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The purpose of this research assignment was to reflect upon sensory processing strategies
and interventions which are available for autistic children. I chose to focus on two different peer
reviewed articles which were published within the past 5 years. Little et al. (2022) focused on
various different strategies which caregivers utilized for autistic children. Mills et al. (2021)
studied an activity schedule and what effect it had on autistic students and their use of cognitive
strategies. Sensory processing strategies are a key tool for treatment plans of autistic children and
have shown success.
Students with autism struggle with atypical sensory processing and this affects their
school performance. This has led to the use of school based sensory interventions integrated into
curriculum activities (Mills et al., 2021). Occupational therapists created teacher led sensory
based activities to be used in the classroom. These sensory based activities have been shown to
be a means of improving student performance in special school settings.
Mills et al. (2021) conducted a study in Australia with 42 autistic children who struggled
with sensory processing. There is no one standard definition for sensory processing
interventions. Reports of interventions and effectiveness also vary. Research has shown that
Sensory Activity Schedules (SAS) when utilized in a school setting for autistic students were
found to be effective. To meet effectiveness, four criteria must be met:
1. Assessment of students for atypical sensory processing
2. Interventions individually tailored to the student
3. Consideration of educational needs were met
4. Training and consultation for teachers to administer interventions
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The study by Mills et al. (2021) focused their research on the following research question:
What is the impact of Sensory Activity Schedule (SAS) interventions on cognitive strategy use
for autistic students in a classroom setting as determined by the Perceive, Recall, Plan, and
Perform (PRPP) Stage Two Cognitive Task Analysis.
School principals invited teachers to participate in the study with at least 1 to 3 of their
students. These students were between the ages of 4 and 12 and must have been determined by
the school OT and their teacher as having atypical sensory processing that affects their school
participation. Teachers were required to participate in relevant training provided by school
occupational therapists and comment on sensory processing in all students’ individual education
plans (Mills et al., 2021).
All student participants were required to complete a sensory processing assessment which
was comprised of the SSP2 (Short Sensory Profile 2 and SPSC2 (Sensory Profile School
Companion. Parents and teachers were to complete a five-point scale questionnaire which
indicated how often their child or student responded to different sensory inputs and sensory
situations. Using school observations and interviews with parents and teachers, occupational
therapists in the school were able to conduct their evaluations.
Students who were participating along with their teachers were broken down into two
different groups based on the order in which they signed up for the study. The intervention
condition consisted of SAS intervention in addition to usual classroom teaching according to the
Aspect Comprehensive Approach to Education (ACAE) and students in the control group
participated in their normal classroom teaching according to the ACAE (Mills et al., 2021).
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Data on the participating students was collected on two occasions. First, baseline data
was collected for all students prior to the 7-week intervention period as well as post-intervention
data was collected immediately following the 7-week intervention period (Mills et al., 2021).
Participating students were required to complete at least 80% of the intervention sessions
otherwise their data was not included.
Out of the 42 participants who started the study, only 30 completed the analysis step.
During the follow-up 3 students discontinued their participation due to either not completing
80% of the intervention sessions or their teacher had an injury. When it came time to complete
the analysis of the study, 5 participants of the SAS group and 3 participants of the control group
were excluded due to lost data (Mills et al., 2021).
The final participant count consisted of 3 girls and 27 boys with an average age of 7 years
old. The results of the Mills et al. (2021) study showed no significant differences in SPSC-2 or
SSP-2 scores between the two groups prior to the study, no significant difference between the
two groups at baseline on all PRPP Stage 2 scores, and no significant differences between the
two groups (SAS group and control group) at baseline on all PRPP Stage 2 scores.
Another article I reviewed focused on strategies that caregivers implement in response to
specific sensory features in a child. Little et al. (2022) conducted a survey which consisted of 40
children with developmental disabilities and 77 children with autism spectrum disorder. The
children were between the ages of 2 to 10 years old. Caregivers of the participants were required
to complete a questionnaire, the Sensory Experiences Questionnaire-2.1.
Recent research and studies have shown that caregivers of children with ASD and DD use
various different strategies to support the sensory needs of their children. Strategies are often
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matched to specific child characteristics such as communication skills and self-care abilities
(Little et al., 2022). What ways have caregivers used strategies to better assist the sensory stimuli
and input of their children? Studies have shown that caregivers of ASD and DD children will
often dampen sensory stimuli by offering a softer bristle toothbrush or turn down sounds. Studies
have also shown that caregivers will offer a monkey jump or trampoline or turn on brighter
lighting to amplify the sensory input of children with ASD and DD.
Little et al. (2022) explains that here are three patterns of response for sensory features in
children:
1. Hyperresponsiveness: exaggerated response or aversion to sensory stimuli such as
distress during grooming.
2. Hyporesponsiveness: under or a lack of response to sensory stimuli such as not reacting
to pain.
3. Sensory seeking: craving sensory stimuli such as being fascinated by the way water
looks.
Caregivers use these response patterns when determining sensory strategies for their children.
As I previously mentioned, the caregivers of this study were given the SEQ-2.1 (Sensory
Experiences Questionnaire Version 2.1) which included 45 items for caregivers to answer which
evaluated everyday sensory experiences in their children. Examples of the items include the
following: Do you attempt to change your child’s following behaviors: Refuse new foods, Ignore
name called, Stare at objects, Ignore loud noises. Sensory response patterns in social and non-
social contexts were measured with the SEQ-2.1. This assessment is very reliable and has high
internal consistency (Little et al., 2022). The SEQ-2.1 is broken up into three sections:
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a. Frequency of occurrence of sensory experience
b. Caregivers choose yes or no if they attempt to change their child’s behavior such as
implementing a strategy.
c. Caregivers asked to specify the types of strategies they use when they attempted to
change their child’s behavior.
This study provided various results. Quantitative results found that children’s level of
HYPER, HYPO, and SEEK helped determine the number of strategies a caregiver would have to
use during everyday activities. Novel findings from this study showed that regardless of a child’s
diagnosis (ASD or DD), higher levels of children’s sensory behaviors were associated with
significantly increased use of caregiver strategies to address the sensory experiences (Little et al.,
2022). Caregiver strategy and sensory response patterns were not significantly influenced by
chronological or mental age in children diagnosed with either DD or ASD. This suggests that
regardless of a child’s overall cognitive or developmental level, a child’s response to sensory
stimuli may require caregiver involvement.
Qualitative analysis of this study by Little et al. (2022) revealed that caregivers were
allowing or encouraging the behaviors, encouraging replacement behaviors or in some cases
attempting to eliminate such behaviors. Caregivers of children with autism (ASD) had reported
using more strategies than caregivers of children with developmental disabilities (DD).
As a parent of a child with autism who struggles with sensory processing I have myself
needed to implement strategies to support my son’s daily activities and routines. As parents and
teachers continue to be educated and trained in ways that we can better assist our children and
students with atypical sensory processing our children and students will be able to improve
student performance.
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References
Little,CL.CM., Ausderau,CK., Freuler,CA., Sideris,CJ., & Baranek,CG.CT. (2022). Caregiver strategies
to sensory features for children with autism and developmental disabilities.CFrontiers in
Psychology,C13.Chttps://doi.org/10.3389/fpsyg.2022.905154
Mills,CC.CJ., Chapparo,CC., & Hinitt,CJ. (2021). Impact of a sensory activity schedule intervention
on cognitive strategy use in autistic students: A school-based pilot study.CBritish Journal
of Occupational Therapy,C84(12), 775-784.Chttps://doi.org/10.1177/0308022620982888
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