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An exploratory study of parent–child association in sensory modulation disorder involving ADHD-related symptoms



Sensory modulation disorder (SMD) and attention deficit hyperactivity disorder (ADHD) can co-occur and have overlapping symptoms, thus challenging practitioners. This study aimed to phenotypically explore parent–child associations in SMD, and the interplay between SMD- and ADHD-related symptoms in children with SMD and their parents.


A cross-sectional study examined 70 parents (n = 35 mothers; n = 35 fathers) and their 35 children with and without SMD, aged 4–6 years. Parents completed care-giver reports: The Short Sensory Profile (SSP) and the ADHD Rating Scale, and self-reports: The Sensory Responsiveness Questionnaire (SRQ) and the ADHD Self-Report Scale (ASRS).


In the entire sample, we found a mother–offspring correlation between SSP and SRQ-Aversive scores (rs = −0.68; p < 0.001), but no such father–offspring correlation. However, when testing the ADHD Rating Scale and ASRS scores, we found correlations between mothers and offspring (rs = 0.54, p = 0.0008), and between fathers and offspring (rs = 0.34, p = 0.0494). In the entire sample a high correlation was found between SSP and ADHD Rating Scale scores (rs = −0.837, p < 0.001). We further found a high correlation in mothers (rs = 0.70, p < 0.001), and a moderate correlation in fathers (rs = 0.40, p = 0.019) between SRQ-Aversive and ASRS scores.


Novel findings reveal that parents–offspring heritability patterns differ in both these related conditions. These may contribute to familial practice and research.

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This work was performed in partial fulfillment of the requirements for an OT M.Sc. degree


  1. 1.

    Faraone, S. V., Biederman, J. & Mick, E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol. Med. 36, 159–165 (2006).

  2. 2.

    Polanczyk, G. V., Willcutt, E. G., Salum, G. A., Kieling, C. & Rohde, L. A. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int. J. Epidemiol. 43, 434–442 (2014).

  3. 3.

    Steinhausen, H. C. The heterogeneity of causes and courses of attention‐deficit/hyperactivity disorder. Acta Psychiatr. Scand. 120, 392–399 (2009).

  4. 4.

    Subcommittee on Attention-Deficit. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 128, 2011–2654 (2011).

  5. 5.

    Mechler, K., Krömer, T., Landauer, M., Dittmann, R. W. & Häge, A. Screening for ADHD-related symptoms in preschoolers should be considered—results from a representative sample of 5-year-olds from a German metropolitan region. Front. Psychiatry 9, 612 (2018).

  6. 6.

    The Interdisciplinary Council on Developmental and Learning Disorders. In Diagnostic Manual for Infancy and Early Childhood: Mental Health, Developmental, Regulatory–Sensory Processing and Language Disorders and Learning Challenges. ICDL-DMIC Work Groups (Ed.) (ICDL, Bethesda, 2005).

  7. 7.

    DC: 0-3R. Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0-3R) (National Center for Clinical Infant Programs, Arlington, 2005).

  8. 8.

    Bar-Shalita, T., Vatine, J. J. & Parush, S. Sensory modulation disorder: a risk factor for participation in daily life activities. Dev. Med. Child Neurol. 50, 932–937 (2008).

  9. 9.

    Chien, C.-W., Rodger, S., Copley, J., Branjerdporn, G. & Taggart, C. Sensory processing and its relationship with children’s daily life participation. Phys. Occup. Ther. Pediatr. 36, 73–87 (2016).

  10. 10.

    Bar Shalita, T., Vatine, J.-J., Seltzer, Ze & Parush, S. Psychophysical correlates in children with sensory modulation disorder (SMD). Physiol. Behav. 98, 631–639 (2009b).

  11. 11.

    Bar-Shalita, T., Deutsch, L., Honigman, L. & Weissman-Fogel, I. Ecological aspects of pain in sensory modulation disorder. Res. Dev. Disabil. 45, 157–167 (2015).

  12. 12.

    Leekam, S. R., Nieto, C., Libby, S. J., Wing, L. & Gould, J. Describing the sensory abnormalities of children and adults with autism. J. Autism Dev. Disord. 37, 894–910 (2007).

  13. 13.

    Parush, S., Sohmer, H., Steinberg, A. & Kaitz, M. Somatosensory function in boys with ADHD and tactile defensiveness. Physiol. Behav. 90, 553–558 (2007).

  14. 14.

    Ahn, R. R., Miller, L. J., Milberger, S. & McIntosh, D. N. Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. Am. J. Occup. Ther. 58, 287–293 (2004).

  15. 15.

    Ben-Sasson, A. et al. A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. J. Autism Dev. Disord. 39, 1–11 (2009).

  16. 16.

