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Outcome
or the Effectiveness of sensory integrative therapy in children
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References Compiled on December 15, 2003
Several times in the last two years, this question has been
directed to the library, mainly in response to reimbursement
questions and the push for evidence-based practice. This last
time, I pulled together as many references as I could from
OT SEARCH and other sources to serve as my base on which I'll
build as new literature appears. In the future, I'll look
at sensory integrative therapy intervention for adults and
the elderly.
Mulligan, S. (2003). Examining the evidence for occupational
therapy using a sensory integration framework with children:
part one. Sensory Integration Special Interest Section Quarterly,
26(1), 1-4.
No abstract available for this record
Mulligan, S. (2003). Examining the evidence for occupational
therapy using a sensory integration framework with children:
part two. Sensory Integration Special Interest Section Quarterly,
26(2), 1-5.
No abstract available for this record
Foss, A, Swinth, Y, McGruder, J &Tomlin, G. (2003). Sensory
modulation dysfunction and the Wilbarger Protocol: an evidence
review. OT Practice, 8(12), CE-1 - CE-8.
Occupational therapists have used brushing as an intervention
technique for many years. More recently, the Wilbarger Protocol
has been used by pediatric occupational therapists who use
a sensory integrative framework within occupational therapy.
Specifically, this protocol has been recommended for use with
children who have sensory modulation dysfunction (SMD) with
manifestations of overresponsiveness to sensory stimuli, also
called sensory defensiveness. This article reviews relevant
literature, provides an overview of some of the issues surrounding
the application of this intervention technique, and provides
strategies for applying this material to clinical practice.
Implications for future research are discussed.
Uyanik M, Bumin G, & Kayihan H. (2003). Comparison of
different therapy approaches in children with Down syndrome.
Pediatric International, 45(1):68-73.
BACKGROUND: Children with Down syndrome have sensory integrative
dysfunction as a result of limited sensory experience from
lack of normal motor control. The aim of the present study
was to compare the effects of sensory integrative therapy
alone, vestibular stimulation in addition to sensory integrative
therapy and neurodevelopmental therapy, on children with Down
syndrome. METHODS: The present study was carried out at the
Occupational Therapy Unit, School of Physical Therapy and
Rehabilitation of Hacettepe University. Forty-five children
who were diagnosed as having Down syndrome by the Departments
of Paediatric Neurology and Medical Genetics at Hacettepe
University were assessed and randomly divided into three groups.
Sensory integrative therapy was given to the first group (n=15),
vestibular stimulation in addition sensory integrative therapy
was given to the second group (n=15) and neurodevelopmental
therapy was given to the third group (n=15). All children
were evaluated with Ayres Southern California Sensory Integration
Test, Pivot Prone Test, Gravitational Insecurity Test and
Pegboard Test. The hypotonicity of extensor muscles, joint
stability, automatic movement reactions and locomotor skills
were tested. Treatment programs were 1.5 h per session, 3
days per week for 3 months. RESULTS: When these groups were
compared, statistically significant differences were found
in subjects' performance of balance on right foot-eyes open,
pivot prone position-quality score and locomotor skills-front
tests (P<0.05). There were no significant differences in
the other tests (P>0.05). CONCLUSIONS: The results of the
present study showed that sensory integration, vestibular
stimulation and neurodevelopmental therapy were effective
in children with Down syndrome. It was concluded that when
designing rehabilitation programs for children with Down syndrome,
all treatment methods should be applied in combination, and
should support each other according to the individual needs
of the child.
Baranek GT. (2002). Efficacy of sensory and motor interventions
for children with autism. Journal of Autism and Developmental
Disorders, 32, 397-422.
Idiosyncratic responses to sensory stimuli and unusual motor
patterns have been reported clinically in young children with
autism. The etiology of these behavioral features is the subject
of much speculation. Myriad sensory- and motor-based interventions
have evolved for use with children with autism to address
such issues; however, much controversy exists about the efficacy
of such therapies. This review paper summarizes the sensory
and motor difficulties often manifested in autism, and evaluates
the scientific basis of various sensory and motor interventions
used with this population. Implications for education and
further research are described.
Salokorpi T, Rautio T, Kajantie E, & Von Wendt L. (2002).
Is early occupational therapy in extremely preterm infants
of benefit in the long run? Pediatric Rehabilitation, 5(2):91-98.
A total of 126 infants with extremely low birth weight (ELBW;
<1000 g) were enrolled in a prospective case-control study
in order to examine the effect of occupational therapy based
on sensory integration (SI) and neurodevelopmental therapy
(NDT) on neurological development. The children were grouped
as matched pairs on the basis of determined developmental
risk scores assessed at the age of 3 months. The intervention
children had a 6-month period of weekly occupational therapy
from the corrected age of 6-12 months. The follow-up showed
that the social development of the intervention children was
significantly better at the age of 12 months, but at the age
of 2 years the groups had equal developmental scores in neurological,
neuropsychological and speech therapy assessments. The Miller
assessment for pre-schoolers (MAP) performed in a total of
96 (92%) of the study children at the age of 4 years failed
to demonstrate any significant differences between the groups.
It is concluded that this amount of occupational therapy in
ELBW infants does not have any detectable effect on long-term
neurological development.
Zbytniewski, R. (2002). The effects of sensory integration's
Wilbarger technique on engaging behaviors. Bay Shore, NY:
Touro College. (Master's project)
The short term effects of Wilbarger's brushing Protocol was
the focus of this research project. Three different types
of engaging behaviors were examined including visual, motor,
and both visual and motor combined. This investigation used
the quasi-experimental, one group, and subjects serving as
their own control design. Each subject also served as a single
case study subject. Seven child en, two girls and five boys,
with Sensory Integrative Dysfunction, especially sensory defensiveness,
were observed in a pre-school classroom for five minutes pre-brushing
treatment and five minutes post-brushing treatment. However,
the data from this research project was unable to support
the Wilbarger Protocol. Although the data was not significant,
boys may show a greater response to the Wilbarger technique
than girls. Research has now been started and other occupational
therapists may want to continue a different perspective on
this topic.
Bumin G, & Kayihan H. (2001). Effectiveness of two different
sensory-integration programmes for children with spastic diplegic
cerebral palsy. Disability and Rehabilitation, 23(9), 394-399.
PURPOSE: This study was planned to investigate the effects
of individual and group approaches to sensory-perceptual-motor
(SPM) training on children with cerebral palsy. METHOD: This
study was carried out at the School of Physical Therapy and
Rehabilitation of Hacettepe University, Occupational Therapy
Unit. Forty-one children who were diagnosed as having spastic
diplegic cerebral palsy by the Department of Paediatric Neurology
of Hacettepe University were assessed. Forty-one children
with cerebral palsy were randomly divided into three groups.
Individual and group SPM training were given to first group
(IND) (n = 16) and second group (GRP) (n = 16) respectively.
The third group was determined as a control group (n = 9)
and only the home programme was given. All children were evaluated
with Ayres Southern California Sensory Integration Test and
Physical Ability Test before and after training. The SPM training
programmes were applied for 1.5 hours, 3 days per week for
3 months. RESULTS: Estimates of effect sizes were calculated
for group, individual and control treatments. Results indicated
that both group and individual treatments had a measurable
effect that was consistently greater than that of controls.
