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Benefit Of Popular Autism Therapy Questioned

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New research is casting doubt on the merits of a popular autism treatment which relies on weighted vests, bouncy balls and other sensory stimuli.

Researchers reviewed 25 existing studies looking at sensory integration therapy and found that the method is not scientifically supported.

“Rigorous, methodologically sound studies do not indicate that it helps and, in fact, the majority of studies that were reviewed reported no benefits for children with ASD,” said Mark O’Reilly of the University of Texas at Austin who worked on the analysis, which was published in the journal Research in Autism Spectrum Disorders.

Sensory integration therapy is intended to address the atypical responses that many with autism have to sight, sound, touch and other sensory stimuli. Therapists utilize swings, balls, brushes and other specially-designed tools to help those on the spectrum learn to cope.

The review is not the first to question the value of sensory integration therapy. Earlier this year, the American Academy of Pediatrics issued a policy statement indicating that support is lacking for the method, but did not go so far as to advise against it.

“Parents should be informed that the amount of research regarding the effectiveness of sensory integration therapy is limited and inconclusive,” the pediatrics group said.

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Comments (24 Responses)

  1. KC says:

    Seriously? You should come to my house to see the benefits of those techniques when used appropriately. I am a mom of 2 boys with ASD. I beg to differ. I am extremely disappointed in this unjust finding. You really need to live with autism day in and day out and I am most sure that opinion will change. My sons could have not ‘survived’ without their therapy balls, koosh balls, theratubes, chew tubes, ball bits, lycra swings, etc. These items do help my children cope.
    The American Academy of Pediatrics needs to rethink what they are saying. Why don’t YOU ask us??

  2. Stacy H says:

    I agree with KC. Sensory therapy has done so much for my 7 year old identical twin boys who both have Autism and Down Syndrome that we even had a sensory room built in our home. We started sensory therapy about four years ago and noticed great things right away.

  3. fairlady68 says:

    If it helps some people, great…it has not helped me very much. People vary so widely in their responses to almost everything in medicine and in life. Until they well and truly crack the human genome and can design custom therapies and medications on an individual basis, trial and error is about all we are left with, unfortunately.

  4. Nancy Reeves says:

    As an early interventionist working with birth to three year old children with disabilities, I have to say that I have utilized sensory integration therapy in my work in the home with the parents. This therapy certainly should not be utilized alone but in conjunction with other methodologies. I have seen its effectiveness and do believe that this approach is beneficial to some ASD children. I would hate to see it thrown out as “ineffective.”

  5. THD says:

    Behaviorists have been trying to squelch SI from the beginning, as well as speech therapy and therapies for auditory processing. At some point, somebody needs to tell them to stop using behavioral measures to look at outcomes of therapies from other specialties. Many, many, many famillies, including my own, have found some benefit from SI therapy. My son had severe gravitational insecurity and sensory hyperreactivity which was helped tremendously by an OT trained in SI. I have seen my son go mute after a few weeks with a behaviorist supposedly trained in VBT, who has thrived and now is quite verbal after years with speech therapists. I woudl say there is no evidence that evidence-based research is anything more than statistical elaboration of existing data that is available within specific data resources that lazy researchers only access through electronic means, when they never actually see a real chart.

  6. ASD mom says:

    This therapy as well as so many other ‘Biomedical’ therapies are total crap. They don’t work and are designed to get money from uniformed parents desperate to do anything to ‘cure’ their kids of ASD. It’s about time someone shines the light of science on these therapies. How much of our tax money is wasted on useless therapies when it could be spent on improving educational programs and community supports that actually help children.

  7. Carrie says:

    I think it is important to point out that there may be a benefit of sensory integration therapy but that it may not be so much because of that type of therapy but that there is an intervention at all. I think that for the money that can be spent on sensory rooms and such, there are other kinds interventions that could be more helpful. ABA is supported by research but some parents prefer a floor time approach … and there is a certain amount overlap with all of them.

