Therapies for Children With Autism Spectrum Disorders

addressed, 85 typically involves one-on-one, child-directed treatment with a trained occupational
therapist and a focus on somatosensory and vestibular systems. Ultimately, it is hypothesized
that if a child is better able to process, modulate, and integrate sensory information, he will then
be better able to acquire higher-order skills. 16
Auditory integration training (AIT) relates more specifically to sensory differences in the
auditory realm. AIT involves repeatedly presenting children with modulated music according to
specific protocols with a therapeutic goal of improving auditory processing, lessening auditory
hypersensitivities, and increasing concentration. 87 Finally, music therapy is at times employed
with children with ASDs, hinging on speculation that children engage more with music. This
treatment method is improvisational and unstructured in nature, and practitioners purport that it
can improve both verbal and nonverbal communication skills including joint attention abilities,
thereby improving core symptoms of autism. 88,89
Content of the literature. We identified two studies 266-268 that addressed sensory integration
interventions, including a prospective case series with two publications presenting nearly
identical results 267,268 conducted in South Korea. Both were completed in a clinic setting and
included children ages 6 years 267,268 and older. 266 All children in both studies met criteria for
autism (i.e., none had diagnoses of PDD-NOS or Asperger Disorder). Both studies used outcome
assessments developed within the project and focused on sensory and motor functioning. Both
sensory studies were poor quality.
Two papers assessed auditory integration interventions 269,270 and targeted children between 3
and 7 years old 270 and 7 to 13 years old. 269 Both studies were conducted through a clinic
associated with an academic institution and enrolled children with diagnoses of autism across a
broad range of cognitive functioning levels. Table 24 provides additional study details.
We identified two papers from a single crossover RCT that compared music and play therapy
interventions. 89,271 The study included children ages 3 to 5 years meeting DSM-IV criteria for
autism and meeting criteria on the Childhood Autism Rating Scale; some were also administered
the ADOS to confirm diagnosis. Among studies of auditory integration and music therapy, two
were fair quality and one was poor.
Summary of the literature. Two studies examining sensory integration training met our
inclusion criteria (Table 25). 266-268 An RCT from Fazlioglu and colleagues 266 examined the
effects of a sensory integration protocol on low-functioning children with autism ages 7 to 11
years who had not previously received sensory integration therapy. The intervention program
used in this study was based on “The Sensory Diet” and included a prescribed schedule of
somatosensory stimulation activities targeting 13 behaviors across sensory modalities and motor
skills development and conducted in a specially arranged sensory room. Results indicated that
the difference between treatment and control groups was significant at outcome, but not at
baseline, with children receiving sensory integration intervention showing significantly fewer
sensory problems at followup than children in the control group.
In contrast to Fazlioglu’s more traditional play-based, child-directed sensory integration
intervention, Jung et al. 267,268 used a virtual reality – tangible interaction system sensory
integration training protocol in 12 five- and 6-year-old children with autism The sensory
integration components comprised less than a third of the intervention described, and no outcome
measures were reported related to sensory integration activities.
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