Interventions for Sensory Processing Problems in Autism

The considerable literature that exists on the effectiveness of various treatments (e.g., pharmacological, behavioral, nutritional, sensory-based etc.) for children with autism has inconsistent findings. The array of possible treatments can be bewildering when parents and others are confronted with making decisions about what the “best” treatment is for their child. Given the prevalence of unusual sensory features in autism, “sensory-based” interventions are common yet controversial. These often hinge on the assumption that improving faulty underlying mechanisms (i.e., sensory processing) may ameliorate sensory symptoms, as well as facilitate broader developmental, behavioral, or adaptive outcomes such as increased social participation. This talk will discuss the evidence-base for common approaches used to treat sensory processing problems in autism and highlight one intervention, occupational therapy with a sensory integrative approach (OT/SI). The principles of OT/SI will be presented using video-taped examples of treatment, and OT/SI will be demystified using two clinical reasoning models: (1) the Sensory Matrix and (2) “A SECRET” (Miller, 2006). Controversial issues will be noted such as: To what extent does the child direct the treatment session? Should OT/SI be focused on changing underlying brain function or on functional outcomes? What is the “best” intensity of treatment? What is the “just right challenge”? Preliminary results of a randomized controlled trial on OT/SI highlighting two of the outcome measures used (i.e., psychophysiologic functions and Goal Attainment Scaling) will be presented, taking into consideration four key criteria for implementing rigorous outcome studies. The session will conclude with directions for future research using a translational approach to describe how studies of the behavioral features, neurophysiology, and treatment may interrelate.

Miller, L. J. (2006). Sensational kids: Hope and help for children with Sensory Processing Disorder. New York: Putnam.