method

104

Research Methods and Design

107

Participants

109

Materials/Instruments

Ill

Operational Definition of Variables

120

Data Collection, Processing, and Analysis

126

Ethical Assurances

133

Summary

136

Chapter 4: Findings

141 vii

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

Results

141

Evaluation of Findings

158

Summary

167

Chapter 5: Implications, Recommendations, and Conclusions

169

Implications

172

Recommendations

178

Conclusions

182

References

185

Appendixes

197

Appendix A: Sensory Profile

198

Appendix B: Adolescent/Adult Sensory Profile

199

Appendix C: Children's Behavior Questionnaire

200

Appendix D: Family Demographic Questionnaire

209

Appendix E: Cover Letter

210

Appendix F: Informed Consent Form

212

Appendix G: Address Card (Optional)

214

Appendix H: Letter from Pearson Assessments

215

Appendix I: Permission Letter Regarding the Children's Behavior Questionnaire

216

Appendix J: Recruitment Flyer

217

vm

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

List of Tables Table 1 Participant Demographics

144

Table 2 Means and Standard Deviations for the Scores in the SP and CBQfor the children in the sample 145 Table 3 Means and Standard Deviations for the Scores in the AASP for the adults in the sample 146 Table 4 Correlations among the main variables for Temperament and SensoryProcessing Behavior Patterns

148

Table 5 Correlations among the main variables for Temperament and the 14 subcategories of Sensory-Processing Behavior Patterns 149 Table 6 Correlations among the main variables for Sensory-Processing Behavior Patterns and the 15 sub-categories for Temperament 151 Table 7 The Bivariate and Partial correlations of the predictors with the Temperament characteristic of Extraversion/Surgency 152 Table 8 The Bivariate and Partial correlations of the predictors with the Temperament characteristic of Negative Affectivity 153

IX

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS

List of Figures Figure 1. Dunn's Model of Sensory Processing

68

Figure 2. Scatter plot depicting the relationships between standardized predicted and residual extraversion/surgency scores 142 Figure 3. Number of cases that are typical and atypical for children and parents on the Sensory Profile and the Adolescent/Adult Sensory Profile 156

x

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 1

Chapter 1: Introduction Temperament and sensory-processing behavior patterns are two separate theoretical constructs that describe styles of behavioral interactions used by individuals when engaging in social interactions and daily life activities. Parallel research regarding these two constructs has suggested that, when the individual's temperament behavioral characteristics or sensory-processing behavior patterns positively coincide with the demands of the context, the individual is better able to functionally engage in social and activity interaction (Dunn, 2007; Lengua & Kovacs, 2005; Rothbart, 2004). Researchers have suggested that characteristics of temperament and sensory-processing behavior patterns are interrelated; however, few studies have examined these relationships (BurnsDaniels, 2003; Dunn, 2001, 2007; Thomasgard, 2003). The nature of an individual's interpersonal interactions, social behaviors, and responses to daily experiences can be shaped by temperament. Temperament describes how an individual may react or respond to daily experiences, is influenced by genetic and environmental factors, and has many characteristic features that involve mood, behavioral self-regulation, self-control, reactivity and responsiveness, alertness, approach and avoidance behaviors, and adaptability (Rothbart, 2004; Rothbart & Bates, 2006). Sensory-processing behavior patterns describe the quality of an individual's responsiveness and reactivity toward sensory experiences, and can influence social interactions and performance of cognitive, motor, and daily living activities (Dunn, 1997a, 2001, 2007; White, Mulligan, Merrill, & Wright, 2007). Dunn (2001) suggested that descriptive characteristics of temperament and descriptive features of sensory-

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 2

processing behaviors are interrelated, and that an individual's behavior is related to daily sensory experiences and is linked to the descriptions of mood, activity levels, attention and responsiveness. Therefore, further investigation regarding the relationships between temperament and sensory-processing behavior patterns may provide additional insight regarding the nature of an individual's interpersonal interactions and activity engagement. Chapter Overview. A brief background history of construct development of temperament and sensory-processing behavior patterns is presented in this chapter. Concepts and terminology related to temperament and sensory-processing behavior patterns is introduced and defined. In addition, an overview of the influences and issues of temperament and sensory-processing behavior patterns on social interaction and task engagement is outlined. Research questions and hypotheses for a study of the relationships between temperament and sensory-processing behavior patterns are presented. Finally, methods of analysis of the relationships between the constructs of temperament and sensory-processing behavior patterns are described. Background The seminal work of Chess and Thomas (1996) introduced temperament as a construct based on a continuum of nine descriptive characteristics. These characteristics describe behaviors related to the intensity of an individual's activity level, the approach and avoidance behaviors regarding new situations, the ability to adapt to changes in a context, ability to attend and persist in goal-directed behavior, the level of distractibility, intensity of responses, the individual's predominant mood, and the biological patterns of

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 3

wakefulness, sleep, hunger, and gastrointestinal functions. Features of temperament for each individual tend to be relatively stable throughout the lifespan due to genetic factors; however, the demands of the context in which the individual interacts can shape the way an individual's temperament influences interpersonal relationships and goal-directed behaviors (Chess & Thomas, 1996; Rothbart, 2004; Rothbart & Bates, 2006). Subsequent research on temperament by Rothbart, Ahadi, and Evans (2000) reconfigured the nine descriptive features of temperament from Chess and Thomas into three behavioral categories entitled negative emotionality, positive emotionality, and attentional behavioral regulation (effortful control). Further research on temperament identified behavioral reactivity toward experiences within a context and the ability to self-regulate behavioral responses as critical components of behavior, attention, social interaction, and activity engagement (Caspi, Roberts, & Shiner, 2005; Olson & Sameroff, 2009; Rothbart & Bates, 2006; Rothbart, Ellis, & Posner, 2004). Behavioral self-regulation refers to the capacity of an individual to control his/her emotional and behavioral reactivity (Rothbart, Ellis, & Posner, 2004). Behavioral reactivity is considered to be an influential component of temperament that impacts the expression of temperament and describes the quality of an individual's affect, intensity, and reaction (e.g., approach or avoidance behavior) toward contextual experiences (Henderson & Wachs, 2007; Rothbart, 2004). Active engagement in behavioral selfregulation allows for the development of behavioral strategies that allow an individual to manage tasks, goals, and social interaction (Baumeister, & Vohs, 2004; Henderson & Wachs, 2007; Rothbart & Bates, 2006).

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 4

In a different line of research, Dunn (1997a, 1999) explored concepts regarding sensory-processing behavior patterns and its influences on social interaction and activity engagement. During the factor analysis of the Sensory Profile, an assessment tool, Dunn (1997a, 1999) found that sensory-processing behaviors reflect the interaction between an individual's neurological threshold reactivity to sensory stimuli and the individual's behavioral tendency toward active or passive responsiveness regarding sensory experiences within a context. After controlling for physiological factors that may influence the reception of sensory input (e.g., a visual or auditory disorder that cannot be corrected by lenses or hearing aids), Dunn (1997a, 1999) proposed four quadrant descriptions of behavioral responses to sensory stimuli, entitled: low sensory registration, sensory sensitivity, sensory avoidance, and sensory seeking. A continuum of behavioral responses to sensory stimuli can occur where the individual may respond easily to low amounts of stimuli or where the individual may require high amounts of stimuli before responding; thus, these behavioral responses have the potential to influence behavioral reactivity and the perception of social interaction and activity engagement. "Goodness-of-fit," a term originally coined by Chess and Thomas (1996), is used to describe the match or complement between the temperament behavioral abilities of the individual and the demands or expectations of the context or social interaction. An individual's ability to successfully adjust and adapt to challenges and stresses within a context or during a social interaction imply a goodness-of-fit between that individual's temperament and the demands of the context (Seifer & Dickstein, 2000; Chess &Thomas, 1996; Olson & Sameroff, 2009). For example, research regarding the interaction

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 5

between temperament of school-age children and classroom contexts found that schoolage children, who demonstrate temperament characteristics where they are excessively reactive in their emotions and less able to regulate emotional control, tend to have more behavioral management issues in classrooms that offer multiple activity choices, and they have less behavioral issues in classrooms that have a structured routine (Janson & Mathiesen, 2008; Rothbart & Bates, 2006; Rothbart, Ellis, Rueda, & Posner, 2003; Rudasill, & Rimm-Kaufman, 2009). In contrast, children who have temperaments characterized by low activity and less emotional reactivity, demonstrate more engagement in learning activities in classrooms that offer multiple opportunities. The goodness-of-fit between child temperament and classroom environments provides an opportunity for children to focus their energy and attention on the learning demands of the classroom instead of focusing energy on components of the context that were distracting or uncomfortable (Rothbart & Jones, 1998: Rudasill, & Rimm-Kaufman, 2009). Similarly, sensory-processing behaviors have the potential to influence how an individual responds to sensory events in daily life experiences and goodness-of-fit between sensory-processing behavior patterns and social and contextual interactions can support an individual's activity participation (Dunn, 2001, 2007). For example, an individual who tends to demonstrate a "sensory avoidance" behavior pattern may elect to circumvent unfamiliar situations and prefer routine situations that provide predictable sensory experiences. In an unfamiliar context, this individual might be perceived as being "introverted" or to have a "negative affect" because of his reticent behavior in an

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 6 unfamiliar context. However, this same individual would be able to comfortably participate and appear animated in social interactions and activities in familiar contexts as compared to unfamiliar contexts. Understanding the relationships between sensoryprocessing behavior patterns and the behavioral self-regulation characteristics of temperament may allow for further awareness of the nature of behavior within a given context. This additional knowledge may assist healthcare professionals in the development of intervention programming that facilitates improved behavioral strategies that promote goodness-of-fit in interpersonal and contextual interactions. Problem Statement Neuroscience research on temperament and sensory processing behaviors suggests that the level of emotional reactivity toward sensory experiences can influence the ability to modulate and self-regulate behavior (Dunn, 2007; Evans & Rothbart, 2009; Henderson & Wachs, 2007). Research regarding behavioral self-regulation has explored its influence on cognitive attention, goal attainment, social-emotional development, interpersonal relationships, and impulse control (Fox, Henderson, Marshall, Nichols, & Ghera, 2005; Henderson & Wachs, 2007; Olson & Sameroff, 2009). Consequently, issues with behavioral self-regulation may negatively influence the quality of task engagement, social-emotional development, or social interaction. The possibility exists that descriptive characteristics of temperament and descriptive features of sensoryprocessing behaviors are interrelated. The examination of these relationships may promote further understanding of the nature of behavior within contexts, and may facilitate strategies for goodness-of-fit between the individual, task, and context.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 7

Research regarding temperament has demonstrated that temperament and behavioral self-regulation influence the development of social behavior, social competence, and peer and adult-child relationships (Cockenberg & Leerkes, 2006; Dennis, 2006; Harris, Robinson, Chang, & Burns 2007; Kochanska, Aksan, & Carlson, 2005; Paulussen-Hoogeboom, Stams, Hermanns, Peetsma, & van den Wittenboer, 2008: Rudasill & Rimm-Kaufman, 2009; Spinrad et al., 2004). Studies have shown that temperament characteristics can affect relationships by influencing how students are perceived by their teachers (Eisenberg, Fabes, Guthrie, & Reiser, 2000; Rudasill & Rimm-Kaufman, 2009), and by influencing how parents perceive their children (Crockenberg & Leerkes, 2006; NICHD Early Child Care Research Network, 2004; Szabo et al., 2008). Likewise, studies of sensory-processing behavior patterns indicate that sensoryprocessing patterns can influence play preferences, attention, social interaction, and performance of daily activities (Bundy, Shia, Qi, & Miller, 2007; Dunn, 2007; Lawson & Dunn, 2008; White et al., 2007). Thus, the ability to adequately interpret sensory experiences and respond appropriately may have an influence on behavioral selfregulation, and promote healthy development of social skills and activity engagement. Purpose The purpose of this non-experimental, descriptive correlation study was to examine the extent to which relationships exist between the descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns in parentchild dyads. Constructs of temperament and self-regulation have been applied to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 8

strategies that promote optimal social development (Henderson & Wachs, 2007; Rothbart, 2004; Rothbart & Bates, 2006; Sameroff, 2009); however, these constructs may need to be further expanded to include the varying influences of sensory experiences on behavior. Understanding the relationships between sensory-processing behavior styles and temperament behavioral reactivity and self-regulation may allow for the development of strategies that promote successful activity and interpersonal engagement and improved goodness-of-fit in interpersonal and contextual interactions. The inclusion criteria for subject participation in this study were: adults, 19 years or older who were without a diagnosis of mental health conditions or uncorrectable sensory-neural hearing loss or visual impairment and who did not take medications that may influence the responses on the questionnaires, and who were the primary caregiver of a child between 3 to 7 years-11 months of age, who was without a diagnosed condition, uncorrectable sensory-neural hearing loss or visual impairment, or medical condition that would require the regular use of medications that may influence behavior. Fifty-nine parent-child dyads were recruited for this study from the greater Phoenix metropolitan area of Arizona. Theoretical Framework The transactional model of development describes the interacting relationships between parent, child, and context that can influence child social, emotional, and cognitive development (Sameroff, 2009). The development of socialization in childhood is influenced in part by the child's temperament. Temperament, as a construct in child development, has been researched since the 1970's as a critical feature in childhood

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 9

social/emotional development following the seminal work of Chess and Thomas (1996) of their 1977 publication of the New York Longitudinal Study. Chess and Thomas (1996) described dimensions of temperament that influence a child's interactive behavioral approaches to social and contextual interactions and defined three basic temperament "styles" (i.e., the "easy" child, the "difficult" child, and the "slow-to-warmup" child). However, these descriptive styles did not hold up in research. Subsequent temperament research in the 1980s and 1990s redefined the dimensions described by Chess and Thomas into basic individual behavioral styles based on reactivity (e.g., an individual's thresholds for motor arousal, emotionality, and orientation/attention to stimuli) and behavioral self-regulation (e.g., an individual's ability to modulate his/her reactivity) (Kochanska, Murray, & Harlan, 2000; Rothbart, 2004; Rothbart, Ahadi, & Hershey, 1994). More recent research in temperament and advances in neuroscience have linked temperament behavioral styles to executive attention skills and social interaction (Henderson & Wachs, 2007; Kochanska, Friesenberg, Lange, & Martel, 2005; Murray & Kochanska, 2002; Rothbart & Bates, 2006; Schwartz, Wright, Shin, Kagan, & Rauch, 2003). Currently, core features of temperament are identified as extraversion/surgency that includes behavioral factors of positive anticipation, impulsivity, activity level, and sensation seeking, negative affectivity that includes behavioral factors of fear, frustration, sadness, and discomfort, and effortful control that includes behavioral self-regulation factors of attention focus and shifting, inhibitory control, perceptual sensitivity, and low intensity pleasure (Rothbart, 2004; Rothbart, Ahadi, Hershey, & Fisher, 2001; Rothbart & Bates, 2006). Further exploration of factors

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 10 that contribute to the expression of these temperament characteristics may support the development of strategies that promote functional social interactions. In a parallel trajectory, research in the field of occupational therapy has explored the nature of behavioral responses to contextual sensory experiences. These behaviors are reflected through sensory-processing patterns, which are defined as a set of neurological abilities that allow the brain to receive, organize, and understand contextual sensory experiences (University of Kansas Medical Center, n.d.). Earlier studies during the 1990s explored the relationships between sensory-processing patterns on psychosocial function and activity engagement in children and adults, and found that extreme responses to sensory experiences influenced and reduced the potential for successful participation in social interactions and task performance (Cermak & Danhauer, 1997; Kinnealey & Fuiek, 1999; Stephens & Royeen, 1998). More recent studies exploring neurological links between sensory-processing and behavior found that children with sensory-processing issues demonstrated physiological differences in behavioral responses to sensory stimuli (Davies & Gavin, 2007; Schaaf, Miller, Seawell, & O'Keefe, 2003). Following the analysis of studies involving sensory-processing, the model of sensory processing was proposed (Dunn, 1997a, 2001, 2007). This model describes the interactions between an individual's neurological thresholds for arousal toward sensory stimuli (as illustrated by a continuum between habituated responses and sensitive responses) and self-regulation behaviors (as reflected by passive or active behavioral reactivity toward sensory experiences). Four quadrants of sensory-processing behaviors

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 11 are identified in this model: low sensory registration, sensory sensitivity, sensory seeking, and sensory avoiding (Brown & Dunn, 2002; Dunn, 1997a, 1999). Individuals with low neurological thresholds to sensory input and who respond passively toward their low thresholds toward sensory input tend to be sensitive to stimuli (e.g., sensory sensitivity). These individuals tend to react easily to input and demonstrate increased alertness, attention, or distraction toward sensory stimuli. Individuals with high sensory thresholds and who respond passively toward their high sensory thresholds tend to be under-reactive to stimuli (e.g., low sensory registration). These individuals may require large amounts of sensory stimuli before alerting, attending, and responding to experiences within their surroundings. Individuals with a low sensory threshold but who behave actively toward their low sensory thresholds tend to control the amount of stimuli they experience by limiting or avoiding sensory experiences (e.g., sensory avoiding), and may perceive sensory stimuli as uncomfortable. Individuals with high sensory thresholds but who actively behave to manage their high sensory thresholds tend to seek out additional sensory stimulation in order to maintain alertness and attention (e.g., sensory seeking). Dunn (2001, 2007) hypothesized that sensory-processing patterns are related to temperament and personality. Dunn (2001, 2007) observed that individuals who seek sensation seem to find pleasure in daily experiences and appear to have a positive mood, whereas, individuals who avoid sensory experiences appear to demonstrate a more negative and/or anxious mood. Thomasgard (2003) reviewed temperament research and sensory-processing research and surmised that both constructs are complementary in their descriptions of children's behavior in unfamiliar situations. Thomasgard suggested that a

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 12 child's temperament responses for activity levels, negative or positive affect, approach or withdrawal behavior to novel situations may be related to the child's responses toward the sensory experiences within a context. Research Questions Processing of sensory experiences involves the ability of the central nervous system to receive, organize, and understand contextual sensory experiences in order to respond and regulate behavior (Dunn, 1997b, 2001; University of Kansas Medical Center, n.d.). Temperament is also considered to be biologically based and is used to describe an individual's behavioral style toward social interactions and contextual demands (Rothbart, 2004; Rothbart & Bates, 2006; Sanson, Hemphill, & Smart, 2004). Both constructs of temperament and sensory-processing behavior patterns describe aspects of human behavior that influence how an individual interacts within social and environmental contexts. The purpose of this study was to examine whether relationships existed between the descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns in parent-child dyads. To evaluate the relationships between temperament and sensory-processing behavior patterns, two research questions and their corresponding null hypotheses (H0) and alternative hypotheses (Ha) were formulated. The first research question (RQ1) was: RQ1: To what degree is there a relationship between sensory-processing behavior patterns and characteristics of temperament in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized?

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 13

Hlo: There are no statistically significant relationships between sensoryprocessing behavior patterns and the temperament characteristics in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized. Hl a : There are statistically positive relationships between sensoryprocessing behavior patterns and characteristics of temperament in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized. The second research question (RQ2) was: RQ2: To what degree is there a relationship between the sensory-processing behavior patterns in children between the ages of 3 to 7 years-11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized? H2o: There are no statistically significant relationships between sensoryprocessing behavior patterns of children between the ages of 3 to 7 years-11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized. H2a: There is a statistically significant positive relationship between sensoryprocessing behavior patterns of children between the ages of 3 to 7 years-11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 14 Nature of the Study This study utilized a non-experimental, descriptive correlation design to determine the extent to which descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns were interrelated. Variables from terms that were originated from the work of Rothbart et al. (2001) were used as variables for descriptive characteristics of temperament. These temperament characteristics were entitled negative affectivity (e.g., describes behaviors related to fear, anger, frustration, sadness, and discomfort), extraversion/surgency (e.g., describes behaviors related to positive anticipation, impulsivity, activity level, and sensation seeking), and effortful control (e.g., describes behaviors related to the ability to sustain attention focusing and shifting, inhibitory control, perceptual sensitivity, and low intensity pleasure) (Rothbart, 2004; Rothbart et al., 2001). Variables from terms that were originated from the work of Dunn (1999, 2001) were utilized to identify the descriptive features of sensory-processing behavior patterns. These sensory-processing patterns were entitled low sensory registration, sensory sensitivity, sensory avoidance, and sensory seeking (Brown & Dunn, 2002; Dunn, 1997a, 1999, 2007). Two standardized parent-report questionnaires that were designed to measure the sensory-processing behavior patterns in children and caregivers were utilized. The Sensory Profile (SP) (Dunn, 1999) (Appendix A) was used to assess the sensoryprocessing behaviors of the children and the Adolescent/Adult Sensory Profile (AASP) (Brown & Dunn, 2002) (Appendix B) was used to assess the sensory-processing behaviors of the adults. The Children's Behavior Questionnaire (CBQ) (Rothbart et al.,

