Systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children

Investigating the Maintained Motor Skill Achievements in a Visual Praxis Based Occupational Therapy Program: Single Blind Randomized Follow up Study

To examine the long-term effects of Visual Praxis Based Occupational Therapy Program on the motor skills of children with Specific Learning Disabilities. Ninety-six boys and girls were divided into two groups: Experimental (n = 48) and Control (n = 48). The Experimental group received Visual Praxis Based Occupational Therapy Program in two weekly sessions for 8 weeks. All participants were assessed with the Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form at three-time points; pre-test, post-test, and follow-up. The experimental group showed superior results, Bruininks-Oseretsky Motor Proficiency Test-2 Brief Form's Fine Motor Precision, Fine Motor Integration, Bilateral Coordination, Balance, Speed and Dexterity, Upper Extremity Coordination and Total Score significantly increased after the intervention (p ≤ 0 0.05) and the scores were maintained at the follow-up (p > 0.05). The Visual Praxis Based Occupational Therapy Program intervention provided a retained positive effect in the development of motor skills in children with Specific Learning Disabilities.

Neurodivergent patient experience in a tertiary children's hospital-a qualitative analysis

Introduction

Sensory processing challenges are commonly encountered in pediatric patients, particularly in those who are neurodivergent. We previously developed a novel clinical pathway (named "Sensory Pathway") which aimed at improving patient care for those with sensory barriers via staff training, provision of sensory toolkits and early integration of families throughout the hospital stay. We hypothesized that utilization of this pathway will result in improved patient experience and provide valuable feedback to improve care.

Methods

A voluntary survey was made available to all patients who utilized this resource as part of our hospital wide patient satisfaction survey. Qualitative data was coded using open coding as part of the constant comparison method data using NVivo 12 for Windows software for analysis. Software was used to create word clouds and clusters for visualization, which confirmed the themes and patterns that were noted from initial open coding.

Results

Between 2021 and 2022, surveys were obtained from 160 patients who utilized the Sensory Pathway. More than 50% reported that the most helpful components of the pathway were the approach by the staff and sensory tools. The three major themes identified from the survey were (1) Tools and techniques that benefited their children; (2) Positive interactions and communication with the hospital staff, and (3) Suggestions for future improvement.

Conclusion

The survey results highlight the importance of having tools readily available to aid with sensory regulation and comfort of patients during healthcare encounters, the value of a positive patient and staff encounter, as well as opportunities for improvement.

Effectiveness of sensory integration therapy in children, focusing on Korean children: A systematic review and meta-analysis

BACKGROUND

Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development. Currently, various sensory integration interventions are being applied, but research methodological problems are arising due to unsystematic protocols. This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.

AIM

To prove the effectiveness of sensory integration therapy, examine the latest trend of sensory integration studies in Korea, and provide clinical evidence for sensory integration therapies.

METHODS

The database of Korean search engines, including RISS, KISS, and DBpia, was used to search for related literature published from 2001 to October 2020. The keywords, "Children", "Sensory integration", "Integrated sensory", "Sensory-motor", and "Sensory stimulation" were used in this search. Then, a meta-analysis was conducted on 24 selected studiesRISS, KISS, and DBpia, was used to search for related literature published from 2001 to October 2020. The keywords, "Children", "Sensory integration", "Integrated sensory", "Sensory-motor", and "Sensory stimulation" were used in this search. Then, a meta-analysis was conducted on 24 selected studies.

RESULTS

Sensory integration intervention has been proven effective in children with cerebral palsy, autism spectrum disorder, attention deficit/hyperactivity disorder, developmental disorder, and intellectual disability in relation to the diagnosis of children. Regarding sensory integration therapies, 1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective. In terms of dependent variables, sensory integration therapy effectively promoted social skills, adaptive behavior, sensory processing, and gross motor and fine motor skills.

CONCLUSION

The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children, and can help to present standards for sensory integration intervention protocols.

Studying the Specificity of Research Reporting for Ayres Sensory Integration® Interventions in the Published Literature: A Scoping Review

IMPORTANCE

A contributing factor to the gap between research publication and clinical implementation is the lack of specificity used when reporting findings.

OBJECTIVE

This scoping review used the Rehabilitation Treatment Specification System (RTSS) to determine which elements of specificity are most often present and omitted from research using Ayres Sensory Integration® (ASI).

DATA SOURCES

The following databases were searched: PubMed, CINAHL, PsycINFO, Cochrane Library, and ERIC.

STUDY SELECTION AND DATA COLLECTION

Eligible studies used ASI in an outpatient setting with children who had sensory integration or processing difficulties. Studies selected were quantitative (Level 1, 2, 3, or 4), available in full text, peer reviewed, and published in English within the past 20 yr.

FINDINGS

Of the 22 studies that met inclusion criteria, 100% included ingredients (actions of the therapist), 63% included mechanisms of action (reasoning behind these actions), 86% included targets, and 23% described client progression. We also found that 49% of all ingredients were listed in conjunction with a target, 15% were listed in conjunction with a mechanism of action, and 11% were listed in conjunction with both a target and a mechanism of action.

CONCLUSIONS AND RELEVANCE

Findings indicate that many studies list ingredients but often omit the mechanism of action. This omission makes replication of the intervention increasingly difficult and prevents a deeper understanding of the clinical reasoning process behind the intervention. Plain-Language Summary: Gaps identified in this scoping review highlight inconsistencies in the reporting of treatment specificity that may affect the replication and translation of Ayres Sensory Integration® (ASI) research into practice.

EEG Correlates of Cognitive Functions in a Child with ASD and White Matter Signal Abnormalities: A Case Report with Two-and-a-Half-Year Follow-Up

This research aimed to examine the EEG correlates of different stimuli processing instances in a child with ASD and white matter signal abnormalities and to investigate their relationship to the results of behavioral tests. The prospective case study reports two and a half years of follow-up data from a child aged 38 to 66 months. Cognitive, speech-language, sensory, and EEG correlates of auditory-verbal and auditory-visual-verbal information processing were recorded during five test periods, and their mutual interrelation was analyzed. EEG findings revealed no functional theta frequency range redistribution in the frontal regions favoring the left hemisphere during speech processing. The results pointed to a positive linear trend in the relative theta frequency range and a negative linear trend in the relative alpha frequency range when listening to and watching the cartoon. There was a statistically significant correlation between EEG signals and behavioral test results. Based on the obtained results, it may be concluded that EEG signals and their association with the results of behavioral tests should be evaluated with certain restraints considering the characteristics of the stimuli during EEG recording.