CONCLUSIONS: This study shows that programmes of SPM training
in individuals and group treatments affect children with cerebral
palsy. It was concluded that SPM training in children with
cerebral palsy will be applied to combined programmes and
the relationship with individual and group treatments developed.
Cohn, ES. (2001). Parent perspectives of occupational therapy
using a sensory integration approach. The American Journal
of Occupational Therapy, 55, 285-294.
This qualitative study explored parents' points of view regarding
their children's participation in occupational therapy using
a sensory integration approach. Data were collected through
parent interviews and were analyzed using grounded theory
methods. The parents' perceptions of the benefits of therapy
for their children were categorized into three interrelated
constructs: abilities, activities, and reconstruction of self-worth.
For themselves, parents valued understanding their children's
behavior in new ways, which facilitated a shift in expectations
for themselves and their children, having their parenting
experience validated, and being able to support and advocate
for their children. Implications for family-centered intervention
and future research are proposed.
Nackley, VL. (2001). Sensory diet applications and environmental
modifications: A winning combination. Sensory Integration
Special Interest Section Quarterly, 24(1), 1-4.
No abstract available for this record
Dawson G, & Watling R. (2000). Interventions to facilitate
auditory, visual, and motor integration in autism: a review
of the evidence. Journal of Autism and Developmental Disorders,
30(5):415-421.
Evidence is reviewed on the prevalence of sensory and motor
abnormalities in autism and the effectiveness of three interventions
designed to address such abnormalities--sensory integration
therapy, traditional occupational therapy, and auditory integration
training. Although sensory processing and motor abnormalities
are neither universal nor specific to autism, the prevalence
of such abnormalities in autism is relatively high. There
is, however, little controlled research on the effectiveness
of interventions designed to address these abnormalities.
Four objective outcome studies of sensory integration therapy
were identified. These were of such small scale that no firm
conclusions regarding efficacy could be made. No empirical
studies of traditional occupational therapy in autism were
found. Five studies of auditory integration training were
found. Results of these studies provided no, or at best equivocal,
support for the use of auditory integration training in autism.
Miller, L J& Lane, SJ. (2000). Toward a consensus in
terminology in sensory integration theory
and practice: Part 1: Taxonomy of neurophysiological processes.
Sensory Integration Special Interest Section Quarterly, 23(1),
1-4.
No abstract available for this record
Lane, SJ, Miller, LJ & Hanft, BE. (2000). Toward a consensus
in terminology in sensory integration theory and practice:
Part 2: Sensory integration patterns of function and dysfunction.
Sensory Integration Special Interest Section Quarterly, 23(2),
1-3.
No abstract available for this record
Hanft, BE, Miller, LJ & Lane, SJ. (2000). Toward a consensus
in terminology in sensory integration theory and practice:
Part 3: Observable behaviors: Sensory integration dysfunction.
Sensory Integration Special Interest Section Quarterly, 23(3),
1-4.
No abstract available for this record
Davidson, T & Williams, B. (2000). Occupational therapy
for children with developmental coordination disorder: A study
of the effectiveness of a combined sensory integration and
perceptual-motor intervention. The British Journal of Occupational
Therapy, 63, 495-499.
Developmental coordination disorder (DCD) is a problem for
a significant proportion of children during school years and
may result in more enduring social and emotional problems.
Both occupational therapists and physiotherapists provide
services for children with DCD. However, there are few studies
examining the effectiveness of interventions for this client
group.
This has resulted in continuing uncertainty over the most
effective treatment for this condition. This paper examines
past problems with regard to definitions of the disorder,
research design and ethical barriers. The results of a pre-test,
post-test single-group study of an occupational therapy intervention
for DCD are then presented. Outcomes were measured by the
Movement ABC and the Beery-Buktenica Developmental Test of
Visual-Motor Integration (Beery 1982) at one-year follow-up.
The results are discussed in relation to the shortcomings
of research design used in the study. It is concluded that
the intervention, consisting of combined sensory integration
and perceptual-motor training, is likely to be ineffective
at 12-month follow-up.
Joshi, AS. (2000). Single-system design: An effective strategy
for evaluating clinical change. The British Journal of Occupational
Therapy, 63, 283-287.
Documentation and research are two essential factors for
the growth of any profession and, therefore, have priority
in occupational therapy. Documentation is the key to the communication
of the clinical services rendered by the occupational therapist
to clients and to other members of the professional team (Gillette
1982, Ottenbacher and York 1984). Single- system research,
sometimes referred to as single-subject research, is a quantitative
research method. In single-system research, the efficacy of
a certain intervention can be evaluated in a systematic way
by studying one subject in a single setting (Ottenbacher 1984).
A therapist can make use of any therapeutic technique to work
in a single-system design. Gillette (1982, p499) stated: 'Each
occupational therapy clinic is a virtually untouched laboratory,
a storehouse of evidence that, properly recorded, analysed
and published, would serve to confirm the value of occupational
therapy as a health care service." This article describes
the application of single-system design in a clinical setting.
The client discussed was treated using sensory integrative
therapy. The purpose of this article is to show how a selected
behaviour can be recorded and measured effectively using a
single-system design.
Leemrijse C, Meijer OG, Vermeer A, Ader HJ, Diemel S. (2000).
The efficacy of Le Bon Depart and Sensory Integration treatment
for children with developmental coordination disorder: a randomized
study with six single cases. Clinical Rehabilitation, 14(3),
247-259.
OBJECTIVE: Evaluation of the efficacy of Le Bon Depart (LBD)
treatment and Sensory Integration (SI) treatment on motor
performance of children with developmental coordination disorder.
DESIGN: A single subject design with multiple baseline and
alternating treatments. Order of treatment and length of phase
were randomized. Measurements were blinded. SETTING: Department
of Occupational Therapy at the Academic Hospital Vrije Universiteit
Amsterdam, The Netherlands. SUBJECTS: Five boys and one girl
with developmental coordination disorder (age: 6.0-8.1 years).
INTERVENTIONS: Baseline condition, Le Bon Depart treatment
and Sensory Integration treatment. MAIN OUTCOME MEASURES:
The Movement ABC, Praxis Tests, a rhythm test and visual analogue
scales. With the exception of the Praxis Tests, lower scores
indicate better performance. RESULTS: During both treatments,
the performance on the Movement ABC (x = 7.21) and the scores
on the visual analogue scales (x = 46.64) were significantly
better than in the baseline (Movement ABC(baseline): x = 17.38;
visual analogue scales(baseline): x = 68.18). After treatment
2, performance on the Praxis Tests and scores on the visual
analogue scales were significantly better than after treatment
1 (Praxis Tests: 113.54 versus 104.68; visual analogue scales:
34.74 versus 58.54). All six children performed better on
the Movement ABC during treatment as compared to the baseline.
