Sensory integration therapy for autism spectrum disorders: A systematic review

Intervention studies involving the use of sensory integration therapy (SIT) were systematically identified and analyzed. Twenty-five studies were described in terms of: (a) participant characteristics, (b) assessments used to identify sensory deficits or behavioral functions, (c) dependent variables, (d) intervention procedures, (e) intervention outcomes, and (f) certainty of evidence. Overall, 3 of the reviewed studies suggested that SIT was effective, 8 studies found mixed results, and 14 studies reported no benefits related to SIT. Many of the reviewed studies, including the 3 studies reporting positive results, had serious methodological flaws. Therefore, the current evidence-base does not support the use of SIT in the education and treatment of children with autism spectrum disorders (ASD). Practitioners and agencies serving children with ASD that endeavor, or are mandated, to use research-based, or scientifically-based, interventions should not use SIT outside of carefully controlled research.

[1]  H. Polatajko,et al.  Sensory Integration Treatment for Children with Learning Disabilities: Its Status 20 Years Later , 1992 .

[2]  Stacy L. Carter An Empirical Analysis of the Effects of a Possible Sinus Infection and Weighted Vest on Functional Analysis Outcomes of Self-Injury Exhibited by a Child with Autism. , 2005 .

[3]  K. Piravej,et al.  Effects of Thai traditional massage on autistic children's behavior. , 2009, Journal of alternative and complementary medicine.

[4]  M. O'Reilly,et al.  Challenging behaviour and developmental disability , 2003 .

[5]  J. Matson,et al.  Questions about behavioral function (QABF): a behavioral checklist for functional assessment of aberrant behavior. , 2000, Research in developmental disabilities.

[6]  S. Rogers,et al.  Evidence-Based Comprehensive Treatments for Early Autism , 2008, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[7]  G. Dawson,et al.  Interventions to Facilitate Auditory, Visual, and Motor Integration in Autism: A Review of the Evidence , 2000, Journal of autism and developmental disorders.

[8]  L. J. Hall,et al.  Evaluation of the Effects of Sensory Integration-Based Intervention by a Preschool Special Education Teacher. , 2010 .

[9]  B. Iwata,et al.  Toward a functional analysis of self-injury. , 1994, Journal of applied behavior analysis.

[10]  G. Camilli,et al.  A meta-analysis of research on sensory integration treatment. , 1999, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[11]  L. Miller,et al.  Development of a fidelity measure for research on the effectiveness of the Ayres Sensory Integration intervention. , 2011, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[12]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[13]  B. Iwata,et al.  TOWARD A FUNCTIONAL ANALYSIS OF SELF‐INJURY , 1994 .

[14]  K. Ottenbacher,et al.  Sensory integration therapy: affect or effect. , 1982, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[15]  Tonya N. Davis,et al.  The Effects of a Brushing Procedure on Stereotypical Behavior. , 2011 .

[16]  Mark Carter,et al.  The Use of Weighted Vests with Children with Autism Spectrum Disorders and Other Disabilities , 2009, Journal of autism and developmental disorders.

[17]  N L Smith,et al.  The certainty of judgments in health evaluations. , 1981, Evaluation and program planning.

[18]  D. Krug,et al.  ASIEP-3 : Autism screening instrument for educational planning : examiner's manual , 2008 .

[19]  Temple Grandin,et al.  The Effectiveness of Self-Initiated Vestibular Stimulation in Producing Speech Sounds in an Autistic Child , 1988 .

[20]  L. Miller,et al.  Fidelity in sensory integration intervention research. , 2007, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[21]  J. Case-Smith,et al.  Occupational therapy with children with pervasive developmental disorders. , 1999, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[22]  A. Ayres Sensory integration and learning disorders , 1973 .

[23]  Jeff Sigafoos,et al.  Internet survey of treatments used by parents of children with autism. , 2006, Research in developmental disabilities.

[24]  O. Healy,et al.  Response to a Letter to the Editors re: “Comparison of Behavioral Intervention and Sensory-Integration Therapy in the Treatment of Challenging Behavior” , 2011 .

[25]  Victoria Shea,et al.  Evidence-Based Practices and Autism , 2011, Autism : the international journal of research and practice.

[26]  S. Hollon,et al.  Defining empirically supported therapies. , 1998, Journal of consulting and clinical psychology.

[27]  Gulen Baran,et al.  A Sensory Integration Therapy Program on Sensory Problems for Children with Autism , 2008, Perceptual and motor skills.

[28]  A. Baumeister,et al.  A Critique of the Application of Sensory Integration Therapy to Children with Learning Disabilities , 1994, Journal of Learning Disabilities.

[29]  T. May-Benson,et al.  Systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children. , 2010, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[30]  John J. Wheeler,et al.  An Analysis of Evidence-Based Practices in the Education and Treatment of Learners with Autism Spectrum Disorders , 2010 .

[31]  K. Stewart,et al.  Sensory integrative-based occupational therapy and functional outcomes in young children with pervasive developmental disorders: a single-subject study. , 1999, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[32]  Shawn P. Quigley,et al.  Effects of a Weighted Vest on Problem Behaviors during Functional Analyses in Children with Pervasive Developmental Disorders. , 2011 .

