Remedial sensory interventions currently lack supportive evidence and can be challenging to implement for families and clinicians. It may be timely to shift the focus to optimizing participation of children with autism spectrum disorders (ASD) through accommodation and self-regulation of their sensory differences.
Purpose.
A framework to guide practitioners in selecting strategies is proposed based on clinical reasoning considerations, including (a) research evidence, (b) client- and family-centredness, (c) practice contexts, (d) occupation-centredness, and (e) risks.
Key issues.
Information-sharing with families and coaching constitute the basis for intervention. Specific strategies are identified where sensory aversions or seeking behaviours, challenges with modulation of arousal, or sensory-related behaviours interfere with participation. Self-regulatory strategies are advocated. The application of universal design principles to shared environments is also recommended.
Implications.
The implications of this framework for future research, education, and practice are discussed. The clinical utility of the framework now needs to be tested.
Description.
Il y a actuellement peu de données probantes sur les interventions sensorielles thérapeutiques et ces interventions peuvent être difficiles à mettre en œuvre pour les familles et les cliniciens. Il peut être judicieux de mettre l’accent sur l’optimisation de la participation des enfants atteints de troubles du spectre de l’autisme (TSA), en proposant des aménagements, de même que des stratégies d’autorégulation de leurs différences sensorielles.
But.
Un cadre visant à aider les praticiens à choisir des stratégies est proposé; ce cadre est basé sur les différents aspects du raisonnement clinique, soit (a) les données probantes; (b) l’intervention centrée sur le client et la famille; (c) les contextes de la pratique; (d) l’intervention centrée sur l’occupation; et (e) les risques.
Mots clés.
Le partage d’information avec les familles et l’encadrement forment la base de l’intervention. Les stratégies spécifiques mises en relief étaient les comportements d’aversions sensorielles ou de recherche sensorielle, les difficultés liées à la modulation de l’état d’éveil ou les comportements difficiles liés à des troubles sensoriels qui interférent avec la participation. Les stratégies d’autorégulation sont préconisées. L’application des principes de la conception universelle dans les environnements partagés est également recommandée.
Conséquences.
Les conséquences de ce cadre pour la recherche, la formation et la pratique dans l’avenir sont discutées. L’utilité clinique du cadre doit maintenant être testée.
AlcantaraJ. I.WeisblattE. J. L.MooreB. C. J.BoltonP. F. (2004). Speech-in-noise perception in high-functioning individuals with autism or Asperger’s syndrome. Journal of Child Psychology and Psychiatry, 45, 1107–1114. doi:10.1111/j.1469-7610.2004.t01-1-00303.x
2.
American Academy of Pediatrics. (2012). Policy statement: Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics, 129, 1186–1189. doi:10.1542/peds.2012-0876
3.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
4.
AndersonJ. M. (1998). Sensory motor issues in autism. Austin, TX: Hammill Institute on Disabilities.
5.
AshburnerJ.RodgerS.ZivianiJ.JonesJ. (2013). Occupational therapy services for people with autism spectrum disorders: Current state of play, use of evidence and future learning priorities. Australian Occupational Therapy Journal. Advance online publication. doi:10.1111/1440-1630.12083
6.
AshburnerJ.ZivianiJ.RodgerS. (2008). Sensory processing and classroom emotional, behavioral, and educational outcomes in children with autism spectrum disorder. American Journal of Occupational Therapy, 62, 564–573. doi:10.5014/ajot.62.5.564
AyresA. J. (1972). Sensory integration and learning disorders. Los Angeles, CA: Western Psychological Services.
9.
BagatellN.MiriglianiG.PattersonCReyesY.TestL. (2010). Effectiveness of therapy ball chairs on classroom participation in children with autism spectrum disorders. American Journal of Occupational Therapy, 64, 895–903. doi:10.5014/ajot.2010.09149
10.
Ben-SassonA.HenL.FlussR.CermakS. A.Engel-YegerB.GalE. (2008). A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 1–11. doi:10.1007/s10803-008-0593-3
CidavZ.MarcusS. C.MandellD. S. (2012). Implications of childhood autism for parental employment and earnings. Pediatrics, 129, 617–623. doi:10.1542/peds.2011-2700
CoxA. L.GastD. L.LuscreD.AyresK. M. (2009). The effects of weighted vests on appropriate in-seat behaviors of elementary-age students with autism and severe to profound intellectual disabilities. Focus on Autism and Other Developmental Disabilities, 24, 17–26. doi:10.1177/1088357608330753
15.