Le Bon Depart led to significant improvement on all dependent
variables, Sensory Integration on the visual analogue scales
only. The improvements after Le Bon Depart were larger than
the improvements after Sensory Integration treatment. On the
rhythm test this difference was significant: LBD led to an
improvement of 43.01 points, while the improvement after SI
was 17.59 points (p < 0.05). CONCLUSION: Motor performance
of children with developmental coordination disorder improved
significantly on all dependent variables after the combination
of treatments. Le Bon Depart led to more improvement than
Sensory Integration. LBD appears to be a valuable treatment
method for children with developmental coordination disorder.
May-Benson, T Reeves, GD Young, SB. (2000). Creating a consensus
on terminology in Sensory Integration: Comments and reflections.
Sensory Integration Special Interest Section Quarterly, 23(4),
1-3.
No abstract available for this record
Cicchino, C & Monteleone, V. (2000). The efficacy of
sensory integration therapy on pre-school children with autism
and its effects on verbalization and engagement. Bay Shore,
NY: Touro College. (Master's thesis)
This multiple case study design explored the efficacy of
a sensory diet coupled with individual occupational therapy
intervention with six preschool children with autism. Within
this design two behaviors were measured, engagement and verbalization.
The factors of engagement analyzed for results included adult
interaction, peer interaction, mastery play, and non-engagement.
Comparisons were made of baseline and intervention phases
for the six children. All four children analyzed for verbalizations
demonstrated an increase in frequency of verbalizations during
post- sensory diet activity from baseline to final month.
Of the four children analyzed for engagement in the baseline,
middle, and final months three demonstrated an increased frequency
of adult interaction by the final month during the post-sensory
diet activity. Whereas, the other two children were analyzed
only during the pre-sensory diet activity for a beginning
and an end month in which they both demonstrated an increased
frequency of mastery of play and a decreased frequency of
non-engaged behaviors. Individual gains were observed for
all children in the many behavior areas analyzed, however,
it is difficult to categorize these gains as a whole for the
group due to individual differences. Overall, these children
appeared to have demonstrated an increased tolerance to sensory
stimulation and positive experiences during the sensory motor
play as evidenced through higher engagement levels and higher
frequency of verbalizations.
Case-Smith, J & Bryan, T. (1999). The effects of occupational
therapy with sensory integration emphasis on preschool-age
children with autism. The American Journal of Occupational
Therapy, 53, 489-497.
OBJECTIVE. Using single-subject research design, the effects
of an occupational therapy intervention emphasizing sensory
integration with five preschool children with autism were
examined. METHOD. In the AB design, nonengagement, mastery
play, and interaction were measured, using videotape clips
of each child's free play in the preschool. Following a 3-week
baseline, an occupational therapist provided one-on- one sessions
and consultation to teachers for 10 weeks. RESULTS. When baseline
and intervention phases were compared, four children demonstrated
decreased frequency on nonengaged behavior, and three demonstrated
increased frequency of mastery (goal-directed) play. Improvements
in frequency of interaction were minimal. CONCLUSION. The
results support descriptions in the literature regarding the
behavioral changes that children with autism can make when
participating in intervention using a sensory integration
approach.
Clark, GF & Ward, S. (1999). Charting results: Evaluating
progress of children with sensory processing disorder. OT
Practice, 4(10), 12-16.
No abstract available for this record
Vargas, S & Camilli, G. (1999). A meta-analysis of research
on sensory integration treatment. The American Journal of
Occupational Therapy, 53, 189-198.
OBJECTIVE. The purpose of this study was to find whether
existing studies of treatment using sensory integration approaches
support the efficacy of these approaches. METHOD. With meta-analysis,
the results of sensory integration efficacy research studies
published from 1972 to the present were synthesized and analyzed.
Sixteen studies were used to compare sensory integration effect
with no treatment (SI/NT), and 16 were used to compare sensory
integration effect with alternative treatments (SI/ALT). Overall
average effect sizes, comparisons of the effect sizes for
different dependent variables, and secondary factors associated
with effect size variation were examined. RESULTS. The weighted
average effect size of SI/NT studies was .29. However, there
was a significant difference between the average effect sizes
of the earlier studies (.60) and the more recent studies (.03).
Of the outcome measures, larger effect sizes were found in
the psychoeducational category (.39) and motor category (.40).
Of SI/ALT studies, the average effect size was .09, not significantly
different from zero. CONCLUSION. Three central conclusions
can be made. First, in the SI/NT comparison, a significant
effect was replicated for sensory integration treatment effects
in earlier studies, but more recent studies did not show overall
positive effects. Second, larger effect sizes were found in
psychoeducational and motor categories. Third, sensory integration
treatment methods were found to be as effective as various
alternative treatment methods.
Linderman, TM & Stewart, KB. (1999). Sensory integrative-based
occupational therapy and functional outcomes in young children
with pervasive developmental disorders: A single- subject
study. The American Journal of Occupational Therapy, 53, 207-213.
OBJECTIVE. This single-subject study explored the effects
of sensory integrative- based occupational therapy provided
in an outpatient clinic on the functional behaviors of two
young children with pervasive developmental disorder (PDD)
at home.
METHOD. The participants were two 3-year-old boys with PDD.
Before the study, the participants had not received a consistent
program of sensory integrative-based occupational therapy.
Before the baseline phase, three target behaviors were identified
for each child, using an adapted version of Cook's revised
Functional Behavior Assessment for Children with Sensory Integrative
Dysfunction. These target behaviors were operationalized and
used as repeated measures taken in the home during both the
2-week baseline and treatment phases. The treatment phase
was 11 weeks for Participant 1 and 7 weeks for Participant
2.
RESULTS. Both participants displayed significant improvements
in the areas of social interaction, approach to new activities,
response to holding or hugging, and response to movement.
Decreases were noted in the frequency and duration of disruptive
behaviors (e.g., high activity levels, aggressive behaviors),
with an increase in functional behaviors, such as spontaneous
speech, purposeful play, and attention to activities and conversation.
Concurrent interventions that were not part of this study
(e.g., initiation of speech therapy, preschool, vitamins)
may have confounded these results.
CONCLUSIONS. These findings support the application of sensory
integrative-based occupational therapy as a part of the services
provided to some children with PDD. Further research is needed
to replicate these findings and to isolate the effects of
sensory integrative-based occupational therapy because both
participants were receiving other interventions at the time
of this study.
Cohn, ES & Cermak, SA. (1998). Including the family perspective
in Sensory Integration outcomes research Approach. The American
Journal of Occupational Therapy, 52, 540-546.
Occupational therapy, along with other health and rehabilitation
professions, is experiencing an increased emphasis on measurement
of intervention outcomes. The results of outcomes research
are being used to develop practice guidelines, set standards
for reimbursement, and justify health care policy. The outcome
assessments used by therapists reflect our belief systems
and the assumptions about behaviors we expect to influence.
Using a sensory integration perspective to illustrate key
points, we present a conceptual framework that is based on
the disablement framework and Coster's occupational functioning
for children model. We highlight the need to examine each
of the multiple levels at which intervention may influence
child and family function and the links among levels. Sensory
integration theory and efficacy studies are reviewed to identify
assumptions relative to how sensory integration affects the
everyday occupations of children in the context of their families.
Potential research methods and assessments are suggested to
include the family perspective in outcome studies.
