Date Presented 03/28/20
A systematic review of literature from 2010 to 2019 yielded 2,035 studies of sensory interventions for children and youth. Using established criteria, 22 qualifying studies were identified that spanned six interventions: environmental modifications, deep touch pressure, sensory integration, sensory diet, weighted vests, and stability balls. Strong evidence supported one approach, with moderate evidence in support of three approaches. The results yielded moderate evidence against two approaches.
Primary Author and Speaker: Victoria Battin
Additional Authors and Speakers: Julia Panzone, Marguerite Fish, Nicole Lorthioir, Justine Odierna, Andrea Dow, Alexandra Regimbald, Gabrielle Lukovich, Taylor Heitmann, Morgan Eberley
PURPOSE: The purpose of this study was to appraise the evidence on the effectiveness of interventions using specific sensory techniques or environmental modifications for children from 2-21 years old with sensory processing challenges and the resultant impact on participation.
DESIGN: This study entailed a systematic review of literature from 2010 to 2019 addressing sensory interventions for children and youth.
METHOD: The researchers explored six databases: CINAHL, MEDLINE, PubMed, OT Seeker, Eric, and Google Scholar using search terms related to specific diagnoses and interventions for children with sensory processing challenges. This process yielded an initial 2035 studies from 2010 to 2019. Through title and abstract review, a total of 361 studies resulted. The researchers screened for inclusion criteria and duplicate publications with elimination of systematic reviews, meta-analyses, case studies, and pilot studies; this process resulted in 65 studies which underwent a full-text review. Subsequent full text review yielded a total of 22 studies which were included in this study.
The researchers extracted data from the 22 studies pertinent to study design, level of evidence, participant demographics, interventions, and outcomes. The collection entailed 8 Level I, 1 Level II, 1 Level III, and 12 Level IV studies. Using a bias table, researchers identified pertinent inherent biases within the studies. No studies were eliminated due to bias however this process informed the researchers on the quality of the study. The researchers graded the evidence based on strength and quality, in order to determine an action using the Evidence Alert Traffic Light System (Novak & McIntyre, 2010, p. 388). The researchers then grouped the interventions into six categories: environmental modifications, deep touch pressure, sensory integration, sensory diet, weighted vests / weighted items, and stability / therapy balls.
RESULTS: Based on the 22 studies reviewed, the researchers deemed that strong to moderate evidence from two studies existed for the use of environmental modifications to increase participation at home and at school for children and adolescents with sensory processing challenges. Thus a green light designation was identified for environmental modifications, indicating that the approach could be implemented due to support from strong research. Moderate evidence from nine studies was identified for the use of deep touch pressure, sensory integration, and the sensory diet, with resultant improvements in behavior and functional skills. Based on quality indicators and the results of the studies, the researchers designated these as yellow light interventions, indicating that the interventions should be used with some caution. Lastly, strong evidence from eleven studies was revealed to be against the use of weighted vests / weighted items, and stability / therapy balls for children with sensory processing challenges. This resulted in a red light designation for these practices, indicating that therapists should not use these approaches for children with sensory processing challenges.
CONCLUSION: The results of this systematic review spanning nine years of literature on interventions for children and adolescents with sensory processing challenges yielded strong to moderate support for the use of environmental modifications, moderate support for the use of deep touch pressure, sensory integration, and sensory diet interventions. Sufficient evidence against the use of weighted vests / weighted items and stability / therapy balls. These results provide clinicians, educators, and family members with valuable information on interventions that are appropriate for children and youth with sensory processing challenges.
References
Bodison, S. C., & Parham, L. D. (2018). Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: A systematic review. American Journal of Occupational Therapy, 72, 1-11. doi: 10.5014/ajot.2018.029413
Kinnealey, M., Pfeiffer, B., Miller, J., Roan, C., Shoener, R., & Ellner, M. 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
Novak, I., & McIntyre, S. (2010). The effect of education with workplace supports on practitioners’ evidence-based practice knowledge and implementation behaviours. Australian Occupational Therapy Journal, 57, 386–393. https://doi.org/10.1111/j.1440-1630.2010.00861.x
Riquelme, I., Hatem, S. M., & Montoya, P. (2018). Reduction of pain sensitivity after somatosensory therapy in children with autism spectrum disorders. Journal of Abnormal Child Psychology, 46, 1731-1740. doi: 10.1007/s10802-017-0390-6