CraneL.GoddardL.PringL. (2009). Sensory processing in adults with autism spectrum disorders. Autism, 13, 215–228. doi:10.1177/1362361309103794
16.
DavisT. N.DacusS.StricklandE.CopelandD.ChanJ. M.BlendenK.…ChristianK. (2013). The effects of a weighted vest on aggressive and self-injurious behavior in a child with autism. Developmental Neurorehabilitation, 16, 210–215. doi:10.3109/17518423.2012.753955
17.
DickieV. A.BaranekG. T.SchultzB.WatsonL. R.McComishC. S. (2009). Parent reports of sensory experiences of preschool children with and without autism: A qualitative study. American Journal of Occupational Therapy, 63, 172–181. doi:10.5014/ajot.63.2.172
18.
DunnW. (2001). The 2001 Eleanor Clark Slagle Lecture: The sensations of everyday life. Empirical, theoretical, and pragmatics considerations. American Journal of Occupational Therapy, 55, 608–620. doi:10.5014/ajot.55.6.608
19.
DunnW. (2009). Occupational therapy: Daring to be sensational for everyone. Occupational Therapy Now, 11, 3–5.
20.
DunnW.CoxJ.FosterL.Mische-LawsonL.TanquaryJ. (2012). Impact of a contextual intervention on child participation and parent competence among children with autism spectrum disorders: A pretest–posttest repeated-measures design. American Journal of Occupational Therapy, 66, 520–528. doi:10.5014/ajot.2012.004119
21.
EllisE. A.Ala’i-RosalesS. S.GlennS. S.Rosales-RuizJ.GreenspoonJ. (2006). The effects of graduated exposure, modelling, and contingent social attention on tolerance to skin care products with two children with autism. Research in Developmental Disabilities, 27, 585–598. doi:10.1016/j.ridd.2005.05.009
22.
FosterS. H.MashE. J. (1999). Assessing social validity in clinical treatment research: Issues and procedures. Journal of Consulting and Clinical Psychology, 67, 308–319. doi:10.1037/0022-006X.67.3.308
23.
GalE.DyckM.PassmoreA. (2002). Sensory differences and stereotyped movements in children with autism. Behaviour Change, 19, 207–219. doi:10.1375/bech.19.4.207
24.
GrahamF.RodgerS.ZivianiJ. (2010). Enabling occupational performance of children through coaching parents: Three case reports. Physical and Occupational Therapy in Pediatrics, 30, 4–15. doi:10.3109/ 01942630903337536
25.
GrayC. (2004). Social stories 10.0: The new defining criteria and guidelines. Jenison Autism Journal, 15, 2–21.
26.
HagopianL. P.RookerG. W.RoliderN. U. (2011). Identifying empirically supported treatments for pica in individuals with intellectual disabilities. Research in Developmental Disabilities, 32, 2114–2120. doi:10.1016/j.ridd.2011.07.042
27.
HodgettsS.Magill-EvansJ.MisiaszekJ. (2011a). Effects of weighted vests on classroom behavior for children with autism and cognitive impairments. Research in Autism Spectrum Disorders, 5, 495–505. doi:10.1016/j.rasd.2010.06.015
28.
HodgettsS.Magill-EvansJ.MisiaszekJ. (2011b). Weighted vests, stereotyped behaviors and arousal in children with autism. Journal of Autism and Developmental Disorders, 41, 805–814. doi:10.1007/s10803-010-1104-x
29.
HoffmanT.BennettS.Del MarC. (2013). Evidence-based practice across the health professions (2nd ed.). Sydney, NSW: Churchill Livingstone.
30.
JoostenA. V.BundyA. C.EinfeldS. L. (2009). Intrinsic and extrinsic motivation for stereotypic and repetitive behavior. Journal of Autism and Developmental Disorders, 39, 521–531. doi:10.1007/s10803-008-0654-7
31.
KasnerM.ReidG.MacDonaldC. (2012). Evidence-based practice: Quality indicator analysis of antecedent exercise in autism spectrum disorders. Research in Autism Spectrum Disorders, 6, 1418–1425. doi:10.1016/j.rasd.2012.02.001
32.