Belsky, MM. (1998). Parents' Perceptions of the Effectiveness
of Sensory Integration and Behavior Modification in Autistic
Preschool Children. NY, NY: Touro College. (Master's thesis)
Autism is a developmental disorder of brain function that
interferes with reasoning, communication, and social interaction.
There are a number of behavioral problems associated with
this disorder and they include the following: tantrums, aggression,
self-stimulatory, and property destruction.
This study focused on parents' perceptions of the effectiveness
of combining two occupational therapy treatments, sensory
integration and behavior modification, in reducing the self-injurious
and self-stimulatory behaviors of autistic preschool children.
Data was obtained from 57 returned questionnaires sent to
parents attending support groups in the New York and New Jersey
area.
Questions asked were to determine their perceptions of these
treatments by noting changes in these behaviors exhibited
by the children at the end of the school year (June 1998)
as compared to the beginning of the school year (September
1997). The hypothesis assumed that parents would perceive
the effectiveness of combining sensory integration and behavior
modification.
Results supported the hypothesis and indicated that future
research is needed to validate the effectiveness of these
two treatment approaches.
Sokol, A. (1998). Occupational therapists' perception of
the effectiveness of neurodevelopmental, sensory integration,
and behavior modification treatments in decreasing self-stimulatory
and self-injurious behaviors in children with autism. NY,
NY: Touro College. (Master's thesis)
This study investigated the perceptions of 30 NBCOT certified
occupational therapists in the New York City area who belong
to AOTA's school-based special interest section. Three treatment
methods (NDT, SI, and BM) were investigated in their effectiveness
of decreasing self-stimulatory and self- injurious behaviors
in children with autism. Questionnaires consisted of demographic
data information and 15 descriptors of the three treatment
methods. The results of the data examined three different
aspects, if therapists perceive a combined approach is more
effective, if there are clusters within each of the three
treatment methods, and if there are clusters within all
three-treatment methods. Results of the data revealed that
occupational therapists may not be using a single approach
for intervention but in fact are using a holistic approach.
Ideally, a holistic approach, such as occupational genesis,
which focuses on the entire individual, should be employed
in treatment settings. However, many factors, such as a small
sample population and slight distinctions of treatment methods
may have influenced the results of this study.
Stonefelt, LL & Stein, F. (1998). Sensory integrative
techniques applied to children with learning disabilities:
An outcome study. Occupational Therapy International, 5, 252-272.
Learning disabilities are the most frequently reported causes
of functional limitation among school-age children (McNeil,
1995). Many children with learning disabilities have an underlying
sensory integrative dysfunction (Hoehn and Baumeister, 1994);
therefore sensory integration therapy has been widely used
in treating those children. Research on the effectiveness
of sensory integration therapy in treating children with learning
disabilities has shown conflicting results; many studies supported
the use of sensory integration therapy in treating children
with learning disabilities, as perceived by their parents,
teachers and occupational therapists. Thirty surveys were
sent to participants in the Midwest; 10 each to parents, teachers
and occupational therapists. Twenty- three surveys were returned,
giving a response rate of 77%. Most of the respondents identified
that sensory integration therapy was extremely or somewhat
effective in helping the children improve function in 12 skill
areas. All parents reported doing activities in the home to
help their child and all teachers reported making adaptations
in the classroom to better accommodate the child. The sensory
integrative techniques most frequently used by the therapists
were linear activities, tactile stimulation, games and jumping/bouncing.
Seven of the therapists reported using another treatment method
in addition to sensory integration. These seven noted that
a combination of treatments, a multimodel approach, was more
effective than sensory integration alone. This study was consistent
with previous research showing that sensory integration is
an effective treatment method for children with learning disabilities.
However, further research is needed using prospective designs
involving single-subject or group studies where extraneous
variables are rigorously controlled.
Dunkerley, E, Tickle-Degnen, L & Coster, WJ. (1997).
Therapist-child interaction in the middle minutes of sensory
integration treatment. The American Journal of Occupational
Therapy, 51, 799-805.
The purpose of this study was to describe the management
of challenge during therapist-child interaction in sensory
integration treatment. This descriptive and relational study
of the middle minutes of treatment sessions partially replicated
an earlier study of the beginning minutes. One-minute videotape
clips taken from the middle minutes of 38 treatment sessions
were shown to therapist judges who rated qualities of therapist
and child behavior. Two patterns emerged from the correlations
of ratings: work and playfulness. Work for the child involved
trying hard, cooperating, and seeking assistance, whereas
work for the therapist involved assisting and guiding the
child. Play for the child included enjoying the activity,
being successful and confident, and trying hard. For the therapist,
play involved being creative and behaving playfully. Patterns
of work and play were different across different levels of
challenge to the child.
Cross, LA & Coster, WJ. (1997). Symbolic play language
during sensory integration treatment. The American Journal
of Occupational Therapy, 51, 808-814.
OBJECTIVE. Clinical writings on sensory integration treatment
and theory have long professed that play serves as an important
means of implementing treatment goals. However, to date, there
has been little research that examines this aspect of the
intervention. With the use of play language as an indicator
for the occurrence of play, this study examined the frequency
and characteristics associated with symbolic play language
that therapists and children use during sensory integration
therapy. This study is part of an ongoing research program
designed to examine therapist-child interactions.
METHOD. The frequency of symbolic play language observed in
41 videotaped treatment sessions of therapist-child dyads
(21 children, 12 therapists) was recorded with the Challenge
Coding System. The presence of symbolic play language was
recorded if the child or therapist used language that incorporated
the child, therapist, equipment, or activity into a symbolic
or pretend play theme. The frequency of symbolic play language
and percentage of time spent using play language were calculated.
Associations among frequency of play language, child age,
and behavior during the session (e.g., seeking assistance,
cooperation) were also examined.
RESULTS. Symbolic play language proved to be a major feature
of sensory integration treatment sessions. It also correlated
with child age and with some features associated with therapeutic
interactions (i.e., child tries hard, child seeks assistance,
therapist assists child, therapist modifies activity, therapist
structures activity).
CONCLUSION. The results suggest that these therapists used
play language frequently and that this usage may support children
in sensory integrative therapy to successfully accomplish
activities.
Leary PM. (1997). Interventions for children with neurodevelopmental
delay. South African Medical Journal, 87(12), 1680-1684.
OBJECTIVES: To review studies in the scientific literature
of five physical interventions commonly recommended for children
with neurodevelopmental delay. DESIGN: A literature search
for and a review of the results of controlled and other studies
conducted in the course of the last 25 years. SETTING: Institute
of Child Health, University of Cape Town. SUBJECTS: Patterning;
neurodevelopmental therapy; sensory integrative therapy; optometric
visual training; auditory integration therapy. OUTCOME MEASURES:
Findings and conclusions drawn in the studies reviewed. RESULTS:
Controlled studies fail to provide evidence to support claims
made for the five interventions examined. CONCLUSIONS: In
the absence of scientific evidence for efficacy patterning,
neurodevelopmental therapy, sensory integrative therapy, optometric
visual training and auditory integrative therapy cannot be
recommended for children with neurodevelopmental delay.
Kemmis, BL & Dunn, WL. (1996). Collaborative consultation:
The efficacy of remedial and compensatory interventions in
school contexts. The American Journal of Occupational Therapy,
50, 709-717.
