None listed
Conditions
Brief summary
Autism Spectrum Disorder (ASD) affects learning, social participation and daily function across the lifespan. Approximately 35,000 school-aged Australian children live with ASD; 95% of these experience educational restrictions. Available treatments are only moderately successful and are not effective for all children with ASD. Knowledge about what (intervention) is likely to work for whom is missing from the field. Individuals with ASD and their families frequently attribute the significant functional difficulties experienced to sensory symptoms. Sensory symptoms are reflected in behaviours such as hyper-reactivity (e.g. extreme distress in response to an unexpected sound), hypo-reactivity (e.g. failure to respond to a painful stimulus) and unusual sensory interests (e.g. excessive smelling of objects). Sensory symptoms are so common in ASD that they now form one subset of the diagnostic criteria for ASD. Therapies to remediate sensory symptoms are in high demand. In fact, occupational therapy, which is the lead profession providing sensory-directed therapies, is the second most frequently utilised therapy by families of children with ASD. The few controlled studies that examine the efficacy of sensory-directed therapies, however, report inconclusive results. A critical issue limiting previous research in this area is that sensory symptoms have been broadly defined and imprecisely characterised. Our group has developed a method of classifying children with ASD into clinically meaningful subtypes based on their parent-reported sensory symptoms. We observe that children with ASD can be classified into sensory subtypes that vary on the dimensions of sensory reactivity (regulating the intensity of a response to a given stimulus) and multisensory integration (MSI; simultaneous processing of concurrent sensory modalities). Each sensory subtype has been found to display a distinct pattern of behaviour thus providing a novel basis on which to customize treatments. The primary objective of our study is to assess the relative effectiveness of a sensory regulatory intervention - Alert Program for Self-Regulation (AP) - for children with ASD and their caregivers. The hypothesis for the study is that for all participants, engagement in the AP will result in: 1) achievement of caregiver defined goals in self-regulation, 2) reduced physiological sensory reactivity (EEG & ANS cardiac), 3) reduced clinical sensory reactivity, 3) reduced parent stress and caregiving effort and 4) improved adaptive behaviour and anxiety following participation in the AP. We further hypothesise that participants with a sensory subtype indicating more difficulties with sensory reactivity will demonstrate significantly greater improvements on all measures than matched ASD participants whose sensory subtype indicates difficulties in MSI.
Interventions
The intervention (AP) will be provided to all participants. It involves a one-on-one face to face consultation weekly for 1 hour for 10 weeks (10 hours total) to be held in the UON Occupational Therapy Clinic. The occupational therapist, child participant and caregiver will be involved in each session and there will be recommendations for follow up and carry over at home. The AP combines principles of cognitive behavioural therapy and sensory integration. The AP is a three-stage active learning
The intervention (AP) will be provided to all participants. It involves a one-on-one face to face consultation weekly for 1 hour for 10 weeks (10 hours total) to be held in the UON Occupational Therapy Clinic. The occupational therapist, child participant and caregiver will be involved in each session and there will be recommendations for follow up and carry over at home. The AP combines principles of cognitive behavioural therapy and sensory integration. The AP is a three-stage active learning program. In Stage 1, an engine analogy is used to explain the concepts of arousal and self-regulation (slow engine=low arousal, sluggish feeling; high engine=high arousal, out of control; just right engine= just right arousal for learning, playing, getting along). Stages 2 and 3 introduce and implement the concept of ‘sensory diet’, where the sensory environment and specific child sensory needs are considered in optimising child arousal and regulation for the activity and environment. Usefulness of the AP has been documented with preschool through early adolescent aged children. Sensory diets are commonly used with children by occupational therapists and are endorsed for use with children with ASD by the American Occupational Therapy Association. AP has been shown effective in improving self-regulation and behaviour in children with emotional disturbance. Sessions will be conducted by a qualified occupational therapist blinded to the sensory subtype of the child. Intervention sessions will be videoed for the purposes of review of intervention fidelity. The occupational therapist will keep session notes after each session detailing attendance, content of the session, child progress and adherence to home activities.
Sponsors
University of Newcastle
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
6 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Confirmed diagnosis of Autism Spectrum Disorder; can be classified using established methods into either Reactive or MSI sensory subtypes; IQ>70; can attend all study procedures. Caregiver participants must be the parent or legal guardian of a child with ASD who meets the above criteria.
Exclusion criteria
Nil additional for either child or parent participants.
Outcome results
None listed