In the process of writing a grant application for a music therapy research project focused on ASD, I have been reading a lot of current research. Something that has been more prevalent in the research over the past two years is a consideration of sensory needs in ASD (see Kwakye et al., 2011 or Marco et al., 2011 to read about sensory and autism). Within this literature I found two articles investigating sensory supports for children with ASD.
Pfeiffer et al. (2011) conducted a pilot study that compared fine motor intervention (n=17) and sensory integration (n=20). They conducted a randomized control trial with thirty-seven children between 6 and 12 years of age. All children had a formal diagnosis of PDD-NOS or autism. Furthermore, all children exhibited sensory needs as determined by the Sensory Processing Measure.
Researchers utilized standardized measures of behavior and social skills. Children received eighteen 45-minute interventions over a 6-week period. The SI treatment intervention was provided by persons with advanced training in SI techniques.
A quick reminder that the purpose of a pilot study is to determine initial efficacy and feasibility information in order to pursue a larger project. The researchers found significant improvement in the Goal Attainment Scale for both groups; however, the SI group showed a greater difference in these measures. Furthermore, there was a significant decrease is “autistic mannerisms” as determined by the Social Responsiveness Scale compared to the CG.
This was a nice pilot study on SI for children with ASD; however, a diagnostic testing for a more homogeneous participant sample would have made the study stronger. The authors could use the Autism Diagnostic Observation Schedule, which is now considered one of the best assessment for autism.
Some of you may use sensory balls (aka therapy balls) in your clinic. Bagatell et al. (2010) studied the impact of therapy balls on behavior and engagement during 16-minute circle time. The researchers utilized a single-subject design with six children with ASD.
Using observation of behavior, the researchers indicated mixed results with positive results for the child with the greatest sensory needs, and variable results for all other children (including an increase in out-of-seat behavior and increase disengagement). This study also had some issues with high variability in the children’s needs.
As a MT clinician, I use therapy balls and sensory supports for children with ASD. The results from these two studies are mixed, with some indication that sensory supports may be beneficial for children with ASD; however, research with better study constrains/designs are needed. One of the differences from this study to my clinic is that I am using rhythm and engagement exercises to help the children become “organized” on the sensory ball or with the sensory supports. I won’t change my use of sensory accommodations based on these studies (too preliminary), but I would like to see a study that incorporated rhythm in order to determine if this auditory modality can enhance sensory experiences for children with ASD.
Bagatell, N., Mirigliani, G., Patterson, C., Reyes, Y., & Test, L. (2010). Effectiveness of therapy ball chairs on classroom participation in children with autism spectrum disorders. Am J Occup Ther., 64(6), 895-903. PMID: 21218680
Kwakye, L.D., Foss-Feig, J.H., Cascio, C.J., Stone, W.L., & Wallace, M.T. (2011). Altered auditory and multisensory temporal processing in autism spectrum disorders. Front Integr Neurosci., 4, 129. PMID: 21258617
Marco, E.J., Hinkley, L.B., Hill, S.S., & Nagarajan, S.S. (2011) Sensory Processing in Autism: A Review of Neurophysiologic Findings. Pediatr Res. Feb 1. [Epub ahead of print]. PMID: 21289533
Pfeiffer, B.A., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Effectiveness of sensory integration interventions in children with autism spectrum disorders: a pilot study. Am J Occup Ther, 65(1), 76-85. PMID: 21309374