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 15

2001) (Appendix C), a standardized parent-report questionnaire, was used to assess temperament characteristics of the children in the study. In addition, these assessment tools included subscales that were compared in order to obtain additional information regarding the relationships between temperament and sensory-processing behavior patterns. The SP questionnaire had 14 subscales that described an individual's responses toward sensory-processing of specific sensory systems (i.e., auditory, visual, vestibular, touch, and gustatory), sensory modulation, and behavioral/emotional responses toward sensory input. The CBQ included 15 subscales that are factored together to describe an individual's tendency toward a particular temperament style. Pearson's product-moment correlation through the use of a correlation matrix was utilized to assist in understanding the degree or the extent to which the three main variables for temperament and subscales for temperament were related to the four variables for sensory-processing behavior patterns and their subscales. In addition, multiple linear regression analyses were completed to determine whether variables that described sensory-processing behavior patterns predicted variables that described specific characteristics of temperament. Relationship trends for sensory-processing behavior patterns in the parent-child dyads were analyzed using a two-way contingency table analysis using the McNemar test with crosstabs to discover whether contextual factors, sensory thresholds and behavioral styles of parent-child dyads were interrelated. Significance of the Study Sensory-processing behavior patterns and temperament styles describe personal qualities that illustrate the manner in which an individual may engage in activities and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 16

socially interact. An individual's temperament style and sensory-processing behavior pattern may either facilitate or inhibit activity engagement and interaction, depending on the demands of the context. A particular temperament style or sensory-processing patterns is not inherently better than another temperament style or sensory-processing behavior pattern. However, the ability to recognize the features or demands of a context, and be able to successfully adapt and manage the experience is critical for goodness-of-fit between the individual, task, and context. Therefore, increased knowledge regarding the interrelationships between the constructs of temperament and sensory-processing behavior patterns may lead to greater understanding of the nature of behavior within a context. Consequently, this knowledge may lead to the development of strategies that promote goodness-of-fit and allow for successful engagement in daily life experiences. Definitions Adolescent/Adult Sensory Profile. An assessment tool that describes sensoryprocessing patterns of individuals from 11 years to 65+years (Brown & Dunn, 2002). Behavioral reactivity. Describes the quality of an individual's affect and the intensity and reaction speed toward experiences within a context. Behavioral reactivity is considered to be an influential component that impacts the expression of temperament (Henderson & Wachs, 2007; Rothbart, 2004; Rothbart & Bates, 2006). Behavioral self-regulation. Capacity of an individual to control emotional and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 17

behavioral reactivity and describes the continuum of an individual's ability to modulate or manage behavioral responses to demands within a context. For example, an individual with a strong ability to self-regulate or adjust behaviors can focus on a task despite the presence of distractions within the context (Baumeister, & Vohs, 2004; Dunn, 2007; Olson & Sameroff, 2009). Children's Behavior Questionnaire. An assessment tool of children from 3years to 7 years-11-months that is "grounded in a definition of temperament as constitutionally based individual differences in reactivity and self-regulation" (Putman & Rothbart, 2006, p. 103). Effortful control. A composite category of temperament that describes an individual's ability for attention focusing and attention shifting, inhibitory control, perceptual sensitivity, and low intensity pleasure (Rothbart, 2004; Rothbart et al., 2001). Extraversion/surgency. A composite category of temperament that features an individual's expression of activity level, positive anticipation, impulsivity, high-intensity pleasure, sensation seeking, and level of shyness (Rothbart, 2004; Rothbart etal., 2001). Goodness of fit. Describes the extent to which an individual's temperament matches or is complementary to the expectations and opportunities of the context or situation (Chess & Thomas, 1996; Olson & Sameroff, 2009). The concept of goodness-of-fit is also applicable when examining the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 18

match between an individual's sensory-processing behavior patterns and the sensory experiences and demands of the context (Dunn, 2007). Habituation. Describes reduced behavioral reactions or responsiveness, reduced awareness, or a high sensory threshold toward sensory experiences (Carlson, 2004; Dunn, 1997b). Low sensory registration. One of the four sensory-processing behavior patterns that describes the behavior of individuals with high sensory thresholds and who respond passively toward their high sensory thresholds and tend to be under-reactive to stimuli. These individuals may require large amounts of sensory stimuli before alerting, attending, and responding to experiences within their surrounding (Brown & Dunn, 2002; Dunn, 1999,2001,2007). Negative affectivity. A composite category of temperament that features an individual's expression of fear, anger, frustration, sadness, sooth-ability, and discomfort (Rothbart, 2004; Rothbart et al., 2001). Neurological thresholds. Describes the point at which enough sensory stimulation has occurred to activate a particular nerve cell or sensory system (Carlson, 2004). Neurological thresholds operate on a continuum of low thresholds, where small amounts of stimuli can activate a sensory system, to high thresholds, where large amounts of stimuli are needed to activate a sensory system (Dunn, 1997b). Sensitivity. Describes heightened, hyper-reactivity, or low sensory thresholds to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 19

sensory experiences (Carlson, 2004; Dunn, 1997b). Sensory avoidance. One of the four sensory-processing behavior patterns that describes the behavior of individuals with a low sensory threshold but who behave actively toward their low sensory thresholds and tend to control the amount of stimuli they experience by limiting or avoiding sensory experiences. These individuals may perceive sensory stimuli as uncomfortable (Brown & Dunn, 2002; Dunn, 1999, 2001, 2007). Sensory processing. The ability of the central nervous system to receive, organize, and understand internal and external sensory input from contextual experiences in order to respond to contextual demands. Sensory processing involves the interaction between neurological thresholds for alerting to sensory input and the ability to self-regulate and to manage the sensory input that is being experienced (Dunn, 2001, 2007; University of Kansas Medical Center, n.d.). Sensory-processing behavior patterns. Behavioral expressions that reflect the nature of an individual's method of response toward sensory experiences. Four descriptive methods of response describe sensory-processing behavior patterns and are called Low Sensory Registration, Sensory Sensitivity, Sensory Seeking, and Sensory Avoiding (Dunn, 1997a, 2001). Sensory Profile. An assessment tool that describes a child's sensory-processing behavior patterns (Dunn, 1999). Fourteen subsections describe a child's sensory profile and are defined by Dunn (1999, p.

14 - 15) as follows:

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 20

Auditory processing. Measures the child's response to things heard Visual processing. Measures the child's response to things seen Vestibular processing. Measures the child's response to movement Touch processing. Measures the child's response to stimuli that touch the skin Multi-sensory processing. Measures the child's response to activities that contain a combined sensory experience. Oral sensory processing. Measures the child's response to touch and taste in the mouth. Sensory processing related to endurance/tone. Measures the child's ability to sustain performance. Modulation related to body position and movement. Measures the child's ability to move effectively. Modulation of movement affecting activity level. Measures the child's demonstration of activeness. Modulation of sensory input affecting emotional responses. Measures the child's ability to use body senses to generate emotional responses. Modulation of visual input affecting emotional responses and activity level. Measures the child's ability to use visual cues to establish contact with others. Emotional/social responses. Indicates the child's psychosocial coping strategies. Behavioral outcomes of sensory processing. Indicates the child's ability to meet performance demands. Items related to threshold for response. Indicates the child's level of modulation.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 21

Sensory seeking. One of the four sensory-processing behavior patterns that describes the behavior of individuals with high sensory thresholds but who actively behave to manage their high sensory thresholds by seeking out additional sensory experiences in order to maintain alertness and attention. These individuals, in order to maintain alertness and attention, tend to seek out novel situations, change routines, prefer intense sensory experiences, or may react impulsively to gain extra sensory experiences (Brown & Dunn, 2002; Dunn, 1999, 2001, 2007). Sensory sensitivity. One of the four sensory-processing behavior patterns that describes the behavior of individuals with low neurological thresholds to sensory input and who respond passively toward their low thresholds toward sensory input and tend to be sensitive toward stimuli. These individuals tend to react easily to input and demonstrate increased alertness, attention, or distraction toward sensory stimuli (Brown & Dunn, 2002; Dunn, 1999, 2001, 2007). Temperament. A description of an individual's disposition that is based upon the individual's behavioral reactivity toward contextual experiences and the individual's ability to self-regulate his/her behavioral responses (Rothbart, 2004; Rothbart & Bates, 2006; Sanson et al., 2004). The various characteristic features of temperament are expressed as behavioral continuums that range from weakly present to strongly present. Fifteen

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 22

temperament characteristic features are described and defined by Rothbart et al. (2001, p. 1406) as follows: Activity level. Gross motor activity, including rate and extent of locomotion. Anger/frustration. Negative affectivity related to interruption on ongoing tasks or goal blocking. Attentionalfocusing.

Capacity to maintain attentional focus on task-

related channels. Discomfort Negative affectivity related to sensory qualities of stimulation, including intensity, rate, or complexities of light, movement, sound, and texture. Fear. Negative affectivity, including unease, worry, or nervousness, which is related to anticipated pain or distress and/or potentially threatening situations. High intensity pleasure. Pleasure or enjoyment related to situations involving high stimulus intensity, rate, complexity, novelty, and incongruity. Impulsivity. Speed of response initiation. Inhibitory control. Capacity to plan and to suppress inappropriate approach responses under instructions or in novel or uncertain situations. Low intensity pleasure. Pleasure or enjoyment related to situations

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 23

involving low stimulus intensity, rate, complexity, novelty, and incongruity. Perceptual sensitivity. Detection of light, low-intensity stimuli from the external environment. Positive anticipation. Amount of excitement and anticipation for expected pleasurable activities. Sadness. Negative affectivity and lowered mood and energy related to exposure to suffering, disappointment, and object loss. Shyness. Slow or inhibited speed of approach and discomfort in social situations. Smiling/laughter. Positive affect in response to changes in stimulus intensity, rate, complexity, and incongruity. Soothability. Rate of recovery from peak stress, excitement, or general arousal. Summary Temperament is a reflection of our behavioral reactivity and self-regulation as we interact within our daily life contexts (Putnam & Rothbart, 2006; Rothbart, 2004; Sanson et al., 2004). Sensory-processing behavior patterns involve the ability of the central nervous system to receive, organize, and understand contextual sensory experiences that help us to respond and regulate our behavior (Dunn, 2001; University of Kansas Medical Center, n.d.). Both of these constructs have the potential to impact how we interact within our social and environmental contexts. The ability to successfully adjust to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 24

challenges and stress within one's environment or during interpersonal relationships often involves the goodness-of-fit between one's temperament and the expectations of the environment or interpersonal relationships and interactions (Olson & Sameroff, 2009). In her research regarding sensory-processing and behavioral responses, Dunn (2001, 2007) also emphasized the importance of goodness-of-fit between an individual's sensoryprocessing patterns, sensory experiences and the demands of the context. Sensory-processing behavior patterns and temperament styles describe personal qualities that illustrate the manner in which an individual may engage in activities and social interaction. An individual's temperament style and sensory-processing behavior patterns may either facilitate or inhibit activity engagement and interaction, depending upon the demands of the context. Descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns are potentially interrelated. The ability to recognize the features or demands of a context and be able to successfully adapt and manage the social experience or task is critical to optimal engagement. The purpose of this study was to examine whether relationships exist between the descriptive characteristics of temperament and descriptive features of sensory-processing behaviors in parent-child dyads. Understanding the relationships between sensory-processing behavior styles and temperament behavioral reactivity and self-regulation may allow for greater awareness of the nature of behavior within specific situations and promote goodness-of-fit between child, social interaction, task, and context. This knowledge may allow for the development of strategies that promote successful engagement in daily activities and social interaction.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 25

Chapter 2: Literature Review Introduction The purpose of this study was to examine whether relationships existed between the descriptive characteristics of temperament and descriptive features of sensoryprocessing behavior patterns in parent-child dyads. According to the transactional model of development, parent-child interactions are bi-directional; the context and the behavior of each family member influences their relationships and, consequently, the child's development of social skills and task engagement (Broderick, 1993; Eisenberg, Fabes, & Spinrad, 2006; Sameroff, 2009). Parents model and manage features of their context or environment in order to influence their child's social development and activity engagement, and the child's behavior reciprocally influences the behavioral responses of his or her parents. As a result, the nature of parent-child relationships is critical for social-emotional growth for the developing child (Greenspan, 2007; Sameroff, 2009; Zeanah, 2009). The development of socialization and activity engagement in childhood is influenced in part by the child's temperament. Temperament is described as an individual's disposition and is based upon the individual's behavioral reactivity toward contextual experiences and the individual's ability to self-regulate his/her behavioral responses (Rothbart, 2004; Rothbart & Bates, 2006; Sanson et al., 2004). The child's ability to adapt and adjust to expectations within a context allows the child to demonstrate successful social interaction and activity engagement. Often, the goodnessof-fit between the child's temperament and the responsiveness, challenges, and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 26 expectations within a context or interpersonal relationship can influence a child's ability to adjust and adapt behavior that lead to successful social interactions and activity engagement (Chess & Thomas, 1996; Sameroff, 2009; Seifer & Dickstein, 2000; Zeanah, 2009). Similarly, an individual's behavioral responses toward sensory experiences as part of daily contextual activities can influence social interaction, cognitive, and motor performance (Dunn, 1997a, 2007). Responses to sensory experiences can vary in intensity and quality and can shape the manner in which the individual elects to participate and engage in activities or interactions. The possibility exists that the descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns are interrelated. Chapter Overview. This literature review chapter presents information regarding the constructs of temperament and sensory-processing behavior patterns as related to social and activity interaction and participation. First, an overview of the transactional model of development (Broderick, 1993; Sameroff, 2009) as related to parent-child interaction is presented, followed by a description of temperament and its influences on social interaction and parent-child relationships. Next, the model of sensory processing (Dunn, 1997a, 2007) is described and the influences of sensory-processing behavior patterns on social interaction and parent-child relationships are explained. An individual's predisposition for temperament and sensory-processing behavior patterns based on neurophysiologic responses is discussed. Finally, concepts regarding goodness-

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 27

of-fit and its influences on parent-child relationships and activity participation are presented. Literature search strategy for this literature review involved the use of search terms such as "temperament," "parent-child relationship or interaction," "temperament and social skills," "sensory-processing," "sensory sensitivity, sensory responsiveness, and interaction," "family systems," "effortful control, attention, and reactivity," and "behavior self-regulation" using search engines such as Psych Info, Dissertations International, Science Direct, OTSeeker, and ProQuest. Author search was also used to find articles from individuals who did prominent research in temperament and/or sensory-processing. Reference lists from workshops and conferences were utilized and library assistance through inter-library loan aided in locating these resources. Websites from researchers of temperament and from associations that have been researching sensory-processing behavior patterns were also utilized for article search and retrieval. The Transactional Model of Development and Parent-Child Relationships The goals of family functioning are centered upon ensuring physical, cognitive, and social-emotional development, health and well being, and cultural and spiritual growth among family members (Sameroff & Fiese, 2000; Zeanah, 2009). The "family" is considered to be a self-regulating social system where interactions between family members are structured and family roles are organized to allow for problem-solving, decision-making, and sharing of resources (Broderick, 1993; Sameroff & Fiese, 2000; Zeanah, 2009). When stress occurs from external sources (i.e., economic factors, or community issues) or internal factors (i.e., a family member illness or death, birth of new

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 28 family member), family interactions involve strategies that work to manage the demands of the stressor (Murray, Kelley-Soderholm, & Murray, 2007; Zeanah, 2009). Consequently, each family member influences or can potentially influence the development, health, and socialization of other members of the family. In his seminal work regarding family systems theory, Broderick (1993) described the interactional model and the transactional model to illustrate characteristics in parentchild relationships that influence the development of socialization. The interactional model describes characteristics within a family, such as parenting styles, self-esteem, gender effects, developmental abilities, family size, and genetic factors (e.g., temperament, health status, body build). As suggested by Broderick (1993), temperament of family members is an interactional characteristic that can directly influence the development of socialization of the children within the family. The transactional model involves experiences that are external to the family, such as cultural factors, daily events, history and world events, socio-economic factors, and cohort experiences (Broderick, 1993). The perceived meaning of encounters with external factors involves family member perception of the experiences (Broderick, 1993). As suggested by Broderick and later by Sameroff and Fiese (2000), the transactional model suggests that the perceived meaning of experiences external to the family can potentially influence the nature of social development within the family. Sameroff (2009) further expanded and reorganized the transactional model described by Broderick (1993) into the construct of the transactional model of development to include the interacting features and bi-directional influences of child

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 29 behavioral characteristics, the parent/caregiver behavior characteristics, and the context. According to Sameroff (2009): The child's behavior at any point in time is a product of the transactions between the phenotype, that is, the person, the environtype, that is, the source of external experience, and the genotype, that is, the source of biological organization, (p. 14) In the transactional model of development, phenotype refers to the behavioral characteristics, such as temperament. Environtype refers to experiences with the family system, family perception of behavior, and culture, community, socioeconomic, and political factors that influence the family system. Genotype refers to innate biological factors such as behavioral regulatory responses, and responsiveness. Sameroff (2009) described that the behavior of children and the demands of contexts reciprocally influence each other. Thus, Sameroff implied that parent-child relationships and developmental outcomes have multiple sources of influence and the potential exists for multiple strategies for intervention and healthy development. From a neurological standpoint, the individual's responsiveness, processing, and regulation of sensory experiences influence perception of the experience (Carlson, 2004). From the perspective of the transactional model of development, sensory-processing behavior patterns can be considered a component of genotype. One can speculate that sensory-processing behaviors influence the perceived meaning of experiences (i.e., environtype) external to the family and child. Through the perspective of the transactional model of development, one may reason that influences from family member temperament styles and sensory-processing behavior patterns can be potential factors that

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 30 shape child behavior and, likewise, child temperament and child sensory-processing behavior patterns may influence family behaviors. Since parent-child relationships are bi-directional and reciprocal, characteristics of both the child and the parent shape the nature and behaviors of their relationship and social development of the child (Lengua & Kovacs, 2005; Janson & Mathiesen, 2008; Russell, Mize, & Bissaker, 2004; Sameroff, 2009; Sanson et al., 2004). Parent-child relationships that involve predominantly negative interactions have been shown to be associated with issues in social development; whereas, parent-child relationships that are more positive and cooperative tend to lead toward successful socialization (Lengua & Kovacs, 2005; MacKenzie & McDonough, 2009; Russell et al., 2004). Studies have shown that behavioral characteristics of children can influence parent perception regarding parent-child relationships and social development (Baumeister & Vohs, 2004; Bussing et al., 2003; Smith & Hart, 2004; Wong, McElwain, & Halberstadt, 2009; Zeanah, 2009). For example, in a 5-year longitudinal study of emotional affect in 1,364 children from ages 1 to 54 months and its impact on mother-child relationships and social function in school, the NICHD Early Child Care Research Network (2004) found that, after controlling for family factors, mothers of the children who presented negative affect and issues in behavioral regulation reported feeling "less close" to their children. Furthermore, results of this study demonstrated a correlation between negative affect and behavioral dysregulation in infants at 1 month and difficult social and behavioral outcomes in children at 54 months, in kindergarten and in first grade (e.g., higher

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 31

incidence of impulsivity, fewer social skills, and more behavior problems) as compared to the children who presented with a positive affect and self-regulation skills at 1 -month. This outcome leads to questions regarding the characteristics of the contexts in which the children with negative affect and behavioral dysregulation were engaged. Although information about contextual characteristics was not part of the NICHD Early Child Care Research Network study, it would be interesting to investigate the quality of goodness-offit and responsiveness between the demands of the context and the behavioral needs of the child and whether strategies to support behavioral regulation may have altered the social and behavioral outcomes in these children. Conversely, other studies have demonstrated that parent behavior, such as parenting styles and responsiveness can influence social development in their children and parent-child relationship outcomes (Baumeister & Vohs, 2004; Smith & Hart, 2004; Wong et al., 2009; Zeanah, 2009). For instance, an association between maternal mental health and problematic parent-child relationships were found in the following studies. Edhborg, Seimyr, Lundh, and Widstrom (2002), in a 1-year longitudinal study of mothers with depression and parent-child relationships, found that mothers with depression rated their children as being more "fussy" and perceived their children as having more "difficult" temperaments. Similarly, Pauli-Pott, Mertesacker, and Beckman (2004) found, through a hierarchical regression analysis that the infant's temperament characteristic of negative emotionality, along with maternal depression/anxiety and reduced social support contributed to increased withdrawal behavior and fear when the child was 12-months of age. In a more recent study, Feldman (2007) found that reduced

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 32

quality of parent-child relationship reciprocity occurred in parent-child dyads with mothers experiencing depression and anxiety. Interestingly, both of the studies by PauliPott et al. (2004) and Feldman (2007) also found that better social interactive outcomes occurred in infants who were described as having a negative or fussy temperament who had mothers or fathers who demonstrated more interactive responsiveness. An explanation of this outcome could be that these parents were able to utilize strategies to manage a context that supported behavioral self-regulation in their children. Parent personality and child temperament have been found to influence parentchild relationship outcomes in other studies. Kochanska et al. (2005) found that child temperament, maternal personality, and paternal personality had an effect upon positive interactions, responsiveness, and attentiveness; however, gender of child had no effects. For example, mothers who scored high on neuroticism tended to have less positive interactions with their child; and mothers and fathers who scored high on extraversion were less attentive and less sensitive toward their child's needs. Of interest, this study supports the outcome of previous studies by revealing an association between parent responsiveness and child positive affect. In a study of self-perception of parenting abilities, Pizur-Barnekow (2006) found that maternal attitudes influenced the perceived nature of parent-child relationships. This study of 21 mothers of infants who were 16 weeks of age found that mothers, who rated themselves with lower self-confidence, also rated their infants as being difficult to care for and having difficult temperaments. These mothers also had more negative feelings regarding infants and children. Although this study had a small sample size, it does support the bi-directional nature of parent-child

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 33

interaction. As implied by the transactional model of development, one can question whether children with difficult temperaments influenced their mother's self-perception of inadequate parenting or whether the mothers' personality traits of low self-confidence influenced the mothers' perception of having an inadequate relationship with their child. Outcomes of the preceding studies suggested that child behavior, temperament, parental attitudes, and parental personality traits could have influenced parent-child relationships. However, for all of the preceding studies, the relationships between the underlying features of the context, child temperament and parenting behavioral styles were not explored. Therefore, understanding factors that support and facilitate the development of positive parent-child relationships is critical. Temperament of child and parent is one factor that contributes to parent-child relationships. Description of temperament and its influence on parent-child relationships and social development will be presented in the next sections. Temperament: Definition and History Temperament is described as a person's response style toward interactive experiences within his or her environment and is considered by many researchers to be individualized, have genetic origins, appear early in development, and involve a set of behavioral configurations that evoke predictable behavior patterns (Chess & Thomas, 1996; Fox et al., 2005; Henderson & Wachs, 2007; Rothbart, 2004; Saudino, 2009). Theories regarding child development during the mid-20th century explored the notion that general trends existed for developmental milestones in motor and cognitive development along with individual differences that allowed for developmental variability.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 34

However, in their landmark New York longitudinal study during the 1970's, Chess and Thomas (1996) presented the concept that behavioral style or temperament should be differentiated from the concepts of motor/cognitive skill and ability. This concept introduced the idea that temperamental influences on emotional affect and attention account for individual differences in motor/cognitive skills and ability by describing the manner in which an individual interacts socially and with materials. The research of Chess and Thomas (1996) identified nine categories of temperament that occur on a continuum. A summary of these categories are described as follows (Chess & Thomas, 1996, pp. 43-46): •

Activity level refers the motor function and movement intensity of the individual.



Rhythmicity refers to the sleep, awake, hunger, feeding, and eliminating schedule of the individual.



Approach or withdrawal behavior refers to the manner in which the individual may select to engage or not engage in a new or novel experience.



Adaptability refers to the ease that the individual can modify or adjust his or her responses to an experience.



Response threshold refers to the amount of stimulation that is required for the individual to respond to an experience and interaction.



Intensity of reaction refers to the strength of response to stimuli, experiences, or social interactions with the individual's context.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 35



Quality of mood refers to the continuum of positive/friendly to negative/unfriendly behavior of the individual.



Distractibility refers to the level of the individual's behavior that allows extraneous stimuli to interfere with task performance.



Attention span and persistence refers to the length of time the individual can focus and complete a task without being distracted.