  8. Annie B says:

    I find it humorous that this article is just next to an article or video on the front page of DS about Temple Grandin. She invented the full body press for deep pressure which she has said helps her calm and organize and went on to apply it to her work in animal sciences. A commenter below suggested taking, and I’m paraphrasing, monies devoted to “total crap” therapies that are designed to take advantage of desperate parents and apply it to educational programs and community supports. There are several fallacies in that one statement. First, which therapies are “total crap,” exactly, and who gets to decide? Only the scientific community? thats like leaving the legislators to make decisions about the schools and we all see how well that is going! Second, what would make someone so incredibly cynical that they would believe thousands of people that are doing anything they can to help these kids do so to take advantage of desperate parents? In fact, many of those desperate parents end up in those professions because of the way it helped their families. Third, just because you take “your tax money” away from certain therapies ( and quite often it’s paid for by the insurance company) what would make you believe they are going to apply it to educational programs and community supports? Which ones, specifically, do you think they should be applied to? SI is a way to organize the system to free the person up for therapies like Floortime and ABA. Until such a time as there is a definitive answer to this puzzle, lets continue to use ALL the tools in our toolbox to help these families.

  9. Brett H vedani says:

    Thank you Annie B for a lucid and balance response.

  10. ASD Mom says:

    I would honestly like to know where they get this information and data from. This is ridiculous. Every Autism diagnosis is different, therefore every response to therapies will be different. It is a miracle for some – like my son – and doesn’t work for others. How is it detrimental to have it on the table as an OPTION? Let the families and the child’s team decide if it’s worth a try. This infuriates me. Are they testing SI therapy on lab rats and deciding it just doesn’t do anything for them? Come to my house any day of the week and observe. When my son doesn’t get his sensory needs met (which we learned what worked and what didn’t through SI), he is 100% more likely to get violent and out of control. You want to get hit and kicked and punched and bit? Take away his SI therapy. You want a happy, relatively calm, engaging little boy? Let him keep his weighted blanket, sensory break bucket, deep pressure squeezes and so on. Life with autism is challenging enough. You want to talk about a waste of money? Take the money that went into this joke of a study and put it towards finding out what causes autism or creating a new type of therapy to be offered. Ugh.

  11. ASD Mom says:

    I just posted above about my son and his experience with SI. I would just like to point out that I am not the same “ASD mom” as further above who called the therapies “total crap”. Not judging others for their opinions, just differentiating myself. Sorry I took your name!

  12. Barbara says:

    SI is THE one thing that has helped him more than anything else. He is a sensory seeker. Without therapy, he will 24/7 try to alleviate his symptoms, he can ‘t think of anything else. He will
    be up half the night, pinching and hitting himself trying to provide input to his body. And that usn’t the half of it, it becomes a serious safety issue. Those who have family members with autism must know that each autistic individual is not like the other, and require and respond to different therapies. Autistic persons have such a history of being discriminated against in receiving medical aid, with autism used as a diagnostic exclusion. When you purport to be an expert at what definitely does and does not help symptoms if autism without any experience or knowledge in a particular therapy, you are needlessly throwing autistic persons and their families under the bus. Please keep in mind that the therapy you can’t do without could be next on the chopping block, with no scientific or medical basis to exclude it.

  13. KA101 says:

    Hmm. All I could get was the abstract–not sure if there’s a paywall or if it’s a scripting issue.

    I wonder if the research controlled for participants’ reason for engaging in SI–I wasn’t fond of scheduled appointments with a therapist (brushing, box o’ material, etc) once I was diagnosed, but one of the factors in the diagnosis was my habit of walking around with ~45 pounds of textbooks & binders on top of 2-3 coats throughout & after the school day.

    (The whole day’s load of books in the backpack and 2 messenger bags–worn one over each shoulder–with 2 binders in each. Coats: synthetic fleece, down vest, water-resistant shell, in that order, and I used the pockets in the vest & shell. If that isn’t weighted gear, I don’t know what is.)

    Being sent to something to “fix” one seems like it might be less effective than doing something on one’s own that helps reduce stress–in my case, both from the weight and from not needing one’s locker.

