Children with autism can benefit from a type of therapy that helps them
become more comfortable with the sounds, sights and sensations of their daily
surroundings, a small new study suggests.
The therapy is called sensory integration. It uses play to help these kids
feel more at ease with everything from water hitting the skin in the shower to
the sounds of household appliances.
For children with autism, those types of stimulation can be overwhelming,
limiting them from going out in the world or even mastering basic tasks like
eating and getting dressed.
"If you ask parents of children with autism what they want for their
kids, they'll say they want them to be happy, to have friends, to be able to
participate in everyday activities," said study author Roseann Schaaf.
Sensory integration is aimed at helping families move toward those goals,
said Schaaf, an occupational therapist at Thomas Jefferson University's School
of Health Professions, in Philadelphia.
It is not a new therapy, but it is somewhat controversial partly because
until now it has not been rigorously studied, according to Schaaf.
Her findings were recently published online in the Journal of Autism and
The research team randomly assigned 32 children aged 4 to 8 to one of two
groups. One group stuck with their usual care, including medications and behavioural
therapies. The other group added 30 sessions of sensory integration therapy
over 10 weeks.
At the study's start, parents were helped in setting a short list of goals
for the family. For example, if a child was sensitive to sensations in his
mouth, the goal might be to have him try five new foods by the end of the
study, or to take some of the struggle out of the morning tooth-brush routine.
Schaaf said each child's particular play was individualised and guided by an
occupational therapist. But in general, the therapy is done in a large gym with
mats, swings, a ball pit, carpeted "scooter boards", and other equipment.
All are designed to encourage kids to be active and get more comfortable with
the sensory information they are receiving.
After 30 sessions, Schaaf's team found that children in the sensory
integration group scored higher on a standardized "goal attainment
scale", versus kids in the comparison group, and were generally faring
better in their daily routines.
A standard approach
"Parents rated their kids as more independent in self-care and
participation in everyday activities," Schaaf said.
An autism expert not involved in the study said it was well done, and marks
a "first step" in proving the potential benefits of sensory
"Sensory-related issues are a problem for families of children with
autism, and we really don't fully understand them," said Dana Levy, a
clinical assistant professor of child and adolescent psychiatry at NYU Langone
Medical Centre, in New York City.
Behavioural therapies are the standard approach to managing sensory issues.
That teaches kids ways to deal with the particular types of sensory overload
that bother them, Levy noted. Kids might, for example, squeeze a stress ball
when a noise is too loud.
Whatever role sensory integration might have for kids with autism, she said,
it's not a replacement for behavioural approaches or other therapies. "It
would have to be a part of a child's overall treatment programme," Levy
Schaaf agreed. "We're not suggesting this is an either/or," she
said. "Behavioural therapy helps children with autism." Sensory
integration, delivered by an occupational therapist, "is a nice
adjunct," Schaaf said.
In the real world, the availability of sensory integration varies depending
on where you live, Schaaf said.
Unclear how therapy works
It's provided by occupational therapists, who are often part of the health
care team that helps families of children with autism. But not all occupational
therapists are specifically trained in sensory integration, Schaaf noted.
Insurance coverage also varies, she said, so some parents might have to pay
out-of-pocket if they wanted to try it. And while this study tested 30
sessions, the "right" number for any one child would vary depending
on the child's needs, Schaaf said.
It's not clear exactly how sensory integration works. But it's thought that
it might actually change how the brain processes sensory stimulation, Schaaf
That's partly because it's playful. "When something is playful,"
Schaaf said, "you'll usually go a little outside your comfort zone."
But Levy said it's not certain that sensory integration actually promotes
changes in the brain's reactions. The therapy, she said, "is fun. It
offers things that a lot of kids like."
At least some of the benefit, Levy noted, might come from giving children a
chance to socialize and simply enjoy themselves.
Autism Speaks has more on autism therapy options.
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