These nine categories were clustered into three main temperament behavior styles: the easy child, the slow-to-warm-up child, and the difficult child. According to Chess and Thomas (1996), the temperament of an easy child represents someone who adjusts and adapts quickly and easily to changes in environmental demands/expectations and who generally has a positive mood. The temperament of the slow-to-warm-up child is described as someone who is reticent about new experiences and needs time to get adjusted and who is often described as shy. The temperament of the difficult child describes someone who is highly sensitive, rejects, or becomes extremely upset in new experiences, and whose mood is generally negative. However, as research regarding temperament progressed, these three temperament styles did not hold up as originally described; and the descriptions of these temperament behavior styles evolved to include concepts of behavioral self-regulation and reactivity (Rothbart, 2004; Rothbart et al., 2003). During the 1980's and 1990's, other researchers explored how temperament behavioral styles could be influenced by positive and negative reactivity toward experiences and by the ability to inhibit behavior or be uninhibited; and, these behavioral

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 36 influences could also affect social responsiveness (Goldsmith et al., 1987; Kochanska et al., 2000; Rothbart, 2004). In the late 1990's, the construct of effortful control as a component of temperament was introduced and described as a behavioral component that is critical for adaptive functioning (Baumeister & Vohs, 2004; Murray & Kochanska, 2002; Rothbart, 2004; Rothbart et al., 2003). Effortful control refers to the behavioral ability to inhibit or suppress responses in order to attend to and complete a task; this ability requires voluntary action and cognitive skills in order to plan a strategy and delay a "reward" (Baumeister & Vohs, 2004; Kochanska et al., 2000; Murray & Kochanska, 2002; Rothbart & Bates, 2006; Rothbart et al., 2003). As one of the descriptive features of temperament, the concept of effortful control illustrates the ability of an individual to regulate behavior and demonstrate self-control (Rothbart, 2004). Research by Rothbart and associates since the 1990's reconfigured the original work of Chess and Thomas (1996) into three major temperament characteristics that are comprised of a set of behavioral dimensions or tendencies. These temperament characteristics are represented as continuums of behavior. Every individual demonstrates these characteristics and set of tendencies; however, some characteristics and tendencies are expressed more than others and lead toward a general temperament behavioral style (Rothbart et al., 2000; Rothbart et al., 2001). The three major temperament characteristics described by Rothbart and associates are entitled: extraversion/surgency, negative affectivity, and effortful control. The behavioral dimension tendencies that can be clustered and factored into the three major temperament categories are: activity level (level of gross motor activity), anger/frustration (level of behavior when interrupted or

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 37

unable to complete a task), positive anticipation (level of enthusiasm toward an expected experience), attentional focusing (ability to maintain attention), discomfort (level of distress or anxiety toward an experience), falling reactivity/soothabihty (ability to recover from a distressful or an exciting experience), fear (reaction toward the anticipation of a painful or threatening experience), high-intensity pleasure (level of pleasure from intense, often risky, sensory experiences), impulsivity (speed of initiation of a behavioral response to experiences), inhibitory control (ability to suppress a behavioral response), low intensity pleasure (level of pleasure from low level sensory experiences), perceptual sensitivity (ability to detect sensory stimulation), motor activation (use of extraneous movement patterns), sadness (reduced energy in response to disappointment and loss), shyness (level of inhibited, withdrawn behavior in response to new situations), and smiling/laughter (behavioral response to changes in experiences) (Rothbart et al., 2000). The temperament characteristic of extraversion/surgency is comprised of higher levels of high intensity pleasure, activity level, impulsivity, and with low levels of shyness. The temperament characteristic of negative affectivity is comprised of higher levels of sadness, discomfort, anger/frustration, fear, and lower levels of soothabihty. The temperament characteristic of effortful control is comprised of higher levels of low intensity pleasure, inhibitory control, attentional focusing, perceptual sensitivity, and smiling/laughter. Other researchers have supported the temperament construct model proposed by Rothbart and associates (Else-Quest, Hyde, Goldsmith, & Van Hulle, 2006; Henderson & Wachs, 2007). For example, in a longitudinal study of 231 Finnish children from age 6

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 38

months to 5.5 years, Komsi et al. (2006) found that continuity existed in the maternal ratings of the children's temperament characteristics and the behavioral tendencies clustered into categories as described by Rothbart's model. Komsi et al. (2006) used the Infant Behavior Questionnaire (IBQ) and the Children's Behavior Questionnaire (CBQ) to assess temperament and used Pearson correlations, and a confirmatory factor analysis to examine the relationships between the temperament variables evaluated by the IBQ and the CBQ. Among the many findings of this study, negative affectivity and fear in infants was found to predict fear, high level of sadness, and low levels of low intensity pleasure and smiling/laughter at 5.5 years; high levels of orienting behavior in infants predicted high levels of approach/anticipation and perceptual sensitivity at 5.5 years; high levels of infant activity predicted high levels of impulsivity, high intensity pleasure, smiling/laughter, and low levels of shyness and inhibitory control at 5.5 years. In a similar, longitudinal study that explored the relationships between paternal ratings of temperament in 115 father-child pairs, Komsi et al. (2008) found continued support for the theoretical framework developed by Rothbart et al. (2003), Rothbart et al. (2004), and Rothbart and Bates (2006). Results revealed relationship patterns between temperament behaviors where high-level positive affectivity (increased smiling, laughter) and lowlevel negative affectivity at 6 months of age predicted high level effortful control (increased attentional focusing) at 5.5 years; negative affectivity at 6 months predicted negative affectivity (increased fear, low levels of soothability and inhibitory control) at 5.5 years; high level of activity at 6 months predicted high level of anger/frustration, low level of soothability and inhibitory control at 5.5 years. Both studies by Komsi et al.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 39

(2006, 2008) suggest continuity and congruency of father- and mother-rated temperament. No differences were found between child genders in both studies. However, it should be noted that the impact or influences of context was not considered in these studies. Temperament can also be described as an individual's behavioral reactivity toward experiences within a context and the individual's ability to self-regulate behavioral responses (e.g., effortful control) (Rothbart, 2004; Rothbart & Bates, 2006; Sanson et al., 2004). Self-regulation or the ability to modulate one's responses is a critical component for behavior, attention, and activity engagement (Rothbart et al., 2004; Rothbart & Bates, 2006). For example, in a study of behavioral self-regulation and parent-child interactions, Harris et al. (2007) examined the associations between effortful control, temperament, attention, motivation, and parent interactions in 61 low income preschool children, between the ages of 3 to 5 years, and their mothers. The children were asked to complete six tasks involving puzzles during two sessions scheduled oneweek apart. Mothers participated in a parent-child task during the second session. The Children's Behavior Questionnaire (CBQ) was used to assess child temperament and effortful control. The Kaufman Brief Intelligence Test (K-BIT) was used to assess cognitive skills and to rule out poor cognition as a factor in puzzle-task completion. Puzzle completion accuracy, attention, and parent-child interaction were assessed and coded through videotaped sessions using a standardized puzzle-matching task. Moderately high, significant correlations were found between attention regulation and task performance accuracy, attention regulation and effortful control, and task

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 40

performance accuracy and effortful control. Hierarchical regression analyses, that examined attention, motivation, and effortful control and task performance accuracy in children completing a puzzle task, revealed that motivation was a moderating factor in attention that lead to task accuracy for children with increased ability for effortful control, but not for children with lower abilities in effortful control. When Harris et al. (2007) compared the same variables and task performance accuracy during a parent-child puzzle task, effortful control and attention to task became moderating factors that influenced task accuracy, whereas, motivation became less influential. The researchers suggested that children with higher abilities for effortful control and attention regulation had increased capabilities for task accuracy when working alone, and demonstrated adaptive behaviors, such as persistence and motivation for problem-solving. However, children with lower abilities for effortful control and regulation of attention had more difficulty directing their behavior in task performance and less accuracy when alone. But, these children could better manage abilities for effortful control and attention during tasks that allowed supportive parent-child interaction. Although this study did not discuss parenting behavior styles that may have supported their child's behavioral self-regulation and attention to task, it did suggest that supportive social interactions provided positive learning environments, especially in children at risk for academic issues due to attention and self-regulation behaviors that impeded appropriate expression of cognitive skills. In another study of temperament characteristics and behavioral reactivity, Stifter, Putnamn and Jahromi (2008) explored the influences of effortful control and behavioral

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 41

outcomes in a longitudinal study of 72 children at 2 years and at 4.5 years of age. Participants in the study were assigned to three groups (exuberant-highly active children, inhibited children, and low reactive children) following a temperament assessment using an adapted version of the Infant Behavior Record (Bayley, 1969) and the Child Behavior Checklist (CBCL) (Achenbach, 1991). Effortful control was measured through videotaped observations that coded facial expressions and behaviors during a series of tasks that were designed to bring out approach/inhibition, frustration, and delayed gratification behaviors using toys and snacks. Following the use of ANOVA and regression analyses, results of the study found that the exuberant-highly active children, who demonstrated less ability for emotional self-regulation through effortful control at 2 years of age, demonstrated more aggressive and defiant behavior at 4.5 years of age than the exuberant-highly active children who demonstrated more effortful control and were able to regulate their behavior. Parents of the exuberant-highly active children with lower abilities for effortful control rated their children has having more problematic behaviors. No differences were found over time in the reactions of inhibited children and low reactive children toward the tasks; thus implying that the abilities for effortful control may be critical in the development of emotional self-regulation for highly active children. Of note, the study did not examine the influences of parent behaviors or parenting styles on the development of emotional self-regulation and effortful control. Behavioral reactivity toward contextual experiences is an influential component that impacts the expression of temperament behavior tendencies, and describes the quality of an individual's affect and the intensity and reaction speed toward experiences

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 42 to stimulation (Henderson & Wachs, 2007; Rothbart, 2004). As a result, behavioral selfregulation refers to the capacity of an individual to control emotional and behavioral reactivity; therefore, active engagement in behavioral self-regulation allows for the development of behavioral strategies that allow an individual to manage tasks, goals, and social interaction (Baumeister, & Vohs, 2004; Henderson & Wachs, 2007; Rothbart, 2004; Rothbart & Bates, 2006). The varying qualities of temperament provide the foundation for an individual's ability to respond emotionally, regulate attention, and regulate behavioral responses that influence the process of social interaction and activity engagement. The next section explores the influences of temperament on parent-child relationships, parenting styles, teacher-child relationships, and social development. Temperament and Its Influences on Social Interaction, Social Competence, and Adult-Child Relationships Researchers concur that developmental outcomes in children are influenced by a combination of the child's health condition, cognitive abilities, family circumstances and relationships, social and cultural context, and the child's temperament (Caspi et al., 2005; Lengua & Kovas, 2005; Rosenblum, Dayton, & Muzik, 2009; Sanson et al., 2004). The transactional model of development (Sameroff, 2009) suggests that bi-directional interactions between individuals and experiences within contexts help to shape developmental outcomes. Thus, parent behavior, parent perception and parenting styles, and interactive styles of other adults and peers can potentially influence emotional/behavioral outcomes in children. Conversely, a child's emotional/behavioral style can influence parent behavioral outcomes and the behavioral reactions of other

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 43

adults and peers. The following series of studies illustrate research that examines the bidirectional and influential nature of parent behavior, child temperament, adult-child relationships, and peer interaction on the development of child social and activity engagement. The first set of two studies considered the impact of parent perception on child temperament through the examination of parent-child relationships where the mother had symptoms of depression. In a longitudinal descriptive study, Edhborg, Seimyr, Lundh, and Widstrom (2002) used Pearson product-moment correlation and multivariate statistics to explore the relationships between postpartum depression, maternal perception of their child's temperament, and perceptions of parenthood. At 2-months postpartum, 304 mother-father pairs participated in the study, and at 1-year follow-up, 223 motherfather pairs of the 304 pairs participated in the study. The following assessment measures were used: Edinburgh Postnatal Depression Scale (EPDS) to screen for postnatal depression, Infant Characteristic Questionnaire (ICQ) to assess parent perception of child temperament, and the Experience of Motherhood/Fatherhood Questionnaire to measure perceptions of parenthood. Following the assessment of the EDPS, families were divided into two groups: couples with a depressed mother and couples without a depressed mother. At 2-months post-partum, results indicated that couples with a depressed mother rated their children as being more irritable and perceived their children as having more difficult temperaments. At 1-year follow-up, results indicated that mothers with postpartum depression reported more stress and less satisfaction with motherhood that the non-depressed mothers. No differences between

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 44

groups regarding perception of parenthood were found with the fathers. Across groups, mothers and fathers who rated their children as having a difficult temperament at 2 months of age reported more stress and anxiety regarding parenthood. In a more recent longitudinal study of maternal depression and infant temperament, McGrath, Records, and Rice (2008) studied 139 women from third trimester of pregnancy to 8-months postpartum to investigate the whether differences existed in maternal perceptions of infant temperament between mothers with and without depression. Mothers were divided into depressed group and non-depressed group following the outcomes of EPDS and the Centers for Epidemiologic Studies Depressed Mood Scale. Maternal perception of child temperament was assessed using a 3-item temperament measure at 2 and 6 months after birth. No significant changes in childcare stress or differences in family support were reported between 2 and 6 months postpartum. Results indicated that depressed mothers reported having infants with difficult temperaments as compared to the non-depressed mothers as represented by higher mean values on the assessment of infant temperament. Both of these previous studies suggested that symptoms of depression and poorer perception of infant behavior might have influenced child temperament and parent-child relationships. However, neither of these studies considered other behaviors that might have affected parent-child interactions (such as sleep and feeding patterns). In addition, the assessments of infant temperament were not detailed enough to gain further insight regarding temperament characteristics. However, due to risks in the development of functional parent-child

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 45

relationships, both studies illustrated the need for parental support in cases where maternal depression existed. The following set of research examples illustrated studies that presented the influence of child temperament on parenting behavior and perception and its influences on parent-child relationships and the development of social skills. First, in their longitudinal study of 50 first-time mothers and their infants, Porter and Hsu (2003) examined the relationships between pre- and post-natal reports (during the last trimester of pregnancy and when infants were 1 and 3 months of age) of maternal depression and anxiety, marital quality, and infant temperament. The Self-Efficacy in the Nurturing Role Scale was used to measure maternal efficacy; the Beck Depression Inventory (BDI) was used to assess depression, the State-Trait Anxiety Inventory was used to assess anxiety; and the Martial Quality Questionnaire was used to measure marital satisfaction. Infant temperament was assessed through the ICQ. During the initial assessments (prenatal and 1-month assessments), feelings of maternal efficacy were found to be associated with depression and anxiety (e.g., higher scores for depression and anxiety were related to reduced feelings of efficacy). However, the mothers' reports of maternal efficacy when their infants were 3 months of age were associated with infant temperament as evidenced by positive correlations between decreased feelings of maternal efficacy and negative infant temperament. As first-time mothers improved in their ability to understand the social cues of their infants and learned to manage and influence their infant's emotional state, the mothers' feelings of maternal efficacy increased. These results supported the bi-directional nature of parent-child relationships

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 46

and the importance of parent responsiveness. Although not a focus of the study, it would have been interesting if the Porter and Hsu study had included information regarding strategies used by the mothers that assisted their ability to manage and influence their child's behavior. The findings of the Porter and Hsu (2003) study were supported by an extended study done by the NICHD Early Child Care Research Network (2004). The transactional model of development was used as a construct to explore the manner in which child temperament influenced parent-child relationships in 1,364 families from across the United States through phone interviews with parents when the children were 6, 15, 24, 36, and 54 months of age and when the children were in kindergarten and first grade. In addition, teachers completed a questionnaire when the child was in kindergarten and first grade, and, play observations within the family home between mother and child occurred when the child was 24 and 36 months of age. To evaluate parent personality, parent depression, parent-child interactions within the home, infant temperament, child development, and attachment behaviors respectively, assessment measures included NEO Personality Inventory, Center for Epidemiological Studies Depression Scale (CES-D), Home Observation for Measurement of the Environment (HOME), ICQ, Bayley Scales of Infant Development, and the Attachment Q-set. After initial assessments, participants were assigned to one of two groups: those participants with infants who demonstrated positive affect and self-regulation, and those participants with infants who demonstrated negative affect and behavioral dysregulation. Results indicated an association between infants with negative affect and behavioral dysregulation and difficult social and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 47

behavioral outcomes at 5 months, in kindergarten and in first grade, as seen by higher incidence of impulsivity. After controlling for family factors, mothers of the infants who presented negative affect and dysregulation behavior reported feeling "less close" to their children and had more "externalizing problems," and teachers rated these children as having fewer social skills, higher impulsivity, and lower skills in reading. However, teachers did not demonstrate differences in feelings of closeness for either group. These results illustrated how the behavioral regulation component of temperament can have an influence on parent-child relationships and social/behavioral ability. For the Porter and Hsu (2003) and NICHD Early Child Care Research Network (2004) studies, information about the types of activities or contexts that projected irritable behavior in the children who presented negative affect and dysregulation behavior would have provided additional insight regarding the influence of contextual demands on behavior. Research over the past decade regarding temperament characteristics demonstrated that temperament style is related to social behavior and social competence and can impact peer relationships and adult-child relationships (Birch & Ladd, 1998; Eisenberg et al., 2000; Rothbart & Jones, 1998; Rudasill & Rimm-Kaufman, 2009; Spinard et al., 2004). For example, two early research studies by Birch and Ladd (1998) and Rothbart and Jones (1998) examined the impact of temperament characteristics on teacher-child relationships and teacher expectations of children's academic performance. Birch and Ladd (1998) explored how children's temperament influenced teacher-child relationships and their ability to adjust to classroom demands in their investigation of 199 kindergarten students with a follow-up through first grade and 17 of their teachers.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 48 Through the use of correlation and hierarchical regression analysis of children's behavioral assessment and student-teacher relationship assessment outcomes, Birch and Ladd (1998) found that teacher ratings of closeness negatively correlated with children's negative affect and predicted poor quality peer relationships and teacher-student relationships in the first grade. Similarly, Rothbart and Jones (1998) described the impact of children's ability to self-regulate their behavior, to express positive and negative emotions, to respond and adapt to demands of the classroom (i.e., reactivity and adaptability toward novel experiences) on academic success and teacher's attitudes regarding acceptable classroom behavior. Those students with issues in behavioral selfregulation and who demonstrated more negative temperament had more difficulty in adapting to classroom demands. Rothbart and Jones summarized that the temperament traits of emotional negativity and low self-regulation predicted poor or ineffective social competence, whereas, the ability to demonstrate controlled attention and behavioral regulation resulted in better social functioning. Rothbart and Jones suggested that promoting the understanding of children's temperament would assist teachers in shifting their focus from problem behaviors toward facilitation of adaptive behaviors to reduce conflict. Subsequent research regarding temperament and the quality of teacher-child relationships and peer relationships supported the outcomes of these earlier findings. In their 2-year longitudinal descriptive study examining the relationships between emotionality and regulation traits of temperament and social functioning and the prediction of social functioning, Eisenberg et al. (2000) hypothesized that the manner in

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 49

which emotionality and self-regulation interact could impact the quality of social behavior. The participants in this study included 142 children in kindergarten through grade 3 and were grouped into either high or low negative emotionality categories following outcomes on standardized assessments of temperament (e.g., CBQ and the Affect Intensity Scale) and were further assessed using social assessment tools and observations of specific task behaviors. The results indicated that children who demonstrated increased emotional negativity and low self-regulation were more at risk for problematic social functioning in school. In addition, the temperament traits of emotional negativity and low self-regulation predicted poor or ineffective social competence. Conversely, the ability to demonstrate controlled attention and behavioral regulation resulted in better social functioning. In a more recent study, Rudasill and Rimm-Kaufman (2009) found similar outcomes in their study of temperament and child-teacher interactions, and quality of child-teacher relationships of 819 first grade students and their teachers from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD). The CBQ was used to measure characteristics of temperament, the Student-Teacher Relationship scale was used to assess teacher-child relationships, and frequencies of teacher-child interactions were recorded through timesampled observations. Correlation and path analyses were used to evaluate the relationships between variables of attentional focusing, inhibitory control, effortful control, shyness, social conflict, interpersonal closeness, gender, child-initiated interaction, and teacher-initiated interactions. The only variables that demonstrated a

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 50

positive significant correlation were inhibitory control behavior and attentional focus, and effortful control and attentional focus and inhibitory control, indicating that children that demonstrate behavioral self-regulation and effortful control had increased abilities for maintaining attention for task completion. Results using path analysis indicated that children who demonstrated lower levels of shyness and higher levels of effortful control were more likely to have closer child-teacher relationships and less social conflicts. Those children with lower levels of shyness and lower levels of effortful control were more likely to have conflicting relationships. The outcomes of the Rudasill and Rimm-Kaufman (2009) study indicated that children who were able to inhibit inappropriate behavior and demonstrate acceptable behavior tend to be viewed more positively by their teachers and were able to appropriately meet classroom demands. Of interest, children labeled as shy in this study engaged in less teacher-child interactions and were less likely to develop a close relationship with their teacher. This finding suggested that a shyer temperament might influence the development of social skills. However, avoidant behavioral responses toward sensory activities could also be interpreted as shy behavior. For example, a child labeled as having a shy temperament characteristic, might appear to be shy due to his or her anxious behaviors related to a sensory avoiding behavior style in contexts with intense sensory experiences. However, the same child might not appear shy in contexts with minimal sensory experiences. Therefore, it is important to consider the sensory features within a context and its impact on behavioral reactivity and self-regulation. Sensory reactivity might potentially influence the nature of social interactions.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 51

Finally, in a study that explored temperament and social competence in peer relationships, Spinrad et al. (2004) examined the relationships between play behaviors, temperament, and peer relationships in a 9-month study of 138 preschool children. Outcomes from play observations, the CBQ, and a teacher-reported play-behavior assessment were analyzed using correlation statistics that were controlled for number of observations, age, and gender. Although correlations were low, results indicated that children who preferred solitary play had a tendency to be excluded by their peers during play. Those children who demonstrated temperament characteristics of increased fear/anxiety, and decreased inhibitory control/self-regulation also demonstrated more solitary play and tended to be excluded by their peers. The results suggested that the temperament characteristic of anxiety/fear tended to predict socially withdrawn behavior and a tendency to engage in more nonsocial play. Spinrad et al. (2004) suggested, "Children who experience anxiety or are unregulated may choose to play alone and therefore may not learn the social skills that foster peer acceptance and play with peers" (p. 76). However, it would be interesting to examine the types of play activities and the sensory attributes of the activities that these children preferred in this study. The case may be that these children found solitary activities to be more calming and they felt less anxious when engaging in solitary activities as compared to the social activities. More information about nature of the context might have provided additional insight regarding child behavior in this study. The previous studies illustrated the influence of temperament and behavioral selfregulation in the development of social skills and task performance. Of interest, the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 52

following three studies illustrated the influence of the behavioral self-regulation component of temperament in learning and social adjustment in challenging contextual situations. First, Buckner, Mezzacappa, and Beardslee (2009) identified behavioral selfregulation as a critical feature in perceived social competence and academic performance in 155 low-income youths between the ages of 8 to 18 years. These researchers used various assessment methods to control for age, gender, non-verbal intelligence, negative life events, chronic stress, and social support to examine the process of self-regulation and adaptive function. The California Child Q-Sort (CCQ) and the Haan Q-Sort assessments were used to evaluate self-regulation that involved inhibitory control, attention, motivation, and emotional regulation. The Child Behavior Checklist (CBCL), Children's Depression Inventory (CDI), and the Revised Children's Manifest Anxiety Scale (RCMAS) were used to assess mental health. The Child Global Assessment Scale (CGAS) was used to assess adaptive skills regarding social relationships. The My Family and Friends measure evaluated social skills and social supports. The Wechsler Individual Achievement Test Screener (WAIT-S) evaluated cognitive and academic achievement, and the Life Events Questionnaire (LEQ) was used to assess the impact of stressful life experiences. Finally, participants' coping skills were assessed using their responses to three actual stressful life experiences and to three hypothetical stressful events. Analysis of the assessment outcomes of the Buckner et al. (2009) study on the full sample (N- 155) involved correlation and regression statistics. Participants who scored in the first and fourth quartiles on the self-regulation assessments were split into two groups: high self-regulation skills {n = 39) and low self-regulation skills {n = 39).

