Sensory Integration Therapy and Autism

Mother and son touching hands covered in wet paint

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Sensory processing dysfunction (over and/or under-sensitivity to light, sound, smell, taste, or touch) has long been described as a symptom of autism. In 2013, with the DSM-5 (the newest version of the diagnostic manual), sensory issues became an official part of the diagnosis, described as: "Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)." 

Sensory dysfunction can be disabling because it interferes with so many ordinary activities of daily life. A relatively new technique, sensory integration therapy, was developed to help people with and without autism to lower their reactivity and improve their ability to participate in activities ranging from school to dances to sex.

Sensory Processing Dysfunction in Autism

Many people with autism, in addition to having challenges in other areas, are also hypersensitive or under-sensitive to light, noise, and touch.They may be unable to stand the sound of a dishwasher, or, on the other extreme, need to flap and even injure themselves to be fully aware of their bodies. These sensory differences are sometimes called "sensory processing disorder" or "sensory processing dysfunction," and they may be treatable with sensory integration therapy.

Sensory processing involves taking in information through our senses (touch, movement, smell, taste, vision, and hearing), organize and interpret that information, and make a meaningful response. For most people, this process is automatic.

People who have Sensory Processing Disorder (SPD), however, don’t experience these interactions in the same way. SPD affects the way their brains interpret the information that comes in and how they respond with the emotional, motor, and other reactions. For example, some children with autism feel as if they're being constantly bombarded with sensory information.

Sensory integration therapy is essentially a form of occupational therapy, and it is generally offered by specially trained occupational therapists. It involves specific sensory activities to help a child appropriately respond to light, sound, touch, smells, and other input. Intervention may include swinging, brushing, playing in a ball pit and a whole gamut of other activities. The outcome of these activities may be better focus, improved behavior, and even lowered anxiety.

Sensory Integration Therapy

Sensory integration therapy can make a real difference by helping individuals to manage their sensitivities and cravings. The American Occupational Therapy Association describes several types of remediation that can help with both sensory challenges and the performance challenges that can go along with them:

  • Remedial intervention involving the skilled use of sensory and motor treatment activities and equipment (activities may include swinging, massage, activities that cross the centerline), 
  • Accommodations and adaptations such as wearing earplugs or noise-canceling headphones, or using a loofa sponge when showering,
  • Sensory diet programs involving a daily routine/plan with a menu of individualized, supportive sensory strategies (e.g., rocking chair, quiet space, aromatherapy, weighted blanket), identified physical activities (e.g., yoga, swimming) and materials (e.g., sensory kits containing music, stress balls, items for distraction). 
  • Environmental modifications and adaptations such as lighting, use of white noise machines, wall murals, and other types of furnishings and equipment to increase or decrease the sensory stimulation space provides.
  • Education of individuals, family members, caregivers, administrators, and policymakers about the influence of sensory functions on occupational performance and how to minimize their negative impact on function; proactively help prevent and de-escalate maladaptive behaviors; and, in some settings, decrease the need for the use of seclusion or restraint.

In the long run, sensory integration therapy can decrease the need for adaptations and help individuals become more functional at home, at school, and in the workplace.

Research on Sensory Integration Therapy

Quite a bit of research supports the validity of sensory integration therapy. For example, one study of children on the autism spectrum between ages 6 and 12 found a "significant decrease in autistic mannerisms" in a group treated with sensory integration therapy. The researchers wrote that further study was needed, including looking at individualized treatments for autistic children. 

The Sensory Integration Fidelity Measure was developed to provide occupational therapists with a set of guidelines for how to provide consistent intervention. A group of researchers used this measure and a goal attainment scale to be used to help children gradually transition toward modified behavior.

At the study's conclusion, children were given standardized tests that showed that the group who received the sensory integration therapy required less assistance from their parents to manage social situations and self-soothing.

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  2. Parham LD, Roley SS, May-benson TA, et al. Development of a fidelity measure for research on the effectiveness of the Ayres Sensory Integration intervention. Am J Occup Ther. 2011;65(2):133-42. doi:10.5014/ajot.2011.000745

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  4. Schaaf RC, Benevides T, Mailloux Z, et al. An intervention for sensory difficulties in children with autism: a randomized trial. J Autism Dev Disord. 2014;44(7):1493-506. doi:10.1007/s10803-013-1983-8

Additional Reading
  • Roseann C. Schaaf, R, Benevides,T, Mailloux, Z, Faller, F, Hunt, J, Hooydonk, E, Freeman, R, Leiby, B, Sendecki, J, Kelly, D. Journal of Autism and Developmental Disorders  "An Intervention for Sensory Difficulties in Children with Autism." (2014)

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