OBJECTIVE. This study examined the intervention success of
weekly collaborative consultation between therapists and teachers.
METHOD. Ten therapist-teacher pairs consulted for 60 minutes
weekly throughout the school year about students identified
as having sensory integration dysfunction with learning problems.
Each week, the pairs identified a specific functional classroom
goal then designed either a remedial or compensatory intervention
and set criteria for intervention success. At each successive
weekly meeting, the pairs determined whether the goal was
met. Intervention success was analyzed across 10 students
(for a total of 213 goals).
RESULTS. There was a positive effect for overall intervention
success. Although remedial and compensatory interventions
were equally successful across student performance areas,
therapist-teacher pairs demonstrated a preference for compensatory
and academic goals. CONCLUSION. The overall positive effect
for intervention success suggests that when occupational therapists
and teachers collaborate on behalf of students, they can facilitate
student success in a variety of performance areas. Therapist-
teacher preference for compensatory and academic goals indicates
that therapist- teacher collaboration can be useful for occupational
therapists to link interventions to academic goals in school
contexts.
DeGangi, GA, Sickel, R, Wiener, AS & Kaplan, EP. (1996).
Fussy babies: to treat or not to treat. The British Journal
of Occupational Therapy, 59, 457-464.
In this prospective study, the developmental outcomes of
39 infants with high irritability and sensory processing problems,
also described as regulatory disordered, were examined at
7-30 months and at 3 years using clinical interdisciplinary
assessment. Infants with regulatory disorders were defined
as being behaviourally difficult with disturbances in sleep,
feeding, state control, self-calming, mood regulation and
sensory processing. The performance of samples of infants
with regulatory disorders, 13 untreated and 26 treated, and
11 normal children were compared at 3 years. All subjects
in the clinical sample were offered 12 weeks of intervention
after the initial
assessment to address regulatory problems. Of the 39 subjects,
26 chose treatment, thus resulting in a self- selected treated
sample. Post hoc analysis revealed that, at 7-30 months, untreated
subjects had more sleep problems and were more irritable whereas
treated subjects had more feeding problems and their mothers
reported feeling depressed. At 3 years, the children with
regulatory disorders differed from their normal counterparts
in sensory integration, mood regulation, attention, motor
control, sleep and behavioural control. Untreated subjects
showed more emotional and behavioural problems than treated
subjects. Treated subjects had more motor and sensory integrative
problems than untreated subjects but, despite the fact that
they had more constitutional problems, they did not show the
emotional and behavioural problems that were found in the
untreated group. The clinical importance of these findings
for occupational therapists is discussed.
Coster, W, Tickle-Degnen, L & Armenta, L. (1995). Therapist-child
interaction during sensory integration treatment: development
and testing of a research tool. The Occupational Therapy Journal
of Research, 15, 17-35.
Although Ayres (1972) identified the interaction between
therapist and child as an essential feature of successful
sensory integration treatment, this aspect of the treatment
process has not been examined in efficacy studies to date.
In part, this omission may be explained by the lack of adequate
measurement tools for this purpose. This paper reports on
the development and reliability testing of the Challenge Coding
System, a quantitative research tool designed to examine the
collaboration of therapist and child in the sensory integration
treatment process. Data from three studies are reported that
collectively demonstrate that important aspects of the therapeutic
interaction can be measured reliably. Potential uses of the
new instrument in research are discussed.
Allen, S & Donald, M. (1995). The effect of occupational
therapy on the motor proficiency of children with motor/learning
difficulties: a pilot study. The British Journal of Occupational
Therapy, 58, 385-391.
A pilot study was undertaken to consider the effect of occupational
therapy on the motor proficiency of children with motor/learning
difficulties. Intervention was based on Ayres' model of sensory
integration. Motor proficiency was assessed before and after
10 sessions of occupational therapy. The assessment tool used
was the Bruininks- Oseretsky Test of Motor Proficiency. The
subjects were five children attending mainstream primary schools.
Change was noted in all cases: four subjects improved whilst
one deteriorated. Further data are required for statistical
analysis; however, the mean standard score improved. Age appeared
to be a factor in the level of improvement attained. Recommendations
for future studies are made in relation to assessment techniques
and study design.
Wilson, BN & Kaplan, BJ. (1994). Follow-up assessment
of children receiving sensory integration treatment. The Occupational
Therapy Journal of Research, 14, 244-266.
Following the completion of a study of the efficacy of sensory
integration (SI) treatment compared with tutoring, the question
raised was whether a greater difference between the two groups
would exist after a period of time had elapsed after treatment
ended. Twenty-two of the original 29 subjects completed follow-up
assessment two years after the completion of their treatment.
Only one significant difference between the two groups was
seen at follow-up: The gross motor performance of the group
who received SI treatment was significantly greater than that
of children who received tutoring. There was no difference
between the groups on measures of reading skills, fine motor
skills, visual motor skills, or behavioral factors. There
were no significant correlations between the amount of improvement
a child made during treatment and the maintenance of the gains.
Daems, J. (Ed.). (1994). Reviews of Research in Sensory Integration.
Torrance, CA: Sensory Integration International.
No abstract available for this record
Hoehn TP, & Baumeister AA. (1994). A critique of the
application of sensory integration therapy to children with
learning disabilities. Journal of Learning Disabilities, 27,
338-350.
Sensory integration (SI) therapy is a controversial--though
popular--treatment for the remediation of motor and academic
problems. It has been applied primarily to children with learning
disabilities, under the assumption that such children (or
at least a subgroup of them) have problems in sensory integration
to which some or all of their learning difficulties can be
ascribed. The present article critically examines the related
issues of whether children with learning disabilities differentially
exhibit concomitant problems in sensory integration, and whether
such children are helped in any way by means specific to SI
therapy. An overview of theoretical contentions and empirical
findings pertaining to the first issue is presented, followed
by a detailed review of recent studies in the SI therapy research
literature, in an effort to resolve the second issue. Results
of this critique raise serious doubts as to the validity or
utility of SI therapy as an appropriate, indicated treatment
for the clinical population in question--and, by extension,
for any other groups diagnosed as having "sensory integrative
dysfunction." It is concluded that the current fund of
research findings may well be sufficient to declare SI therapy
not merely an unproven, but a demonstrably ineffective, primary
or adjunctive remedial treatment for learning disabilities
and other disorders.
Humphries, TW, Snider, L & McDougall, B. (1993). Clinical
evaluation of the effectiveness of sensory integrative and
perceptual motor therapy in improving sensory integrative
function in children with learning disabilities. The Occupational
Therapy Journal of Research, 13, 163-182.
After 72 1-hour therapy sessions for 3 hours per week, significantly
more subjects, aged 58-107 months, receiving sensory integration
therapy (n=35) and perceptual motor training (n=35) than those
receiving no treatment (n=33) showed improvement in their
sensory integrative functioning. The same effect was found
for a subgroup of children exhibiting vestibular dysfunction
only. Improvement could include an increase of all test scores
defining a child's particular dysfunction into the normal
range with associated clinical observations indicating no
problem, or a reduction in the severity of a child's dysfunction,
the number of their dysfunctional systems, or both severity
and dysfunctional systems. The groups did not differ in the
incidence of any one of these individual types of improvement
but only in their overall improvement represented by the total
of all types. Discussion focused on the type and degree of
improvement therapists can...