Ayres Sensory Integration Therapy for a Child With Rett Syndrome: A Case Report

Rett syndrome (RTT) is a neurodevelopmental disorder characterized by severe dyspraxia, hand stereotypies, and sensory processing issues for which there is no known treatment. This case describes a child with classic RTT and the child's responses to an Ayres Sensory Integration (ASI) treatment intervention (36 one-hour sessions, 3 per week). We coded and analyzed 36 detailed treatment notes to answer the following questions: What strategies and factors facilitated or interfered with participation in the intervention? What critical elements of treatment documentation might detect small changes in praxis and participation? How do patterns of motor or praxis milestones that emerge over time relate to this child's level of participation? We observed an increase in participation when the therapist incorporated elements of neurodevelopmental treatment (NDT) and motor learning theory- treatment strategies commonly used with children who have neuromotor conditions. This increase in participation in the ASI intervention emerged at approximately the same time that the therapist documented acquisition of new motor and praxis skills. We observed the importance of using: lateral movement activities to develop weight-shifting and bilateral coordination, rotary play to increase trunk rotation and improve postural transitions, and rhythm to promote continuing or initiating actions. The documentation of the specific amounts of assistance and prompting needed during treatment sessions was an important tool for tracking small yet meaningful responses to treatment. This case illustrates a novel use of ASI intervention supplemented with strategies that developed foundational skills, and the emergence of praxis and participation in the therapeutic intervention. We suggest further research is needed to determine efficacy of ASI for other children with this rare disorder.

Pain sensitivity and perceptual sensitivity are associated with severity of emotional dysregulation in children with ADHD: a cross-sectional analysis using the Temperament in Middle Childhood Questionnaire

PURPOSE

Nearly 50% of children with attention-deficit/hyperactivity disorder (ADHD) experience emotional dysregulation or sensory over-responsiveness; this study examines their association.

METHODS

This cross-sectional analysis (n = 124) used data from the Micronutrients for ADHD in Youth (MADDY) Study, which enrolled children aged 6-12 with ADHD and emotional dysregulation. Sensory responsiveness was assessed using two subscales from the factor-analyzed Temperament in Middle Childhood Questionnaire: Pain Sensitivity and Perceptual Sensitivity. Emotional dysregulation was assessed using the Emotional-Problems and Conduct-Problems subscales from the Strengths and Difficulties Questionnaire and a composite score from the Child & Adolescent Symptom Inventory-5. Multivariable linear regression measured the association of pain and perceptual sensitivity with the severity of emotional dysregulation.

RESULTS

In adjusted models, pain sensitivity was positively associated with Emotional Problems (β = 0.97; 95% CI: 0.52, 1.41; p < 0.0001), Conduct Problems (β = 0.83; 95% CI: 0.44, 1.21; p = 0.0001), and CASI-5 composite (β = 0.25; 95% CI: 0.16, 0.34; p < 0.0001). Perceptual sensitivity was positively associated with Emotional Problems (β = 0.75; 95% CI: 0.15, 1.35; p = 0.01) but not Conduct Problems (β = 0.27; 95% CI: -0.24, 0.77; p = 0.30) or CASI-5 composite (β = 0.12; 95% CI: -0.01, 0.24; p = 0.07).

CONCLUSION

Pain sensitivity was associated with the severity of emotional dysregulation in this ADHD sample. To better understand possible causal links, longitudinal studies are warranted.Implications for rehabilitationEmotional dysregulation and sensory over-responsiveness are both common in children with ADHD and contribute to added challenges in school and family life.Two types of sensory over-responsiveness, pain sensitivity and perceptual sensitivity, were associated with emotional dysregulation in children with ADHD in our study.Sensory over-responsiveness may be a modifiable treatment target.

Evaluation of Ayres Sensory Integration® Intervention on Sensory Processing and Motor Function in a Child with Rubinstein-Taybi Syndrome: A Case Report

The Rubinstein-Taybi Syndrome (RSTS) literature is limited about sensory integration, which is a foundational neurological function of the central nervous system that may affect the development of cognitive, social, and motor skills. The aim of this case report was to investigate the effects of Ayres Sensory Integration® (ASI) intervention on processing and integrating sensations, motor functions and parental goals of 3-year-old child with RSTS. Analysis of assessment data reviewed before and after treatment. Assessment collected by interview, Sensory Profile (SP), Sensory Processing Measure-Preschool (SPM-P) Home, Peabody Developmental Motor Scales-2 (PDMS-2), Gross Motor Function Measurement-88 (GMFM-88), and Gross Motor Function Classification System (GMFCS). Progress toward goals and objectives was measured with Goal Attainment Scale (GAS). ASI intervention was implemented 3 times per week for 8 weeks. At pre-intervention, SP and SPM-P Home revealed prominent sensory processing and integration difficulties in this case. PDMS-2 scores indicated the child was far behind his peers in fine and gross motor areas. In addition, systematic observations determined that the child's GMFCS level was III. After 8 weeks of ASI intervention significant improvements were found in parent reports of sensory processing in the areas of vestibular, tactile, and oral functioning on the Sensory Profile. Gains in functional motor skills were found on the GMFM-88 and the GMFCS. Consistent with these results, significant gains at or above expected levels of performance were found on GAS goals which reflected the family's main concerns for social participation, feeding, play, and movement. There are limited studies on sensory processing and integration in children with RSTS. This case report identified sensory processing and integration difficulties for the first time in a child with RSTS. Results also provide preliminary support for the positive effects of ASI intervention on sensory processing, functional motor skills, and parental goals of a child with RSTS.