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 53 Participants in these two groups were comparable in race/ethnic status, gender, age, household income and family constellation and their assessment outcomes were compared using /-test and chi-square analysis. Results revealed that self-regulation skills were not associated with age, race/ethnicity, or household constellation. Self-regulation was positively associated with social competence, with higher academic/school performance as measured on the WAIT-S, and with adaptive functioning as measured by the CGAS. Self-regulation was negatively associated with higher scores for behavior problems on the CBCL, for depression on the CDI, and for anxiety on the RCMAS. When controlling for life events and social support, self-regulation moderately correlated with adaptive coping skills. Participants in the high self-regulation group had a 91% probability of demonstrating adaptive coping skills as compared to 76% in the low selfregulation group. The outcomes of this study supported the idea that children with high behavioral self-regulatory skills demonstrate improved adaptive functioning as seen by better achievement in school, better social competence, reduced behavior problems, and reduced depression and anxiety. Dixon, Salley, and Clements (2006) found that behavioral self-regulation skills were critical features in learning within distracting contexts. Participants included 39 typically developing toddlers who were presented a word-learning task (i.e., identification of common objects) and a non-word-learning task (i.e., making a "rattle" using nesting cups and a ball; and a pretend feeding activity) in contexts that involved auditory and visual distractions (i.e., use of videotaped children's television programs and a mechanical monkey that played cymbals). The Early Childhood Behavior

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 54 Questionnaire (ECBQ) was used to assess attentional focus and behavioral self-regulation and used to divide participants into two groups (e.g., "low focused" and "high focused" groups). Results, using ANOVA analyses, indicated that the presence of environmental distractions influenced the children's ability to learn both of the tasks; however, children in the high focused group were better able to learn the tasks than the children in the low focused group. No associations were found between distraction and type of task to be learned. Dixon et al. (2006) suggested that the abilities for attentional focus in behavioral self-regulation could mediate the effects of distractions within a context. Of interest, Dixon et al. reported that one boy in the study became so upset and fearful whenever the mechanical monkey was activated that he discontinued participation in the study. This child's reaction might have reflected the influence of sensory-processing on behaviors. Perhaps the outcomes of this study indicated that the ability to modulate sensory processing within a distracting context could have an influence on attentional focus and behavioral self-regulation. The ability for effortful control in behavioral self-regulation was found to moderate behavior within at-risk contexts (Lengua et al., 2008). This longitudinal study involved 189 typically developing children from grade 3 to grade 5 and their female primary caregivers through the use of interviews and assessments on three occasions, each separated by one year. Contextual risk factors were assessed through questionnaires and identified as socioeconomic risk (combination of family income and maternal education level), maternal risk (maternal history of depression, mental health, substance abuse, or legal issues), and environmental risk (number of household members, quality of

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 55

home and neighborhood environment). Effortful control was assessed using the inhibitory control subscale of CBQ (Rothbart et al., 2001), the attention regulation subscale of the Early Adolescent Temperament Questionnaire (Capaldi & Rothbart, 1992), and through the use of the Stroop Color and Word test (Golden, 1978). Adaptive behavior issues were assessed using the CBCL, the CDI, and the Revised Children's Manifest Anxiety Scale (RCMAS). Correlation analyses and cross-group tests regarding behavior, risk factors, and levels of effortful control were used to assess the relationships between the contextual risk factors, effortful control, and behavioral adaptation. The results indicated that cumulative contextual risks were positively associated with higher levels of issues in behavioral adaptation. Although maternal risk factors and environmental risk factors were separately found to predict problematic adaptive behavior in children with lower levels of effortful control, these risk factors were not found to be associated with adaptive behavior issues for children with higher levels of effortful control. Lengua et al. (2008) suggested that the development of skills for effortful control might assist in moderating adaptive behavior issues related to contextual risks. The findings of this study supported the findings of the Rudasill and RimmKaufman (2009) study where higher abilities for effortful control were associated with fewer behavioral issues. The results of the three previous studies indicated that the promotion of selfregulatory behaviors might also support adaptive functioning. However, the question remains regarding the nature of behavioral reactivity and its impact on the development of self-regulation. Perhaps understanding the influences of sensory experiences on

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 56 behavioral reactivity may lead to learning strategies that promote better self-regulatory behaviors and, consequently, better adaptive functioning. The previous sets of studies illustrated how characteristics of temperament can be critical components in the development of parent-child, teacher-child, and peer relationships, and for the development of adaptive functioning. The next set of three research studies suggested that understanding the influences of temperament characteristics on social interactions can promote the use of adaptation strategies that enhance goodness-of-fit between person and context, and facilitate positive interactions through moderating the influences of negative behavior. First, Crockenberg and Leerkes (2006), in a longitudinal study, explored whether infant temperament characteristics of negative reactivity and activity level to novel situations predicted anxious behavior, whether temperament characteristics of attention control could moderate the development of anxious behavior, and whether maternal sensitivity and engagement could moderate the development of anxious behavior in infants that demonstrated temperament characteristics of negative reactivity. Participants included 64 mothers and healthy children when the children were 6-months of age and again when the children were 2.5 years of age. To assess temperament, the IBQ was administered to the children at 6 months of age and to assess symptoms of depression, mothers completed the CES-D. In addition, when the children were 6 months of age, the mother and child participated in a videotaped interaction session that involved the presentation of toys in order to assess mother-child interaction. Videotapes were coded using a computerized video coding system for infant and mother behavior regarding task engagement, visual regard at a

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 57

novel toy (e.g., a bumble ball and a fire truck), and infant-mother interaction through the use of soothing/calming behavior, attention, communication, and affect. At 2.5 years, the mothers completed the CBCL, a 100-item list that assessed children's behavioral and emotional abilities/issues. Through the use of correlation and regression statistics, results of the Crockenberg and Leerkes (2006) study indicated a moderate association between social engagement, self-calming, and activity level. Infants who were less socially engaged tended to look away from a novel toy and engaged in less self-soothing/calming behaviors, and infants who withdrew from the novel toy were less active. However, the more the mothers engaged with their children and the novel toy, the less the infants withdrew from the toy. Following a hierarchical multiple regression analysis to assess affects of maternal behaviors on infant behaviors, anxious behavior at 2.5 years of age was predicted in infants at age 6 months with increased activity levels and distress to novel situations with mothers who demonstrated low maternal sensitivity and engagement. No significant interactions for predictions of anxious/depressed behavior at 2.5 years were found between infants who demonstrated distress at novel situation, increased activity, and decreased looking away behaviors at age 6 months whose mothers were above the median for sensitivity or engagement. The results of the Crockenberg and Leerkes (2006) study suggested that although infant behavior regarding regulation of attention and distress during novel situations predicted the development of anxious behavior, this trajectory could be moderated by maternal behavior. In addition, the outcomes of this study supported the notion of the bi-

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 58 directional influences of parent-child behaviors on relationship development and goodness-of-fit in the use of adaptive strategies to facilitate positive social interactions. Of note, the bumble ball, one of the items used as the novel toy, is colorful, vibrates, moves, and makes sounds all at the same time. It is possible that the multi-sensory experiences of this toy contributed to the distress, anxiety and withdrawal behaviors for the children in the study who were more sensitive to multi-sensory experiences. It is also possible that mothers who recognized that the multi-sensory experiences of the bumble ball toy influenced their child's behavior were better able to engage in calming strategies to sooth their child's anxious behaviors. Perhaps sensory reactivity and learning to manage sensory reactivity played a part in behavioral self-regulation in this study. Also, the study did not address interactive issues related to depression or whether mothers who were identified as being depressed were included in the study. Depression could have been a confounding factor in this study. The Kochanska, Aksan, and Carlson (2005) study of temperament and parentchild interactions achieved similar results. These researchers explored social responsiveness and parent-child interaction in 101 families with healthy children at 7 and 15 months of age. Variables included assessment of the child's proneness to anger and the parents' responsiveness, the child's receptive cooperation, and the child's attachment security. Videotaped sessions of a situation designed to elicit anger in the child (e.g., taking away a favorite toy) were used to assess proneness to anger; video taped sessions of naturalistic day-care routines (e.g., bath-time, meal-time) were used to assess parentchild responsiveness; and videotaped sessions of a child's reaction to the introduction of

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 59 a stranger was used to assess attachment security. The videotapes were coded using child development professionals who were not familiar with the information regarding the participants. Results of the Kochanska et al. (2005) study indicated that no differences were found between child gender and proneness to anger and parent-child gender interaction. However, results revealed that a child's behavioral temperament to be prone to anger at 7 months demonstrated a negative slope in receptive cooperation at 15 months for insecure children. Of interest, the children, at 7 months who demonstrated behavioral proneness to anger and who had mothers or fathers who were highly responsive, became more cooperative at 15 months as compared to those infants who were prone to anger and who had less responsive parents (these infants became more uncooperative at 15 months). The Kochanska et al. (2005) study illustrated the benefits of goodness of fit and parent responsiveness within a parent-child relationship in the development of social relationships. As in the study by Crockenberg and Leerkes (2006), this study demonstrated that by understanding temperament, parents helped to promote the development of more cooperative social behaviors in children with difficult temperaments, thus supporting the idea that adaptive strategies helped to facilitate positive social interactions. Of note, this study used regular, familiar daily experiences (e.g., familiar toy, bath-time, meal-time) to evaluate parent-child interactions and responsiveness; thus, minimizing the influence of unfamiliar sensory experiences on behavior that might have impacted behavioral reactivity and self-regulation.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 60

As in the studies by Crockenberg and Leerkes (2006) and Kochanska et al. (2005), a study by Jaffe (2007) explored the relationships between parenting, child temperament, and behavioral outcomes; however, the focus of this study involved developmental outcomes of at-risk children (e.g., infants and toddlers who experienced abuse and neglect) with difficult temperaments. Participants included 1,720 children who experienced abuse and neglect that demonstrated difficult temperaments (e.g., low levels of positive affect, more fussy and irritable as determined by temperament assessments adapted for the study), and were at risk for cognitive and language delays and regulatory behavior disorders. Children with known neurodevelopmental issues, such as cerebral palsy, were excluded. Participants were obtained from the National Survey of Child and Adolescent Well-Being (NSCAW) that was conducted by Child Protective Services from across the United States during an 18-month time frame that included children between the ages of 3 to 24 months during the first caregiver interview at the time children were initially removed from their homes and entered foster care and at approximately 36 months at the fourth interview following an 18-month placement into foster care. Fourth interview involved caseworkers, teachers, and foster caregivers. The Bay ley Infant Neurodevelopmental Screener was used to evaluate development; the HOME was used to assess cognitive and emotional support provided by the caregivers; the Preschool Language Scale was used to measure language development, and the CBCL was used to assess behavior and behavioral issues of the children. The study's goals were to examine the relationships between difficult temperament and developmental outcomes, and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 61

whether improvements in home environments predicted better language and behavioral development in the at-risk children. Through the use of correlation and regression analyses, the results of the Jaffe (2007) study revealed several interesting findings. First, the presence of moderate to high risk for developmental delays was positively associated with difficult temperament. In addition, difficult temperament and high risk for developmental delays were positively associated with problem behaviors and lower ability in language skills. Regression analyses of children who were identified as high risk for developmental delays and difficult temperaments but who performed better than expected cognitive and language development as compared to the at-risk children who demonstrated less developmental improvements revealed that a cognitively stimulating, care-giving environment predicted improvements in language development. In addition, an emotionally supportive caregiving environment predicted improvements in behavior. These outcomes supported the idea that caregivers who understood the nature of their child's temperament and demonstrated responsive parenting could mediate the potential for problematic behavior secondary to difficult temperament. These outcomes also supported the notion of goodness-of-fit between child, caregiver, and context; however, information about parenting styles as a potential strategy to support child temperament was not reported, as in the next set of studies. The influences of parenting styles and parent behaviors on child temperament and behaviors were the focus of the following studies by Paulussen-Hoogeboom et al. (2008), Dennis (2006), and Szabo et al. (2008). To study whether parenting styles had a

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 62

mediating effect on negative behavior, Paulussen-Hoogeboom et al. (2008) explored the relationships between the temperament trait of emotionality, its impact on behavior, and the influence of parenting style as a mediator in 196 preschool children and their mothers. The CBQ was utilized to assess temperament of the children and the researchers focused on the CBQ scales that measured negative emotionality. The parent-report CBCL was used to assess for problematic behavior. Parenting styles were assessed through a selfreport parenting styles rating scale. Through the use of a confirmatory factor analysis, Paulussen-Hoogeboom et al. (2008) found a statistically relevant correlation between child negative emotionality and problematic behavior. However, results revealed a negative association between authoritative parenting style and children's negative emotionality and a negative association between authoritative parenting style and children's problematic behaviors. These outcomes indicated that an authoritative parenting style that provided structure and concrete expectations was found to mediate the problematic behavior and the negative mood in their children. Again, recognition of child temperament styles allowed for the goodness-of-fit and the use of adaptive strategies that promoted behavior management. In a study by Dennis (2006), the relationship between child emotional selfregulation, temperament, and parenting style was explored in 120 4-year old children and their mothers. The CBQ was used to assess child temperament, emotional reactivity, and behavioral self-regulation. Parenting styles and parent-child interaction were assessed and coded through videotaped sessions of free-play and a waiting task. Emotional selfregulation for task persistence and frustration in the child was also assessed using the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 63

Transparent-Box Task and the Imperfect Circles Task sub-tests that are parts of the Laboratory Temperament Assessment Battery (LabTAB). Moderate correlations were found between parental styles of warmth and engagement during free-play and waiting activities and positive child behavior. Dennis (2006) used several step-wise regression analyses to examine the associations between parenting styles and child self-regulation behaviors. One result demonstrated that children with less approach behaviors and more abilities for selfcalming were more persistent in tasks; however, children with more approach behaviors and less self-calming behaviors demonstrated less task persistence. For children who demonstrated less approach behaviors and increased inhibitory control, mothers reported more behavioral compliance. In general, the child's ability for inhibitory control and self-calming predicted better social interaction. In addition, during the waiting task, children whose mothers who were less engaged demonstrated more frustration and less task persistence. During the free-play task, children whose mothers who were more engaged demonstrated more behavioral compliance. These outcomes suggested that the use of adaptive strategies for inhibitory control and self-regulation and the parents' ability to recognize temperamental features in their children facilitated positive social interactions and less frustration. However, a component to consider within the outcomes of this study was the nature of the child's reactivity toward the sensory experiences within the testing contexts and the influence of sensory reactivity on behavioral selfregulation. Perhaps the mothers' responsiveness and ability to recognize the impact of sensory experiences upon their child and their ability to utilize calming techniques

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 64 assisted the children in learning inhibitory control, self-regulation, and social competence. Next, Szabo et al. (2008) examined the relationships between parenting styles of intrusiveness and sensitivity and child temperament characteristics and behavior in 117 mother-son (ages 16- to 19-months) dyads. The ECBQ was used to measure child temperament. Videotaped sessions involving play with blocks, reading a picture book and cleaning up after play were coded to measure for parenting behavior style ("sensitivity" and "intrusiveness") and child negative behavior using the Erickson Scales (a 7-point rating system of parent and child behavior). The variable for sensitivity was measured by rating the parent's use of hints or supports in response to child's efforts in the activity. The variable for intrusiveness was measured by rating the parent's interference in child's actions. Child negative behavior was measured by rating the child's responses of anger, hostility, or resistance toward parent during the activity. The research assistants who rated the videotapes were blinded to the hypotheses of the study. The results of correlations between child temperament and child negative behavior and between maternal and child behavior supported findings of other research where lower child soothability and higher child frustration were associated with high child negative behavior. Higher levels of maternal intrusiveness and lower levels of maternal sensitivity correlated with more negative child behaviors. Through the use of a hierarchical regression analysis, Szabo et al. (2008) examined whether parenting styles moderated the relationships between child temperament and negative child behavior. Interestingly, the results indicated that

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 65 parenting style of sensitivity did not mediate child temperament and negative child behaviors as reported by Kochanska et al. (2005) and by Crockenberg and Leerkes (2006). However, the parenting style of intrusiveness was found to increase the correlation between high activity level and negative child behavior and increase the association between low soothability and negative child behavior. Szabo et al. (2008) suggested that overly intrusive parents "may need help in understanding the unique nature of their child" and find "appropriate ways of parenting that child" (p. 374). Another possible way to interpret the outcomes of this study might be that children with high activity levels and negative behavior may require a context that is more structured, as suggested in the study by Paulussen-Hoogeboom et al. (2008) where authoritative parenting styles were found to mediate the problematic behavior and the negative mood. Plus, an understanding of the links between sensory experiences of the contexts within the Szabo et al. (2008) study and the child's behavioral reactivity toward these experiences could provide additional interpretation of the outcomes in this study. The notion that negative temperament styles in young children set up a trajectory of problematic behaviors in children in less supportive environments; whereas parenting styles, especially responsive, authoritative parents, can be mediating factors is reflected in other research (Bridgett et al., 2009; Coplan, Reichel, & Rowan, 2009; Mathiesen & Prior, 2006). Negative reactivity, impulsive behavior, and activity levels as part of behavioral reactivity have often been associated with a child's responsiveness and intensity of response toward sensory experiences (DeGangi, 2000; Greenspan, 2007; Williamson & Anzalone, 2001). Consequently, how a child reacts to or behaves toward

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 66 daily sensory experiences may have an effect upon mood, emotional affect, and interaction. Therefore, the ability to adequately interpret the meaning of sensory experiences and to respond appropriately may have an influence on the individual's ability to engage and participate in daily activities and social interactions. For example, Evans and Rothbart (2009) reviewed the relationships between temperament constructs of positive emotionality and negative emotionality to orienting and perceptual sensitivity and social skills in 258 university students through correlation factor analysis of the short-form Adult Temperament Questionnaire (ATQ). Results indicated that positive emotionality and orienting/perceptual sensitivity, and positive emotionality and social skills were positively related and that negative emotionality was inversely related to effortful control, but not related to orienting/perceptual sensitivity or social skills. The results in this study indicated that individuals with a greater tendency for negative emotionality had reduced abilities for effortful control and an inability to moderate behavior that may have accounted for a lack of association with orienting/perceptual sensitivity and social skills. The outcome of the Evans and Rothbart (2009) study suggested that sensory responsiveness might have an influence on the quality of social and task engagement. The next section describes the constructs related to sensoryprocessing patterns and behaviors. Model of Sensory Processing In her seminal 1997 article, Dunn (1997a) examined the interactions between neuroscience concepts and behavior and proposed the model of sensory processing to describe sensory-processing behavior patterns and its influences on children's activity

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 67 preferences, interaction and participation. This model emerged following factor analysis studies of the Sensory Profile, an assessment tool that was under development at the time (Dunn, 1994; Dunn & Brown, 1997; Dunn, & Westman, 1997). In the model of sensory processing, Dunn (1997a, 1997b, 2007) described the interaction between neurological thresholds (e.g., the amount of sensory stimuli needed to provoke a response by the central nervous system) and the style of behavioral response or action. Key neurological concepts in this model involve the ability to modulate or regulate sensory input in order to maintain an appropriate level of attention, the ability to habituate (habituation) to sensory input (e.g., the ability to recognize familiar sensory experiences and decrease attention to the sensory experience because the sensory input is not relevant to the situation), and the ability to be sensitized (sensitization) to input in order to increase attention and action. These neurological concepts occur on a continuum where high sensory thresholds involve habituation to input whereas low sensory thresholds involve sensitization to input. Behavioral responses to sensory input also occur on a continuum and individuals may respond actively or passively according to their sensory thresholds (Dunn, 2007). For individuals who respond passively to sensory thresholds and when sensory thresholds are low, these individuals tend to respond quickly to many sensory experiences or require minimal amounts of stimuli before responding and becoming alert. Or, if sensory thresholds are high, individuals may respond slowly to stimuli or require greater amounts of sensory input before alerting to stimuli. Alternatively, for individuals who tend to respond actively toward sensory thresholds and when sensory thresholds are high, these

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 68

individuals actively seek out more or additional stimuli. Or, if sensory thresholds are low, individuals who respond actively toward thresholds may try to limit or avoid encountering stimuli. The interactions between low/high thresholds and passive/active behavior result in four types of sensory-processing behavior patterns: low sensory registration, sensory sensitivity, sensory seeking, and sensory avoiding These patterns are based on sensory responses to visual, auditory, tactile-proprioception, vestibular, gustatory, and olfactory sensory occurrences in daily life experiences and interactions (See Figure 1). Thresholds and Reactivity Continuum

* Respondfng/Self-Regulation Strategies, ^ \

t

/

Passive Behavioral Strategy Active Behavtora! Strategy ~* Low Sensory Registration High Sensory Threshold Sensory Seeking (Habituation) Low Sensory Threshold Sensory Sensitivity Sensory Avoiding (Sensitization) Figure 1 Dunn's Model of Sensory Processing This figure illustrates four types of sensoryprocessing behavior patterns that result from intersections of sensory thresholds and selfregulation strategies Adapted from "The Sensations of Everyday Life Empirical, Theoretical, and Pragmatic Considerations," by W Dunn, 2001, American Journal Of Occupational Therapy, 55(6), p 612

Subsequent research regarding the model of sensory processing and use of the Sensory Profile on different age groups and on children with and without disabilities found several trends. First, the pattern of sensory seeking or searching for sensory experiences was found to be a main method that individuals use to attend and to maintain attention and each individual has his or her own unique pattern of sensory-processing (Dunn, 2001, 2007). Behaviors regarding sensory experiences tended to cluster according to threshold levels instead of through specific sensory modalities, such as vision, auditory, tactile, and vestibular, thus influencing activity preferences (Dunn & Brown, 1997; Dunn, 2001, 2007). Sensory-processing behavior patterns tended to be

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 69 stable and consistent across the lifespan (Brown & Dunn, 2002; Brown, Tollefson, Dunn, Cromwell, & Filion, 2001; Dunn, 2001). Finally, evidence existed that for individuals with specific conditions, such as autism, Asperger syndrome, and attention deficit hyperactivity disorder (ADHD), sensory-processing behavior patterns were different or extreme when compared to normally developing peers, suggesting that differences in sensory-processing behavior patterns might be a factor in behavioral and psychosocial development (Ermer & Dunn, 1998; Myles et al., 2004; Yochman, Parush, & Ornoy, 2004). Therefore, it is important to consider how sensory-processing behavior patterns influence an individual's engagement in activities and social interactions. Sensory-Processing Behaviors and Context The ability to engage and participate in daily activities involves the ability to understand and appropriately respond to contextual demands that often involve sensory experiences. The following set of research studies illustrated how sensory-processing patterns could impact activity performance, especially in children who demonstrate extreme sensory-processing behaviors. First, Bundy et al. (2007) investigated the correlation between descriptions of play behaviors and sensory-processing behaviors in 20 children between the ages of 4.4 and 9.8 years who were identified as having sensoryprocessing dysfunction (SPD) and 20 typically developing age-matched peers. Based on the premise that children with SPD have difficulties interacting with people and objects in their environment, the research questions of this study examined whether SPD interfered with playfulness and investigated how the characteristics of SPD related to characteristics of playful behavior. Scores on the Short Sensory Profile (SSP) (Dunn,

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 70 1999) determined inclusion criteria for children with SPD. Children with diagnosed motor (e.g., cerebral palsy), behavioral (e.g., autism, Fragile X, fetal alcohol syndrome), cognitive issues, or traumatic birth histories or history of traumatic life event were not included in the study. The Test of Playfulness (TOP, as cited in Bundy, Nelson, Metzger, & Bingaman, 2001) was used as an assessment measure of playfulness and play behaviors. The TOP involved videotaped play sessions of free play with peers in a natural environment that included interesting age-appropriate toys (Bundy et al., 2001). Higher scores on the TOP indicated more playfulness and play behaviors. Through the use of Spearman rank order correlation coefficient statistical analysis, higher scores on the TOP were significantly correlated with the "no sensory differences" categories on the SSP for the typically developing children. Children with SPD demonstrated lower scores on the TOP. Thus, playful behavior in children with SPD was more limited as compared to typically developing children. Children with SPD demonstrated more clowning and joking play behaviors as preferred play behaviors, and less use of pretend play and less tendency to use objects in an imaginary way. No specific sensory-processing behavior patterns were found to be statistically significant in relation to play behaviors in this study. Next, in another study of play and sensory-processing patterns, Lawson and Dunn (2008) explored the play activity levels and preferences in 53 typically developing preschool children between the ages of 3 to 5.5 years. The SP was used to gather information about sensory-processing patterns. Information about play activity levels and preferences was gained through a standardized observation format that involved