  14. Maty Ashland says:

    I found out years ago from a famous Autism Professor at U of MD “There is no scientific basis for sensory integration.” Actually the person who wrote the Out of Sync Child book was a music preschool teacher in DC. Now she has quit that and is toting around this stuff and making much more money than she did in the preschool field. I believe that these people can benefit from some of these things. However, the reality is most of these things are not socially appropriate activities that create inappropriate behaviors. Case in point my younger son would constantly jump around in his seat when he was using the bouncy ball at school. We would take him out to eat and he would be bouncing on his seat. My older son was using a weighted blanket in school. As a result he started wearing his t shirt with his hands inside. Dam when I sent him to school as least he wore clothes. Shen he was off in the summer he started wearing is shirt correctly and then when he went back to school in the fall he went back to the arms inside the shirt. What we need to do is to teach these people more normal activities that are socially appropriate that will enhance their lives and their inclusion in the community not give them more inappropriate quirky behaviors. Personally I think sensory integration is a bunch of bunk.

  15. Justi says:

    My son is very involved and nonverbal. He is 20. If we did not do some kind of SI therapy he would not be able to function in school at all. We use no medication at all and this is the only type of therapy he has ever responded to. In fact, he has gotten where he will intitiate the SI himself when he begins to get frustrated. I believe that it is important not to rule anything out as many of you have already stated; Autism is very different for each person and what works on one may not work on another. The SI is also about the most inexpensive therapy I have seen. We can implement this at home and school with no tax dollars involved at all.

  16. michele says:

    really?? i am incredulous!!!

  17. LD says:

    I’m an OT and BCBA. What these findings are stating is that there is that the research is not rigorous enough. Like many of you, I have used these techniques and have seen progress with my clients. But in research, variables have to be controlled in order to find significant correlations. This is very difficult when investigating SI treatments.

  18. Sharon says:

    This states that reviewers looked at 25 EXISTING studies for this report. Well, I can probably find at least 25 existing reports on my child, or many others, who have benefited from SI. And I would be willing to bet that my “report” would provide a more balanced approached with direct cause and effect outcomes. It’s pretty simple, not every therapy works for every child–so why are we trying to pigeonhole every child with ASD or any other DD? I think the last line is the most telling, “Parents should be informed that the AMOUNT of research regarding the effectiveness of SI therapy is LIMITED and INCONCLUSIVE.” This is mainly due to the way that research is done on such a limited number of subjects and then projected to represent a greater population. And just how MANY children were involved and how many PARENTS/CAREGIVERS of people with ASD were interviewed to provide a more balance approach instead of what was observed in a limited atmosphere and time? Bottom line, it works for some and is relatively inexpensive compared to other therapies since it can be adapted to different setting and use a many types of materials. In the grand scheme of things, I’m providing an outlet for my child to stimulate part of the brain so another part can better attend. It works for him and I’ll be willing to be part of any study to prove it to some doubter. In fact, his teachers have asked for MORE SI therapies throughout the day since it has improved his academics. Win-Win in my book. I’m sorry it doesn’t work for all; but don’t ask me to give it up just so I can be forced to follow something less effective for my child. Greater & more consistent studies need to be considered.

  19. Kellen says:

    When you actually read the real study in the actual journal, is much less a commentary on whether or not SIT works as a therapeutic intervention, than it is much more a commentary on the relatively weak experimental designs conducted in the 25 studies they reviewed. They performed a retrospective meta-analysis (review, critique) on previous studies done in the field.

