Improving quality of life for the differently abled Children & Adults

Sensory Integration

by Shannon O’Neill- Occupational Therapy Student of Kim Betancourt, MS-OTR/L

Throughout my internship at Laurens Institute For Education, I have learned so much about the field of Occupational Therapy.  Many of the treatment techniques I have become accustomed to are sensory based. At LIFE, I was lucky to have the opportunity to learn and expand my knowledge of sensory integration.  As part of my internship, I conducted a review of an evidence-based article about sensory integration and its effect on everyday activities.

The article that I reviewed is titled “An Intervention for Sensory Difficulties in Children with Autism: A Randomized Trial” by Roseann C. Schaaf, Teal Benevides, Zoe Mailloux, Patricia Faller, Joanne Hunt, Elke van Hooydonk, Regina Freeman, Benjamin Leiby, Jocelyn Sendecki, and Donna Kelly.

There were two purposes to this study.  First, to assess the effectiveness of occupational therapy/sensory integration using a “manualized protocol” on client goal achievement in comparison to usual care.  Second, to evaluate the influence of this approach on the child’s adaptive behaviors, functional skills, and sensory behaviors (Schaaf, 2013).  When the authors discuss the manualized protocol, they are describing a strict individualized treatment plan that therapists follow.

This particular study is a significant achievement in the research of sensory integration and occupational therapy.  The study is considered a randomized controlled trail, which is the highest level of research one can conduct.  For this study, the researchers had a control and experimental group.  The control group did not receive the treatment or medication that was being tested, whereas the experimental group did.  With the research surrounding sensory integration, there are not many randomized controlled trials on record.

Schaaf et al (2013) described the criteria set for the participants of the study.  The criteria included the following:
•    The child must between the ages of 4 years and 7 years and 11 months old at the time of the study
•    The child must have a diagnosis of  Autism Spectrum Disorder (ASD) from a licensed psychologist.  The diagnosis is based off the results of the Autism Diagnostics Interview-Revised ADI-R) and the Autism Diagnostics Observation Schedule (ADOS).
•    A non-verbal cognitive level of less than 65.
•    The child must demonstrate a difficult time processing and integrating sensory information.  This is measured using either of the following: the Sensory Profile or the Sensory Integration and Praxis Test (SIPT).
•    Parents are willing to participate and attend three weekly sessions over a 10-week duration.  Also parents will not have their children participate in any new treatments including medications during the study period.

Overall, there were 32 children who participated in the study.  The study took place in a central New Jersey children’s hospital.  The 32 children were randomly assigned between the two groups, control and experimental groups.  The experimental group received the manualized protocol treatment.  The control group was described as receiving occupational therapy services that were not focused on sensory integration and other non-study related services.  Over a course of 10 weeks, each participant received treatment three times a week and one hour per session.

The manualized protocol treatments were based off of each participant’s sensory characteristics.  These characteristics were identified through the preliminary assessments administered.

Through the process of the 10-week treatment, the authors noted significant improvements in the following areas with the treatment group: care giver assistance with self-care, autistic behaviors, and social skills.  Overall, the information and results collected from this study provides support for the effectiveness of a manualized intervention, created to address difficulties of integrating and processing sensory information.

Many of the treatment examples provided in the article are very similar to treatments that we use at LIFE.  For instance, we incorporate scooter board activities, where clients lay on their stomachs and propel themselves with their arms.  This activity promotes proprioception in the upper body, knowing where the joint or portion of the body is in space.  Another activity mentioned in the article, was the use of the trapeze swing to increase body awareness through proprioceptive and vestibular input.  These activities are customized around the clients’ needs, which we at LIFE do too.

An Intervention for Sensory Difficulties in Children with Autism: A Randomized Trial

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