Combined sensory integration therapy plus neurodevelopmental therapy (NT) versus NT alone for motor and attention in children with Down syndrome: a randomized controlled trial

In this study, we aimed to analyze the incremental effects of sensory integration therapy (SIT) plus neurodevelopmental therapy (NT) versus NT alone on the attention and motor skills in children with Down syndrome (DS). We randomly assigned into experimental (i.e. SIT + NT; n = 21) and control (i.e. NT alone; n = 21) groups. While NT was applied to both groups for six weeks, SIT was applied simultaneously to the experimental group for six weeks. Participants' motor functions (Bruininks-Oseretsky Test of Motor Proficiency-Short form (BOT-2 SF)) and attention skills (Stroop TBAG (Turkish Scientific and Technological Research Association) Form) were evaluated before and after treatment (6 weeks later). Stroop TBAG and BOT-2 SF scores of the groups were similar at the baseline (p > 0.05). Significant improvement from baseline was observed in both BOT-2 SF, and Stroop TBAG results in both groups (p < 0.05). In addition, the improvement in both BOT-2 SF and Stroop TBAG results was found to be greater in the experimental group compared to the control group (p < 0.01). There were clear advantages to adding SIT to NT alone when seeking to improve motor and attention skills in children with DS.

Sensory Modulation in Children with Developmental Coordination Disorder Compared to Autism Spectrum Disorder and Typically Developing Children

Developmental Coordination Disorder (DCD) is one of the least studied and understood developmental disorders. One area that has been minimally investigated in DCD is potential issues with sensory modulation. Further, in other neurodevelopmental disorders (e.g., autism spectrum disorder (ASD)) sensory modulation is related to many other challenges (e.g., social issues, repetitive behaviors, anxiety); however, such potential relationships in children with DCD have been largely unexplored. The purpose of this study is to explore sensory modulation differences in DCD and to understand the relationships between sensory modulation and social emotional measures, behavior, and motor skills in DCD in comparison to ASD and typically developing (TD) peers. Participants (aged 8-17) and their caregivers (DCD, N = 26; ASD, N = 57; and TD, N = 53) completed behavioral and clinical measures. The results indicated that 31% of the DCD group showed sensory modulation difficulties, with the DCD group falling between the ASD and TD groups. In the DCD group, sensory modulation was significantly associated with anxiety, empathic concern, repetitive behaviors, and motor skills. Data are compared to patterns seen in ASD and TD groups and implications for interventions are discussed.

Feasibility of a randomized controlled trial of a proprioceptive and tactile vest intervention for children with challenges integrating and processing sensory information

BACKGROUND

Children with challenges integrating and processing sensory information can have difficulties participating in play and learning activities. One way to support participation is to offer sensory stimulation, such as proprioceptive and tactile stimulation provided by wearing a sensory-stimulating vest. The aim of this study was to investigate the feasibility of the key procedures of a planned full-scale randomized controlled trial (RCT) of a proprioceptive and tactile stimulation vest for children aged 6-12 years who have challenges integrating and processing sensory information. The study focused on the feasibility of the recruitment and information processes, the relevance of the study materials, the usefulness of diaries completed by parents, and use of the following outcome measures: Test of Everyday Attention-Children (TEACh), registration of off-task behaviour, and pulse rate.

METHODS

Ten schoolchildren aged 6-12 years (mean 8.4) who had challenges integrating and processing sensory information and sensory-seeking behaviours (based on their Short Sensory Profile scores) participated in the study. Study feasibility was assessed using data from interviews with the participating children, their parents and teachers, and psychologists from the municipal Educational Psychological Counselling Departments.

RESULTS

Recruitment and introductory materials were found to be relevant and non-problematic, while the outcome measurements, diaries, and pulse measurements did not work well, and the tool for registering off-task behaviours needed to be revised. The results indicated that an outcome measure relating to the children's subjective experiences and closer involvement of teachers in the study could be beneficial.

CONCLUSION

The aim of the study was to investigate the feasibility of the planned methodology for a full-scale RCT of a proprioceptive and tactile stimulating vests for children with challenges integrating and processing sensory information. We found that a partial redesign of the study is needed before a full-scale RCT is conducted and that this should include outcome measures on the children's subjective experiences with using the vest.

The Effects of Ayres Sensory Integration and Related Sensory Based Interventions in Children with Cerebral Palsy: A Scoping Review

The theory of Ayres Sensory Integration® was formulated in the 1960s, and is also known as sensory integration (SI). It has been used in people with cerebral palsy (CP), though the research evidence for its effects in this population is contradictory and inconclusive. To fill in this knowledge gap, we conducted a scoping review of the body of literature on the topic, including any type of quantitative or qualitative research of SI in people with CP without any restrictions of age, language, geography, professionals involved, etc. In September 2020, we searched Scopus, ProQuest Central, MEDLINE (via PubMed), CINAHL Plus and the Academic Search Ultimate and Web of Science, as well as the grey literature sources OpenGrey and MedNar. Two reviewers independently screened the texts and the references lists of the included papers. We finally included seven relevant papers (four randomized controlled trials, two quasi-experimental studies and one case series), though not all fidelity measures required for Ayres SI were reported in the papers. The age of participants ranged from 3 months to 15 years; no studies were identified on adults. There is some evidence that SI or related sensory-based interventions (SBI) may be useful for movement development and other outcomes (attention span, therapy of sensory processing disorders, body perception and therapy of strabismus), but there is only scarce and low-quality evidence comparing interventions. We recommend to conduct well-designed randomized controlled trials (RCTs) with an optimal sample size on the effectiveness of formal Ayres SI for the motor development or other outcomes (as attention span or self-care abilities) using standardized measurement tools.

Sensory Modulation Dysfunction in Child Victims of Trauma: a Scoping Review

Due to the high level of violence globally, providing intervention for child victims of trauma has become a priority for various government departments and health professionals including occupational therapists. Child appropriate sensory modulation intervention, which has its theoretical origins within the occupational therapy profession, has been suggested as a suitable treatment approach for children who are victims of trauma, since the initial experience of trauma occurs on a somatosensory level. Advances in trauma care indicate that children may experience the effects of trauma as an inability to appropriately regulate and organize sensory responses. This results in sensory modulation dysfunction associated with emotional and behavior difficulties. This scoping review provides an overview of the extent to which sensory modulation dysfunction has been identified and treated in child victims of trauma. Using the Arksey and O'Malley (2005) framework, five databases and three manual hand searches were conducted. This scoping review confirmed the scarcity of research available. The 13 studies which met the inclusion criteria indicated that child victims of trauma (CVT) present with a sensory modulation disorder (SMD). Sensory modulation intervention, within the theoretical framework of Ayres Sensory Integration® (ASI®), alone and in combination with psychotherapy approaches was found to be valuable for CVT, in the studies chartered. Identification and treatment of sensory modulation dysfunction in CVT has been researched and is becoming an area of increasing need. Therefore, to remain relevant to the violent contexts within communities, there is a need to expand research in this field.