DeGangi, GA, Wietlisbach, S, Goodin, M & Scheiner, N.
(1993). A comparison of structured sensorimotor therapy and
child-centered activity in the treatment of preschool children
with sensorimotor problems. The American Journal of Occupational
Therapy, 47, 777-786.
his study compared the benefits of a child-centered therapy
approach emphasizing child-initiated play interactions within
a structured therapy environment to those of a therapist-directed,
structured sensorimotor therapy approach in 12 preschool children
with sensorimotor dysfunction. Each child received a pretest,
8 weeks of intervention (A or B) provided once weekly for
a 1-hour session, a retest, 8 weeks of intervention (B or
A) provided once weekly, and a final retest. A case study
methodology was used to evaluate outcome data. Structured
sensorimotor therapy was more useful than child-centered therapy
in promoting gross motor skills, functional abilities (i.e.
self-care), and sensory integrative functions. Child-centered
therapy appeared to promote fine motor skills better. Although
there were no differences in the two therapies for gains in
play, attention, and behavior, variables such as temperament,
attentional abilities, family stress, severity of sensorimotor
delay...
Horowitz LJ, Oosterveld WJ, & Adrichem R. (1993). Effectiveness
of sensory integration therapy on smooth pursuits and organization
time in children. Pediatrie und Grenzgebiet, 31(5), 331-44.
In this study the effect of sensory integration (SI) therapy
on smooth pursuit eye movements, tracking and learning time
was evaluated in 21 children diagnosed with sensory integration
dysfunction. A control group of 11 normal children, matched
for age and sex was also tested. Electrooculograph (EOG) recordings
were inspected for number of saccadic intrusions during smooth
pursuit movements. Prior to therapy the children in the SI
treatment group exhibited significantly more saccadic intrusions
during smooth pursuit movements and took significantly longer
to perform the task than the normal control group. After 6-9
months of SI therapy one hour a week, there was a significant
reduction in the number of saccades in the treatment group.
The treatment group demonstrated a reduction in the time necessary
to accomplish smooth pursuits and organizational time. The
etiology of these improvements may be related to the subcortical
substrated utilized in SI therapy as well as in the generation
of smooth pursuit eye movements.
Kadrmas, CJ. (1993). Is sensory integration therapy an effective
treatment for children with learning disabilities. Journal
of Occupational Therapy Students, 7, 15-22.
This article presents a position on the efficacy of sensory
integration therapy in the treatment of children with learning
disabilities. In addition to Ayres' pioneering work, six studies
supporting the effectiveness of the therapy are cited. The
coexistence of sensory integration dysfunction with learning
disabilities is suggested in these studies. In opposition
to the effectiveness of the therapy, four studies and two
research reviews are referenced. The opposing research does
not find a notable relationship between sensory integration
dysfunction and learning disabilities, and sensory integration
therapy was found to have no influence on areas of cognitive
and academic performance. Areas of concern within the research
indicate a need for methodological strength and suggest a
revision of sensory integration theory. After examination
of the available research, I have concluded that sensory integration
therapy does not have enough supporting evidence...
Kaplan BJ, Polatajko HJ, Wilson BN, & Faris PD. (1993.)
Reexamination of sensory integration treatment: a combination
of two efficacy studies. Journal of Learning Disability, 26(5),
342-347.
Little empirical support exists for the application of sensory
integration treatment (SIT) to assist children with learning
problems. Treatment efficacy studies are expensive and difficult
to carry out, and they have necessarily employed small samples
that are inevitably heterogeneous. We have reanalyzed the
efficacy of SIT by combining the data from one study involving
29 children in Alberta and a second study involving 67 children
in Ontario. The results from each individual study, and now
the results from the combined study, lead one to the conclusion
that the therapeutic effect of SIT on children with learning
deficits is not greater than other, more traditional methods
of intervention.
Miller, LJ & Kennealey, M. (1993). Researching the effectiveness
of sensory integration. Sensory Integration Quarterly, 21(2),
1, 3-5, 7.
Humphries T, Wright M, Snider L, McDougall B. (1992). A comparison
of the effectiveness of sensory integrative therapy and perceptual-motor
training in treating children with learning disabilities.
Developmental and Behavioral pediatrics, 13(1), 31-40.
This study compared the effect of sensory integration therapy
(SI), perceptual-motor training (PM) and no treatment (NT)
on the performance of 103 children with learning disabilities
and sensory integrative dysfunction, aged 58 to 107 months,
who were randomly assigned to one of the two treatment groups
or to no treatment. After receiving a total of 72 1-hour sessions
of therapy for 3 hours per week, PM-treated subjects showed
significant gains over the other two groups, primarily in
gross motor performance. SI-treated subjects showed an advantage
in motor planning. There were no accompanying group differences
in visual perception, handwriting readiness, copying ability,
cognitive, academic, language and attentional skills or in
self-concept. These findings demonstrate motor gains resulting
from motor treatments without carry-over to functional skills
and abilities more directly associated with school performance.
Polatajko, HJ, Kaplan, BJ & Wilson, BN. (1992). Sensory
integration treatment for children with learning disabilities:
its status 20 years later. The Occupational Therapy Journal
of Research, 12, 323-341.
Ayres' seminal paper in 1972 reported that Sensory Integration
(SI) Treatment was a promising method for improving the academic
scores of children with learning disabilities. Ottenbacher's
(1982a) review of research reported during that first decade
indicated that SI treatment was worthy of further investigation.
In this report, we reviewed randomized, controlled trials
conducted primarily in the second decade, and conclude that
the status of the literature 20 years after Ayres' original
article does not support SI treatment as an effective treatment
for the academic problems of learning disabled children. With
respect to sensory or motor variables, it is not clear whether
or not SI treatment is more effective than perceptual-motor
approaches. Future research also must determine whether SI
treatment is more effective than maturation alone.
Wilson, BN, Kaplan, BJ, Fellowes, S, Gruchy, C & Faris,
P. (1992). The efficacy of sensory integration treatment compared
to tutoring. Physical & Occupational Therapy in Pediatrics,
12(1), 1-36.
Controversy surrounds the use of sensory integration (SI)
treatment for children with motor difficulties and learning
disabilities. The efficacy of 75 sessions of individual SI
therapy was compared to equal amounts of individual tutoring
with 29 subjects, aged 5-9 years. Assessments by people blind
to group assignment occurred at pre-test and after 6 and 12
months of treatment, using academic, motor and behavioural
measures. No significant differences were noted between the
two treatment groups after 6 or 12 months of treatment. The
fact that the SI group improved as much in reading and other
academic measures as the tutoring group who received extensive
work in those areas supports the theory that SI may be as
effective as tutoring in improving academic functioning. Tutoring,
however, was as effective as SI in improving motor functioning,
which was unexpected.
