The Efficacy of An Intervention for Sensory-Related Behaviors in Children with Autism

Background: Upwards of 90% of individuals with Autism Spectrum Disorders (ASD) demonstrate unusual responses to sensory stimuli or sensory differences including hypo and hyper sensitivity in multiple and varied sensory domains (Tomchek and Dunn, 2007; Marco, Leighton, Hinkley, et al 2011).  Our work, to date, shows that families report that these sensory differences create social isolation for them and their child, significantly restricting full participation in daily activities.  Consequently, interventions to address sensory differences are among the most often requested services, and, although data on their effectiveness is promising, more rigorous trials are needed. 

Objectives: To address this need, our program of research developed an intervention for sensory differences entitled Intervention using Sensory Integration for Children with Autism or InSInc; and completed a pilot study to evaluate feasibility, safety, acceptability, satisfaction and fidelity.  Next we conducted a small randomized control trial to evaluate the efficacy of InSInc on decreasing sensory processing difficulties and problem behaviors, and improving adaptive behaviors and progress toward individual, parent identified goals.  All subjects were well characterized using the ADOS, ADI-r and a cognitive assessment.

Methods:   The design of our studies is based on recommendations in the literature for design and conduction of psychosocial intervention studies in autism (Smith, Scahill, Dawson, et al, 2007).  Following this model, we first present the findings from the feasibility study (n = 10) and then provide data from the RCT.  In the RCT (n = 26) all children were evaluated by a blind, independent evaluator and then randomized to treatment (30 sessions of InSInc) or usual care. Outcomes include measures of adaptive behavior, problem behaviors, sensory behaviors, and participation in activities of daily living, as well as individual progress in parent-identified goals using Goal Attainment Scaling. 

Results: Data shows that this intervention is feasible and safe, that parents are satisfied with the intervention, and that therapists are able to obtain high fidelity.  Preliminary data from RCT shows that outcomes are in the hypothesized direction with statistical significant improvements in individual, parent-identified goals.  The RCT will be completed in April 2012 and full data set will be reported. 

Conclusions: InSInc is feasible to deliver, acceptable to parents, and safe. Final data on efficacy will be analyzed and presented.