Exploration of Sensory Processing Difficulties among Children Attending Primary School in Denmark

Current research shows that children with sensory processing (SP) difficulties have limited participation and enjoyment in their daily activities at school. The aim of this study was to explore the prevalence of SP difficulties among Danish children and to explore possible associated factors. Since SP difficulties can affect children's prerequisites for participation in school activities and learning possibilities, this study focused on primary school children. Method. The study was designed as a cross-sectional survey. The sample consisted of 1723 children age 5 to 11 years, who were attending Danish public school (45.5% girls, 53.2% boys). The parents or caregivers of the child completed a Short Sensory Profile (SSP) questionnaire and a demographic questionnaire. One-way ANOVA was used to examine differences between girls and boys regarding sports, geographic area, and parental level of education. Chi-square analysis was used to explore the relationship between sex and SPP scores in the different behavioral sections. Logistic regression analysis was used to investigate possible associations between SP difficulties and sex and the included demographics. Results. A total of 21.3% of the children had SSP scores suggesting SP difficulties. Boys had a higher probability of having SP difficulties than girls (odds ratio (OR) = 1.55, confidence level (Cl): 1.22, 1.97). An association was found between participating in sports outside of school and SP difficulties (OR = 0.55, Cl: 0.47, 0.65 (p ≤ 0.001)). Additionally, a slight association between SP difficulties and parental education level (OR = 0.80) was found. No association was found regarding geographic area, i.e., where in Denmark the children attended school (OR = 1.00). Conclusion. The study results suggest that approximately 20% of the children in Danish public schools might have SP difficulties and over 20% might be at risk of having SP difficulties. The results suggest that Danish schools should focus on both identifying children with SP difficulties and implement interventions such as sensory integration through occupational therapy to help children with SP difficulties, in order to improve their ability to participate and learn from school activities.

Motor skill intervention for pre-school children: A scoping review

Background

There is a high prevalence of motor skill difficulties amongst pre-school children living in low socio-economic areas. Motor skill impairment can affect these children’s school readiness and academic progress, social skills, play and general independence.

Objectives

This scoping review investigates the key elements of existing motor skill interventions for pre-school children.

Method

We gathered information through structured database searches from Cinahl, Eric, PubMed, Cochrane, ProQuest, Psych Net, PEDro and Scopus, using a keyword string. The PRISMA-SCR design was used to identify 45 eligible studies. All included studies investigated a motor skill intervention with well-defined outcome measures for children aged 4–7 years with motor skill difficulties. Studies that exclusively focused on children with neurological conditions such as cerebral palsy, physical disabilities or medical/physical deteriorating conditions were excluded. Information was charted on MS Excel spreadsheets. Fundamental concepts were categorised into common key themes and were converted into a proposed framework.

Results

Fifteen intervention approaches were identified. Treatment is mostly managed by occupational therapists and physiotherapists. Evidence supports individual and group treatment with a child-centred, playful approach in a school or therapeutic setting. Whilst session information varied, there is moderate evidence to suggest that a 15-week programme, with two weekly sessions, may be feasible.

Conclusion

Children with motor skill difficulties need therapeutic intervention. This study identified the key elements of existing therapy intervention methods and converted it into a proposed framework for intervention planning. It is a first step towards addressing motor skill difficulties amongst pre-school children in low socio-economic areas.

Impact of Sensory Processing on School Performance Outcomes in High Functioning Individuals with Autism Spectrum Disorder

Difficulty processing sensory information may impede progress in school for students with autism spectrum disorder (ASD). We explore the relationship between sensory processing and school performance in 26 high-functioning youths with ASD and 26 controls (age 8-14) using measures of sensory, social, cognitive, and academic functioning. In the ASD group, bivariate Pearson correlations indicated a significant positive relationship between intelligence quotient (IQ) and the School Competence Scale (SCS) of the Child Behavior Checklist (CBCL), and a significant negative relationship between Dunn's Sensory Processing Framework and SCS scores. Final hierarchical multiple linear regression model accounting for SCS scores in ASD included IQ, ADHD symptoms, and sensory features. An interaction between increased sensory sensitivity with reduced sensory avoidance behaviors explained the greatest amount of variance in SCS, meaning school performance is lowest for children with greater hypersensitivity and fewer avoidance behaviors. Results indicate a strong impact of sensory processing on school performance in ASD.

Balance Training as an Adjunct to Methylphenidate: A Randomized Controlled Pilot Study of Behavioral Improvement Among Children With ADHD in China

Objective: This study aimed to compare the therapeutic effects of two different approaches to attention deficit hyperactivity disorder (ADHD): (1) methylphenidate (MPH) treatment combined with balance training, and (2) MPH monotherapy. Methods: The study was based on a randomized, single-blind trial involving 27 ADHD patients. An experimental group received the treatment combining MPH and balance training, while a control group were administered just MPH. After 40 sessions of training at the 6-month mark, patients' improvement as observed in their core symptoms and behavioral problems were compared between the experimental and control group. Results: A total of 27 patients underwent randomization, with 13 assigned to the experimental group and 14 to the control group. After the 6-month trial, the experimental group outperformed the control group in terms of teachers' scores for inattention on the ADHD-RS-IV (19.38 ± 2.96 vs. 23.21 ± 3.91, t = -2.854, P = 0.009). The experimental group also showed greater improvement on the items involving behavior (3.14 ± 1.46 vs. 5.24 ± 1.04, t = 1.463, P = 0.026) and hyperactivity (1.92 ± 1.19 vs. 3.86 ± 2.32, t = -2.697, P = 0.012). Conclusion: In children with ADHD, the experimental group displayed a significant improvement in the symptoms and behavior associated with inattention than did the group whose treatment consisted of only MPH.

Assessment of Sensory Processing and Executive Functions at the School: Development, Reliability, and Validity of EPYFEI-Escolar

The aim of this study was to determine the psychometric properties of the Assessment of Sensory Processing and Executive Functions at the School (EPYFEI-Escolar), a questionnaire designed to assess the sensory processing and executive functions as underlying processes for school participation. The total sample consisted of 536 children aged between 3 and 11 years old who lived in Spain. A total of 103 teachers completed the questionnaire. An exploratory factor analysis was conducted, which showed five main factors: (1) initiation, organization, execution, and supervision of the action; (2) inhibitory control; (3) sensory processing; (4) emotional self-regulation and play; and (5) self-competence. Some of these factors were similar to those found in the EPYFEI for parents in the home context. The reliability of the analysis was high, both for the whole questionnaire and for the factors it is composed of. The results provide evidence of the potential usefulness of the EPYFEI-Escolar in school contexts for determining academic needs and difficulties of children; moreover, this tool can also be used to plan intervention programs in the school environment according to the needs of each child and school.

