Sensory Processing Profiles and Observed Behaviour: An Ecological, Function-Based Study of Challenging Behaviour in a Clinically Referred Sample of Children with Autism Spectrum Disorder and/or Intellectual Disability.

Sensory processing differences are common in autism spectrum disorder (ASD) and intellectual disability (ID) and have been linked to maladaptive behaviour and reduced adaptive functioning, largely through caregiver-report measures. How they relate to the ecological organisation of observable challenging behaviour remains to be established. This retrospective study analysed routine care data from 70 children aged 3 to 16 years with ASD and co-occurring ID or ID alone, in which naturalistic functional behavioural assessments documented 7560 behavioural episodes. Episodes whose recorded functional hypothesis explicitly designated a sensory function were labelled sensory-motivated behaviours (SMBs), a clinically formulated hypothesis about the function of the episode. Beta-binomial models examined predictors of the proportion of episodes assigned a sensory function, and mixed-effects models accounting for the clustering of episodes within children examined the association between behavioural class and inferred function. SMBs accounted for 7.47% of episodes (565 of 7560; participant-level mean 8.19%), with substantial inter-individual variability, and because only explicit designations were retained this figure is a conservative estimate of how often practitioners attributed a sensory function. Whether the function was seeking or avoiding tracked the form of the episode, body-directed behaviours being associated with avoidance and object- or intake-directed behaviours with seeking, whereas the analyses did not detect consistent associations between the proportion of sensory episodes and either caregiver-reported sensory profiles (Sensory Profile-2) or adaptive functioning (Vineland Adaptive Behaviour Scales-II). The study thus provides an ecological benchmark for how often sensory functions are attributed in routine practice, and shows that the form of an episode carries information about its sensory direction that trait-level questionnaires do not.