Law, M, Polatajko, HJ, Miller, J, Schaffer, R & Macnab,
J. (1991). The impact of heterogeneity in a clinical trial:
motor outcomes after sensory integrative therapy. The Occupational
Therapy Journal of Research, 11, 177-189.
The effect of a therapeutic intervention in a clinical trial
may be obscured by heterogeneity in the study subjects. This
paper examines the results of a randomized clinical trial
to evaluate the effects of 6 months of sensory integration
therapy, perceptual-motor treatment, and no program ( control)
on learning disabled children with sensory integrative dysfunction.
Contrary to expectations, Polatajko, Law, Miller, Schaffer,
and Macnab (1991) found no significant differences between
the groups on motor performance. However, overall, the children
made motor gains; indeed, some children made very large gains.
Others did not make gains or deteriorated. Change scores indicated
that approximately half of the children improved more than
can be expected by maturation alone while half did not. The
heterogeneity of the response of individual children to treatment
appeared to have led to an overall non-significant result...
Danos, J. (1990). Review of early intervention practices
with preterm infants.
Journal of Occupational Therapy Students, 5, 15-22.
Preterm infants have had higher mortality rates than full-term
infants in the past, but now more of them are reaching adulthood.
This paper reviews the current literature on the use of early
sensory intervention approaches with preterm infants and their
success in facilitating normal growth and development. The
role of the occupational therapist in the neonatal nursery
is examined and recommendations are made for further research
in sensory intervention programs.
Humphries T, Wright M, Snider L, McDougall B, & Vertes,
J. (1990). The efficacy of sensory integration therapy for
children with learning disability. Physical & Occupational
Therapy in Pediatrics, 10(3), 1-17.
No abstract available for this record
Schaaf, RC. (1990). Case Report: Play Behavior and Occupational
Therapy. The American Journal of Occupational Therapy, 44,
68-75.
No abstract available for this record
Werry JS, Scaletti R, & Mills F. (1990). Sensory integration
and teacher-judged learning problems: a controlled intervention
trial. Journal of Pediatric Child Health, 26(1), 31-35.
Seventy-four children from 21 schools referred because of
teacher-perceived learning difficulties and prescreened for
sensory integration (SI) deficits were given tests of SI,
reading, vocabulary, perceptuo-motor function and motor development,
and their teachers rated their classroom behaviour. The results
showed that the children suffered primarily from attention
deficit disorder without hyperactivity, and from mild deficits
of SI. They were then divided into two groups matched approximately
for sex, school and degree of SI deficits. One group received
no treatment while the other was given about 13 weekly SI
sessions, each of 1 h duration. All children were then reassessed
on the same set of measures. There were significant improvements
with time in both treated and untreated groups on most measures
except classroom behaviour. Only one measure showed a treatment
effect, though this one was most reflective of SI theory.
Densem JF, Nuthall GA, Bushnell J, Horn J. (1989). Effectiveness
of a sensory integrative therapy program for children with
perceptual-motor deficits. Journal of Learning disabilities,
22, 221-229.
This study was an evaluation of the sensory integrative therapy
(SIT) program (Ayres, 1972a) for children at the Christchurch
Hospital. Fifty-five children were randomly assigned to the
SIT program, a parallel physical education program, or to
a no-treatment condition. The children were assessed before
and after treatment on measures of perceptual-motor development,
language and reading development, self-concept, and handwriting
skills. Covariance analysis, with age and pretest scores as
covariates, found no significant differences between groups
on any of the measures except reading progress among those
children who could already read at the beginning of the program.
Children who made the least progress during therapy were those
who (a) had epilepsy, (b) were from a low-income, single-parent
family, or (c) had behavioral problems.
Arendt RE, MacLean WE Jr, & Baumeister AA. (1988).Critique
of sensory integration therapy and its application in mental
retardation. American Journal of Mental Retardation, 92(5):401-429.
Studies on the use of sensory integration therapy with mentally
retarded persons were critically reviewed. Experimental design
and statistical procedures were found inadequate to support
the use of this therapy on an empirical basis. In addition,
certain methodological and design problems seriously cloud
interpretation of research results on this topic. Alternative
explanations of positive outcome as well as equivocal findings
among studies appear related, in part, to the conceptual foundation
of sensory integration therapy. Recommendations for future
directions in research and restraint in application were discussed.
Pettit, KA. (1987). Sensory integration and ego development
in a schizophrenic adolescent male. Occupational Therapy in
Health Care, 4(2), 87-100.
This single case study of a schizophrenic adolescent presents
a detailed analysis of gains in ego functions and clinical
observations. A time out record was retrospectively compiled.
The purpose of the time out record was to evaluate the generalized
effects of sensory integrative treatment procedures on the
client's ability to deal with anger and frustration in his
living environment. Statistical analysis did not yield a significant
difference between pre- and post-treatment data. The results
of this study demonstrate the usefulness of statistical analysis
versus visual comparison of pre- and post-treatment data in
the validation of treatment effectiveness. Visual inspection
might support a conclusion of a significant difference, when
statistic analysis will not. Although marked decreases were
noted in the client's time out record as he mastered hypersensitivity
to movement, development of protective extension, and gravitational
security no...
Schaaf, RC, Merrill, SC & Kinsella, N. (1987). Sensory
integration and play behavior: a case study of the effectiveness
of occupational therapy using sensory integrative techniques.
Occupational Therapy in Health Care, 4(2), 61-75.
This paper presents a case study describing a developmentally
delayed child and examines the changes in environmental interactions
that occurred during a study period in occupational therapy
in which sensory integration (SI) techniques were applied.
Its purpose is to discuss the use of play observation as a
means of measuring change in individuals involved in SI treatment
and to demonstrate the relevance of qualitative research methodologies
to the collection of data on play behaviour. The study is
a first step in a process of developing methods to evaluate
the effectiveness of SI treatment in occupational therapy
through collecting qualitative data on play and other behavioral
measures of environmental interactions.
Hamill, JS. (1987). Sensory integrative dysfunction: parental
participation in the child's therapy program. Occupational
Therapy in Health Care, 4(2), 47-59.
Parental participation in the occupational therapy program
for the child with sensory integrative dysfunction may significantly
improve the achievement of therapy goals, as well as adaptive
behaviours within the home. An individual plan for effective
parent involvement is developed with consideration given to
levels of parent/child interaction and to the parents' ability
to accept their child's difficulties. Purposes of parental
participation are outlined in conjunction with an existing
model for evaluation and intervention. A case presentation
is presented which illustrates optimal parental involvement
and the resulting positive outcomes.
Larrington, GG. (1987). A sensory integration based program
with a severely retarded/autistic teenager: an occupational
therapy case report. Occupational Therapy in Health Care,
4(2), 101-117.
ABSTRACT: This case report illustrates occupational therapy
based on sensory integration philosophy and treatment principles
with a severely mentally retarded/autistic fifteen year old
boy. Evaluation, treatment and results are outlined and discussed
retrospectively. An oral stimulation and feeding program is
presented as an additional and integral part of his occupational
therapy program. The integration of his occupational therapy
program into his daily group home and school life is presented
and the contribution of these other caregivers assessed.
Shuer, J & Weiner, L. (1985). Developing pediatric programming
in a private occupational therapy practice. Occupational Therapy
in Health Care, 2(2), 53-67.
