Pfeiffer, B., Koenig, K., Kinnealey, M., Shepperd, M., & Henderson, L. (2011). Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy, January/February 2011, 65(1), 76-85.
Reviewed by:
Melissa Taylor, BCaBA
and
Karen Fried, PsyD, BCBA-D
Why research this topic?
Sensory Integration (SI) theory posits that atypical behavior in ASD is due to inadequate neurological processing of sensory stimuli. SI interventions are intended to provide controlled sensory experiences to help the child’s nervous system produce adaptive responses. These interventions are widely used for children with autism spectrum disorder (ASD) despite a lack of evidence showing effectiveness. This study aimed to use a strong design to evaluate the effects of SI intervention on children with ASD and to function as a model for future SI research.
What did the researchers do?
The participants were 37 children, ages 6 to 12, diagnosed with autism or pervasive developmental disorder, not otherwise specified (PDD-NOS). All participants attended a particular, summer therapeutic activities program and were identified as having a sensory processing disorder based on a parent-completed rating scale and evaluation by an SI clinician. Participants were randomly assigned to receive either SI intervention or Fine Motor (FM) intervention for 18, 45-minute sessions over six weeks at the summer program. To measure outcome, evaluators completed the Quick Neurological Screening Test (QNST-II) and clinical observations while the parents completed three questionnaires before and after intervention. Also, before intervention, clinicians and parents collaborated to set measurable goals using the Goal Attainment Scaling (GAS) system. After intervention, the researchers reviewed the GAS with parents over the phone to determine progress toward the identified goals. The evaluators and parents were not privy to the group assignments.
What did the researchers find?
The SI and FM groups both improved on the GAS, but the SI group made larger gains than the FM group. The SI group also scored significantly lower than the FM group on parent-reported autistic mannerisms. No other significant differences were noted between the two groups.
What are the strengths and limitations of the study?
Strengths of the study included random assignment to groups, multiple measures of outcome, and checks on whether SI and FM were carried out as intended (i.e., treatment integrity). However, only a few sessions were checked for adherence to intervention procedures (as few as one of the 18 sessions that a participant received). Also, there may have been overlap in procedures between the groups. For example, SI clinicians were required to create a “playful context” to collaborate with the child on “activity choice” and to foster “therapeutic alliances.” Although not required in FM, FM clinicians may have naturally incorporated these strategies anyway, unintentionally blurring the difference between the two treatments. A key limitation is that most of the pre- and post-measures were based on parent reports rather than direct observation by independent observers. While parent reports can be valuable, they are prone to bias and therefore should not be the most prominent source of data. An additional limitation is that the researchers did not conduct evaluations to confirm participants’ ASD diagnoses.
What do the results mean?
The current study improves on the methodology used in previous studies of outcome in SI by including random assignment to groups, multiple measures of outcome, and treatment integrity checks, but the results are inconclusive because of the limitations in its design. Further research is needed to determine whether or not SI is effective as an intervention for children with autism spectrum disorder.
Citation for this article:
Taylor, M., & Fried, K. (2016). Research synopses: Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. Science in Autism Treatment, 13(4), 40-41.