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 71 unstructured play with a standard set of age-appropriate materials. One-tailed Spearman rank correlations were used to determine relationships between the sensation seeking and sensation avoiding sensory-processing patterns and the use of varying body positions during play. ANOVA was used to analyze the associations between sensory-processing patterns and toy selection through scores on the SP and a 15-category age-appropriate toy selection. Although correlations were low, results demonstrated that children who scored in the sensory avoiding category tended to change their body position less often than children who scored within the sensory seeking category on the SP. Children who scored within the sensation-seeking category preferred creative art toys, building materials, or would engage in active play without a toy and, perhaps, running and chasing a peer. Children who scored within the sensation-avoiding category preferred more sedentary play that involved pretend play with miniature versions of the actual object. These results suggested that sensory-processing behavior patterns had the potential to influence the nature of play and selection of objects for play. In a continued exploration of relationships between sensory-processing behaviors and leisure/play activities, Hochhauser and Engel-Yeger (2010) studied the sensoryprocessing behaviors and play/leisure preferences of 25 children with high-functioning autism spectrum disorders (HFASD) between the ages of 6 to 11 years and 25 agematched, typically developing peers. The SSP was used to measure sensory-processing behavior patterns and Children's Assessment of Participation and Enjoyment (CAPE) was used to measure activity preferences and the intensity of activity engagement. Through the use of MANOVA, significant group differences existed between the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 72

sensory-processing abilities of the children with HFASD as compared to the typically developing children. The children with HFASD demonstrated atypical sensoryprocessing behaviors for tactile, taste/smell, auditory, and visual sensory experiences and demonstrated sensory-processing behavior patterns that tended toward low sensory registration or sensory seeking behaviors. Generally, the results indicated that the children with HFASD participated in a limited variety of activities that involved less socialization with other people. Although this kind of behavior is a characteristic of HFASD, the results of this study found that a moderately significant relationship existed between atypical sensory-processing of taste experiences/smell and reduced participation in activities and lower enjoyment levels during activity engagement, according to the CAPE. In addition, a moderately significant relationship existed between sensitivity toward movement experiences and a preference for indoor activities. Plus, moderately significant associations were found between sensitivities toward auditory and visual experiences and preferences for cognitive-type activities on the CAPE, such as reading, going to the library, and completing homework. Of note, these activities do not involve intense auditory or visual experiences nor do they involve much socialization. A moderately significant association was found between sensitivity toward tactile experiences and preference for physical activities. Of interest, the children with HFASD who demonstrated sensitivity toward tactile experiences preferred more solitary physical activities (e.g., skateboarding, bicycling riding), whereas the typically developing children with tactile sensitivities preferred physical activities that were more social (e.g., team sports). The outcomes of the Hochhauser and Engel-Yeger (2010) study suggested

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 73

that the sensory attributes of a context and activities needed to be considered in order to support comfort, participation, and socialization during activity engagement. In a study by White et al. (2007), the impact of sensory-processing behaviors on participation in daily activities was examined by evaluating the relationships between sensory-processing and motor processing skills for age-appropriate daily activities in 68 children between the ages of 5 and 13 years. Following administration of the SP, participants were assigned into an atypical sensory-processing group that included 38 children and a control group of 30 age-matched typically developing peers. The Assessment of Motor and Process Skills (AMPS) (Fisher, 2003) was used to evaluate performance in age-appropriate activities of daily living (ADL) in terms of efficiency, safety, and quality. White et al. (2007) hypothesized that the children with atypical sensory-processing would demonstrate issues in ADL performance. Through the use of one-tailed independent /-tests, results revealed that the children in the atypical sensory-processing group demonstrated lower scores and more functional difficulties in performance of AMPS ADL process measure and the AMPS ADL motor measure as compared to the typically developing peers. Correlation statistics were used to examine the relationships between the SP factor scores and the AMPS ADL process and motor measures. Moderate correlations were found between the AMPS ADL motor measure and the SP fine-motor/perceptual factor, SP sensory sensitivity factor, the SP low endurance factor, and SP vestibular processing factor. Low correlations were found between the AMPS ADL motor measure and the SP visual processing, SP auditory processing, and SP touch processing. Low correlations were found between the AMPS

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 74

ADL process scores and SP visual processing, SP multi-sensory-processing, and the SP inattention/distractibility factor. These results illustrated that sensory-processing abilities could potentially influence the quality and performance of ADL function. Therefore, it may be important to account for the sensory attributes of a context when considering performance expectations for children with sensory-processing issues. The preceding studies by Bundy et al. (2007), Lawson and Dunn (2008), Hochhauser and Engel-Yeger (2010), and White et al. (2007) illustrated that sensory-processing abilities could have an influence on the quality, selection, and performance of play, leisure, and ADL function. The sensory-processing behavior patterns of children with specific diagnosed conditions can also impact social interaction and activity participation within contexts, as illustrated in the following studies. First, Yochman et al. (2004) examined the relationships between sensory-processing patterns and symptoms of hyperactivity and inattention in 48 preschool children with ADHD and 46 age-matched typically developing peers without ADHD. The Preschool Behavior Questionnaire was used to assess behaviors related to ADHD, and sensory-processing behavior patterns were assed using the SP. Through the use of MANOVA, results revealed that the children with ADHD demonstrated significantly lower scores on six of the nine factor categories of the SP (i.e., sensation seeking, emotionally reactive, oral sensitivity, inattentiondistractibility, poor registration, and fine-motor perceptual). This outcome indicated that children who demonstrated behaviors related to ADHD also demonstrated sensoryprocessing behavior patterns that were more extreme (e.g., atypical) as compared to the normative sample used to standardize the SP. Since children with behaviors related to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 75

ADHD are often labeled as having difficult temperaments (Foley, 2004; Foley, McClowry, & Castellanos, 2008), the possibility exists that extreme behavioral reactions to sensory experiences are factors in behavioral self-regulation and inhibitory control, which are both characteristics of temperament. Next, Baker, Lane, Angley, and Young (2008) explored the relationships between sensory-processing behavior patterns and emotional and social skills of children with autism. Twenty-two children, between the ages of 2.9 and 8.5 years, with autism as diagnosed following assessment using the DSM-IV criteria, Autistic Diagnostic Interview-Revised, and the Childhood Autism Rating Scale participated in this study. The SSP was used to measure sensory-processing behaviors; the Vineland Adaptive Behavior Scales (VABS) were used to assess behavior during activities that involved communication, motor function, ADL, and socialization; and the Developmental Behavior Checklist (DBC) was used to assess behavior and emotional responses. The majority of the participants in this study demonstrated atypical sensory-processing behavior patterns for low sensory registration, sensory seeking, and atypical sensoryprocessing of auditory and movement experiences. Correlation analysis of the assessment results revealed moderately significant associations between atypical sensoryprocessing of auditory and movement experiences as measured by the SSP and maladaptive behavior, disruptive/antisocial behavior, self-absorbed behavior, communication disturbances, and anxiety as measured by the DBC. Atypical sensoryprocessing issues as measured by the SSP were also moderately associated with decreased ADL function as measured by the VABS. This study, along with the studies

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 76 by Yochman et al. (2004) and White et al. (2007), illustrated the influences of sensoryprocessing behavior patterns on functional social, communication, and daily skill abilities. The next study further explored the challenges of atypical sensory-processing behavior patterns and interaction within contexts. In a study by Ashburner, Ziviani, and Rodger (2008), the associations between sensory-processing patterns, classroom emotional behavior, and educational abilities of 28 children autistic spectrum disorders (ASD) (between the ages of 6 to 10 years who were enrolled in regular education) were compared to 51 age-matched and IQ matched peers. The SSP was used to measure sensory-processing patterns. Classroom emotional behavior was measured by the Conner's Teacher Rating Scale (CTRS), and academic skills were measured by the Achenbach System of Empirically Based Assessment: Teacher report Form (ASEBA:TRF). Through use of Pearson correlations for the SSP and the CTRS for children with ASD, moderately significant associations were found between issues with tactile sensitivity and cognitive problems/inattention, between movement sensitivity and oppositional behavior, between under-responsive and cognitive problems/inattention, and between auditory filtering and cognitive problems/inattention. Moderately significant correlations were found between the SSP and the ASEBA:TRF for children with ASD for auditory filtering, anxious/depressed behavior and poor academic performance, and between under-responsive sensory-processing and poor academic performance. These findings related to the findings of Baker et al. (2008) regarding the relationships between atypical sensory-processing patterns, anxiety, and functional performance of activities within a context. In addition, no significant

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 77

differences were found between scores on the SSP and the CTRS, and scores on the SSP and the ASEBA:TRF for children without ASD. In general, children with ASD had more issues with auditory and tactile filtering (e.g., more hypersensitive) that impacted their ability to cognitively attend, resulting in academic underperformance. The outcomes of this study implied that instructional methods and classroom environments might need to be adjusted to manage the sensory issues to support academic success children with ASD. Management of contextual sensory experiences in order to influence behavior supports concepts related to the transactional model of development. Finally, the next two studies illustrate the links between the abilities for sensoryprocessing and social skills. First, Cosby, Johnston, and Dunn (2010) explored the relationships between sensory-processing behavior patterns and social participation. Participants included 12 boys between the ages of 6 to 12 years with a diagnosis of SPD as measured by the SSP (and without other co-existing conditions) and 12 typically developing age-matched, gender-matched peers. All children participants attended regular education programming and performed academic skills at grade level. The sensory-processing abilities of both groups of children were assessed using the SSP. The CAPE was used to assess interests and preferences in activities that involved social participation. The researchers also used questionnaires that were specifically developed for this study to interview teachers and parents regarding the nature of activity participation and socialization of the children participants. A mixed method approach was used to determine outcomes through the use of multivariate ANOVA of between group scores from the CAPE and SSP and through the use of qualitative data analysis of

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 78

the questionnaires through the use of triangulation methods to evaluate adult perceptions of social participation of the children at home and at school. The results revealed that the typically developing children had more varied social networks and more often interacted with others outside their immediate family for social activities as compared to the children with SPD; however, the children with SPD expressed higher ratings for enjoyment in social activities. No differences between groups were found in intensity of engagement in activities or location of activity (e.g., indoors, outdoors); however, children with SPD preferred engagement in quieter activities, such as doing puzzles, playing board games, doing table-top craft activities or coloring, whereas the typically developing children rated these activities as least preferred. Although this study was limited in participant number, gender, and socioeconomic background, the outcome of this study suggested that sensory-processing preferences had an influence on preferences for the types of activities that involve socialization. In addition, the outcomes of this study suggested that sensory-processing behaviors and abilities could be used to identify activities that can promote enjoyment, participation, and skill development. In another study of sensory-processing abilities, behavior, and socialization, BenSasson, Carter, and Briggs-Gowan (2009) investigated the relationships between sensory over-responsiveness toward auditory and tactile sensory experiences and social-emotional abilities in their study of 925 elementary school children between the ages of 7 to 11 years. Children with disabilities were excluded in this study. The Sensory OverResponsivity Scales (SenOR) were used to assess tactile and auditory processing behaviors; the CBCL was used to assess social-emotional behaviors and issues; and the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 79 Adaptive Social Behavior Ratings (ASBR) were used to assess social behaviors. Of the children participants in the study, 148 children demonstrated sensory sensitivity toward both auditory and tactile sensory experiences. These participants were the focus of further data analysis in this study. Through the use of ANCOVA, while controlling for socioeconomic groups, children who demonstrated greater sensory sensitivity toward tactile and auditory sensory experiences also demonstrated decreased ASBR scores and higher scores for behavioral issues as measures by the CBCL. The analysis revealed statistically low significance in the relationships between the presence of over-sensitive behavior toward tactile and auditory sensory experiences and social-emotional issues and competence. The authors suggested that sensory-processing issues might have had an influence on behavioral self-regulation for the children who demonstrated more sensitivity toward auditory and tactile sensory experiences. Therefore, in order to ensure success and emotional support for the overly sensitive child, the sensory features of the context might need to be considered during situations that have greater social demands. Support for the influences of sensory-processing behavior patterns on activity engagement and social participation has been illustrated by the previous series of studies. Behavioral self-regulation is also a critical component in activity engagement and social participation. The ability to adequately interpret the meaning of sensory experiences and respond appropriately through behavioral self-regulation may influence an individual's ability to engage and participate in daily activities and social interactions. Neuroscience research on temperament and sensory-processing suggests that the level of emotional reactivity toward sensory experiences is an important feature of an individual's ability to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 80 modulate and self-regulate behavior (Dunn, 2007; Evans & Rothbart, 2009; Henderson & Wachs, 2007). Emotional and behavioral reactivity and self-regulation are components of temperament (Berger, Kaufman, Livneh, & Henik, 2007; Rothbart, 2004). Emotional and behavioral reactivity is comprised of emotional and attentional intensity and reaction speed that involves positive and negative emotional reactions regarding experiences within a context (Berger et al., 2007; Henderson & Wachs, 2007; Rothbart, 2004). All contextual experiences involve some form of sensory experience. Since behavioral selfregulation involves an individual's ability to attend to, orient, and select stimuli from the contextual experience in order to respond appropriately to the contextual demands (Bates, Goodnight, Fite, & Staples, 2009; Berger et al. 2007; Eisenberg & Morris, 2002; Rothbart, 2004), it stands to reason that the ability to engage in social interactions and daily activities involves the ability to understand, process, regulate, and appropriately respond to sensory experiences. The next section explores the role of neurophysiology in the expression of sensory-processing behaviors and temperament. Neurophysiological Components of Sensory-Processing Behaviors and Temperament Researchers in the fields of neuroscience and behavior have sought to understand the central nervous system (CNS) structures and neurological processes involved in temperament and in sensory-processing. The neuroscience research in temperament has focused on CNS reactions toward stimuli, but in relation to behavioral self-regulation (Berger et al., 2007; Chajut & Algom, 2003; Rothbart, 2004). The neuroscience research

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 81

in sensory processing has focused on the CNS mechanisms of responsiveness toward sensory stimuli in individuals with known sensory-processing issues or conditions, such as attention-deficit-hyperactivity disorder (ADHD) or sensory-processing disorder (SPD) (Davies & Gavin, 2007; Dunn, 2007). Research regarding the maturation of infant brain and its relationship to social-emotional development and parent-child interactions suggested that the primary sensory cortices mature first and assist the infant in processing and filtering sensory cues (Parsons, Young, Murray, Stein, & Kringlebach, 2010). Both tracks of research appear to be investigating parallel constructs and offer insights in how the constructs of temperament and sensory-processing interrelate. Neuroscience researchers of temperament have been using neuro-imaging techniques and measures of emotional reactivity to identify how CNS structures and systems are involved in temperament inhibitory behavior, self-regulation, and emotional expression. CNS processing through selective attention has been found to be a critical feature in self-regulation and management of emotions (Baumeister & Vohs, 2004; Chajut & Algom, 2003; Rothbart, 2004). However, an individual's selective attention during social or task engagement is dependent upon the interplay between temperament and the sensory characteristics and demands of the context (Chajut & Algom, 2003). Evidence suggests that the amygdala and its connections to the frontal cortex, brainstem, and hypothalamus help to regulate responses to fear and anxiety, the anterior cingulated cortex (a region within the prefrontal cortex) and its links with the limbic system have been found to be involved in cognitive control and motivation for approach/withdrawal and self-regulatory behavior, and executive function is involved in effortful control (Fox

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 82

et al., 2005; Henderson & Wachs, 2007; Lewis & Stieben, 2004; Posner, Rothbart, Sheese, & Tang, 2007). To understand more about the relationships between CNS functions and temperament, neuroscience researchers have focused on neurological differences between individuals who demonstrate specific temperament characteristics (e.g., shyness, negative or positive affect, and effortful control) and their ability to use selective attention in task performance. In a line of research by Perez-Edgar and Fox (2005, 2007), the interplay between features of temperament and CNS responses to contextual demands was examined in association with task performance in order to understand the role of temperament and the process of selective attention. In two separate experimental studies, Perez-Edgar and Fox (2005, 2007) sought to understand relationships between CNS attentional processing and temperament by exploring selective attention, cognitive processing, emotions, and task performance in healthy 7-year-old children. In the 2005 study, Perez-Edgar and Fox selected the temperament characteristic of shyness as the moderating variable to evaluate the differences in task performance and selective attention within a stressful context. In the 2007 study, Perez-Edgar and Fox selected the temperament characteristics of attentional control and soothability as the moderating variables to evaluate the differences in CNS processing and affective responses in an auditory selective attention task. Both studies involved the collection of CNS physiological data through EEG signals, event-related potential (ERP), and reaction time (RT) based on EEG wave amplitudes. The Colorado

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 83

Child Temperament Inventory (CCTI) was used in both studies to evaluate the variables for temperament. Perez-Edgar and Fox (2005) hypothesized that shy children would have greater difficulty in task performance, as measured by increased errors and reaction times (RT), and would attend more to negative cues during task performance in a stressful context. Participants included 61 healthy 7-year-old children (32 boys, 29 girls), without psychological disorders. Participants were assigned into groups through a median split of the shyness scores following assessment using the CCTI. The "low shyness" group included 29 children and the "high shyness" group included 31 children. To evaluate differences in selective attention and task performance, the children participated in a 50item, neutral Posner task (box color identification through visual to verbal responses), and in a 50-item, affective Posner task where participants identified colors of boxes, but were told that they would be giving an embarrassing speech if they demonstrated too many errors. To further increase stress during the affective Posner task, participants were shown plus or minus signs to indicate correct scores and number of errors. Through the use of repeated-measures ANOVA, and the Greenhouse-Geisser procedure to minimize Type-I error, the results of the Perez -Edgar and Fox (2005) study found no physiological differences between groups on the neutral Posner task. However, for the affective Posner task, shy children demonstrated an increase in EEG activity with larger ERP and an increase in errors with slower RT. Although children in both groups responded similarly to the neutral Posner task, differences in attention to positive and negative cues (e.g., the minus and plus signs) occurred during the affective Posner task

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 84

when a stress was added to the context. Children identified as shy had a tendency to attend to negative (e.g., the minus signs) cues, indicating that individual differences in temperament and increased contextual demands could influence selective attention and, consequently, task performance. Perez -Edgar and Fox (2005) suggested that, although children in both groups responded in a similar fashion to a neutral task, differences in attention to positive and negative cues occurred when a stress component was introduced to task performance. Children identified as shy in the study had a tendency to attend to negative cues that impacted their ERP, RT, and error rates; therefore individual differences in temperament and contextual demands could potentially influence task performance. The outcome of the Perez-Edgar and Fox (2005) study supported the notion of person-context goodness-of-fit. Of note, because participants in the Perez-Edgar and Fox (2005) were assigned into low shy and high shy groups through a median split of scores on the CCTI, issues with internal validity secondary to a selection-instrumentation interaction may have impacted the analysis. In addition, the use of stress might have induced an emotional response based on fear. Thus, the fear response might have become a confounding variable and influenced the ability to focus attention on the task. Several questions regarding the outcomes of this study exist. For instance, descriptive information about the qualities or personality characteristics of shy individuals may provide more information about what characteristics may have influenced interactive styles and task performance. Also, information about the methods that participants used to complete the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 85 tasks would provide insight regarding the use of sensory cues or cognitive-perceptual abilities as strategies to support success in task completion. To understand more about the influences of behavioral reactivity, Perez-Edgar and Fox (2007) focused on exploring the relationships between cognitive processing (i.e., selective attention) and affective processing (i.e., emotional reactions) through examination of CNS processing in children with behavioral reactivity as defined by the temperament characteristics of attentional control and soothability. Perez-Edgar and Fox hypothesized that children with issues with attentional control and soothability would show issues with emotional and cognitive control on neurological measures during an auditory selective attention task. Participants included 65 healthy children (7 years of age), without psychological conditions. Again, a median split based on outcomes from the CCTI, was utilized to group participants into temperament categories for attention control and for soothability. Participants were assigned to a "low attention-control" group (n = 34) or a "high attention-control" group {n~ 27), and a "low soothability" group (n = 29) or a "high soothability" (n = 32) group. The Child Behavior Checklist (CBCL) was used to assess the presence of behavioral issues (i.e., anxiety/depression, aggressiveness, social interaction issues, and attention problems). Correlation analysis of the CCTI and the CBCL revealed that children with better attentional control and soothability demonstrated more adaptive, appropriate social behaviors on the CBCL than children with lower abilities in self-regulation and increased emotional reactivity. Through analysis of EEG outcomes by the use of/-tests and AN OVA, PerezEdgar and Fox (2007) examined whether children who demonstrated more emotionality

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 86

(low soothability) and less self-regulation (low attention) would demonstrate slower RT, higher ERP amplitudes for an auditory stimulus of socially negative words. Reaction time was recorded as participants verbally responded to a series of 60, recorded, randomly presented words through headphones. Words were categorized into groups as nonsocial positive, nonsocial negative, social positive, social negative, and neutral words. Using paired sample Mests, results indicated that all the participants responded significantly slower (RT) to socially negative words, socially positive words, and nonsocial negative words as compared to the neutral words. Thus, CNS processing for selective attention became more focused and attention increased for social words and negative words. To further evaluate the CNS processing of affective words, a 2 (social) x 2 (emotion) ANOVA was used. Results of the Perez-Edgar and Fox (2007) indicated that negative words elicited slower RT than positive words and social words elicited slower RT than nonsocial words. To determine whether temperament impacted CNS processing, attentional control and soothability were added as factors i n a 2 x 2 x 2 x 2 ANOVA. Results revealed that participants in the low soothability group and participants in the low-attention group did not respond differently between word groups. However, children who scored high in soothability demonstrated significantly slower RT to social words as compared to nonsocial words and the participants in the high-attention group demonstrated significantly slower RT for the socially negative words. Therefore, children with better attentional control and soothability demonstrated better ability to selectively attend to auditory social and emotional words.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 87 These results indicated that cognitive processing differences exist in CNS selective attention of positive and negative social words where reactions to positive social words produced lower EEG wave amplitude than negative social words. Plus, emotional processing differences existed where reactions to negative social words produced higher EEG wave amplitude than positive social words. Because these differences appeared more frequently in the participants in the high attention-control and soothability groups, Perez-Edgar and Fox (2007) suggested that children with better self-regulatory control might have better neuro-physiological ability to cognitively process and prioritize sensory input for an adaptive/emotional response. Since stress and fear were eliminated as contextual factors in task performance, the outcomes in the Perez-Edgar and Fox (2007) study revealed how selective attention to sensory cues differed according to temperament characteristics and influenced socialemotional function. However, because the participants were 7 years of age, the possibility existed that limited semantic development for emotional language might have impacted the outcomes of the 2007 study. Again, the question exists regarding the use of sensory cues as strategies to support behavioral adaptation in these task situations. Research by Fox et al. (2005), Perez-Edgar and Fox (2005, 2007) have suggested that relationships existed between behavioral reactivity and task performance; however, the next study focused on the associations between temperament, responsiveness to specific sensory experiences, and task performance. Curtindale, Laurie-Rose, BennettMurphy, and Hull (2007) examined the relationships between temperament and performance of auditory and visual processing tasks in 48 children in 2nd-grade and 48