KinnealeyM.PfeifferB.MillerJ.RoanC.ShoenerR.EllnerM. L. (2012). Effect of classroom modification on attention and engagement of students with autism or dyspraxia. American Journal of Occupational Therapy, 66, 511–519. doi:10.5014/ajot.2012.004010
33.
KoegelR.OpendenD.KoegelL. (2004). A systematic desensitization paradigm to treat hypersensitivity to auditory stimuli in children with autism in family contexts. Research and Practice for Persons with Severe Disabilities, 29, 122–134. doi:10.2511/rpsd.29.2.122
34.
LangR.KoegelL. K.AshbaughK.RegesterA.EnceW.SmithW. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4, 565–576. doi:10.1016/j.rasd.2010.01.006
35.
LeewS. V.SteinN. G.GibbardW. B. (2010). Weighted vests’ effect on social attention for toddlers with autism spectrum disorders. Canadian Journal of Occupational Therapy, 77, 113–124. doi:10.2182/cjot.2010.77.2.7
36.
McCordB. E.IwataB. A.GalenskyT. L.EllingtonS. A.ThomsonR. J. (2001). Functional analysis and treatment of problem behavior evoked by noise. Journal of Applied Behavior Analysis, 34, 447–462. doi:10.1901/jaba.2001.34-447
37.
MarrD.MikaH.MiragliaJ.RoerigM.SinnottR. (2007). The effect of sensory stories on targeted behaviors in preschool children with autism. Physical and Occupational Therapy in Pediatrics, 27, 63–79. doi:10.1300/J006v27n01_05
38.
MillerL. J.AnzaloneM. E.LaneS. J.CermakS. A.OstenE. T. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61, 135–140. doi:10.5014/ajot.61.2.135
39.
MostafaM. (2008). An architecture for autism: Concepts of design intervention for the autistic user. International Journal of Architectural Research, 2, 189–211.
40.
NadonG.FeldmanD. E.DunnW.GiselE. (2011). Association of sensory processing and eating problems in children with autism spectrum disorders. Autism Research and Treatment, 15, 98–113. doi:10.1155/2011/541926
41.
National Autism Center. (2009). National standards report: The national standards project addressing the need for evidence-based practice guidelines for autism spectrum disorders. Randolph, MA: National Autism Center.
42.
NelsonP. B.SoliS. (2000). Acoustical barriers to learning: Children at risk in every classroom. Language, Speech and Hearing Services in Schools, 31, 356–361.
43.
NicholsonH.KehleT. J.BrayM. A.Van HeestJ. (2011). The effects of antecedent physical activity on the academic engagement of children with autism spectrum disorder. Psychology in the Schools, 48, 198–213. doi:10.1002/pits.20537
44.
O’DonnellS.DeitzJ.KartinD.NaltyT.DawsonG. (2012). Sensory processing, problem behavior, adaptive behavior, and cognition in preschool children with autism spectrum disorders. American Journal of Occupational Therapy, 66, 586–594. doi:10.5014/ajot.2012.004168
45.
OCEBM Levels of Evidence Working Group. (2013). The Oxford 2011 Levels of Evidence. Oxford, UK: Oxford Centre for Evidence-Based Medicine. Retrieved fromhttp://www.cebm.net/index.aspx?o=5653
46.
OrielK. N.GeorgeC. L.PeckusR.SemonA. (2011). The effects of aerobic exercise on academic engagement in young children with autism spectrum disorder. Pediatric Physical Therapy, 23, 187–193. doi:10.1097/PEP.0b013e318218f149
47.
PetrusC.AdamsonS. R.BlockL.EinarsonS. J.SharifnejadM.HarrisS. R. (2008). Effects of exercise interventions on stereotypic behaviours in children with autism spectrum disorder. Physiotherapy Canada, 60, 134–145. doi:10.3138/physio.60.2.134
48.
PriorM.RobertsJ. M. A.RodgerS.WilliamsK.SutherlandR. (2011). A review of the research to identify the most effective models of practice in early intervention of children with Autism Spectrum Disorders. Greenway, ACT: Australian Government Department of Families, Housing, Community Services and Indigenous Affairs.
49.
