Sensory Integration, Social Participation and Autism

The American Journal of Occupational Therapy published research from clinical records of 89 children with autism spectrum disorder (ASD) ages 4-11 years old .  The research examined whether sensory integration (SI) and praxis patterns of the children were related to social participation.

Using SIPT standard scores, SPM standard and SPM Social Participation scores, SI and praxis patterns were analyzed.

The results indicated the following:

1.  Children with ASD showed relative strengths in visual praxis.

2.  Marked difficulties were evident in imitation praxis, vestibular bilateral integration, somatosensory perception, and sensory reactivity.

3.  SPM Social Participation scores were inversely associated with areas of deficit on SIPT measures.

The researchers concluded that children with ASD characteristically display strengths in visuopraxis and difficulties with somatopraxis and vestibular functions, which appear to greatly affect social participation.

Reference:  Susanne Smith Roley; Zoe Mailloux; L. Diane Parham; Roseann C. Schaaf; Christianne Joy Lane; Sharon Cermak. Sensory Integration and Praxis Patterns in Children With Autism. American Journal of Occupational Therapy, December 2014, Vol. 69, 6901220010p1-6901220010p8. doi:10.5014/ajot.2015.012476

25+ Bilateral Coordination Exercises
By: Your Therapy Source

Summary: Download of 28 bilateral coordination exercise sheets including
QR codes with links to video demonstration of exercises. Also includes hand
out explaining bilateral coordination.

Find out more at http://www.yourtherapysource.com/bilateralcoordination.html

Research: Analysis of Sensory Integration Therapy

The Journal of Developmental and Physical Disabilities published a meta-analysis on the use of sensory integration with individuals who have or at risk for a developmental or learning disability or delay. The outcomes from 30 studies on sensory integration therapy were reviewed and analyzed.

The results were the following:
1. Studies that compared sensory integration therapy to no treatment yielded a statistically significant but small effect
2. Studies that compared sensory integration therapy to alternative interventions there was no significant differences
3. Many flaws were identified including issues in clearly defining treatment, evaluating integrity, poor quality of research and diversity of outcome measures.

Overall, there was little evidence that sensory integration therapy was an effective intervention for any diagnostic group, particularly when functional blinded outcome measures were analyzed. The authors discussed the minimum methodological requirements for any future research studies.

Reference: Han Ming Leong et al. Meta-analysis of Research on Sensory Integration Therapy for Individuals with Developmental and Learning Disabilities. Journal of Developmental and Physical Disabilities. April 2015, Volume 27, Issue 2, pp 183-206

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The Scale of Sensory Strategies (S.O.S.S.) Tool Kit™ provides an evidence-based plan of care with sensory strategies that will optimize a child’s behavior in the school, home and community.  Find out more at http://yourtherapysource.com/soss.html

Posturography and Sensory Integration

A feasibility study was published on using posturography to monitor changes following vestibular input in children. The participants in the study included 5 children with Autism Spectrum Disorder (ASD) and 5 neurotypical children. Each child received 10 minutes of vestibular swing activity with pre and post evaluations of postural stability under four different conditions and center of pressure data was collected.

The center of pressure data revealed the following:
1. The 5 children with ASD demonstrated decreased mean sway velocity in the eyes open/flat plate condition post-intervention.
2. Four of the five children with ASD demonstrated an increase in sway root mean square and a decrease in anterior/posterior sample post-intervention in the eyes closed, foam pad condition and eyes open, flat plate condition respectively.

The researchers concluded that using posturography with sensory integration warrants further investigation.

Reference: Senia Smoot Reinert, Kurt Jackson and Kimberly Bigelow. Using Posturography to Examine the Immediate Effects of Vestibular Therapy for Children with Autism Spectrum Disorders: A Feasibility Study. Early view online Physical & Occupational Therapy in Pediatrics. DOI: 10.3109/01942638.2014.975313

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Neuromechanical Adaptations Following Trampoline Use

Have you ever heard of "trampoline aftereffect"?  It is that sensation that you have after jumping on a trampoline.  You get off the trampoline and your legs feel a little woozy or jelly like.  Pediatric therapy sessions that include motor skill development or sensory processing skills may include trampoline activities.  Did you know that after jumping on a trampoline there are specific neuromechanical adaptations?  Research that was conducted in 15 adults indicated that following jumping on an elastic surface the following was recorded:

• significant increase in EMG activity of knee extensors during the eccentric phase of the jump and significant increase in co-activation around the ankle jump during the concentric phase of the jump
• significant increase in leg stiffness
• significant decrease in jump height

The researchers suspect that the changes may be due to errors in sensory feedback comparing the elastic surface to the rigid surface.

This is small but important information when planing a therapy session that conjured up some questions for me.  When do you use a trampoline?  At times it is used for proprioceptive input, endurance activities or as a precursor to learning how to jump on the floor.  Although this study was done with adults, we can take some information and perhaps avoid testing any jumping skills following the use of a trampoline since the research indicated a decrease in jump height and increase in leg stiffness.  Does muscle stiffness increase in children with hypotonicity following jumping on a trampoline? 

If (and I say IF) there are errors in sensory feedback following jumping on an elastic surface are trampolines the best proprioceptive input for children with sensory processing disorder?

Reference: Márquez G, Aguado X, Alegre LM, Férnandez-Del-Olmo M. Neuromechanical adaptation induced by jumping on an elastic surface. J Electromyogr Kinesiol. 2013 Feb;23(1):62-9. doi: 10.1016/j.jelekin.2012.06.012. Epub 2012 Aug 9. 