    If the methodology wasn’t aligned with a paramount experimental technique from start-to-finish-to-reporting, they considered that study too weak to accept any positive results observed in the group. Overall, to me, it says the quality of research conducted is limited and of lower quality… (which is not surprising considering all the restrictions and limitations that come from conducting human-subjects research… especially w/ children and kids with disabilities/autism…), and doesn’t really say much about the benefits (or lack thereof) of sensory integration therapy…

    The other problem is that the time-frame span of the 25 studies was over 32 years (1980-2011). That’s an extremely limited pool of studies on such a hot topic. So, on top of research needing to be of better quality (if and when possible), there simply needs to be so much MORE of it before people start commenting on whether or not it works. This highlights another limitation risk of programs that are mandated to utilize only scientifically validated treatments… with autism and sensory processing disorders being so complex and so relatively new to the human services field, along with the world of research just starting to explore it, the burden of proof that anything at all actually works (by itself, in isolation from a constellation of supplemental treatments and therapies) is frankly decades and decades away…

  20. Jeff says:

    I both agree with and disagree with this article. I disagree with the article as I have seen sensory therapy work, however I agree with the premise of the article in saying that relying on any single means of helping individuals with ASD is pure silliness. I have too often seen teachers and parents alike who latch onto the “in” treatment without any regards to their child’s or student’s needs. I agree with this article trying to state, please don’t focus on something so much that you see what you want to see…not what actually does (or does not) work.

  21. Glen S says:

    “Being sent to something to “fix” one seems like it might be less effective than doing something on one’s own that helps reduce stress…”

    Someone completely missed the point of sensory integration!

  22. Christine says:

    Sensory integration therapy for almost three years is the ONLY reason my son who was diagnosed with ASD at age 2 is able to live a normal life today. You can not even tell that there was ever anything “wrong” with him. His therapists worked wonders with him and I am so thankful! The pediatrician was absolutely NO help at the time other than referring us to early intervention and LIU so I wouldn’t put ANY weight on their “professional opinions”.

  23. Steve Meoli OTR/L,MSED,Sensory Integration Certified says:

    I find this small article disappointing. No where in this study does it sight the specific details on #’s students included in the research, how the research was done, who did the research, and what was looked at regarding expected outcomes to note benefit or no benefit. As an Occupational Therapist Sensory Integration Certified who studied under Dr. Jean Ayres in the early 70′s, and who has worked in this field for 36 years, I have documented through progress notes tremendous functional improvements working with Autistic Spectrum Disorder Students primarily in the 3-10 year ages. I have consistently noted that these students will be calmer or more alert, more talkative, ready to sit and do functional skills related to writing, drawing, listening, and decreased behavior problems, all after having Sensory Integration Stimulation. It might be that every few months increased skills are noted rather than every session, but that is to be expected. Just like when a student sees a reading teacher and they don’t suddenly improve one year after the first session, but after several months, definite improvements are noted.
    As a professional Occupational Therapist involved in Sensory Integration Stimulation Therapy, I would trust the research from The Sensory Integration Community of Occupational Therapists before I would accept this brief non-specific research done by ?.

  24. sensory4child says:

    I am so disappointed in some of the comments I have just read regarding this article and SI therapy. If you lived one day in my shoes and see the MANY successes that I see every single day, you would be left with you mouth hanging open and a tears on your cheeks.

    I can give you hundreds of case studies of children with ASD and other development delays not only benefiting but thrieving and others minimizing and others yet coming out of the spectrum all together. It’s not a “cure all” for everyone. Each child varies from one to the other. But the biggest obstacle is parent cooperation and participation. This also varies from one house to another . Some just want a pill to keep the child calm and obiedent and no interaction or activity is followed. It appears as though as long as the parent is not embarassed by the child and they can go on with their life without intrruption, they are happy. In contrast, when we have parents or a parent or grandparent that is engaged and proactive and follows through with our suggested home program, the success rate for our kids are 90%!.

    A huge part of the problem is to identify exactly where the child is performing in each are of development. There are tons of ASQ tests, they are not specfic enough. That is why we designed a FREE online assessment. If you have a child that is 3 yrs who is actually functioning at 6 mths. of age in emotional and social then that is where you have to start with emotional and social. If they are 2 yrs. in fine motor, then that’s where you have to start and if they are 18 mths. with gross motor, that’s where you start, etc. You can’t treat every child the same and the same goes with each developmental area. You have to start where THEY are functioning, not how old they are.

    It does work and to throw out all SI therapy because it didn’t work for you is selfish and harmful. Those of that view should spend a day with one of my parents and their child. I can give you a long list of willing advocates and success stories.

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