Abstract
Individuals with autism spectrum disorder (ASD) often have sensory processing difficulties that impact their occupations. Data were analyzed comparing SCOPE scores at pre- and posttest for children receiving standard-care OT or Ready to Learn and Play (RtLP) framework plus standard care. The intervention group showed statistically significant improvement in SCOPE scores over the control group. The RtLP framework shows promise as an evidence-based tool to positively impact the occupational performance of students with ASD.
Primary Author and Speaker: Janis Leinfuss
Additional Authors and Speakers: Erin Ohara
Individuals with autism spectrum disorder (ASD) often have sensory processing challenges impacting occupational performance (Ismael, Lawson, & Hartwell, 2018). The organization of sensory information in the nervous system is critical to successful development and the ability to regulate one’s arousal level. In children with ASD, the ability to achieve and maintain an optimal level of arousal for learning may be compromised by sensory processing differences and therefore, affect their attention and occupational performance (Pfeiffer, et al., 2011). Since most of the child’s day is in school, there is significant importance on the educational system having adequate programming to facilitate their students’ success in both academic and social interactions. The Ready to Learn and Play (RtLP) framework is a tool to simplify the complexity of sensory processing for occupational therapists (OT) to use with their clients with ASD, their teachers, and others; thus, providing a new model for OTs to consider in their intervention planning. This research study evaluated the RtLP framework and its impact on occupational performance in a school setting. Research answered the question: For children and adolescents with ASD, does the RtLP sensory regulation framework plus standard OT programming, when compared to standard OT alone, improve occupational performance as measured by the SCOPE in the school environment? De-identified data was used in this quantitative study. Data sets included pretest scores for the Sensory Profile 2 and pre and posttest scores for the Short Child Occupational Profile (SCOPE). Inclusion criteria included full-time enrollment at a specialized school for students with ASD, received OT services, and diagnosis of ASD. A diagnosis other than ASD or data sets with prior exposure to RtLP were criteria for exclusion. Both groups, whether RtLP intervention group or standard care group, received OT services by a registered and licensed OT. Paired T-tests evaluated pretest data for homogeneity between groups as well as differences between the pre and posttest scores for the SCOPE to detect total score and improvements per child and between control and intervention groups. Pretest data sets were analyzed using a two-sample unpaired t-test assuming unequal variances. Analysis of pretest data determined no statistically significant differences between the intervention and control groups for gender, age, sensory processing, or occupational performance. When analyzing pre to posttest data following OT or OT plus RtLP, data analysis was conducted to detect differences in SCOPE scores using paired t test, assuming unequal variance. To determine statistical significance, a p value of .05 was set. When comparing the two groups, the intervention group had a greater positive change in SCOPE score indicating statistical significance and thus, greater improved occupational performance (t = 8.24; p = 0.000214). The quantitative findings support RtLP as a viable intervention for students with ASD to improve occupational performance. This research proposal is significant as it validates for OT the impact of sensory regulation on occupational performance and strengthens the position of the OT as an integral team member for individuals with ASD. OTs need to advocate for the inclusion of OT services for their clients with sensory regulation challenges and this research provides evidence to do just that. OTs must utilize evidence-based interventions and this study provides evidence to support use of the RtLP framework in addition to their current OT programming to impact occupational performance.
Ismael, N., Lawson, L. M., & Hartwell, J. (2018). Relationship between sensory processing and participation in daily occupations for children with autism spectrum disorder: A systematic review of studies that used Dunn’s sensory processing framework. American Journal of Occupational Therapy, 72(3), 1-9. https://doi.org/10.5014/ajot.2018.024075
Pfeiffer, B. A., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy, 65(1), 76-85. https://doi.org/10.5014/ajot.2011.09205