Sensory processing challenges as a novel link between early caregiving experiences and mental health

Abstract

Early caregiving adversity (ECA) is associated with elevated psychological symptomatology. While neurobehavioral ECA research has focused on socioemotional and cognitive development, ECA may also increase risk for "low-level" sensory processing challenges. However, no prior work has compared how diverse ECA exposures differentially relate to sensory processing, or, critically, how this might influence psychological outcomes. We examined sensory processing challenges in 183 8-17-year-old youth with and without histories of institutional (orphanage) or foster caregiving, with a particular focus on sensory over-responsivity (SOR), a pattern of intensified responses to sensory stimuli that may negatively impact mental health. We further tested whether sensory processing challenges are linked to elevated internalizing and externalizing symptoms common in ECA-exposed youth. Relative to nonadopted comparison youth, both groups of ECA-exposed youth had elevated sensory processing challenges, including SOR, and also had heightened internalizing and externalizing symptoms. Additionally, we found significant indirect effects of ECA on internalizing and externalizing symptoms through both general sensory processing challenges and SOR, covarying for age and sex assigned at birth. These findings suggest multiple forms of ECA confer risk for sensory processing challenges that may contribute to mental health outcomes, and motivate continuing examination of these symptoms, with possible long-term implications for screening and treatment following ECA.

Keywords: adolescence; early caregiving adversity; mental health; sensory over-responsivity; sensory processing.

Figure 1.

Left: PI and AFC participants show elevated levels of sensory over-responsivity (higher SP3D scores), relative to non-adopted, comparison youth. Right: PI and AFC participants show increased levels of general sensory processing challenges (lower SSP scores) relative to non-adopted, comparison youth. **p <.001, *p <.05.

Figure 2.

(a) 95% percentile bootstrapped regression coefficients for a path analysis model examining the association between ECA (predictor) and internalizing problems (outcome) through SP3D total score, while controlling for age and sex assigned at birth. (b) 95% percentile bootstrapped regression coefficients for a path analysis model examining the association between ECA (predictor) and externalizing problems (outcome) through SP3D total score, while controlling for age and sex assigned at birth. As in OLS regression, R² for each component of the path analysis can be interpreted as the proportion of the variance in the outcome explained by that model (e.g. proportion of SP3D variance explained by OLS with ECA group, sex, and age predictors) **p<.001, *p<.05. PI = Previously Institutionalized; AFC = Adopted from Foster Care; SP3D = Sensory Processing 3-Dimensions Scale Sensory Inventory; SSP = Short Sensory Profile; CBCL = Child Behavior Checklist.

Figure 3.

(a) 95% percentile bootstrapped regression coefficients for a path analysis model examining the association between ECA (predictor) and internalizing problems (outcome) through SSP total score, while controlling for age and sex assigned at birth. (b) 95% percentile bootstrapped regression coefficients for a path analysis model examining the association between ECA (predictor) and externalizing problems (outcome) through SSP total score, while controlling for age and sex assigned at birth. As in OLS regression, R² for each component of the path analysis can be interpreted as the proportion of the variance in the outcome explained by that model (e.g. proportion of SSP variance explained by OLS with ECA group, sex, and age predictors) **p<.001, *p<.05. PI = Previously Institutionalized; AFC = Adopted from Foster Care; SP3D = Sensory Processing 3-Dimensions Scale Sensory Inventory; SSP = Short Sensory Profile; CBCL = Child Behavior Checklist (CBCL).