Early intervention programmes for infants at high risk of atypical neurodevelopmental outcome

The purpose of this review is to present a new framework, EI SMART (early intervention: sensorimotor development, attention and regulation, relationships, and therapist support) for identifying key components that could contribute to more effective interventions for infants at high risk of atypical neurodevelopmental outcome. We present a clinical consensus of current challenges and themes in early intervention, based on multidisciplinary group discussions, including parents of high-risk infants, supported by a literature review. Components to include in early intervention programmes are: (1) promotion of self-initiated, developmentally appropriate motor activity; (2) supporting infant self-regulation and the development of positive parent-infant relationships; and (3) promotion of early communication skills, parent coaching, responsive parenting, and supporting parental mental well-being. Such multimodal programmes may need to be evaluated as a package. WHAT THIS PAPER ADDS: Early intervention programmes should address sensorimotor development, attention, self-regulation, and early communication skills. Therapist input to the programme should include parent coaching and support for parental mental well-being.

Sensory Integration and Functional Reaching in Children With Rett Syndrome/Rett-Related Disorders

Background

The loss of functional hand skills is a primary characteristic of Rett syndrome. Stereotypies, dyspraxia, and other sensory processing issues severely limit the individual's ability to reach toward and sustain grasp on objects. This loss of functional reach and grasp severely limits their ability to participate in self-help, play, and school-related activities. We proposed that Ayres Sensory Integration (ASI) treatment would improve sensory processing and motor planning, which would lay the sensory-motor groundwork for improving grasp of objects, an important first step in developing functional hand use.

Objective

We examined effects of ASI treatment on rate of reaching and grasping for children with Rett syndrome/Rett-related disorders.

Methods

We used an interrupted time series design to measure changes in outcome variables occurring after intervention initiation and cessation. We analyzed daily video observations during baseline, intervention, and post-intervention periods, over a span of 7 months.

Results

During baseline, rate of grasping declined moderately. There was a 15% increase in grasping from the end of baseline to end of the post-intervention period. There was no significant change in rate of reaching.

Conclusions

This study provides preliminary data showing very small improvements in hand grasp of children with Rett syndrome following ASI treatment; larger studies in diverse settings are needed to establish the effectiveness of this approach. This study shows that an interrupted time series research design provides a valid template for evaluating interventions for children with rare disorders.

Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review

INTRODUCTION

Paediatric occupational therapy seeks to improve children's engagement and participation in life roles. A wide variety of intervention approaches exist. Our aim was to summarise the best-available intervention evidence for children with disabilities, to assist families and therapists choose effective care.

METHODS

We conducted a systematic review (SR) using the Cochrane methodology, and reported findings according to PRISMA. CINAHL, Cochrane Library, MEDLINE, OTSeeker, PEDro, PsycINFO were searched. Two independent reviewers: (i) determined whether studies met inclusion: SR or randomised controlled trial (RCT); an occupational therapy intervention for children with a disability; (ii) categorised interventions based on name, core components and diagnostic population; (iii) rated quality of evidence and determined the strength of recommendation using GRADE criteria; and (iv) made recommendations using the Evidence Alert Traffic Light System.

RESULTS

129 articles met inclusion (n = 75 (58%) SRs; n = 54 (42%)) RCTs, measuring the effectiveness of 52 interventions, across 22 diagnoses, enabling analysis of 135 intervention indications. Thirty percent of the indications assessed (n = 40/135) were graded 'do it' (Green Go); 56% (75/135) 'probably do it' (Yellow Measure); 10% (n = 14/135) 'probably don't do it' (Yellow Measure); and 4% (n = 6/135) 'don't do it' (Red Stop). Green lights were: Behavioural Interventions; Bimanual; Coaching; Cognitive Cog-Fun & CAPS; CO-OP; CIMT; CIMT plus Bimanual; Context-Focused; Ditto; Early Intervention (ABA, Developmental Care); Family Centred Care; Feeding interventions; Goal Directed Training; Handwriting Task-Specific Practice; Home Programs; Joint Attention; Mental Health Interventions; occupational therapy after toxin; Kinesiotape; Pain Management; Parent Education; PECS; Positioning; Pressure Care; Social Skills Training; Treadmill Training and Weight Loss 'Mighty Moves'.

CONCLUSION

Evidence supports 40 intervention indications, with the greatest number at the activities-level of the International Classification of Function. Yellow light interventions should be accompanied by a sensitive outcome measure to monitor progress and red light interventions could be discontinued because effective alternatives existed.

Enriched Environments as a Potential Treatment for Developmental Disorders: A Critical Assessment

The beneficial effects of enriched environments have been established through a long history of research. Enrichment of the living conditions of captive animals in the form of larger cages, sensory stimulating objects, and opportunities for social interaction and physical exercise, has been shown to reduce emotional reactivity, ameliorate abnormal behaviors, and enhance cognitive functioning. Recently, environmental enrichment research has been extended to humans, in part due to growing interest in its potential therapeutic benefits for children with neurodevelopmental disorders (NDDs). This paper reviews the history of enriched environment research and the use of enriched environments as a developmental intervention in studies of both NDD animal models and children. We argue that while environmental enrichment may sometimes benefit children with NDDs, several methodological factors need to be more closely considered before the efficacy of this approach can be adequately evaluated, including: (i) operationally defining and standardizing enriched environment treatments across studies; (ii) use of control groups and better control over potentially confounding variables; and (iii) a comprehensive theoretical framework capable of predicting when and how environmental enrichment will alter the trajectory of NDDs.

