Children with autism can benefit from a type of therapy that helps them become more comfortable with the sounds, sights and sensations of their daily surroundings, a small new study suggests.
The therapy is called sensory integration. It uses play to help these kids feel more at ease with everything from water hitting the skin in the shower to the sounds of household appliances.
For children with autism, those types of stimulation can be overwhelming, limiting them from going out in the world or even mastering basic tasks like eating and getting dressed.
"If you ask parents of children with autism what they want for their kids, they'll say they want them to be happy, to have friends, to be able to participate in everyday activities," said study author Roseann Schaaf.
Sensory integration is aimed at helping families move toward those goals, said Schaaf, an occupational therapist at Thomas Jefferson University's School of Health Professions, in Philadelphia.
It is not a new therapy, but it is somewhat controversial -- partly because until now it has not been rigorously studied, according to Schaaf.
Her findings were recently published online in the Journal of Autism and Developmental Disorders.
The research team randomly assigned 32 children aged 4 to 8 to one of two groups. One group stuck with their usual care, including medications and behavioral therapies. The other group added 30 sessions of sensory integration therapy over 10 weeks.
At the study's start, parents were helped in setting a short list of goals for the family. For example, if a child was sensitive to sensations in his mouth, the goal might be to have him try five new foods by the end of the study, or to take some of the struggle out of the morning tooth-brush routine.
Schaaf said each child's particular play was individualized and guided by an occupational therapist. But in general, the therapy is done in a large gym with mats, swings, a ball pit, carpeted "scooter boards," and other equipment. All are designed to encourage kids to be active and get more comfortable with the sensory information they are receiving.
After 30 sessions, Schaaf's team found that children in the sensory integration group scored higher on a standardized "goal attainment scale," versus kids in the comparison group, and were generally faring better in their daily routines.
"Parents rated their kids as more independent in self-care and participation in everyday activities," Schaaf said.
An autism expert not involved in the study said it was well done, and marks a "first step" in proving the potential benefits of sensory integration.
"Sensory-related issues are a problem for families of children with autism, and we really don't fully understand them," said Dana Levy, a clinical assistant professor of child and adolescent psychiatry at NYU Langone Medical Center, in New York City.
Behavioral therapies are the standard approach to managing sensory issues. That teaches kids ways to deal with the particular types of sensory overload that bother them, Levy noted. Kids might, for example, squeeze a stress ball when a noise is too loud.
Whatever role sensory integration might have for kids with autism, she said, it's not a replacement for behavioral approaches or other therapies. "It would have to be a part of a child's overall treatment program," Levy said.
Schaaf agreed. "We're not suggesting this is an either/or," she said. "Behavioral therapy helps children with autism." Sensory integration, delivered by an occupational therapist, "is a nice adjunct," Schaaf said.
In the real world, the availability of sensory integration varies depending on where you live, Schaaf said.
It's provided by occupational therapists, who are often part of the health care team that helps families of children with autism. But not all occupational therapists are specifically trained in sensory integration, Schaaf noted.
Insurance coverage also varies, she said, so some parents might have to pay out-of-pocket if they wanted to try it. And while this study tested 30 sessions, the "right" number for any one child would vary depending on the child's needs, Schaaf said.
It's not clear exactly how sensory integration works. But it's thought that it might actually change how the brain processes sensory stimulation, Schaaf explained.
That's partly because it's playful. "When something is playful," Schaaf said, "you'll usually go a little outside your comfort zone."
But Levy said it's not certain that sensory integration actually promotes changes in the brain's reactions. The therapy, she said, "is fun. It offers things that a lot of kids like."
At least some of the benefit, Levy noted, might come from giving children a chance to socialize and simply enjoy themselves.