    Baroni, A. & Castellanos, F. X. Neuroanatomic and cognitive abnormalities in attention-deficit/hyperactivity disorder in the era of ‘high definition’neuroimaging. Curr. Opin. Neurobiol. 30, 1–8 (2015).

  17. 17.

    Bralten, J. et al. Voxel-based morphometry analysis reveals frontal brain differences in participants with ADHD and their unaffected siblings. J. Psychiatry Neurosci. 41, 272 (2016).

  18. 18.

    Miller, L. J., Nielsen, D. M. & Schoen, S. A. Attention deficit hyperactivity disorder and sensory modulation disorder: a comparison of behavior and physiology. Res. Dev. Disabil. 33, 804–818 (2012).

  19. 19.

    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5 ® ) (American Psychiatric Association Publishing, Arlington VA, 2013.

  20. 20.

    Koziol, L. F. & Budding, D. ADHD and sensory processing disorders: placing the diagnostic issues in context. Appl. Neuropsychol. Child 1, 137–144 (2012).

  21. 21.

    Van Hulle, C. A., Lemery-Chalfant, K. & Goldsmith, H. H. Parent–offspring transmission of internalizing and sensory over-responsivity symptoms in adolescence. J. Abnorm. Child Psychol. 46, pp 557–567 (2017).

  22. 22.

    Faraone, S. V. et al. Molecular genetics of attention-deficit/hyperactivity disorder. Biol. Psychiatry 57, 1313–1323 (2005).

  23. 23.

    Chronis, A. M. et al. Psychopathology and substance abuse in parents of young children with attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry 42, 1424–1432 (2003).

  24. 24.

    McIntosh, D., Miller, L., Shyu, V. & Dunn, W. in The Sensory Profile: Examiner’s Manual (ed Dunn, W.) 59–73 (Psychological Corporation, San Antonio, 1999).

  25. 25.

    DuPaul, G. J. et al. Parent ratings of attention-deficit/hyperactivity disorder symptoms: Factor structure and normative data. J. Psychopathol. Behav. Assess. 20, 83–102 (1998).

  26. 26.

    DuPaul, G. J., McGoey, K. E., Eckert, T. L. & VanBrakle, J. Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioral, social, and school functioning. J. Am. Acad. Child Adolesc. Psychiatry 40, 508–515 (2001).

  27. 27.

    Bar-Shalita, T., Seltzer, Z., Vatine, J. J., Yochman, A. & Parush, S. Development and psychometric properties of the Sensory Responsiveness Questionnaire (SRQ). Disabil. Rehabil. 31, 189–201 (2009).

  28. 28.

    Kessler, R. C. et al. Validity of the World Health Organization Adult ADHD Self‐Report Scale (ASRS) screener in a representative sample of health plan members. Int. J. Methods Psychiatr. Res. 16, 52–65 (2007).

  29. 29.

    Minde, K. et al. The psychosocial functioning of children and spouses of adults with ADHD. J. Child Psychol. Psychiatry 44, 637–646 (2003).

  30. 30.

    Nikolas, M. A. & Burt, S. A. Genetic and environmental influences on ADHD symptom dimensions of inattention and hyperactivity: a meta-analysis. Am. Psychol. Assoc. 119, 1–17 (2010).

  31. 31.

    Tung, I., Brammer, W. A., Li, J. J. & Lee, S. S. Parenting behavior mediates the intergenerational association of parent and child offspring ADHD symptoms. J. Clin. Child Adolesc. Psychol. 44, 787–799 (2015).

  32. 32.

    Johnston, C. & Mash, E. J. Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin. Child Fam. Psychol. Rev. 4, 183–207 (2001).

  33. 33.

    Klein, M. et al. Brain imaging genetics in ADHD and beyond—mapping pathways from gene to disorder at different levels of complexity. Neurosci. Biobehav. Rev. 80, 115–155 (2017).

  34. 34.

    Thissen, A. J., Rommelse, N. N., Altink, M. E., Oosterlaan, J. & Buitelaar, J. K. Parent-of-origin effects in ADHD: distinct influences of paternal and maternal ADHD on neuropsychological functioning in offspring. J. Atten. Disord. 18, 521–531 (2014).

  35. 35.

    Guilmatre, A. & Sharp, A. Parent of origin effects. Clin. Genet. 81, 201–209 (2012).

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We thank Dr. Lisa Deutsch for her statistical consultation.

Author information

M.K.-A.—Substantial contributions to conception and design, and acquisition of data. I.B—Drafting the article, revising it critically for important intellectual content, and final approval of the version to be published. A.R.—Analysis and interpretation of data. T.B.-S.—Substantial contributions to conception and design, analysis, and interpretation of data; drafting the article, revising it critically for important intellectual content, and final approval of the version to be published.

Competing interests

The authors declare no competing interests.

Correspondence to Tami Bar-Shalita.

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