Increased risk of developing psychiatric disorders in children with attention deficit and hyperactivity disorder (ADHD) receiving sensory integration therapy: a population-based cohort study

Parents of children with attention deficit hyperactivity disorder (ADHD) have been found to prefer sensory integration (SI) training rather than guideline-recommended ADHD treatment. This study investigated whether SI intervention for children with ADHD was associated with a reduced risk of subsequent mental disorders. From children < 8-years-old newly diagnosed with ADHD in a nationwide population-based dataset, we established a SI cohort and a non-SI cohort (N =  1945) matched by propensity score. Incidence and hazard ratios of subsequent psychiatric disorders were compared after a maximum follow-up of 9 years. The incidence of psychiatric disorders was 1.4-fold greater in the SI cohort, with an adjusted hazard ratio of 1.41 (95% confidence interval 1.20-1.67), comparing to the non-SI cohort. Risks were elevated for emotional disturbances, conduct disorders, and adjustment disorders independent of age, gender, or comorbidity. Among children with only psychosocial intervention, the incidence of psychiatric disorders was 3.5-fold greater in the SI cohort than in the non-SI cohort. To our knowledge, this is the first study to report an increased risk of developing psychiatric disorders for children with ADHD who received SI compared to those who did not. Potential adverse effects of SI for ADHD children should be carefully examined and discussed before practice.

A systematic review of ayres sensory integration intervention for children with autism

Sensory integration is one of the most highly utilized interventions in autism, however, a lack of consensus exists regarding its evidence base. An increasing number of studies are investigating the effectiveness of this approach. This study used the Council for Exceptional Children (CEC) Standards for Evidence-based Practices in Special Education to evaluate the effectiveness research from 2006 to 2017 on Ayres Sensory Integration (ASI) intervention for children with autism. A systematic review was conducted in three stages. Stage 1 involved an extensive database search for relevant studies using search terms related to sensory integration and autism, interventions suggesting a sensory integration approach, and high-quality study designs. Searches yielded 19 studies that were evaluated in Stage 2. Six of these met inclusion criteria of being peer-reviewed, written in English, description of intervention this is consistent with ASI intervention, and comparison group design or single subject method employed. Prior to analysis using CEC standards, three articles were excluded because intervention details were not consistent with the core principles of ASI, or because of major methodological flaws. In Stage 3, the remaining three studies were rated using the CEC quality indicators and standards for an evidence-based practice. Two randomized controlled trials respectively met 100% and 85% of the CEC criteria items. One additional study met more than 50% of the criteria. Based on CEC criteria, ASI can be considered an evidence-based practice for children with autism ages 4-12 years old. Autism Research 2019, 12: 6-19. © 2018 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY: Ayres Sensory Integration intervention is one of the most frequently requested and highly utilized interventions in autism. This intervention has specific requirements for therapist qualifications and the process of therapy. This systematic review of studies providing Ayres Sensory Integration therapy to children with autism indicates that it is an evidence-based practice according to the criteria of the Council for Exceptional Children.

Single-case synthesis tools I: Comparing tools to evaluate SCD quality and rigor

Tools for evaluating the quality and rigor of single case research designs (SCD) are often used when conducting SCD syntheses. Preferred components include evaluations of design features related to the internal validity of SCD to obtain quality and/or rigor ratings. Three tools for evaluating the quality and rigor of SCD (Council for Exceptional Children, What Works Clearinghouse, and Single-Case Analysis and Design Framework) were compared to determine if conclusions regarding the effectiveness of antecedent sensory-based interventions for young children changed based on choice of quality evaluation tool. Evaluation of SCD quality differed across tools, suggesting selection of quality evaluation tools impacts evaluation findings. Suggestions for selecting an appropriate quality and rigor assessment tool are provided and across-tool conclusions are drawn regarding the quality and rigor of studies. Finally, authors provide guidance for using quality evaluations in conjunction with outcome analyses when conducting syntheses of interventions evaluated in the context of SCD.

Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review

This systematic review addresses the question "What is the efficacy of occupational therapy using Ayres Sensory Integration^® (ASI) to support functioning and participation as defined by the International Classification of Functioning, Disability and Health for persons with challenges in processing and integrating sensory information that interfere with everyday life participation?" Three randomized controlled trials, 1 retroactive analysis, and 1 single-subject ABA design published from 2007 to 2015, all of which happened to study children with autism, met inclusion criteria. The evidence is strong that ASI intervention demonstrates positive outcomes for improving individually generated goals of functioning and participation as measured by Goal Attainment Scaling for children with autism. Moderate evidence supported improvements in impairment-level outcomes of improvement in autistic behaviors and skills-based outcomes of reduction in caregiver assistance with self-care activities. Child outcomes in play, sensory-motor, and language skills and reduced caregiver assistance with social skills had emerging but insufficient evidence.

Sensory Reduction on the General Milieu of a High-Acuity Inpatient Psychiatric Unit to Prevent Use of Physical Restraints: A Successful Open Quality Improvement Trial

BACKGROUND

Impaired sensory gating in patients with acute mental illness predisposes to overstimulation and behavioral dyscontrol.

OBJECTIVE

Explore use of sensory reduction interventions on a high-acuity inpatient milieu to reduce high assault/restraint rates.

DESIGN

A multidisciplinary team using failure mode and effect analysis to explore high restraint use between 4:00 p.m. and 7:00 p.m. observed patient/staff overstimulation contributed to behavioral escalations. The team implemented sensory reduction/integration improvements over a 5-month period to prevent excessive restraint use.

RESULTS

Restraint rates dropped immediately following light and sound reduction interventions and by 72% at 11 months postimplementation. Mann-Whitney statistics for unpaired 6-month comparisons, 1-year pre- and postintervention showed significant reductions: Assault rates (median pre = 1.37, post = 0.18, U = 4, p = .02); Restraint rates (median pre = 0.50, post = 0.06, U = 0, p = .002).

CONCLUSION

Sensory reduction during a high-stress time period on a high-acuity psychiatric unit was associated with a reduction in assaults and restraints.

The Effect of Sensory Integration Therapy on Occupational Performance in Children With Autism

Sensory processing problems and related dysfunctions are among the most common conditions in children with autism spectrum disorder (ASD). This study examined the effect of sensory integration therapy (SIT) on different aspects of occupational performance in children with ASD. The study was conducted on an intervention group ( n = 16) receiving SIT and a control group ( n = 15) with 3- to 8-year-old children with ASD. The Short Child Occupational Profile (SCOPE) was used to compare the two groups in terms of the changes in their occupational performance and the Sensory Profile (SP) was used to assess sensory problems. The intervention group showed significantly greater improvement in all the SCOPE domains, as well as in all the SP domains, except for the "emotional reactions" and "emotional/social responses" domains, ( p < .05). The effectiveness of SIT in improving occupational performance in children with ASD as a health-related factor is supported by our findings.

Brief Report: Meeting the Needs of Medically Hospitalized Adults with Autism: A Provider and Patient Toolkit

In an effort to meet the needs of adults with autism spectrum disorder (ASD) while hospitalized, a team of experts and providers from Massachusetts General Hospital (MGH), MGH for Children as well as parents of individuals with ASD was sparked in 2013. This became a multidisciplinary collaborative, the MGH Autism Care Collaborative, to improve adult care for inpatients with ASD. The collaborative was created with three goals in mind: (1) to educate internal medicine adult inpatient providers and staff on the unique needs of adults with ASD when hospitalized; (2) to create ASD specific resources for internal medicine adult inpatient providers; (3) to optimize patient care from admission to discharge among adults with ASD admitted to internal medicine services.

Longitudinal Study of Sensory Features in Children with Autism Spectrum Disorder

BACKGROUND

Between 45 and 95% of children with Autism Spectrum Disorder (ASD) present sensory features that affect their daily functioning. However, the data in the scientific literature are not conclusive regarding the evolution of sensory features in children with ASD. The main objective of this study was to analyze the sensory features of children within the age of 3-4 (T1) when they received their ASD diagnosis and two years later (T2) when they started school.

METHODS

We conducted a prospective cohort study to assess sensory features in 34 children with ASD over time. The data were collected using a standardized assessment tool, the Sensory Profile.

RESULTS

Our analyses show that sensory features in children with ASD are stable from the age of three to six years. The stability of sensory scores is independent of correction by covariates, such as cognitive level and autism severity scores.

CONCLUSIONS

Children with ASD have sensory features that persist from the time of diagnosis at the age of 3 to 4 years to school age. This persistence of sensory features from an early age underscores the need to support these children and their parents. Sensory features should be detected early and managed to improve functional and psychosocial outcomes.

Manualization of Occupational Therapy Using Ayres Sensory Integration® for Autism

This article reports on the development of a Stage 3 manual (following pilot effectiveness study) for implementing occupational therapy using Ayres Sensory Integration® (OT/ASI) for children with autism spectrum disorders to enhance participation in daily occupations. Three stakeholder groups were surveyed to aid in translation of manual from research to practice (i.e., Stage 3 manual) and an expert consensus meeting was held to finalize recommendations. Data indicated that the manuals usability could be improved by including a section on frequently encountered problems and solutions, and by including video case examples. Also recommended were greater chapter uniformity, improved clarity of forms and charts, and inclusion of a glossary. Changes were made and subject to expert review and consensus using modified Delphi process. The Stage 3 manual has been rigorously vetted and is ready for practice and research replication.

SENSORY PROCESSING DURING CHILDHOOD IN PRETERM INFANTS: A SYSTEMATIC REVIEW

OBJECTIVE

To conduct a systematic search for grounded and quality evidence of sensory processing in preterm infants during childhood.

DATA SOURCE

The search of the available literature on the theme was held in the following electronic databases: Medical Literature Analysis and Retrieval System Online (Medline)/PubMed, Latin American and Caribbean Literature in Health Sciences (Lilacs)/Virtual Library in Health (BVS), Índice Bibliográfico Español de Ciencias de la Salud (IBECS)/BVS, Scopus, and Web of Science. We included only original indexed studies with a quantitative approach, which were available in full text on digital media, published in Portuguese, English, or Spanish between 2005 and 2015, involving children aged 0-9years.

DATA SYNTHESIS

581 articles were identified and eight were included. Six studies (75%) found high frequency of dysfunction in sensory processing in preterm infants. The association of sensory processing with developmental outcomes was observed in three studies (37.5%). The association of sensory processing with neonatal characteristics was observed in five studies (62.5%), and the sensory processing results are often associated with gestational age, male gender, and white matter lesions.

CONCLUSIONS

The current literature suggests that preterm birth affects the sensory processing, negatively. Gestational age, male gender, and white matter lesions appear as risk factors for sensoryprocessing disorders in preterm infants. The impairment in the ability to receivesensory inputs, to integrateand to adapt to them seems to have a negative effect on motor, cognitive, and language development of these children. We highlight the feasibility of identifying sensory processing disorders early in life, favoring early clinical interventions.

Assessment of Sensory Processing Characteristics in Children between 3 and 11 Years Old: A Systematic Review

The assessment of sensory perception, discrimination, integration, modulation, praxis, and other motor skills, such as posture, balance, and bilateral motor coordination, is necessary to identify the sensory and motor factors influencing the development of personal autonomy. The aim of this work is to study the assessment tools currently available for identifying different patterns of sensory processing. There are 15 tests available that have psychometric properties, primarily for the US population. Nine of them apply to children in preschool and up to grade 12. The assessment of sensory processing is a process that includes the use of standardized tests, administration of caregiver questionnaires, and clinical observations. The review of different studies using PRISMA criteria or Osteba Critical Appraisal Cards reveals that the most commonly used tools are the Sensory Integration and Praxis Test, the Sensory Processing Measure, and the Sensory Profile.

Reaction to the sensory integration therapy in children with postural stability deficits

BACKGROUND

The goal was to examine the influence of sensory integration therapy (SIT) on one leg standing in children with deficits of the postural stability.

METHODS

28 children 4-6 year old that could not stand on one leg for more than 20 seconds were randomly divided into control "C" and experimental "E" groups. Group "C" participated in standard classes in the kindergarten. Group "E" participated in sensory integration therapy (SIT) for 2 weeks, 5 times a week (additionally to the standard classes).

RESULTS

Results of the experiment show that the skill of standing on one leg has significantly improved (P<0.01) in the group that underwent additional therapy. The change in time of standing on the right leg with eyes open in the E group was statistically and significantly higher than the changes observed in the same time in group C (F=22.5, P=0.001' η²=0.44). Similarly, significant changes in time of standing on the right leg with eyes closed were observed in group E. The foregoing changes were bigger in group E than in group C (F=16. 1, P=0.004, η²=0.36). The analysis post hoc revealed that while there were no significant differences between the two groups on the pretest (P>0.05), there were significant differences between groups in right leg standing test with eyes open or closed on posttest. (P<0.05). Similar results were observed during on the one, left leg standing. The time of one leg standing with both eyes open and closed improved more significantly in group E than in group C (F=20.4, P=0.001, η²=0.42 respectively for the test with eyes open and F=7.4, P=0.010, η²=0.21 for the test with eyes closed). The analysis post hoc revealed that while there were no significant differences between the two groups on the pretest (P>0.05), there were significant differences between groups in left leg standing test with eyes open or closed on posttest (P<0.05).

CONCLUSIONS

Research conducted show that there is a positive influence of SIT on children with low level of postural stability. Its significant improvement in children with low levels of postural stability is important not only for the current functioning of those children but for their future - by protecting them from falling down and from injuries.

The Efficiency of Sensory Integration Interventions in Preterm Infants

This study aimed to explore the effects of individualized sensory integration interventions on the sensory processing functions of preterm infants. Thirty-four preterm infants (intervention group) at a corrected age of seven months and 34 term infants (control group) were included. The preterm infants underwent an eight-week sensory integration intervention. Before and after the intervention, the preterm infants' sensory processing functions were evaluated using the Test of Sensory Functions in Infants and compared with those of term infants. Preterm infants had significantly poorer sensory processing function preintervention when compared with term infants. There was a significant improvement in preterm infants' sensory processing functions after the sensory integration intervention. In conclusion, preterm infants should be evaluated for sensory processing disorders and individualized sensory integration interventions should be implemented.

Dosage Parameters in Pediatric Outcome Studies Reported in 9 Peer-Reviewed Occupational Therapy Journals from 2008 to 2014: A Content Analysis

Occupational therapists determine the dosage when establishing the plan of care for their pediatric clients. A content analysis was conducted using 123 pediatric occupational therapy outcomes studies from 9 scholarly international occupational therapy journals. The parameters of dosage were calculated using descriptive statistics in order to obtain a representation of dosage available within the current collage of pediatric occupational therapy outcomes studies. The results revealed that most studies reported portions of dosage parameters within the published studies. The average findings for the subcomponents related to dosage were session length (minutes) M = 58.7, duration of plan of care (weeks) M = 12.1, session frequency (per week) M = 3.4, and total hours of therapy (hours) M = 18.1. This first attempt at describing and calculating dosage related to pediatric occupational therapy practice indicates that evidence is lacking within the published literature to adequately guide OT dosage decisions. Further research related to dosage in pediatric occupational therapy practice is needed.

Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies

Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control.

Effectiveness of Ayres Sensory Integration® and Sensory-Based Interventions for People With Autism Spectrum Disorder: A Systematic Review

This systematic review examines the literature published from January 2006 through April 2013 related to the effectiveness of Ayres Sensory Integration® (ASI) and sensory-based interventions (SBIs) within the scope of occupational therapy for people with autism spectrum disorder to improve performance in daily life activities and occupations. Of the 368 abstracts screened, 23 met the inclusion criteria and were reviewed. Moderate evidence was found to support the use of ASI. The results for sensory-based methods were mixed. Recommendations include performing higher level studies with larger samples, using the Fidelity Measure in studies of ASI, and using carefully operationalized definitions and systematic methods in examination of SBIs.

How child's play impacts executive function--related behaviors

Executive functions refer to an array of organizing and self-regulating behaviors often associated with maturation of the prefrontal cortex. In fact, young children with rudimentary neurodevelopment of the prefrontal cortex develop ways to inhibit impulses and regulate behavior from a very early age. Can executive functioning be impacted by intervention, practice, or training? What interventions impact development of executive function in childhood, and how can these be studied? Several programs are reviewed that propose to positively impact executive/self-regulation skills. Evidence-based programs are contrasted with popular programs that have little empirical basis but have apparent wide acceptance by educators and families. As self-regulation has critical implications for later school and life success, interventions may well attenuate the negative consequences of attention-deficit hyperactivity disorder, brain injury, and social stressors. Programs with active play components may be more successful in eliciting improved executive function (defined here as self-regulation) because of the importance of motor learning early on and because of the social motivation aspects of learning. Caution is advised in the recommendation of programs where there is little empirical basis to support program claims. Carefully planned outcome studies can help bring the most effective components of programs to the mainstream.

A systematic review of sensory-based treatments for children with disabilities

Sensory-based therapies are designed to address sensory processing difficulties by helping to organize and control the regulation of environmental sensory inputs. These treatments are increasingly popular, particularly with children with behavioral and developmental disabilities. However, empirical support for sensory-based treatments is limited. The purpose of this review was to conduct a comprehensive and methodologically sound evaluation of the efficacy of sensory-based treatments for children with disabilities. Methods for this review were registered with PROSPERO (CRD42012003243). Thirty studies involving 856 participants met our inclusion criteria and were included in this review. Considerable heterogeneity was noted across studies in implementation, measurement, and study rigor. The research on sensory-based treatments is limited due to insubstantial treatment outcomes, weak experimental designs, or high risk of bias. Although many people use and advocate for the use of sensory-based treatments and there is a substantial empirical literature on sensory-based treatments for children with disabilities, insufficient evidence exists to support their use.

Using Posturography to Examine the Immediate Effects of Vestibular Therapy for Children with Autism Spectrum Disorders: A Feasibility Study

AIMS

The primary objective of this study was to determine the feasibility of using posturography to monitor acute changes in postural control induced by a Sensory Integration (SI) therapy intervention. A secondary objective was to identify which posturography outcome parameters, tests conditions and data analysis methods might be most useful in identifying post-intervention changes.

METHODS

Five children with Autism Spectrum Disorder (ASD) and five children with typical development (TD) participated in a 10 min vestibular swing activity and had their postural stability evaluated pre- and post-intervention under four different sensory testing conditions. Sway ranges, mean sway velocity, sway root mean square (RMS), and sample entropy were calculated from center of pressure (COP) data.

RESULTS

All five children with ASD demonstrated decreased mean sway velocity in the eyes open/flat plate condition post-intervention with an average decrease of 5.87 ± 2.69 mm/s. Four of the five children with ASD demonstrated an increase in RMS and a decrease in anterior/posterior sample entropy post-intervention in the eyes closed, foam pad condition and eyes open, flat plate condition respectively.

CONCLUSION

Posturography may be useful for assessing acute physiologic responses to an SI therapy intervention and warrants further investigation.