Thursday, March 26, 2015

Sensory Integration Therapy and Decreasing Stereotypy

One of the disorders sensory integration (SI) therapy is said to help with is the decrease of behavioral excesses in children with autism. In a new single-subject experimental design to evaluate the efficacy of various SI techniques on reduction of stereotypic behaviors, a net swing, “deep pressure,” and a sensory diet consisting of “deep compression” via a therapy ball, “deep pressure” via heavy work activities, “meatball squeeze,” and joint compression were examined with three preschoolers with autism. 

Single-subject studies are truly experimental; the other truly experimental type of research is randomized control trials. Single-subject studies involve a small number of participants but many data on the dependent variable are collected over time. What you give up in the number of participants, you gain in the number of observations per participant. Furthermore, the controls on the independent variable (i.e., the treatment) are very tight. Finally, you can see the exact results of the difference between conditions—between baseline and treatment, for example.

The study is by Sniezyk and Zane and was published in March in Focus on Autism and Other DevelopmentalDisabilities, Volume 30, Number 1. The occupational therapists conducting the treatments had the freedom to determine what specific behaviors to target and what exact treatments to use. The study used rigorous inter-observer agreement procedures, to ensure the reliability of the data, and they measured the fidelity of the procedures to ensure the children really were receiving the SIT described by their therapists. Quoting the abstract, “The results showed that there was no causal relationship between the sensory procedures and improvements in the targeted dependent variables. Thus, SIT remains an unproven treatment for autism.”

The purpose of this post isn't simply to bash SIT, which is too easy, but rather to encourage the evidence-based treatments for reducing stereotypies. The National Professional Development Center on ASD has an excellent review of evidence-based practices.

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