 

Culture and Sensory Sensitivities

Have you ever considered the influence of culture on sensory sensitivities?  Does being from a different country or upbringing influence sensory preferences?  One would assume the answer is yes but definitive differences would be hard to categorize.

The American Journal of Occupational Therapy published research on a cross cultural comparison of sensory behaviors in children with autism.  The researchers compared the Short Sensory Profile responses completed by Israeli parents and United States parents of children with autism and typically developing peers.  The results indicated that "Israeli parents reported unusual responses to sensory experiences less frequently than U.S. parents for both autism spectrum disorders and typically developing children".  The United States children with autism spectrum disorders exhibited significantly greater difficulty in the Auditory Filtering and Visual/Auditory Sensitivity domains than Israeli children with autism spectrum disorders.

This study is very interesting to me.  By defining sensory behaviors based on culture we can look to different cultures to provide suggestions for other cultures.  For example, in the above study, if it was taken a step further are the researchers able to determine what Israeli parents may do differently in terms of auditory or visual domains that could help US parents?

Reference:  Kristina G. Caron,Roseann C. Schaaf,Teal W. Benevides,and Eynat Gal Cross-Cultural Comparison of Sensory Behaviors in Children With Autism Am J Occup Ther September 2012 66:e77-e80; doi:10.5014/ajot.2012.004226

Free Sensory Integration Webinars

I recently came across a company, Sensational Teaching, that will be offering free webinars on sensory integration. The first one is January 5, 2012 (tomorrow!). I asked the occupational therapist from Sensational Teaching, Katie Ryzhikov, some questions about the upcoming webinars.

1. Who is the target audience for the webinars - therapists, parents, teachers or all three?
- The webinars are aimed at teachers, parents and any therapist or youth worker who works with children who have sensory processing disorders, ADHD or Autistic Spectrum Disorder

2. How long are the webinars?
- The webinars are approximately an hour long

3. What is your background?
- I am an occupational therapist. I have worked with the pediatric population my whole career, both within the school system and privately, but my area of interest is sensory integration.

4. What motivated you to start the free webinars?
- Working in a private outpatient clinic I had the leisure of working on whatever goal the family and I chose. If the child's main goal was to pump a swing or ride a bike, that's what we would work on. Most of the kids we saw were struggling at home and at school, they were being labeled 'difficult' kids because of their sensory processing issues. Sensory integration therapy was really helpful on both social and academic levels. So when I started working within the school system I noticed that often the root of the child's issues was sensory based and many kids would not receive OT services for this. These kids would begin to 'fall through the gap'. I started working with teachers, explaining sensory integration and giving them ideas to build into their lessons to help these kids become more successful. Research was also suggesting that our ADHD kids would also benefit from some sensory strategies. Parents too were struggling, not only to get homework done but to get other daily activities done too, like brushing teeth or just getting dressed. I decided to launch a free webinar series, primarily for parents and teachers to help their 'tougher' kids become successful both at home and at school.

5. Will the webinars be archived online following the live webinar?
- Yes, the webinars will be available online following the webinar.

6. Tell us more about Sensational Teaching.
- Sensational Teaching is based in the Washington DC area. We bring practical, applicable and fun workshops to schools and parent groups. We combine Sensory Integration theory with dynamic teaching strategies in a format that enables parents, teachers and related service providers, to create rich and responsive learning environments. Our current workshops include
APPLYING SENSORY INTEGRATION PRINCIPLES IN THE CLASSROOM
- How to improve attention spans!
APPLYING SENSORY INTEGRATION STRATEGIES AT HOME
- How to get homework and other stuff done!
APPLYING SENSORY INTEGRATION PRINCIPLES FOR HANDWRITING DEVELOPMENT

To register for the webinars you can go to Sensational Teaching.

Sensory Integration or Fine Motor Interventions?

The American Journal of Occupational Therapy published a pilot study comparing sensory integration versus fine motor interventions in children with autism. Children with autism or PDD were divided into two groups, with 20 children receiving sensory integration treatment and 17 fine motor skill treatments. The participants received eighteen, 45 minute treatment sessions during a 6 week summer program. Following the interventions, the children in the sensory integration group had significantly less autistic mannerisms. No significant differences were seen on the Sensory Processing Measure or the Quick Neurological Screening Test Edition 2. Significant differences were seen in both groups with regards towards reaching goals (through Goal Attainment Scales) that were established prior to the interventions. The sensory integration group exhibited more significant improvements towards the goals when compared to the fine motor group.

Reference: Beth A. Pfeiffer, Kristie Koenig, Moya Kinnealey, Megan Sheppard and Lorrie Henderson. Effectiveness of Sensory Integration Interventions in Children With Autism Spectrum Disorders: A Pilot Study doi: 10.5014/ajot.2011.09205 American Journal of Occupational Therapy January/February 2011 vol. 65 no. 1 76-85

Benefits of Sensory Integration Interventions

The American Occupational Therapy Association released information on the sensory integration interventions resulting in positive outcomes. This press release discusses a review of 27 studies on the effectiveness of sensory integration therapy. The researchers found that:

"Results of the systematic review suggest the sensory integration approach may result in positive outcomes in sensorimotor skills and motor planning; socialization, attention, and behavioral regulation; reading-related skills; participation in active play; and achievement of individualized goals. Additionally, gross motor skills, self-esteem, and reading gains may be sustained from three months to two years".

Read the full AOTA Press Release

Or view it below: