Autism Therapy: sensory integration

definition of sensory integration: Neurological process that organizes sensation from one's own body and the environment. Sensory integration makes it possible to use the body effectively within the environment. Children with autism are believed to have difficulties integrating sensory information.

Sensory Integration Therapy for Children with Autism

Published Nov 6, 2009, last updated Dec 21, 2009

What is it?

Most of us unconsciously learn to combine our senses (sight, sound, smell, touch, taste, balance, body in space) in order to make sense of our environment. Children with autism have trouble learning to do this. Sensory integration therapy is a type of occupational therapy (OT) that places a child in a room specifically designed to stimulate and challenge all of the senses. During the session, the therapist works closely with the child to encourage movement within the room.

Sensory integration therapy is driven by four key principles (1):

  1. the child must be able to successfully meet the challenges that are presented through playful activities (Just Right Challenge);
  2. the child adapts her behavior with new and useful strategies in response to the challenges presented (Adaptive Response);
  3. the child will want to participate because the activities are fun (Active Engagement); and
  4. the child's preferences are used to initiate therapeutic experiences within the session (Child Directed).

Sensory integration therapy is based on the assumption that the child is either overstimulated or understimulated by the environment (2). Therefore, the aim of sensory integration therapy is to improve the ability of the brain to process sensory information so that the child will function better in his daily activities (2).

Recently another sensory-related therapy has been reported called Sensory Stories (3). Sensory Stories are similar to social stories (see Social Stories Therapy Fact Sheet ) in that they use individualized stories about sensory situations that an individual child may encounter, and then provides instructions on appropriate behaviors for the child to use in response (3).

What's it like?

A sensory integration room is designed to make the child want to run into it and play (1). During sensory integration therapy, the child interacts one-on-one with the occupational therapist and performs an activity that combines sensory input with motion (1, 2, 4). Examples of such activities include:

The child is guided through all of these activities in a way that is stimulating and challenging (1). The focus of sensory integration therapy is helping children with autism combine appropriate movements with input they get from the different senses.

A parent can integrate sensory integration into the home by providing many opportunities for a child to move in different ways and feel different things. For example, a swing set can be a form of sensory integration therapy, as can a ball pit or a lambskin rug.

What is the theory behind it?

On a daily basis, most people experience events that simultaneously stimulate more than one sense (5). We use our multiple senses to take in this varied information, and combine them to give us a clear understanding of the world around us. We learn during childhood how to do this (6). Thus, through childhood experiences we gain the ability to use all of our senses together to plan a response to anything we notice in our environment (5). Children with autism are less capable of this kind of synthesis and therefore they may have trouble responding appropriately to differently stimuli.

Children with autism may also have a difficult time listening when they are preoccupied with looking with at something. This is an example of their difficulty in receiving information via more than one sense simultaneously (5, 7). Physicians who treat children with autism believe that these difficulties are the result of differences between the brains of children with autism and other children (5, 7, 8).

The underlying concepts of sensory integration therapy are based on research in the areas of neuroscience, developmental psychology, occupational therapy, and education (1-3, 9). Research suggests that sensory information received from the environment is critical; interactions between the child and the environment shape the brain and influence learning. Furthermore, research suggests that the brain can change in response to environmental input, and rich sensory experiences can stimulate change in the brain.

Does it work?

The effectiveness of sensory integration therapy is controversial and there are very few well-designed studies upon which to base a clear assessment of whether or not it works (1, 2, 10, 11). Approximately half of the reports in the scientific literature show some type of effectiveness with sensory integration therapy, and half show no benefits at all (1). Some researchers suggest that sensory integration therapy would be more useful for younger children than for older children (4). It is also possible that it might work for some children and not others. Some experts suggest that sensory integration therapy be discontinued if effects are not apparent during a specified time frame or if the child has a negative reaction (4).

Successful sensory integration therapy has been able to decrease sensitivities to touch and other stimuli (1, 12). The result is that the children are better able to play, learn, and interact with people and surroundings (1, 12).

Is it harmful?

While sensory integration therapy is not harmful, some forms of sensory therapy may be uncomfortable for the child. Children with autism can be especially sensitive to certain types of sensory stimulation; the therapist should respond appropriately to each child. Children should be closely monitored for any negative reactions or self-soothing behavior which might indicate the child is feeling uncomfortable (4).

True sensory integration therapy, however, should be child-directed, playful, and pleasant for the child (1, 11, 15).

Cost

Sensory integration therapy is frequently included as a component of occupational therapy (2). The cost of occupational therapy may be covered by the government through the Individuals with Disabilities Education Act (IDEA) of 2004. Private occupational therapy can be expensive (approximately $100/hour or more).

Sensory integration equipment is relatively low-tech, but can be moderately expensive (4). These include anything from large bins of rice that a child can climb into, to an indoor swing set.

Sensory Stories that can be adapted for individual children are available online at www.sensorystories.com. A collection of 30 Sensory Stories, which can be adapted for the individual child, is available for about $150 through this site.

Resources

Healing Thresholds has partnered with Flag House, which is a great resource for in-home sensory solutions. They sell large sensory toys such as an adjustable tilt balance board and Snoezelen equipment.

Healing Thresholds has also partnered with Natural Learning Concepts which is a good source for large sensory toys as well as smaller sensory items.

Sensory integration equipment can be purchased online through many other sites as well. These include: The Adaptive Child, Pacific Pediatric Supply, The Child Inside, and SticKids. Sensory Stories information is available at www.sensorystories.com.

Autism is a condition covered under the IDEA of 2004. Services covered by IDEA include early identification and assessment by an occupational therapist. This law protects the rights of patients with autism and provides guidelines to assist in their education. It covers children from birth to age 21 (U.S. Department of Education).

Pediatricians can provide contact information for the state early intervention program (for children 0 to 3 years old). School districts can coordinate special services for children 3 to 21 years old. For some additional coverage information in the U.S. go to: http://www.asha.org/public/coverage/autism.htm. In addition, there is a listing on this Web site for state early intervention centers.

Several books that might be useful:

The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, Revised Edition (Paperback) by Carol Stock Kranowitz and Lucy Jane Miller. 2006. Perigree Trade.

Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues (Paperback) by Lindsey Biel and Nancy Peske. 2009. Penguin.

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References

  1. Schaaf, R.C., and L.J. Miller. 2005. "Occupational Therapy Using a Sensory Integrative Approach for Children with Developmental Disabilities." Ment.Retard.Dev.Disabil.Res.Rev. 11(2):143-148.
  2. Dempsey, I., and P. Foreman. 2001. "A Review of Educational Approaches for Individuals with Autism." International Journal of Disability, Development and Education v48 n1 p103-16 Mar 2001.
  3. Marr, D., et al. 2007. "The Effect of Sensory Stories on Targeted Behaviors in Preschool Children with Autism." Phys Occup Ther Pediatr. 27(1):63-79.
  4. Baranek, G.T. 2002. "Efficacy of Sensory and Motor Interventions for Children with Autism." Journal of Autism and Developmental Disorders v32 n5 p397-422 Oct 2002.
  5. Iarocci, G., and J. McDonald. 2006. "Sensory Integration and the Perceptual Experience of Persons with Autism." J Autism Dev.Disord. 36(1):77-90.
  6. Wallace, M.T., and B.E. Stein. 2006. "Early Experience Determines How the Senses Will Interact." J Neurophysiol.
  7. Minshew, N.J., et al. 2004. "Underdevelopment of the Postural Control System in Autism." Neurology. 63(11):2056-2061.
  8. Waterhouse, L., et al. 1996. "Neurofunctional Mechanisms in Autism." Psychol.Rev. 103(3):457-489.
  9. Boddaert, N., et al. 2004. "Superior Temporal Sulcus Anatomical Abnormalities in Childhood Autism: A Voxel-Based Morphometry MRI Study." Neuroimage. 23(1):364-369.
  10. Dawson, G., and R. Watling. 2000. "Interventions to Facilitate Auditory, Visual, and Motor Integration in Autism: A Review of the Evidence." J Autism Dev.Disord. 30(5):415-421.
  11. Case-Smith, J., and M. Arbesman. 2008. "Evidence-Based Review of Interventions for Autism Used in or of Relevance to Occupational Therapy." Am J Occup Ther. 62(4):416-429.
  12. Ayres, A.J., and L.S. Tickle. 1980. "Hyper-Responsivity to Touch and Vestibular Stimuli as a Predictor of Positive Response to Sensory Integration Procedures by Autistic Children." Am.J Occup.Ther. 34(6):375-381.
  13. Cox, A., et al. 2009. "The Effects of Weighted Vests on Appropriate In-Seat Behaviors of Elementary-Age Students With Autism and Severe to Profound Intellectual Disabilities." Focus on Autism and Other Developmental Disabilities. 24(1):17-26.
  14. Stephenson, J., and M. Carter. 2009. "The Use of Weighted Vests with Children with Autism Spectrum Disorders and Other Disabilities." J Autism Dev Disord. 39(1):105-114.
  15. Case-Smith, J., and H. Miller. 1999. "Occupational Therapy with Children with Pervasive Developmental Disorders." Am.J Occup.Ther. 53(5):506-513.
Preventing School Failure, by Murray, M., Baker PH, Murray-Slutsky C., and Paris B., published in 2009, summarized Jul 29, 2010

An understanding of sensory-based behaviors combined with applied behavior analysis (ABA) may help teachers improve the behaviors and learning of children with autism.

Learners with autism may: 1) be sensory seekers who are on the move; 2) have a low response to sensory input and seem passive or aloof; or 3) have a large response to sensory input and have anxiety. These sensory needs may cause the child to act in certain ways, thereby causing some problem behaviors. The authors suggest that teachers address these sensory-based needs in order for learning to take place. If teachers can see the sensory needs of the child, then the teachers may be able to suggest other behaviors that meet the child’s sensory needs and also allow for learning to take place. The purpose of this article was to describe ways that teachers might meet the sensory-based needs of students.


The American Journal of Occupational Therapy, by Silva, LMT, Schalock M., Ayres R., Bunse C., and Budden S., published in 2009, summarized Apr 1, 2010

Qigong massage therapy may help reduce the symptoms of autism in young children, both at school and at home.

This study looked to see if 5 months of qigong massage therapy would improve symptoms of autism compared to controls. The study showed that qigong massage reduced symptoms of autism as measured by tests of behavior and abilities. The children who received qigong massage showed improved sensory and physical systems. The children also gained skills for social learning. The authors plan to expand the study to look at the effects of qigong massage on the nervous system (vagal tone).


Journal of Autism and Developmental Disorders, by Bass, MM, Duchowny CA, and Llabre MM, published in 2009, summarized Oct 5, 2009

Therapeutic horseback riding may improve social skills in children with autism.

Children with autism who rode horses as therapy showed improvements in several social skills after 12 weeks of therapy. This study compared before-therapy and after-therapy scores on social skills tests for 19 children (5-10 years old). Children were improved in sensory seeking and sensitivity. They also had more social motivation and were less distracted. The authors said that this is the first study to measure the impact of horseback riding on social skills in children with autism.


Research in Autism Spectrum Disorders, by Van-Rie, GL, and Heflin LJ, published in 2009, summarized Sep 9, 2009

Sensory-based activities may help some children with autism stay focused on a task.

Children with autism may have sensory integration problems that make it hard to focus on school work and come up with the right answer. Some therapists use sensory activities that may help children with these problems. For example, children may swing slowly on a swing or bounce quickly on an exercise ball. Usually the children enjoy the sensory activities very much. The researchers wanted to find out if a reward system would motivate children to give correct answers to some questions. Three children (ages 6-7) were offered a choice of sensory activities to do before a session. That activity would then be their reward for answering 12 correct answers. The session started when the therapist asked the child to open their workbook. As their task, children were then asked to identify pictures of community helpers and safety. The children earned a token for every correct answer. They needed to earn 12 tokens in order to get the reward of going on the swing or the exercise ball. The researchers added an interspersal procedure by mixing questions that the child clearly knew the answer to with others that they might need to learn the answer to. The sensory activities as rewards helped two of the three children give correct answers when asked to identify what was in the picture. The interspersal procedure also helped motivate children to give the correct answers.


The Midwest Adult Autism Project (MAAP) in Missouri has recently started a day program for adults with severe autism. MAAP’s day program allows those who have moved out of the school system to receive training, physical therapy, and life skills. The mission, “to provide individualized, stimulating physical activities and behavioral therapy for adults with severe austistic behaviors,” will allow these adults to remain in their homes rather than be institutionalized. The MAAP facility has a physical fitness room, occupational therapy space, sensory integration room, and a kitchen, as well as offices for the staff.

Read original article: Day Program Opens for Those with Severe Autism


Patrice Hanlon, a gardener with The Gardens at Heather Farm, knows first hand how horticulture therapy can benefit kids with Asperger Syndrome as well as others suffering emotional and physical disabilities. She works with children with Asperger’s and has seen how their social and motor skills have improved as they’ve gardened. She uses as her focus, the definition created by Rebecca Heller and Christine Kramer, that horticulture therapy is “is to maximize social, cognitive, physical and psychological functioning and to enhance general health and wellness.” The sensory gardens at Heather Farm, built with assistance from the Lions Club, are set up to help people with disabilities work in them. For example, the beds are raised so that they are accessible for those in wheelchairs or using walkers. Working with volunteers in the garden helps instill a work ethic for those getting ready to join the job force. In addition, student gardeners are encouraged to keep a journal that incorporates their writing skills with the science they are learning about gardening. Other horticulture therapy resources Hanlon suggests include: American Horticultural Therapy Association; Horticultural Therapy Institute; and Therapeutic Landscapes Network.