[33]  R. Watling,et al.  Immediate effect of Ayres's sensory integration-based occupational therapy intervention on children with autism spectrum disorders. , 2007, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[34]  E. Rutherford,et al.  Sensory Integrative Therapy as an Intervention Procedure with Grade One "At Risk" Readers--A Three Year Study. , 1980 .

[35]  Brian A Iwata,et al.  Functional analysis of problem behavior: a review. , 2003, Journal of applied behavior analysis.

[36]  D. Bailey,et al.  Evaluating Programme Impact: Levels of Certainty , 1991 .

[37]  John McDonald,et al.  Sensory Integration and the Perceptual Experience of Persons with Autism , 2006, Journal of autism and developmental disorders.

[38]  J. Case-Smith,et al.  The effects of occupational therapy with sensory integration emphasis on preschool-age children with autism. , 1999, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[39]  J. Misiaszek,et al.  Weighted Vests, Stereotyped Behaviors and Arousal in Children with Autism , 2011, Journal of autism and developmental disorders.

[40]  G. Baranek Efficacy of Sensory and Motor Interventions for Children with Autism , 2002, Journal of autism and developmental disorders.

[41]  J Deitz,et al.  Current practice of occupational therapy for children with autism. , 1999, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[43]  D. Gast,et al.  The Effects of Weighted Vests on Appropriate In-Seat Behaviors of Elementary-Age Students With Autism and Severe to Profound Intellectual Disabilities , 2009 .

[44]  Beth Pfeiffer,et al.  Effectiveness of sensory integration interventions in children with autism spectrum disorders: a pilot study. , 2011, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[45]  F. Volkmar,et al.  Development of the Evaluative Method for Evaluating and Determining Evidence-Based Practices in Autism , 2008, Journal of autism and developmental disorders.

[46]  N. Bagatell,et al.  Effectiveness of therapy ball chairs on classroom participation in children with autism spectrum disorders. , 2010, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[47]  B. Iwata,et al.  Artifactual effects of sensory-integrative therapy on self-injurious behavior. , 1990, Journal of applied behavior analysis.

[48]  Ralf W. Schlosser,et al.  Editorial: Moving Evidence-based practice forward , 2007 .

[49]  G E Lancioni,et al.  A review of choice research with people with severe and profound developmental disabilities. , 1996, Research in developmental disabilities.

[50]  Carla J. Thompson MULTI-SENSORY INTERVENTION OBSERVATIONAL RESEARCH , 2011 .

[51]  Ayres Aj,et al.  Hyper-responsivity to touch and vestibular stimuli as a predictor of positive response to sensory integration procedures by autistic children. , 1980 .

[52]  Eynat Gal,et al.  A Meta-Analysis of Sensory Modulation Symptoms in Individuals with Autism Spectrum Disorders , 2009, Journal of autism and developmental disorders.

[53]  L. Miller,et al.  Goal attainment scaling as a measure of meaningful outcomes for children with sensory integration disorders. , 2007, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[54]  O. Healy,et al.  Comparison of behavioral intervention and sensory-integration therapy in the treatment of self-injurious behavior. , 2009 .

[55]  Alison E. Lane,et al.  Sensory Processing Subtypes in Autism: Association with Adaptive Behavior , 2010, Journal of autism and developmental disorders.

[56]  M. O'Reilly,et al.  A Review of School-Based Instructional Interventions for Students with Autism Spectrum Disorders. , 2008 .

[57]  Sally J. Rogers,et al.  Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders , 2010 .

[58]  Erin E. Barton,et al.  Effects of Weighted Vests on the Engagement of Children With Developmental Delays and Autism , 2010 .

[59]  J. Hinojosa,et al.  Effects of a weighted vest on attention to task and self-stimulatory behaviors in preschoolers with pervasive developmental disorders. , 2001, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[60]  R. Schaaf,et al.  Comparison of Behavioral Intervention and Sensory-Integration Therapy in the Treatment of Challenging Behavior , 2011, Journal of autism and developmental disorders.

[61]  L. Heflin,et al.  The effect of sensory activities on correct responding for children with autism spectrum disorders , 2009 .

[62]  W. Dunn Sensory Processing as an Evidence-Based Practice at School , 2008, Physical & occupational therapy in pediatrics.

[63]  S. Rogers,et al.  Annotation: what do we know about sensory dysfunction in autism? A critical review of the empirical evidence. , 2005, Journal of child psychology and psychiatry, and allied disciplines.

[64]  S. Lane,et al.  Examining the neuroscience evidence for sensory-driven neuroplasticity: implications for sensory-based occupational therapy for children and adolescents. , 2010, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[65]  Janet K. Kern,et al.  Examining Sensory Modulation in Individuals with Autism as Compared to Community Controls. , 2008 .

[66]  A. Bundy,et al.  Sensorimotor versus Fine Motor Activities in Eliciting Vocalizations in Autistic Children , 1983 .

[67]  Shirley V Leew,et al.  Weighted Vests' Effect on Social Attention for Toddlers with Autism Spectrum Disorders , 2010, Canadian journal of occupational therapy. Revue canadienne d'ergotherapie.

[68]  Lucy Jane Miller,et al.  Occupational therapy using a sensory integrative approach for children with developmental disabilities. , 2005, Mental retardation and developmental disabilities research reviews.

[69]  M. Wolery,et al.  The Use of Single-Subject Research to Identify Evidence-Based Practice in Special Education , 2005 .