Sensory Treatment for Autism to Alleviate Tactile Abnormalities Reduces Severity of Autism and Improves Self-Regulation: A Randomized Controlled Trial in 100 Pre-School Children

Background:

Two recent studies in pre-school children with autism showed the universal prevalence of tactile/oral abnormalities (pain and numbness) suggestive of tactile impairment. Severity of tactile abnormalities was linearly associated with self-regulatory delay and severity of autism. Concurrently, two small randomized controlled trials (n=47, n=46) evaluating treatment of tactile abnormalities showed a mean 25% decrease in severity of autism, providing initial evidence that tactile abnormalities may be a contributing cause of autism. Treatment was with a Chinese medicine-based massage protocol for autism given daily by parents and weekly by therapists for five-months. Treatment was effective in low and high-functioning children. This was important as there are currently few treatment options for low-functioning children.

Objectives:   To replicate and extend earlier studies with a larger controlled study and determine whether sensory treatment for autism directed at tactile abnormalities decreases severity of autism.

Methods:   104 pre-school children with ASD were recruited, underwent confirmation of autism diagnosis by DSMIV criteria, and were randomly assigned to treatment and wait-list control groups. Pre-testing was accomplished by experienced autism examiners who were blind to group, and parents. The treatment group received 5 months of treatment, and post-testing was accomplished with the same examiners. Treatment was given at multiple sites by multiple trained therapists. No additional research-based autism treatments were initiated during the study period. Autism severity was measured by the CARS and Autism Behavior Checklist; sensory and self-regulatory abnormalities were measured with the Sense and Self-Regulation Checklist; language was measured with the PLS-5; parenting stress was measured with the Autism Parenting Stress Index.

Results:   Repeat-measure multivariate analyses showed medium-to-large effect size on improvement of severity of autism (F(2,81)=5.71, p=.008, Partial η2=.113); large effect size on improvement tactile/oral and self-regulation abnormalities (F(3,80)=6.74, p<.0001, Partial η2=.202); and medium effect size on improvement of receptive language (F(1,83)=4.81, p=.031, Partial η2=.055). Univariate analysis showed large effect size on reduction of parenting stress (F(1,82)=15.69, p<.0001, Partial η2=.161). Treatment was effective in low and high functioning groups, indicating that language was not required for treatment to be effective. 

Conclusions:   Five months of sensory treatment for autism was effective in reducing tactile/oral and self-regulatory abnormalities, as well as in considerably reducing the severity of autism. With parent training and support, the program was readily implemented in the home. This treatment is the first to be effective in reducing severity of autism in low and high-functioning children, and can be helpful to families at the time of autism diagnosis. More improvement can be expected with longer-term treatment, and additional treatment and evaluation is underway.

See more of: Interventions - Non-pharmacologic - Preschool
See more of: Interventions - Non-pharmacologic - Preschool