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 88

college students. The Carey Temperament Scales were used to measure temperament of the child participants and the Adult Temperament Questionnaire was used to measure temperament in the adult participants. Participants were asked to complete an auditory and visual task while sensory discrimination and attention were assessed through recordings of response time, attention, and correct responses. Through mixed ANOVA analysis, results revealed no relationships between temperament and task performance in adults; however, temperament behavioral reactivity in children did impact task performance, especially for the auditory tasks. Children who were more task-oriented and who had better auditory and/or visual perceptual sensitivity performed tasks better than children who were less task-oriented; however, results indicated that children who were less task-oriented but were also less reactive to sensory experiences performed better than children who less task-oriented and were highly reactive to the sensory experiences. The findings of the Curtindale et al. (2007) study implied a critical need for support for children who are highly reactive to sensory experiences in education and/or other settings. Curtindale et al. (2007) suggested that the absence of a relationship between temperament and task performance in adults may be due to the development of strategies that allowed the adults to modulate their temperament characteristics and facilitate successful task performance. Information about the sensory strategies used by the adults to modulate the visual and auditory sensory experiences and maintain their attention in order to successfully complete the tasks would have provided additional insight regarding the process of behavioral self-regulation and effortful control. By

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 89 understanding these sensory strategies, healthcare professionals and educators may be able to teach and create contexts that enhance or support learning and social development in children who are challenged by their behavioral reactivity and issues with selfregulation. Because behavioral reactivity, a component of self-regulation and temperament, refers to the intensity and speed of approach or avoidant behaviors in response to contextual demands that may involve sensory experiences, an individual's behavioral reactivity regarding sensory experiences may potentially influence social and task engagement. The following studies examined the relationships between sensoryprocessing, behavioral reactivity, and social or task engagement in children with known sensory-processing issues as compared to typically developing, age-matched children. The following early study by Mcintosh, Miller, Shyu, and Hagerman (1999) examined the nature of physiological responses in children identified as having behavioral issues related to extreme reactivity (i.e., hypo- or hyper-responsiveness) to sensory experiences. This article was referenced in more recent studies of sensoryprocessing behaviors and provided theoretical background information regarding sensory-processing behaviors. Nineteen children (mean age = 6.0 years) who were identified as having sensory-modulation behavioral issues and sensory-motor behavioral issues (SMD) at home or in school as determined by a research version of the Sensory Profile participated in this study (i.e., children with diagnosed medical conditions such as cerebral palsy, fetal alcohol syndrome, and autism were excluded). In addition, 19 healthy children who were matched by age and sex participated in the study as the control

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 90 group. All subjects participated in a Sensory Challenge Protocol that was designed to gauge responses to repeated sensory experiences that involved olfactory, auditory, visual, tactile, and from vestibular stimulation. Each type of sensory experience lasted 3 seconds and occurred 10 times. A 20-second separation between types of sensory experience was utilized. As the subjects experienced these stimuli, electrodermal responses (EDR) through amplitude tracings of skin-conductance responses were recorded through the use of electrodes placed on the right hand. During sensory-testing and recording of the EDR, examiners were blind to which group the subject was assigned. Through the use of ANOVA, results of the Mcintosh et al. (1999) study revealed that both groups demonstrated neurological habituation to the repeated sensory experiences as evidenced by decreased peak amplitudes in skin responses. However, statistically significant differences were found in response to stimuli where the children with SMD demonstrated larger magnitudes of response to stimuli and more responses to stimuli as compared to control group. However, statistically significant differences between groups were not found the children's rates of habituation to the sensory responses. From results of the Sensory Profile, children with SMD were further identified as having behaviors that were either hyper- or hypo-responsive to sensory experiences. Through the use of/-tests, the children who had lower scores on the Sensory Profile and demonstrated hyper-responsive behavior to sensory experiences also had proportionally higher magnitudes and numbers of EDR as compared to children who scored within the "typical behavior" category on the Sensory Profile. Although the study did not investigate functional behavioral outcomes of the participants, the results

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 91 suggested that children with SMD demonstrated physiological differences in responses to sensory stimuli and spurred further research in this area of study. Next, in a more recent, similarly designed study using the Sensory Challenge Protocol, Schaaf et al. (2003) used an experimental design to investigate differences in parasympathetic function through evaluation of cardiac vagal tone in 15 children identified with sensory-processing disorders (SPD) as determined by scores on the Short Sensory Profile (SSP) and six age-matched typically developing peers. The use of EKG was used to measure cardiac vagal tone, heart period (e.g., time intervals between peak heart waves), and heart rate reactivity while the participants experienced the Sensory Challenge Protocol. This Sensory Challenge Protocol included a series of 50 sensory experiences using olfactory, auditory, visual, tactile, and vestibular stimulation that occur in a random 12- to 17-second intervals over 15 minutes. Results, through the use of /-test analysis, revealed that children with SPD had statistically lower cardiac vagal tone and lower heart period, indicating that children with SPD had less effective parasympathetic functioning than typically developing children. The researchers speculated that less effective parasympathetic functioning in the participants with SPD might influence the ability to self-regulate behavior. No significant differences were found in heart rate between groups; however heart rate and heart function can be influenced by other factors, such as fitness level. To further study relationships between sensory-processing and neurological responses, Davies and Gavin (2007) utilized a descriptive research design using EEG measures to evaluate whether brain processing of auditory stimuli in children with

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 92 sensory-processing disorders (SPD) was different as compared to typically developing peers. Participants included 28 children with SPD as determined by scores on the SSP. The SPD group of children, who ranged in age from 5 to 12 years (Mage = 7.71 years, SD = 1.80), also had diagnoses of attention-deficit hyperactivity disorder (ADHD) or learning disability. Participants also included an age-matched control group of 28 typically developing peers (Mage = 8.34 years, SD = 1.88). Neural responses to auditory stimuli, through a series of auditory clicking sounds, were evaluated through the use of EEG and event-related potentials (ERP). EEG and ERP wave amplitude measurements between the two groups were analyzed through independent /-test and 2 x 2 mixed ANOVA. Although not at statistically significant levels, the children with SPD demonstrated a lower level of sensory inhibition and a longer reactivity (ERP) to the auditory stimuli as compared to the typically developing peers. This result implied that children with SPD tended to alert and attend to irrelevant auditory stimuli for longer time periods, whereas typically developing peers were able to habituate to irrelevant stimuli faster and better able, from a neurological standpoint, to direct attention to meaningful stimuli within the context. Davies and Gavin (2007) also found a statistically significant correlation between sensory inhibition and age in the typically developing peers, where the ability to inhibit to auditory stimuli improved with age. For children with SPD, this relationship was not found, indicating that the ability to develop sensory inhibition for irrelevant auditory stimuli does not improve with age and maturity in children with SPD. This study revealed that children with SPD responded differently to sensory input on a neural level,

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 93

and might have issues in developing the ability to inhibit sensory input in order to selectively attend as compared to typically developing peers. This finding was interesting in light of the outcomes of the study by Curtindale et al. (2007), where results indicated that the temperament characteristic and ability to modulate and self-regulate visual and auditory sensory experiences influenced task performance. The outcomes of the Davies and Gavin (2007) study provided an interesting comparison to the outcomes of the Perez-Edgar and Fox (2007) study. Both studies involved children of comparable ages as participants and utilized EEG measures to evaluate responses to auditory stimuli; however the demands of the auditory tasks were different. The Perez-Edgar and Fox (2007) study required participants to listen to, analyze and respond to neutral or affective words, thereby assessing the use of selective attention in children with high or low abilities for attention control and soothability. The Davis and Gavin (2007) study required participants to listen to and process random, irrelevant sounds, thereby assessing the ability inhibit selective attention in children with or without sensory-processing issues. The outcomes of both studies indicated that children who had issues with attention control, low soothability (or being unable to selfcalm), or increased sensory reactivity demonstrated differences in the way their CNS processes sensory input. These outcomes indicated a potential interrelationship between features of temperament and sensory-processing behavior patterns. Further analysis of the relationships between behavioral reactivity in temperament and sensory-processing may assist in understanding activity engagement styles and performance issues in children with sensory-processing issues. The results from the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 94 studies by Davies and Gavin (2007), Schaaf et al. (2003), and Mcintosh et al. (1999) indicated that children with SPD responded differently to sensory input on a neural and physiological level as compared to typically developing children. Since children with SPD are often identified as being overly active, emotionally reactive, and having a negative affect (all characteristics of temperament), one may reason that the neurological components that influence behavioral responses to sensory input may also be related to behavioral characteristics of temperament. Neuroscience research on temperament and sensory-processing has suggested that the level of emotional reactivity toward sensory experiences might be an important feature of an individual's ability to modulate and self-regulate behavior; thus indicating a possible neural link between temperament and sensory-processing behaviors. In addition, parenting style and sensitivity has been shown to influence behavioral responses, and may even impact neural mechanisms for negative emotionality and stress (Olson & Sameroff, 2009; Parsons et al., 2010). Researchers have suggested that those children who have issues with attention control to sensory input may have a greater challenge in the development of functional adaptive emotional self-regulation abilities (Fox et al., 2005; Greenspan, 2007; Henderson & Wachs, 2007). These ideas imply that goodnessof-fit and environmental supports are critical in the development of adaptive socialemotional skills. A discussion regarding the importance of understanding the relationships between temperament and sensory-processing to enhance goodness-of-fit is presented next.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 95 Links Between Temperament and Sensory-Processing Behavior Patterns Some areas of research have begun to explore the relationships between temperament characteristics and sensory-processing behavior patterns. Thomasgard (2003) reviewed temperament research and sensory-processing research and surmised that both constructs are complementary in their descriptions of children's behavior in unfamiliar situations. Thomasgard (2003) suggested that a child's temperament responses of activity levels, negative or positive affect, approach or withdrawal behavior to novel situations might be related to the child's responses toward the sensory experiences within the situation. For example, a child who is highly motivated by sensory experiences and seeks more sensory experiences may be perceived as having a temperament that is hyperactive, and impulsive in approach behaviors toward a novel situation. Conversely, a child who is easily overwhelmed by sensory experiences and needs to slowly appraise the sensory experiences before engaging in a novel situation may be perceived as having a temperament that is more inhibited, shy, less active, and withdrawn. Therefore, it is critical to understand the nature of sensory experiences within a context, understand how an individual reacts or responds to those experiences in order to understand and interpret the individual's temperament. Burns-Daniels (2003) explored the relationships between descriptions of sensoryprocessing patterns as defined by Dunn and temperament patterns as defined by Rothbart in her dissertation study involving 159 typically developing young children between 18 and 36 months. Constructs for sensory-processing patterns based on the four quadrant descriptions (e.g., sensory sensitivity, sensory avoiding, sensory seeking, low sensory

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 96 registration) and constructs for temperament (e.g., extraversion/surgency, negative affectivity, orienting/regulation) were used as variables in the Burns-Daniels (2003) study. Two standardized parent-report measures were used to obtain data about sensoryprocessing patterns and temperament: Infant/Toddler Sensory Profile and the Early Childhood Behavior Questionnaire. Moderately significant relationships were found between sensory seeking behaviors and activity levels, and between sensory sensitivity or sensory avoidance and negative mood. However, none of the sensory-processing patterns were found to be associated with orienting and self-regulatory behaviors. Burns-Daniels (2003) suggested that the lack of associations between self-regulatory behaviors and sensory-processing might imply that these constructs are unrelated and define different aspects of behavior. However, the assessment tool, Infant/Toddler Sensory Profile uses general categories of sensory-processing behaviors and does not evaluate subscales of sensory-processing behaviors like the Sensory Profile questionnaire, since this tool is designed for children 3 to 10 years of age. Therefore, the Infant/Toddler Sensory Profile might not have been sensitive enough to find relationships between the constructs involving self-regulatory behaviors. In addition, the ability to demonstrate effortful control and behavioral self-regulation emerges around 24 months of age and abilities increase with age (Rothbart & Bates, 2006); therefore the participants in this study might not have been developmentally mature enough to demonstrate measureable relationships between sensory-processing behaviors and self-regulatory behaviors. To further assess the links between sensory behaviors and temperament, Liss, Timmel, Baxley, and Killingsworth (2005) examined the relationships between sensory

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 97

sensitivity as a component of temperament, anxiety and depression, and contextual factors of parenting style in their descriptive study of 213 undergraduate psychology students. Assessments of variables for sensory sensitivity, parenting styles, depression, and anxiety were the Highly Sensitive Person Scale (HSPS), the Parental Bonding Instrument (PBI), the Beck Depression Inventory (BDI), and the State Trait Anxiety Inventory (STAI-2), respectively. Correlation statistics and multiple regression analyses were used to examine the interactions between variables. In the Liss et al. (2005) study, moderately significant associations were found between reports of sensory sensitivity and reports of anxiety. Moderately significant associations were found between reports of depression, anxiety and low levels of parent responsiveness, and between depression and anxiety with higher levels of parent overprotection. Multiple regression analysis revealed that increased sensory sensitivity and depression predicted anxiety and accounted for 66% of the variance. Also, low parent responsiveness and increased sensory sensitivity predicted depression and accounted for 64% of the variance. Parent responsiveness and overprotection were not found to be significant predictors of depression or anxiety. Therefore, results of the Liss et al. (2005) study indicated that individuals with behavioral reactivity trait of sensory sensitivity and who also experienced low levels of parent responsiveness had a tendency to experience depression or anxiety. This outcome implied that context might have an influence on the interaction between behavioral reactivity traits and psychosocial function, a concept that was explored and established in other studies (Berger et al. 2007; Szabo et al., 2008).

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 98 Outcomes from the Liss et al. (2005) study suggested that individuals with behavioral sensory sensitivity who experienced an unsupportive and unresponsive social context might be at risk for psychosocial issues. Because, parenting over-protectiveness and sensory sensitivity were not found to predict depression or anxiety, perhaps overprotective parents tended to shield their over-sensitive children in situations of stress. This idea might suggest that parents who are more aware of their child's behavioral styles might be able to provide the support that allows for the development of behavioral selfregulation. Although this study was limited by the use of a convenience sample and selfreported recall of perception of parenting styles, the outcomes implied that a goodnessof-fit between the behavioral abilities of the child and the responsiveness of the parent might be mediating factors for psychosocial function. Previous research that was presented in this literature review suggested links between behavioral self-regulation of temperament, reactivity to sensory experiences, and context that supported concepts related to goodness-of-fit. For example, Dixon et al. (2006) found that toddlers with higher abilities for attentional focus were less affected by auditory and visual distractions and were to self-regulate their behavior during learning activities as compared to toddlers with less ability for attentional focus. Although these authors were researching the role of temperament in learning, the ability to self-regulate reactivity toward sensory experiences was a feature in the outcomes and implied that sensory attributes of a context and goodness-of-fit between the context and the child's level of sensory reactivity might determine how a child may learn. Ben-Sasson et al. (2009) further reinforced the importance of goodness-of-fit between the sensory attributes

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 99 of the context and the child's level of sensory reactivity and ability for behavioral selfregulation. Ben-Sasson et al. (2009) explored the relationships between sensory overresponsiveness toward tactile and auditory input and the ability to participate in social tasks. The outcomes of this study revealed that school-age children that were overly sensitive and bothered by tactile and auditory experiences also demonstrated reduced abilities for adaptive social skills and increased occurrence of social-emotional issues during social interactions. The authors of this study suggested that early identification of overly sensitive behavior toward sensory experiences might assist in the development of contextual supports (e.g., goodness-of-fit) and help to mediate potential issues in socialemotional abilities. Summary The transactional model of child development suggests that the bi-directional influences of child and parent interactions impacts developmental outcomes (Sameroff, 2009). Future social development and activity engagement of young children is dependent upon the interactions between their temperament, their emotional reactivity, their ability to regulate behavior in response to demands within a context, and their caregivers' parenting styles/behaviors (Greenspan, 2007; NICHD, 2004; Olson & Sameroff, 2009). Characteristics of temperament that involve behavioral self-regulation and effortful control can influence the process of social interaction and activity engagement (Henderson & Wachs, 2007; Rothbart & Bates, 2006). Researchers of child temperament have found that temperament characteristics of negative reactivity and poor self-

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 100 regulation of behavior can potentially evolve into issues with social interaction (Janson & Mathiesen, 2008; Lengua & Kovacs, 2005; NICHD, 2004; Sameroff, 2009), and increased risk for peer rejection and behavioral issues in children (Eisenberg et al., 2000; Eisenberg et al., 2006; Spinrad et al., 2004). Other studies have indicated that children with negative reactivity, shyness, and/or and poor self-regulation are at risk for issues in attention that can influence relationships with teachers and affect the ability to adapt to classroom demands (Eisenberg et al., 2000; Rudasill & Rimm-Kaufman, 2009; Spinrad et al., 2004). Effortful control was found to be a critical feature in being able to learn and develop adaptive behavior in distracting or challenging contexts (Dixon et al., 2006; Lengua et al., 2008). Also, behavioral self-regulation as part of effortful control can be an essential feature in social competence and academic performance (Buckner et al., 2009). Conversely, parenting styles and parental attitudes can have an influence on children's temperament and behavior where parents' perceptions of positive or negative affect of their children predicted positive emotionality or negative emotionality (Kockanska et al., 2005; Pauli-Pott et al., 2003). Parents who reported low selfconfidence and negative feelings rated their children as having negative emotionality (Pizur-Barnekow, 2006). In addition, negative child temperament was associated with decreased feelings of parent efficacy (NICHD, 2004; Porter & Hsu, 2003). Longitudinal studies have shown that caregiver depression/anxiety increased the incidence of negative emotionality, withdrawal behavior, and irritable temperament in their children (Bridgett et al., 2009; Edhborg et al., 2002; McGrath et al., 2008; Pauli-Pott et al, 2004). Thus,

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 101 due to the bi-directional nature of parent-child interaction, the influence of child temperament, parent behavioral styles, and responsiveness can impact social relationships within a family. Sensory-processing behavior patterns also have the potential to influence activity preferences and social interaction (Dunn, 1997a, 2001, 2007). Issues with sensoryprocessing behaviors (e.g. under- or over-reactive to sensory experiences) may facilitate the development of maladaptive behaviors that can impact the quality of activity engagement and social interaction. Research has found that sensory under- or overresponsiveness can influence play behaviors (Bundy et al., 2007; Lawson & Dunn, 2008), classroom behavior (Ashburner et al., 2008), performance of motor activities and activities of daily living (White et al., 2007), and social-emotional behavior (Ben-Sasson et al., 2009). However, goodness-of-fit between parenting behavior and style and the demands/expectations of interactions within a context has the potential to mediate behavior in children and promote adaptive behavior (Crockenberg & Leerkes, 2006; Dennis, 2006; Jaffe, 2007; Kochanska et al., 2005; Lengua et al, 2008). For example, research has demonstrated that increased withdrawal behavior, poor attention, increased negative reactivity toward unfamiliar situations during infancy predicted an increase of anxious behavior as toddlers when mothers were less responsive toward their children; whereas, infants, who had poor self-regulatory behavior, poor attention and were more withdrawn and who had mothers who were more responsive and engaging, demonstrated less anxiety toward unfamiliar situations (Crockenberg & Leerkes, 2006). Young

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 102 children who demonstrated more negative emotionality as infants who had responsive parents demonstrated more cooperative behavior as toddlers (Kochanska et al., 2005). Parenting style that provided structure was found to mediate negative emotionality and problematic behavior in preschool children (Bridgett et al., 2009; Dennis, 2006; Paulussen-Hoogeboom, et al., 2008; Szabo et al., 2008). Therefore, the ability to recognize factors that support adaptive behavior and develop strategies that facilitate goodness-of-fit and positive interactions is critical. Neuroscience research has demonstrated that CNS reactivity toward sensory experiences could influence behavioral self-regulation, temperament characteristics, and task performance (Berger et al., 2007; Curtindale et al., 2007; Lewis & Stieben, 2004; Perez-Edgar & Fox, 2007; Posner et al., 2007). In addition, neuroscience research with children with sensory-processing disorders has demonstrated differences in physiological responses and CNS reactivity toward sensory experiences that influence behavioral selfregulation (Davies & Gavin, 2007; Mcintosh et al., 1999; Schaaf et al., 2003). Neuroscience research on temperament and sensory-processing has suggested that the level of emotional reactivity toward sensory experiences was an important feature of an individual's ability to modulate and self-regulate behavior; thus indicating a possible neural link between temperament and sensory-processing behaviors. Research that explores the relationships between temperament characteristics and sensory-processing behavior patterns has the potential to increase understanding of child behavior. Understanding the links between temperament and sensory-processing behavior patterns may offer the opportunity to use sensory strategies to help mediate

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 103 problematic behaviors that arise from poor attention and ineffective self-regulatory temperament characteristics. Strategies that promote goodness-of-fit and facilitate contexts that support adaptive behavior may help to promote positive social relationships and enhance activity engagement. The next chapter of this study describes the methodology used to examine the relationships between characteristics of temperament and sensory-processing behavior patterns of caregiver and child dyads.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 104

Chapter 3: Research Method Introduction Research regarding the relationships between temperament and behavior style indicates that temperament traits can potentially influence the quality of interpersonal interactions, social development, and engagement in activity within particular contexts (Caspi et al., 2005; Paulussen-Hoogeboom et al., 2008; Rothbart & Bates, 2006; Sanson et al. 2004). Behavioral self-regulation and reactivity are considered to be influential components of temperament that influences the expression of temperament and describes the quality of an individual's behavioral style toward contextual experiences (Henderson & Wachs, 2007; Olson & Sameroff, 2009; Rothbart, 2004). Some of the characteristics of behavioral reactivity are influenced by the individual's responsiveness to sensory experiences within a context. Sensory-processing behavior patterns involve the ability of the CNS to receive, organize, and understand contextual sensory experiences that help individuals respond and regulate behavior (Dunn, 2001, 2007; University of Kansas Medical Center, n.d.). Like temperament, an individual's behavioral responses to sensory experiences, as part of daily activities, can influence social interaction, cognitive, and motor performance (Dunn, 1997a, 2001, 2007). Research studies regarding sensory-processing patterns have indicated that behavioral responses to sensory experiences influenced play preferences, attention, and social interaction (Bundy et al., 2007; Ben-Sasson et al., 2009; Cosby et al., 2010; Lawson & Dunn, 2008). Therefore, both constructs that describe temperament and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 105 sensory-processing behavior patterns have the potential to explain the nature and process of behavioral interactions within social and environmental contexts. Both sensory-processing behavior patterns and temperament styles describe qualities in human beings that illustrate the manner of engagement in activities and social interaction. Thus, the possibility exists that descriptive characteristics of temperament and descriptive features of sensory-processing behaviors are interrelated. The ability to successfully adjust to challenges and stress within one's environment or during interpersonal relationships often involves the goodness-of-fit between an individual's temperament and the expectations of the context or interpersonal interactions (Greenspan, 2007; Olson & Sameroff, 2009). In her research regarding sensory-processing and behavioral responses, Dunn (2001, 2007) also emphasized the importance of goodnessof-fit between an individual's sensory-processing patterns, sensory experiences, and the demands of the context. Appropriate goodness-of-fit between the expectations of the context and an individual's capabilities and style of behavior has the potential to positively influence emotional development; whereas, a poor fit between the context and the individual's behavioral style/capabilities may potentially lead to issues in functioning (Greenspan, 2007; Olson & Sameroff, 2009). An individual's temperament style and sensory-processing behavior patterns may either facilitate or inhibit activity engagement and social interaction, depending on the demands of the context. Thus, the ability to recognize the features or demands of a context and be able to successfully adapt and manage the social experience or task is critical for optimal engagement. Increased knowledge regarding the interrelationships