PrizantB. (2012, Spring). The power of emotional memory. Autism Spectrum Quarterly, pp. 37–40.
50.
PrizantB.WetherbyA. M.RibinE.LaurentA. C. (2003). The SCERTS model: A transactional, family-centred approach to enhancing communication and socioemotional abilities of children with autism spectrum disorder. Infants and Young Children, 16, 296–216.
51.
QuigleyS. P.PetersonL.FriederJ. E.PetersonS. (2011). Effects of a weighted vest on problem behaviors during functional analyses in children with pervasive developmental disorders. Research in Autism Spectrum Disorders, 5, 529–538. doi:10.1016/j.rasd.2010.06.019
52.
ReichowB.BartonE. E.SewellJ. S.GoodL.WoleryM. (2010). Effects of weighted vests on the engagement of children with developmental delays and autism. Focus on Autism and Other Developmental Disabilities, 25, 3–11. doi:10.1177/1088357609353751
53.
RoweC.CandlerC.NevilleM. (2011). Noise reduction headphones and autism: A single case study. Journal of Occupational Therapy, Schools, & Early Intervention, 4, 229–235. doi:10.1080/19411243.2011.629551
54.
RutterM.Le CouteurA.LordC. (2003). Autism Diagnostic Interview–Revised manual. Los Angeles, CA: Western Psychological Services.
55.
SaggersB.HwangY.-S.MercerK. L. (2011). Your voice counts: Listening to the voice of high school students with autism spectrum disorder. Australasian Journal of Special Education, 35, 173–190. doi:10.1375/ajse.35.2.173
56.
SchaafR. C.MillerL. J. (2005). Occupational therapy using a sensory integrative approach for children with developmental disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 11, 143–148. doi:10.1002/mrdd.20067
57.
SchaferE. C.MathewsL.MehtaS.HillM.MunozA.BishopR.MoloneyM. (2013). Personal FM systems for children with autism spectrum disorders (ASD) and/or attention-deficit hyperactivity disorder (ADHD): An initial investigation. Journal of Communication Disorders, 46, 30–52. doi:org/10.1016/j.jcomdis.2012.09.002
58.
SchillingD. L.SchwartzI. S. (2004). Alternative seating for young children with autism spectrum disorder: Effects on classroom behavior. Journal of Autism and Developmental Disorders, 34, 423–434. doi:10.1023/B:JADD.0000037418.48587.f4
59.
SegalR.BeyerC. (2006). Integration and application of a home treatment program: A study of parents and occupational therapists. American Journal of Occupational Therapy, 60, 500–510. doi:10.5014/ajot.60.5.500
60.
SinhaY.SiloveN.HayenA.WilliamsK. (2011). Auditory integration training and other sound therapies for autism spectrum disorders. Cochrane Library, 12, 1–44. doi:10.1002/14651858.CD003681.pub3
61.
StephensonJ.CarterM. (2009). The use of weighted vests with children with autism spectrum disorders and other disabilities. Journal of Autism and Developmental Disorders, 39, 105–114. doi:10.1007/s10803-008-0605-3
62.
ThompsonR. M.JohnstonS. (2013). Use of Social Stories to improve self-regulation in children with autism spectrum disorders. Physical & Occupational Therapy in Pediatrics, 33, 271–284. doi:10.3109/01942638.2013.768322
63.
UmedaC.DeitzJ. (2011). Effects of therapy cushions on classroom behaviors of children with autism spectrum disorder. American Journal of Occupational Therapy, 65, 152–159. doi:10.5014/ajot.2011.000760
64.
Van RieG. L.HeflinL. J. (2009). The effect of sensory activities on correct responding for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3, 783–796. doi:10.1016/j.rasd.2009.03.001
65.
WeeksS.BoshoffK.StewartH. (2012). Systematic review of the effectiveness of the Wilbarger Protocol with children. Pediatric Health, Medicine and Therapeutics, 3, 79–89.
66.
WilbargerP.WilbargerJ. (1991). Sensory defensiveness in children aged 2–12: An intervention guide for parents and other caregivers. Denver, CO: Avanti Educational Programs.
67.
WilliamsM. W.ShellenbergerS. (1996). How does your engine run? A leader’s guide to the Alert Program for Self-Regulation. Albuquerque: NM: Therapy Works.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