Read original article: Now Growing: Horticulture Therapy


Lisa Jo Rudy, the autism columnist at About.com, recently answered a reader’s question about helping a child with autism make friends. Rudy suggested that children with autism may suffer from sensory integration issues, making it difficult to communicate and interact. Therapies that Rudy suggests include: sensory integration therapy, generally offered by occupational therapists; Floortime/RDI/Play therapy, which help a child build relationships; and speech therapy, which can help the child understand and communicate with other children. In addition, camp situations and extracurricular activities that involve the child in non-threatening ways, such as swimming or horseback riding, can be useful.

Read original article: How to Help a Child with Autism Take Part and Make Friends


Rainbow Reins Equine Activities in New Jersey provides therapeutic horseback riding for children with autism and other developmental disabilities. Amelia Opderbeck is one young lady, whose favorite horse is Toby, who has become more social and conversational. Her father, Ted Opderbeck, says, “She's really blossomed. . . . To have something she feels so comfortable with, it really helps. And it has transferred into other parts of her life.” Marlene Meyer, a former nurse, is the founder of Rainbow Reins and uses horses to help kids with disabilities learn to interact, gain muscle strength, sensory integration skills, and emotional growth. She provides individual lessons as well as group camps.

Read original article: Horse-Riding Therapy Programs Help Children with Disabilities



Please comment on this autism topic.

Responding to rebound therapy

Jul 24, 2010 by Anonymous

The phrase "Rebound Therapy" was coined by the founder, Eddy Anderson MCSP, Cert Ed, in 1969 to describe the use of the moving surface (bed) of a trampoline in order to provide therapeutic exercise and recreation for people with a wide range of special needs.


Rebound Therapy is used to facilitate movement, to promote balance, to increase or decrease muscle tone, and to aid relaxation and sensory integration. It is also used to improve fitness and exercise tolerance and to improve communication skills


It is popular in special needs schools and is becoming increasingly popular in mainstream schools with a special needs unit; partly because the trampoline is a piece of apparatus that virtually all people, regardless of their abilities, can access, benefit from and enjoy. 


The UK body for Rebound Therapy is “Rebound Therapy dot org” who state that in addition to the benefits listed above, it is an ideal vehicle for cross curricular teaching activity; with the potential for teaching such things as numeracy, colour recognition, positioning (left, right, backwards, forwards, clockwise and anticlockwise), communication, social awareness and consideration of others.


They further state that the unique properties of the trampoline offer ample opportunities for everybody to enhance movement patterns.


The work is intrinsically motivating and enjoyable and returns high value in therapeutic terms for the time and the effort involved.


The fact that the activity is so enjoyable can enable it to be used as a motivational aid to learn. Many teachers also report increased concentration and willingness to learn in the classroom following a Rebound session. 


“Rebound Therapy dot org” are responsible for the development and provision of certificated staff training courses for schools and centres throughout the UK.


The courses have received approved status from the Professional Development Board for Physical Education which is supported by afPE.


More information about Rebound Therapy and staff training courses can be found on their website: www.ReboundTherapy.org


Their email address is: info@ReboundTherapy.org and telephone no is 01342 870543


Responding to sensory integration

Mar 23, 2010 by Anonymous

Our comapny, Southpaw Enterprises, has been a leader in designing and manufacturing Sensory Integration equipment for 30 years.  We make all of our equipment in Dayton, OH and are also creating and manufacturing our own line of Multisensory Environment products.  Please refer to our website www.southpawenterprises.com


 


Responding to sports

Feb 22, 2010 by Anonymous

I have had my child enrolled in gymnastics as a form of physical therapy. I have lots of experience teaching swim lessons, and I use "aquatic therapy" as a means of therapy for her sensory problems and speech and social skills.


You might be more helpful at teaching children who normaly sabbatage their own products from obnoxioius undisciplined behavior by giving them applied time outs whenever they "just run into" a room, any room of the house except to go to the toilet, we all have to rush on that urge to go to the restroom lavatory at times. Not a good habit too. Anyway, at no time should a child be encouraged to run through a park ding dong unaware, a street to chase a ball where cars are. It shows them respect when we guide them to their play toys, participate in front of a therapist with them intercommunicative style of interest about thier childhood items. Also keeping aloof with the help of a good dr. to remain a disciplinarian parent that often makes too harsh remarks, bad errors, but means do as I say and not as I do and keeps the family goin. That is what the good dr. is for to notice the parents errors and correct them. I encourage the child-parent familiarity to be one of once upon a time and thats it for me. After adulthood a little more approval of talents, achievements, but a stauch, living room parent and a DO NOT EVER ENTER A CHILDS BEDROOM even if it is questionable what is going on, you either call 911 or stand at their doorarch and speak issues from there. A room of a kid is their absolute haven and never to be crossed in my book. Thanks for listening K.K.



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  • Synonyms for sensory integration include: sensory, sensory integration disorder, sensory integration therapy
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