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 106

between the constructs of temperament and sensory-processing behavior patterns may assist healthcare clinicians in the development of intervention strategies that promote goodness-of-fit in interpersonal and contextual interactions. The purpose of this study was to examine the extent to which relationships existed between the descriptive characteristics of temperament and descriptive features of sensory-processing behaviors in parent-child dyads. Two research questions and their corresponding null hypotheses (H0) and alternative hypotheses (Ha) were formulated. The first research question (RQ1) was: RQ1: To what degree is there a relationship between sensory-processing behavior patterns and characteristics of temperament in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized? Hlo: There are no statistically significant relationships between sensoryprocessing behavior patterns and the temperament characteristics in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized. Hl a : There are statistically positive relationships between sensoryprocessing behavior patterns and characteristics of temperament in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized. The second research question (RQ2) was:

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 107 RQ2: To what degree is there a relationship between sensory-processing behavior patterns in children between the ages of 3 to 7years-l 1 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized? H2o: There are no statistically significant relationships between sensoryprocessing behaviors of children between the ages of 3 to 7 years-11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized. H2a: There is a statistically significant positive relationship between sensory-processing behaviors of children between the ages of 3 to 7 years11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized. Research Methods and Design The research method for this study involved a non-experimental, descriptive correlation design that included the use of correlation and multiple linear regression statistics and two-way contingency table analysis using the McNemar test with crosstabs as methods of analysis. This kind of descriptive research can be useful for identifying how two or more variables may interact, can assist in supporting a theoretical hypothesis, or may assist in predicting outcomes (Portney & Watkins, 2008). The purpose of this study was to examine the nature of relationships between defined characteristics of temperament and descriptions of sensory-processing behavior patterns. Therefore, the use of correlation statistics illustrated the extent to which the variables that described

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 108 temperament were related to the variables that described sensory-processing behavior patterns. The use of multiple linear regression statistics revealed whether specific features of sensory-processing behavior patterns predicted specific characteristics of temperament. The use of a two-way contingency table analysis using the McNemar test with crosstabs allowed for analysis of relationship trends for sensory-processing behavior patterns in the parent-child dyads to determine whether sensory thresholds and sensoryprocessing behavioral styles of parent-child dyads were interrelated. Understanding the relationships between these constructs could potentially be useful in clinical practice to support goodness-of-fit in contextual and social interactions. The three main variables for temperament characteristics were entitled: negative affectivity, extraversion/surgency, and effortful control. These terms were derived from the factor analysis work of Rothbart et al. (2001) and included subcategories of temperament characteristics that clustered together to form the three main variables for temperament. The four main variables for sensory-processing behavior patterns were entitled: low sensory registration, sensory sensitivity, sensory avoidance, and sensory seeking. These terms were derived from the factor analysis work of Dunn (1997a, 1999) and were comprised of subcategories of sensory-processing abilities. Standardized parent-report questionnaires that were designed to measure the variables for temperament characteristics and sensory-processing behavior patterns included the Sensory Profile (SP) (Dunn, 1999) (Appendix A), the Adolescent/Adult Sensory Profile (AASP) (Brown and Dunn, 2002) (Appendix B), and the Children's Behavior Questionnaire (CBQ) (Rothbart et al., 2001) (Appendix C). In addition to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 109 evaluating the extent to which individuals presented the main variables for temperament and sensory-processing behavior patterns, these assessment tools included subscales that further described the nature of sensory-processing behaviors and temperament. The SP questionnaire included 14 subscales and the CBQ included 15 subscales. In addition to the use of standardized questionnaires, a demographic questionnaire (Appendix D) was used to gather descriptive characteristics of the participant sample. The demographic questionnaire provided information about parent and child ages, gender, socioeconomic and education status, and self-report of health status. Two research assistants (a certified speech pathologist and a licensed physical therapist trained in the use of the SP, AASP, and the CBQ) scored the standardized questionnaires. The primary investigator compiled the scored data from the questionnaires for analysis. Participants Participants in this study consisted of parent-child dyads that included children between the ages of 3 to 7 years-11 months. To minimize possible confounding variables related to medical conditions, criteria for inclusion in this study were: adults, 19 years or older without a diagnosis of mental health conditions or un-correctable sensory-neural hearing loss or visual impairment and who do not take medications that may impact the responses on the questionnaires, and who were the primary caregiver of a child between 3 to 7 years-11 months of age, who had no history of a diagnosed condition, un-correctable sensory-neural hearing loss or visual impairment, or medical condition that would require the regular use of medications that may influence behavior. Convenience sampling was used to recruit for volunteers to participate in this study.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 110 Recruitment for participants occurred through the use of information flyers and informational presentations to parents in preschools, day care centers, universities, and elementary schools within the greater Phoenix, Arizona, metropolitan area. Individuals who met the inclusion criteria and were interested in participating in the study received a packet that included a cover letter (Appendix E), consent forms (Appendix F), coded self-report questionnaires about temperament (CBQ) and sensory-processing behaviors (SP and AASP), coded optional address card (Appendix G), and a stamped return envelope addressed to the researcher. An incentive for study participation was available. By completing the optional address card, interested participants could receive a $5.00 gift card and/or a summary of the study's outcomes after a completed packet was returned to the researcher. The use of a financial incentive is permitted if it is not considered coercive (Hicks, 2008). To establish appropriate power and to determine a minimal sample size for this study, power and sample size tables for correlation coefficient r from Portney and Watkins (2008) were utilized. In addition, other research studies with similar research designs and variables were reviewed to identify a possible effect size. For example, research by Yochman et al. (2004) describing the relationships between the hyperactive behavior and sensory-processing patterns using scores from the Preschool Behavior Questionnaire and the subsection scores on the Sensory Profile reported statistically significant correlations in 10 out of the 14 Sensory Profile subsections. This research involved 48 children with attention-deficit disorder and a control group of 46 typically developing children. In addition, a research investigation of sensory-processing patterns and temperament styles in 158 typically developing infants using the Infant/Toddler

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 111 Sensory Profile and the Early Childhood Behavior Questionnaire yielded a moderate relationship between sensory seeking behaviors and activity levels, and between sensory sensitivity/sensory avoiding behaviors and negative mood (Burns-Daniels, 2003). According to Portney and Watkins (2008), for a power of .80, with alpha (for a two-tailed test) at .05, for a moderate correlation coefficient r = .50, the minimal number of participants required for this study was 28 parent-child dyads. A total of 94 packets were sent to potential participants, and 61 packets were returned. At the conclusion of data collection, the total number of packets acceptable for data analysis included 59 parentchild dyads. Materials/Instruments Sensory Profile. The Sensory Profile (SP) (Dunn, 1999) is designed to identify sensory-based behaviors and sensory-processing behavior patterns that may be contributing to or impacting a child's functional performance in everyday activities. The SP (Appendix A) is a caregiver-report questionnaire with 125 items about sensory-based behaviors and is standardized for use with children between the ages of 3 to 10 years. Copyright regulations prevent the inclusion of actual test items without permission of the publisher; unfortunately, permission to include samples of test items in this document was not granted by the publisher (Appendix H). However, publisher contact information and samples from a pilot version of the Sensory Profile are presented in appendix A. Items for the SP are grouped into three main sections: sensory-processing behaviors, modulation behaviors, and behavior and emotional responses to sensory input. The sensory-processing section includes six subscales related to the child's responses to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 112 auditory, visual, vestibular, touch, multi-sensory, and oral-sensory processing. The modulation section includes five subscales related to a child's ability to inhibit or alert to sensory stimuli and are entitled: sensory processing related to endurance/tone, modulation related to body position and movement, modulation of movement affecting activity level, modulation of sensory input affecting emotional responses, modulation of visual input affecting emotional responses and activity level (Dunn, 1999, p. 15). The behavioral and emotional responses section includes three subscales that describe a child's behavioral outcomes to sensory input and are entitled: emotional/social responses, behavioral outcomes of sensory processing, and items related to threshold for response (Dunn, 1999, p. 15). In 2006, Dunn published the Sensory Profile Supplement manual that includes scoring of the items to reflect the four quadrant descriptions of behavioral responses to sensory stimuli entitled, low sensory registration, sensory sensitivity, sensory avoidance, and sensory seeking. The SP questionnaire can be administered as an interview with caregivers, or given to caregivers to read and complete on their own by using the questionnaire check sheet. The caregiver uses a Likert scale (e.g., Always, Frequently, Occasionally, Seldom, or Never) to report how frequently the child demonstrates the behaviors described in the specific question item. After completion of the questionnaire, the examiner assigns numerical values to the responses (Always = 1, Frequently - 2, Occasionally = 3, Seldom = 4, Never = 5) and calculates raw scores for each of the 14 subscales and the four quadrant descriptions. Raw scores are entered into a classification system that describes the child's sensory-processing abilities and behaviors as "typical performance,"

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 113

"probable difference," or "definite difference" as compared to the sensory-based behaviors of a normative sample of children. The typical performance classification refers to behavior that is similar to children in the normative sample and falls within +1.0 SD to -1.0 SD. Scores that fall within the probable difference behavior classification are between +1.0 to +2.0 SD, or -1.0 to -2.0 SD and refer to behaviors that occur slightly more or slightly less than children in the normative sample. Scores that fall within the definite difference behavior classification are above +2.0 SD or below -2.0 SD and refer to behaviors that occur much more or much less than children in the normative sample. Generally, lower raw scores indicate the likelihood of a probable difference or definite difference behavior classification. The Sensory Profile (Dunn, 1999) was standardized on 1,037 typically developing children (524 girls and 510 boys) between the ages of 3 to 10 years. There were eight age groupings at 1-year intervals starting with a 3.0 to 3.11-year age group and ending with a 10.0 to 10.11-year age group with roughly 120 children per age group. Demographics of the norm sample included information regarding geographic region (Northeast, North Central, South, and Western United States), race/ethnicity (Native American, Asian, African American, Hispanic, White), income ($10,000 or less to above $70,000), and community (rural, urban, suburban). Most of the participants in the standardization sample were from the North Central and Northeast United States and were white. Most of the participants in the standardization sample had family incomes between $11, 000 to $33,000, and lived in suburban areas.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 114

Reliability information reported in the Sensory Profile manual (Dunn, 1999) includes information about coefficient alpha and standard error of measurement for each of the 14 subscales. The Sensory Profile Supplement manual (Dunn, 2006) includes information about coefficient alpha and standard error of measurement for the four quadrant behavior descriptions. The coefficient alpha scores for each of the 14 subscales are as follows: auditory processing = .6585, visual processing = .7480, vestibular processing = .6959, touch processing = .8568, multi-sensory processing = .6389, oral sensory processing = .8450, sensory processing related to endurance/tone = .8378, modulation related to body position and movement = .7434, modulation of movement affecting activity level = .6621, modulation of sensory input affecting emotional responses = .5817, modulation of visual input affecting emotional responses and activity level = .6177, emotional/social responses = .8986, behavioral outcomes of sensory processing = .6386, and items related to threshold for response = .4717 (Dunn, 1999, p. 48). The coefficient alpha scores for the four quadrant behavior descriptions are as follows: low sensory registration = .7950, sensory seeking = .9012, sensory sensitivity = .8409, and sensory avoiding = .8717 (Dunn, 2006, p. 24). The Sensory Profile manual (Dunn, 1999) includes information regarding content, construct, convergent, and discriminant validity. Content validity was established through literature review, through expert review by eight occupational therapists experienced in working with children with sensory-based behaviors, and through category analysis from 155 occupational therapists that were members of the Sensory Integration Special Interest Section of the American Occupational Therapy Association.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 115

Construct and convergent validity was established between a study of the relationships between the Sensory Profile and the behavior regulation subsection of the School Function Assessment (SFA) (Coster, Deeney, Haltiwanger, & Haley, 1998). Correlations at the/? = .05 level (2-tailed) were found between the behavioral regulation subsection of the SFA and 10 out of 14 subscales of the Sensory Profile. Through several studies of clinical groups, the Sensory Profile was found to be able to delineate differences in behaviors in children with autism and children with attention deficit disorder. Thirty-two children with autism between the ages of 3 to 13 years were found to demonstrate sensory-based behaviors in the definite difference category in 90% of the items as compared to behaviors in typically developing children included in the normative sample. Sixty-one children with attention deficit disorder were found to demonstrate sensorybased behaviors in the probable difference category in 113 of 125 items as compared to behaviors in typically developing children included in the normative sample. Therefore, measures of reliability and validity indicate that the Sensory Profile is an acceptable measure of sensory-based behaviors in children. Adolescent/Adult Sensory Profile. The Adolescent/Adult Sensory Profile (AASP) (Brown & Dunn, 2002) (Appendix B) is structurally designed in the same manner as the Sensory Profile; however, it is designed to measure sensory-processing behavior patterns of individuals who are 11 to 65+ years of age. It has 60 self-report questions that use the same Likert scale format as the Sensory Profile. The AASP reveals information about sensory-based behavioral responses to everyday sensory experiences using the same four-quadrant format (e.g., low sensory registration, sensory sensitivity,

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 116

sensory avoidance, and sensory seeking) and is scored in the same manner as the Sensory Profile. Copyright regulations prevent the inclusion of actual test items without permission of the publisher; unfortunately, permission to include samples of test items in this document was not granted by the publisher (Appendix H). However, publisher contact information and item samples from a pilot version of the AASP are presented in appendix B. The AASP was standardized using 193 adolescents between 11.0 to 17.11 years of age, 496 adults between 18.0 - 64.11 years of age, and 261 older adults ages 65 years and older. Healthy individuals who did not have disabilities or conditions that had a behavioral component (e.g., attention-deficit disorder, obsessive-compulsive disorder, schizophrenia, bipolar disorder, etc.) were included in the norm sample; 92% of the sample was white and predominantly from the mid-western region of the United States. The Adolescent/Adult Sensory Profile manual includes information about its reliability and validity. The values for internal consistency, coefficient alpha, for each of the quadrants and by age group are as follows (Brown & Dunn, 2002, p. 52). For adolescents, coefficient alpha is .712 for low registration; is .748 for sensation seeking; is .646 for sensory sensitivity; and is .678 for sensation avoiding. For adults, coefficient alpha is .692 for low registration; is .639 for sensation seeking; is .657 for sensory sensitivity; and is .699 for sensation avoiding. For older adults, coefficient alpha is .754 for low registration; is .746 for sensation seeking; is .731 for sensory sensitivity; and is .775 for sensation avoiding. The manual for the AASP reported an examination of convergent and discriminant validity through a correlation study between the AASP and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 117

the nine subscales of the NYLS Adult Temperament Questionnaire using 207 adults that completed both measures (Brown & Dunn, 2002). Relationships were found between the adaptability, approach/withdrawal, mood, and sensory threshold subscales of the NYLS Adult Temperament Questionnaire and the sensation seeking, sensory sensitivity, and sensation avoiding quadrants of the AASP; no relationships were found between the nine subscales of the NYLS Adult Temperament Questionnaire and the low sensory registration quadrant of the AASP. These findings suggested that some characteristics and constructs of temperament and sensory-based behaviors as measured by these two tools were related and converge; however, for other concepts of temperament and sensory-based behaviors, these tools might measure different constructs. Children's Behavior Questionnaire. The Children's Behavior Questionnaire (CBQ) (Appendix C), developed by Rothbart et al. (2001), is a caregiver report measure that includes 195 questions designed to gain information regarding the temperament of children between 3 to 7 years-11 months of age. Permission to include test items from the CBQ in this document was granted by the administrator of the Rothbart battery of temperament questionnaires (Appendix I). The CBQ includes 15 subscales that are designed to assess defined characteristics of temperament that were originally based upon temperament dimensions identified from Thomas and Chess' 1977 New York Longitudinal Study and from the 1975 and 1984 work of Buss and Plomin (Rothbart et al., 2001). The temperament characteristics that make up the 15 subscales are identified as positive anticipation, smiling/laughter, high intensity pleasure, activity level, impulsivity, shyness, discomfort, fear, anger/frustration, sadness, soothability, inhibitory

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 118 control, attentional focusing, low intensity pleasure, and perceptual sensitivity. After a confirmatory factor analysis of the 15 subscales, three factor categories emerged: extraversion/surgency, negative affectivity, and effortful control. The CBQ is administered by having the caregiver complete the questionnaire by reading statements that describe children's responses to situations and circling a number that corresponds to how their child might respond to the situation. The caregiver can circle 1 if the statement is extremely untrue of their child; 2 if the statement is quite untrue of their child; 3 if the statement is slightly untrue of their child; 4 if the statement is neither true or false for their child; 5 if the statement is slightly true of their child; 6 if the statement is quite true of their child; and 7 if the statement is extremely true of their child; or N/A if the statement does not describe a behavior that they have observed in their child. Each subscale lists question item numbers that correspond to a described temperament characteristic. There are 9 to 13 question-items per subscale. The examiner scores the CBQ by adding the circled numbers per item question and per subscale. Higher scores indicate that the child is more likely to demonstrate the described temperament behavior characteristic. To score for the three factor characteristics, the examiner averages the scores of the corresponding subscales that comprise the factor. The anger, discomfort, fear, sadness, and reversed soothability subscale scores correspond to the negative affectivity factor characteristic. The attention focusing, inhibitory control, low-intensity pleasure and perceptual sensitivity subscale scores correspond to the effortful control factor characteristic. The activity level, high-intensity

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 119 pleasure, impulsivity, and reversed shyness subscale scores correspond to the extraversion/surgency factor characteristic. The examination of the factor structure and reliability of the CBQ were obtained from analysis of the mean item response scores of the 15 subscales from 341 children between the ages of 6 and 7 years and 516 children between the ages of 4 and 5 years. The children involved in the study of the CBQ resided in the northwestern and midwestern regions of the United States. Coefficient alpha scores for internal consistency for the 15 subscales of the CBQ are as follows: activity level = .81; anger/frustration = .76; approach/anticipation = .76; attentional focusing = .74; discomfort = .74; soothability = .80; fear = .69; high intensity pleasure = .79; impulsivity = .78; inhibitory control = .74; low intensity pleasure = .70; perceptual sensitivity = .77; sadness = .67; shyness = .94, and smiling/laughter = .79 (Rothbart et al., 2001, p. 1398). Goodness-of-Fit indices were used to complete the confirmatory factor analysis of the subscales that comprise the three factor characteristics (extraversion/surgency, negative affectivity, and effortful control). The Bentler and Bonnet Normed Fit Index was .96 for the 4- to 5-year-old sample and was .94 for the 6- to 7-year-old sample, and the Comparative Fit Index was .98 for the 4to 5-year-old sample and was .97 for the 6- to 7-year-old sample; these results indicate an acceptable fit for the model (Rothbart et al., 2001, p. 1400). Through the use of translated versions of the CBQ, the three categories of extraversion/surgency, negative affectivity, and effortful control were also found through factor analysis from CBQ ratings of 468 children between 6 to 7 years of age from China and 372 children between

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 120 4 to 6 years of age from Japan. However, differences in the subscales that comprise the three categories existed. Convergent and concurrent validity of the CBQ was assessed. Convergent validity of the CBQ was examined through analyzing the degree of parental agreement on scores of the 15 subscales from comparing responses from two different samples. From a sample of 49 couples of 5-year old children, parent-rating correlations ranged from .28 to .79 atp < .05 with a mean agreement across scales of .51 (Rothbart et al., 2001). Average parent-rating agreement across all the scales from sample of 114 couples when their children were 5 years of age was .41 atp < .05, and was .37 at p < .05 when their children were 7 years of age. Convergent validity was determined through examining the relationships between temperament characteristics and social behavior patterns. A sample of 80 children between the ages of 6 to 7 years were administered the CBQ and other assessments of aggressiveness, empathy, guilt/shame, help-seeking, and negativity. According to Rothbart et al. (2001), a regression analysis demonstrated a positive association between aggression and negative affectivity and extraversion/surgency. In addition, empathy and guilt/shame were found to be positively associated with effortful control, and help-seeking and negativity were found to be related to negative affectivity on the CBQ. However, statistical information regarding this analysis was not available in the Rothbart et al. (2001) article. Operational Definition of Variables Through the use of the Children's Behavior Questionnaire and the Sensory Profile, respectively, the relationships between the constructs of temperament

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 121 characteristics and sensory-processing behavior patterns in children between the ages of 3 to 7 years-11 months were analyzed as a test of the first research question and its corresponding hypotheses. Through the use of the Sensory Profile and the Adolescent/Adult Sensory Profile, the relationships between the constructs of sensoryprocessing behavior patterns in children between the ages of 3 to 7 years-11 months and their caregivers were analyzed as a test of the second research question and its corresponding hypotheses. Construct/variables for operational definitions for temperament characteristics. Rothbart et al. (2001), in their development of the CBQ, described three temperament behavioral categories that were the three main variables for temperament characteristics in this study. These three temperament variables were entitled, negative affectivity, extraversion/surgency, and effortful control. The variable for the temperament characteristic defined as negative affectivity is described as behavior that reflects an increased tendency toward anger/frustration related to task engagement, discomfort related to sensory experiences, increased fear or worry in anticipation of a situation, increased tendency for sadness or disappointment, and reduced ability to be comforted or to recover from distress. The variable for the temperament characteristic defined as extraversion/surgency is described as behavior that reflects an increased level of gross-motor activity, increased pleasure or enjoyment during novel situations or situations with increased sensory experiences, increased impulsivity, decreased inhibition, and decreased discomfort or shyness in social situation. The variable for the temperament characteristic defined as effortful control is described as behavior that

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 122 reflects an increased ability to maintain attention and focus on tasks, the ability to inhibit responses and distractions during novel situations, the ability to derive pleasure from situations that involve low intensity sensory experiences, and the ability to perceive sensory experiences in low-intensity situations. In addition to these main variables, the CBQ includes 15 subscales based upon primary temperament characteristics and are entitled: positive anticipation, smiling/laughter, high intensity pleasure, activity level, impulsivity, shyness, discomfort, fear, anger/frustration, sadness, soothability, inhibitory control, attentional focusing, low intensity pleasure, and perceptual sensitivity. These temperament behavior characteristics are defined as follows in the CBQ (Rothbart et al., 2001, p. 1406): Activity Level. Gross motor activity, including rate and extent of locomotion Anger/frustration. Negative affectivity related to interruption on ongoing tasks or goal blocking. Attentional focusing. Capacity to maintain attentional focus on task-related channels. Discomfort. Negative affectivity related to sensory qualities of stimulation, including intensity, rate, or complexities of light, movement, sound, and texture. Fear. Negative affectivity, including unease, worry, or nervousness, related to anticipated pain or distress and/or potentially threatening situations. High intensity pleasure. Pleasure or enjoyment related to situations involving high stimulus intensity, rate, complexity, novelty, and incongruity. Impulsivity. Speed of response initiation.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 123 Inhibitory control. Capacity to plan and to suppress inappropriate approach responses under instructions or in novel or uncertain situations. Low intensity pleasure. Pleasure or enjoyment related to situations involving low stimulus intensity, rate, complexity, novelty, and incongruity. Perceptual sensitivity. Detection of light, low-intensity stimuli from the external environment. Positive anticipation. Amount of excitement and anticipation for expected pleasurable activities. Sadness. Negative affectivity and lowered mood and energy related to exposure to suffering, disappointment, and object loss. Shyness. Slow or inhibited speed of approach and discomfort in social situations. Smiling/laughter. Positive affect in response to changes in stimulus intensity, rate, complexity, and incongruity. Soothability. Rate of recovery from peak stress, excitement, or general arousal. Construct/variables for operational definitions for sensory-processing behavior patterns. Variables regarding sensory-based behaviors involved concepts derived from the work of Dunn (1997, 1999). Following her research and factor analysis of the Sensory Profile, Dunn proposed four quadrant descriptions of behavioral responses to sensory stimuli, entitled: low sensory registration, sensory sensitivity, sensory avoidance, and sensory seeking (Brown & Dunn, 2002; Dunn, 1999). These four quadrant descriptions of sensory-based behaviors were the four main variables for sensory-based behavior patterns in this study. The variable for the sensory-processing

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 124 behavior pattern entitled sensory sensitivity describes an individual with low sensory threshold reactivity to sensory input, and who passively responds to the threshold with immediate reactions. Individuals with sensory sensitivity behaviors would be sensitive to stimuli and may easily alert, attend, be reactive, or be easily distracted by sensory stimuli. The variable for the sensory-processing behavior pattern entitled low sensory registration describes an individual with high sensory threshold behaviors and who passively responds to the high threshold. Individuals with low sensory registration behaviors tend to be under-reactive to stimuli, and may require large amounts of sensory stimuli before attending and responding. The variable for the sensory-processing behavior pattern entitled sensory avoiding describes an individual with low sensory behavior thresholds, and who actively reacts to manage the input from sensory experiences. Individuals with sensory avoiding behaviors would be reactive to stimuli, perceive sensory stimuli as uncomfortable, and would tend to avoid, limit, and/or control amounts of sensory stimuli. The variable for the sensory-processing behavior pattern entitled sensory seeking describes an individual with high sensory threshold behaviors, and who actively works to increase sensory experiences to manage the high threshold. In order to maintain alertness and attention, these individuals, tend to seek out novel situations, change routines, prefer intense sensory experiences, or may react impulsively to gain extra sensory experiences. Two assessment tools were used to measure the sensory-based behavior variables in this study, and were the Sensory Profile (Dunn, 1999) and the Adolescent/Adult Sensory Profile (Brown & Dunn, 2002). The Sensory Profile also includes 14 subsections. These subsections are entitled and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 125 described in the Sensory Profile manual (Dunn, 1999, p. 14-15) as: Auditory processing. Measures the child's responses to things heard. Visual processing. Measures the child's responses to things seen. Vestibular processing. Measures the child's responses to movement. Touch processing. Measures the child's responses to stimuli that touch the skin. Multi-sensory processing. Measures the child's responses to activities that contain a combined sensory experience. Oral sensory processing. Measures the child's responses to touch and taste in the mouth. Sensory processing related to endurance/tone. Measures the child's ability to sustain performance. Modulation related to body position and movement. Measures the child's ability to move effectively. Modulation of movement affecting activity level. Measures the child's demonstration of activeness. Modulation of sensory input affecting emotional responses. Measures the child's ability to use body senses to generate emotional responses. Modulation of visual input affecting emotional responses and activity level. Measures the child's ability to use visual cues to establish contact with others. Emotional/social responses. Indicates the child's psychosocial coping strategies. Behavioral outcomes of sensory processing. Indicates the child's ability to meet performance demands. Items related to thresholdfor response. Indicates the child's level of modulation.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 126 Although the three temperament behavioral categories and the four sensory-based behavior quadrant descriptions were the main variables and focus for this study, analysis of the sensory-processing subsections of the SP as they related to the three main temperament variables, and analysis of the subscales of the CBQ as they related to the four main sensoryprocessing behavior patterns were also investigated. Data Collection, Processing, and Analysis Before recruitment of participants and the commencement of data collection, research approval was obtained from the Institutional Review Board (IRB) of Northcentral University and the IRB of the Mesa, Arizona, campus of A. T. Still University. Recruitment of potential subjects occurred within the East Valley area of Metropolitan Phoenix, Arizona. Recruitment for participants occurred through the use of information flyers (Appendix J) and informational presentations to parents in preschools, day care centers, universities, and elementary schools within the greater Phoenix, Arizona, metropolitan area. The parents who were recruited for participation received a confidential, coded packet. The packet included a cover letter (Appendix E) that explained the study and procedural directions for completing the questionnaires; consent forms (Appendix F); coded copies of the Sensory Profile (Appendix A), the Adolescent/Adult Sensory Profile (Appendix B), and the Children's Behavior Questionnaire (Appendix C); a coded demographic questionnaire (Appendix D); a coded optional address card (Appendix G); and a stamped return envelope addressed to the researcher. To aid in maintaining confidentiality, all self-report questionnaire score sheets and demographic sheets were coded using a numerical system that was linked to

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 127 coded optional address cards included in the questionnaire packet. All questionnaires were completed using minimal identifying information. Names, initials, birthdates, and addresses were not required on any of the questionnaires; only information regarding the participant's age and gender, socioeconomic and educational background data, health status, and the age, gender, and health status of their child was required. Participants returned coded questionnaires and the optional address card using a pre-addressed, stamped packet to be mailed directly to the researcher. The coded, self-report, standardized questionnaires were used for the evaluation of the variables for sensory-processing behavior patterns and characteristics of temperament. The demographic questionnaire was used to obtain information about parent and child ages, gender, socioeconomic and education status, and self-report of health status. To minimize the potential for researcher bias, two research assistants scored the coded standardized questionnaires and a third research assistant entered deidentified data onto a spreadsheet. The two research assistants who scored the coded standardized questionnaires were a certified/licensed speech pathologist and a licensed physical therapist trained in the use of the SP, AASP, and the CBQ. The third research assistant who entered the de-identified data into a spreadsheet was a secretary skilled in the use of EXCEL computer programming. The researcher converted the de-identified data from the EXCEL spreadsheets to SPSS spreadsheets for analysis. Data analysis was completed through the use of SPSS versionl7.0 for MAC computers. Descriptive statistics were used to analyze the data from the three scored standardized questionnaires and the demographic information to explain participant characteristics.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 128 Analysis procedures for research question 1. Research question 1 and its corresponding hypotheses were as follows: RQ1: To what degree is there a relationship between sensory-processing behavior patterns and characteristics of temperament in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized? Hlo: There are no statistically significant relationships between sensoryprocessing behavior patterns and the temperament characteristics in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized. Hl a : There are statistically positive relationships between sensoryprocessing behavior patterns and characteristics of temperament in children between the ages of 3 to 7 years-11 months when physiological factors that may influence the reception of sensory input are minimized. To answer this question, Pearson's product-moment correlation statistics were used to analyze the relationships between the variables (e.g., sensory-processing behavior patterns and temperament characteristics) from data from the SP and CBQ standardized questionnaires regarding child behavior. Also, multiple linear regression analyses were used to determine whether specific features of sensory-processing behavior patterns predicted specific characteristics of temperament using data from the SP and the CBQ. Analysis procedures for research question 2. Research question 2 and its corresponding hypotheses were as follows:

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 129 RQ2: To what degree is there a relationship between the sensory-processing behavior patterns in children between the ages of 3 to 7 years-11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized? H2o: There are no statistically significant relationships between sensoryprocessing behaviors of children between the ages of 3 to 7 years-11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized. H2a: There is a statistically significant positive relationship between sensory-processing behaviors of children between the ages of 3 to 7 years11 months and their caregivers when physiological factors that may influence the reception of sensory input are minimized. Data from the AASP regarding the sensory-processing behavior patterns of the caregivers and data from the SP regarding the sensory-processing behavior patterns of the children were utilized to answer Research Question 2. To determine the extent to which relationships existed between the four main variables for sensory-processing behavior patterns (e.g., low sensory registration, sensory sensitivity, sensory avoidance, and sensory seeking) in the parent-child dyads, a two-way contingency table analysis using the McNemar test with crosstabs was completed. Methodological Assumptions, Limitations, and Delimitations Assumptions. A major assumption existed regarding the population and the constructs for this project. It was assumed that characteristics of temperament and

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 130 sensory-processing behavior patterns were biologically based and were stable from early childhood throughout the lifespan, although the expression of temperament and sensoryprocessing behavior patterns could be moderated through contextual factors. Several studies supported these notions. For example of stability of temperament styles, in a longitudinal study of temperament profiles in children 1.5 to 9 years of age, Janson and Mathiesen (2008) reported that individual stability in temperament from age-to-age for their temperament profiles entitled under-controlled, confident, unremarkable, uneasy and inhibited was consistent. In another longitudinal study of children from 2.5 to 5.5 years of age regarding the temperament characteristic of effortful control, Murray and Kochanska (2002) found that tendencies toward effortful control were consistent across age periods. Neuroscience research of temperament tendencies in children and adults identified stability in temperament characteristics and differences in behavioral expression, depending on contextual demands (Rothbart, 2004). As part of her study exploring the relationships between temperament characteristics, symptoms of attentiondeficit hyperactivity disorder, and the influence of contexts, Foley (2004) reported that supportive environments had a moderating effect on the temperament expression of activity levels, attention, and task persistence. Finally, studies and review articles regarding sensory-processing behavior patterns across the life span supported the notion that these patterns remain consistent (Brown & Dunn, 2002; Brown et al., 2001; Dunn, 2001, 2007). Therefore, the ability to examine the relationships between characteristics of temperament and features of sensory-processing behavior patterns would be minimally

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 131 affected by age. During data analysis, age was not found to significantly influence features of temperament and sensory-processing behavior patterns. Limitations. Several limitations were identified for this study. Healthy adults with typically developing children were recruited for this study; however, the possibility existed that undiagnosed conditions were present that may have introduced confounding factors in the results. To minimize the potential for this occurrence, the demographic questionnaire included questions related to health of the caregiver and child. Although any potential participant was free to complete the questionnaires and be eligible to receive the gift card, the data of potential participants who identified confounding health issues for themselves or their child were excluded from data analysis. The use of selfreport questionnaires presented another limitation. Researchers who use self-report questionnaires hope that participants understand the questions, and answer the questions honestly, consistently, and without bias, so that the data from the questionnaires would be reliable. To minimize issues related to self-report questionnaires, it is critical to select standardized questionnaires with appropriate reliability studies. Reliability information for the CBQ, the SP and the AASP revealed that the internal consistency for these tools was adequate for research use. Demographics of participants can pose a potential bias on outcomes. Therefore, it is critical to review the demographics of the individuals used to standardize the assessment tools. Although the demographics for the CBQ, the SP and the AASP were mostly Caucasian and similar in socioeconomic status (middle class), minority groups and individuals from differing parts of the United States were included in the

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 132

standardization samples for these assessment tools. Sampling for this study was limited to the metropolitan area of Phoenix, Arizona, which limited the demographics. However, by recruiting through various locations and agencies, there was an aim to recruit a variety of individuals. Completion of the questionnaires was limited to individuals who can read English at a 5th-grade level. Although questionnaires were not translated or adapted for this project, potential subjects had the option to be interviewed instead of reading the questionnaires. Finally, the reliance on one caregiver in a family as informant on the behavior of the child on the SP and the CBQ presented another limitation in this study. The possibility existed that caregivers in a family might perceive their child's behavior differently. The standardization of the CBQ included information regarding parent-rating correlations that were within acceptable ranges for research purposes; however, no such information was included in the research manual for the SP. Because the same caregiver rated their child for both the CBQ and the SP for this study, issues related to behavior rated by different caregivers would be minimal. Delimitations. Subject recruitment occurred in the metropolitan area of Phoenix, Arizona, and represented delimitation in the ability to generalize the results to a larger population. The focus of this study was to examine the extent to which relationships existed between characteristics of temperament and sensory-processing behaviors. The study of parenting styles, discipline styles, and quality of interpersonal relationships were not included within this project and were further delimitations. Finally, healthy parents and children were included in this study; therefore, the outcomes may not be generalized to parents and children with diagnosed conditions that influence behavior.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 133 Ethical Assurances For research involving human subjects, the likelihood and magnitude of potential harm needs to be identified and managed appropriately; plus, any potential subject has the right to make an autonomous decision regarding participation in research (Cozby, 2007). Because this study included data collection from three standardized questionnaires and a demographic questionnaire, risks for potential participants were issues related to privacy, confidentiality, and possible psychological risks. Information from these questionnaires involved data about age, gender, socioeconomic, educational, and self-report of health of participant and their child, the participant's self-rating of personal behaviors, and the participant's rating of child behavior. Some participants might have found the self-rating portions of the questionnaires to be distressing or too personal in nature. Therefore, as the primary investigator, this researcher was responsible for managing confidentiality in order to minimize the potential for loss of privacy and minimizing the potential for psychological issues for those subjects who might have found the questionnaires to be distressing. Methods to ensure confidentiality and to minimize psychological distress were managed through informed consent, the use of a coding system, and de-identified data. The use of informed consent documentation, minimizing the use of personal identifiers in data management, and securing access to the data were methods that assisted in minimizing the potential risks for loss of privacy, loss of confidentiality, and psychological distress. First, through the use of an informed consent document and a cover letter, potential participants learned about the purposes of the research project, their role in the project, the type of information to be collected, and how their information would be used. Potential participants had

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 134 the opportunity to autonomously decide to participate. Refusal to participate did not adversely affect the potential participant. Because the study's main research question concerned exploring interrelationships between behavioral concepts, providing information about the nature of the study would not bias the outcome and would allow for more direct and honest responses to the questionnaires. The self-rating questionnaires concerned personal responses to regular, everyday experiences that individuals routinely encounter; therefore, the potential for psychological distress from completing these questionnaires was minimal. However, if subjects had questions or concerns regarding participation in the study or became distressed due to the nature of the questions, the subjects had an opportunity to communicate with the primary investigator through contact information available on the informed consent form and the cover letter. To aid in maintaining confidentiality, all self-report questionnaire score sheets and demographic sheets were coded using a numerical system that was linked to coded optional address cards included in the questionnaire packet. All questionnaires were completed using minimal identifying information. Names, initials, birthdates, and addresses were not required on any of the questionnaires; only the participant's age and gender, socioeconomic and educational background data, health status, and the age, gender, and health status of their child was required. Participants returned coded questionnaires and an optional address card using a pre-addressed, stamped packet to be mailed directly to the primary investigator. To help maintain anonymity of the respondents, no separate list of participants' names and addresses was kept. Participants had the option to request information and follow-up regarding the scored outcomes from the selfreport questionnaires by checking an appropriate box on the optional address card and including the optional address card in the pre-addressed, stamped packet if interested. Completed

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 135 questionnaires and optional address cards for participants were kept in a locked cabinet in the primary investigator's locked office. To insure continued anonymity for participants, the questionnaires and the coded optional address cards were destroyed after data analysis was completed and the follow-up information to interested participants was mailed. Data from the demographic questionnaire and the scored self-report questionnaires was uploaded into the primary investigator's personal computer and back-up external hard drive and memory stick using the numerical system. Data was reported as aggregate, de-identified information; therefore, a single participant's data was not individually reported or identified. Although the primary investigator's personal computer was password protected, it was possible that an outside individual might gain access to information on the computer, the back-up external hard drive and memory stick. Because there was no electronic link between participants' names or addresses to the numerical system, any individual who gained access to those electronic devices would not be able to identify the study's participants. Fairness in subject participation is another ethical principle that needs to be considered in this project. Fairness or "justice," according to the Belmont Report, implies that opportunities and risks for subjects in research participation be equally shared (Cozby, 2007). This concept is critical when determining criteria for participant inclusion and during participant selection. Inclusion criteria for this study included: adults, 19 years or older who have no history of mental health conditions or un-correctable sensory-neural hearing loss or visual impairment and who do not take medications that may impact the responses on the questionnaires, and who was the primary caregiver of a child between 3 to 7 years-11 months of age, who had no history of uncorrectable sensory-neural hearing loss or visual impairment, or medical or psychological

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 136 condition that would require the regular use of medications that may influence behavior. Since inclusion criteria for this study was not limited by gender, race, socioeconomic or other demographic factors, participation in this project was open to any healthy adult. However, recruitment methods need to be arranged so that participant selection would not be biased toward or against any particular demographic group. Therefore, recruitment for participants occurred through the use of information flyers posted in a variety of locations within the metropolitan area of Phoenix, Arizona, with the hope that individuals with varying backgrounds would have an opportunity to participate if interested. An incentive for study participation through the use of a $5.00 gift card was used. The use of a financial incentive is permitted if it is not considered coercive (Hicks, 2008). If the participant completed the optional address card, participants received the gift card by mail after the researcher received the coded packet. Finally, prior to data collection and to ensure that issues related to ethical considerations were reviewed, IRB approval was sought and obtained through the IRB of Northcentral University and the IRB of A. T. Still University campus in Mesa, Arizona. Summary The purpose of this study was to explore the relationships between characteristics of temperament and sensory-processing behavior patterns of parent-child dyads. The ability to successfully adjust to challenges and stress within one's environment or during interpersonal relationships often involves the goodness-of-fit between one's temperament, and the expectations of the environment or interpersonal interactions (Greenspan, 2007; Olson & Sameroff, 2009). Behavioral self-regulation and reactivity are considered to be influential components of temperament that impact the expression of

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 137 temperament and describe the quality of an individual's behavioral style toward contextual experiences (Henderson & Wachs, 2007; Olson & Sameroff, 2009; Rothbart, 2004). Some of the characteristics of behavioral reactivity are influenced by the individual's responsiveness to sensory experiences within a context. Like temperament, an individual's behavioral responses to sensory experiences as part of daily activities can influence social interaction, cognitive, and motor performance (Dunn, 1997a, 2001, 2007). The possibility exists that the descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns are interrelated. Improved understanding regarding the relationships between sensory-processing behavior patterns and temperament may lead to more effective adaptation to environmental and activity demands and improved goodness-of-fit in interpersonal and contextual interactions. A non-experimental, descriptive correlational design was utilized to examine the nature and extent to which relationships existed between the descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns in parentchild dyads. Methodology included recruitment of parents with children who were between the ages of 3 and 7 years-11 months. Inclusion criteria for participation in this study were: adults, 19 years or older who had no history of mental health conditions or uncorrectable sensory-neural hearing loss or visual impairment and who do not take medications that may impact the responses on the questionnaires, and who were the primary caregiver of a child 3 to 7 years-11 months of age, who had no history of uncorrectable sensory-neural hearing loss or visual impairment, or medical or psychological condition that would require the regular use of medications that may influence behavior.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 138 Coded, self-report, standardized questionnaires were used for the evaluation of the variables for sensory-processing behavior patterns and characteristics of temperament, through the use of the Sensory Profile (Dunn, 1999), the Adolescent/Adult Sensory Profile (Brown & Dunn, 2002), and the Children's Behavior Questionnaire (Rothbart et al., 2001). In addition, a demographic questionnaire was included to obtain information about parent and child ages, gender, socioeconomic and education status, and self-report of health status. Recruitment for participants occurred through the use of posted information flyers or informational meetings in a variety of locations (preschools, day care centers, universities, elementary schools) within the metropolitan area of Phoenix, Arizona. Potential, interested individuals received a packet that included the cover letter explaining the project, informed consent form, coded self-report questionnaires, coded optional address card, and a stamped return envelope addressed to the researcher. Confidentiality was maintained through the use of the coded packet, and de-identified score sheets. Two research assistants trained in the use of the CBQ, SP, and AASP completed the scoring of these standardized questionnaires. De-identified data was recorded electronically onto the researcher's personal computer. The researcher, through the use of SPSS version 17.0 for the MAC computer, analyzed the data. Descriptive statistics were used to analyze the data from the standardized questionnaires (e.g., Sensory Profile, the Adolescent/Adult Sensory Profile, and the Children's Behavior Questionnaire), and the demographic questionnaire. Pearson's product-moment correlation through the use of a correlation matrix was utilized to assist in understanding the extent to which the three

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 139 main variables for temperament and subscales for temperament were related to the four variables and subscales for sensory-processing behavior patterns using the data from the standardized questionnaires. In addition, multiple linear regression analyses were used to determine whether specific features of sensory-processing behavior patterns predicted specific characteristics of temperament. To determine the extent to which relationships existed between the four main variables for sensory-processing behavior patterns in the parent-child dyads, a two-way contingency table analysis using the McNemar test with crosstabs was completed. The intent of this study was to discover the extent to which temperament and sensory-processing behavior patterns were interrelated. Previous temperament studies have reported that interrelationships between temperament, social interaction, activity engagement, and contextual features have the potential to moderate problematic behaviors (Crockenberg, & Leerkes, 2006; Eisenberg et al., 2000; Kochanska et al., 2005; Paulussen-Hoogeboom et al., 2008; Rudasill & Rimm-Kaufman, 2009). Similarly, studies of sensory-processing have indicated that sensory-processing behavior patterns influence play, activity, and interpersonal relationships (Ashburner et al., 2008; Bundy et al., 2007; White et al., 2007). Intervention using environmental modifications has been found to mediate problematic behaviors related to sensory-processing (DeGangi, 2000; Thomasgard, 2003). The results of the studies described in the literature review suggested that the constructs of temperament and self-regulation could be applied to strategies that promote optimal social development (Curtindale et al., 2007; Evans & Rothbart, 2009; Henderson & Wachs, 2007); however, these constructs need to be further

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 140 expanded to include the varying influences of sensory experiences on behavior. Understanding the relationships between sensory-processing behavior styles and temperament behavioral reactivity and self-regulation may allow for the development of additional strategies that promote successful activity and interpersonal engagement. Thus, the outcomes of this project could provide healthcare professionals with information for supplementary strategies for behavior management when both temperament and sensory-processing patterns are considered.

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 141 Chapter 4: Findings Since temperament behavioral styles and sensory-processing behavior patterns both have the potential to influence the quality of interpersonal interactions, social development, and activity engagement, the possibility exists that these two constructs are interrelated. The purpose of this dissertation study was to examine whether relationships existed between the descriptive characteristics of temperament and descriptive features of sensory-processing behavior patterns in parent-child dyads. First, a discussion of the analysis procedures and assumptions is presented, followed by a description of the study sample. Next, results from data analysis of the hypotheses under investigation are presented, followed by an interpretation of the findings. Results The one-sample Kolmogrov-Smirnov Goodness-of-Fit Test was completed to confirm that assumptions for the random effects models for regression analysis in nonexperimental studies were not being violated, and to determine whether a normal distribution existed for the data set of a quantitative variable (Green & Salkind, 2005). Results from this analysis demonstrated that the distribution of the data was not significantly different from the hypothesized distribution, indicating that the use of regression analyses for this data set was appropriate. Zero order correlations were used to determine the strength of linear relationships between the variables for sensoryprocessing behavior patterns and temperament characteristics of the children in the sample. An alpha significance level of/? < .05 was used for all analyses and all analyses were two-tailed. For the multiple regression analyses, a bivariate regression model was

TEMPERAMENT AND SENSORY-PROCESSING RELATIONSHIPS 142 used and computation of R allowed for determining the proportion of variance of the dependent variable (i.e., temperament characteristic) that was explained by its linear relationship with the independent variables (e.g., sensory-processing behavior patterns) (Green & Salkind, 2005). In addition, scatter plots were completed for sensoryprocessing behavior patterns (predictor) and temperament characteristics to determine whether nonlinearity existed. No apparent patterns were found in the scatter plots, indicating that the assumptions of nonlinearity or homogeneity-of-variance were not violated. See Figure 2 of an example scatter plot depicting the relationship between the standardized predicted and residual scores for the temperament characteristic of extraversion/surgency.

D e p e n d e n t Variable: Extraversion/Surgency

•5

0

•iL ic a tv 3 553 oc QI

,2« I/I

HI Of

i'

c®>

c o o

o

o

8

oV

Suggest Documents