The purpose of this paper is to suggest to occupational therapists
some introductory guidelines which might be followed in developing
a private occupational therapy practice. Elements of a treatment
program are discussed and examples drawn from a currently
successful pediatric program which uses a sensory integrative
approach in offering services. Components of program development
addressed in this paper include the purpose and content of
screening as a recruitment device, how to structure an initial
evaluation and parent conference, general treatment planning
and goal setting, incorporating a theoretical frame of reference
into practice, as well as clinic equipment in the private
setting, documentation, discharge planning and finally, concepts
of marketing for the beginning practice.
Carte E, Morrison D, Sublett J, Uemura A, Setrakian W. (1984).
Sensory integration therapy: a trial of a specific neurodevelopmental
therapy for the remediation of learning disabilities. Developmental
and Behavioral Pediatrics, 5, 189-194.
In the population of learning-disabled (LD) children, there
appears to be a subsample who demonstrate basic dysfunction
in sensory integration. Previous research suggested that sensory
integration (SI) therapy may be effective in improving the
academic performance of this subsample of LD children. This
study is a systematic replication of previous research on
the effects of SI therapy on LD children. The 87 LD children
in this study manifest moderate SI dysfunction, a vestibular
processing disorder, perceptual deficits, and reading retardation.
Data on a subgroup of 45 children with markedly depressed
postrotary nystagmus are presented. After nine months of individual
SI therapy, no systematic effects on any of the dependent
variables were discernible. The implications of these findings
for further research are discussed.
Schaffer, R. (1984). Sensory integration therapy with learning
disabled children: a critical review. The Canadian Journal
of Occupational Therapy, 51(2), 73-77.
No abstract available for this record
Goldstein, PK. (1983). Sensory integration groups: an effective
treatment modality in child psychiatry. Sensory Integration
Special Interest Section Newsletter, 6(1), 1-2.
No abstract available for this record
Jenkins JR, Fewell R, & Harris SR. (1983). Comparison
of sensory integrative therapy and motor programming. American
Journal of Mental Deficiency, 88, 221-224.
The relative effects of individualized sensory integrative
therapy vs. small group, gross-motor programs were examined
with a group of preschool children with mild to moderate motor
delays. Children in the sensory integrative therapy group
received one-to-one treatment twice weekly. Children in the
motor-programming group received intervention four times weekly
in small groups of three to four. Both intervention programs
were carried out simultaneously for 17 weeks. No significant
between group differences were observed in gross-motor gains
on the Peabody Developmental Motor Scales or in sensorimotor
gains on the Assessment of Sensory Integration in Preschool
Children. Results of this study compared to results of similar
previous studies were discussed.
Wells, ME & Smith, DW. (1983). Reduction of self-injurious
behavior in mentally retarded persons using sensory integrative
techniques. American Journal of Mental Deficiency, 87, 664-666.
Four profoundly mentally retarded, multiply handicapped institutionalized
subjects with extensive histories of self-injurious behavior
(SIB) received daily sensory-integrative treatment sessions
that included vestibular and tactile stimulation delivered
noncontingently. Frequency of SIB, as documented by direct-care
staff members throughout the day, decreased significantly
for all subjects.
Ottenbacher K. (1982). Sensory integration therapy: affect
or effect. The American Journal of Occupational Therapy, 36(9):571-578.
The results of studies examining the effectiveness of sensory
integration therapy were reviewed, using recently developed
quantitative methods that treat the literature review process
as a unique type of research. Forty-nine studies were located
initially. Eight of these studies met the following criteria:
(a) they investigated the effect of sensory integration therapy;
(b) they included dependent measures of academic achievement,
motor or reflex performance, and/or language function; (c)
they included a comparison between at least two groups; and
(d) they reported quantitative results of the effect of sensory
integration therapy. The 8 studies contained a total of 47
statistical hypothesis tests that evaluated the effectiveness
of sensory integration therapy. An analysis of these tests,
using quantitative reviewing methods, revealed that subjects
participating in sensory integration therapy performed significantly
better than members in the control groups who did not receive
sensory integration therapy. The application of sensory integration
therapy to various client populations is discussed in relation
to the existing empirical support revealed in the studies
reviewed. The advantages of quantitative reviewing procedures
are discussed, and use of the procedures with the developing
occupational therapy research literature is recommended.
Schoeder, E. (1982). Improvement in academic achievement
through enhancement of perceptual and sensory integrative
functioning. School Psychology International, 3, 97-104.
No abstract available for this record
Van Kampen-Horowitz, LJ. (1982). Effectiveness of sensory
integrative therapy on vestibular & ocular function in
children: intermediate report on eye tracking. The Netherlands:
University of Amsterdam.
No abstract available for this record
Ziviani, J, Poulsen, A & O'Brien, A. (1982). Effect of
a Sensory Integrative/Neurodevelopmental Programme on Motor
and academic performance of children with learning disabilities.
Australian Occupational Therapy, 29, 27-33.
No abstract available for this record
Ottenbacher, K, Scoggins, A & Wayland, J. (1981). The
effectiveness of a program of oral sensory-motor therapy with
the severely and profoundly developmentally disabled. The
Occupational Therapy Journal of Research, 1, 147-160.
The efficacy of a program of oral-motor therapy designed
to facilitate feeding patterns and thus produce increases
in body weight in the severely developmentally disabled was
explored. Twenty severely and profoundly retarded subjects
with neuromotor disorders participated in a pretest/posttest
control group design. The experimental group received a 9-week
program of oral therapy designed to normalize oral motor functions
and reduce pathological oral reflexes. Analysis of covariance
revealed no statistically significant difference in body weight
gains between the experimental and control group over the
treatment period. A post hoc power analysis was computed and
revealed a power of approximately .35, indicating a degree
of insensitivity in the experimental manipulations and statistical
analysis and suggesting the possibility of a Type II experimental
error. The need for continued research in this area to establish
the effectiveness of sensory and motor facilitation procedures
in developing feeding patterns in the severely and profoundly
disabled is discussed.
Ottenbacher, K , Short, MA & Watson, PJ . (1981). The
effects of a clinically applied program of vestibular stimulation
on the neuromotor performance of children with severe developmental
disability. Physical & Occupational Therapy in Pediatrics,
1(3), 1-11.
The effects of a program of controlled vestibular stimulation
on the gross motor, fine motor, and reflex development of
38 severely and profoundly retarded, nonambulatory, developmentally
delayed children were investigated employing a pretest/posttest
control group design. Data analysis revealed that subjects
receiving a combined program of sensorimotor therapy and controlled
vestibular stimulation made significantly greater gains on
measures of reflex, integration, gross motor, and fine motor
development that control subjects receiving a program of sensorimotor
therapy alone. Neuromotor improvements followed the progression
of normal motor development and appeared to be related to
the age of subjects and to the presence or absence of identifiable
neuromotor spasticity.
Semmler, CJ. (1981). Commentary: "The effectiveness
of a program of oral sensory-motor therapy with the severely
and profoundly developmentally disabled". The Occupational
Therapy Journal of Research, 1, 161-163.
No abstract available for this record
Grimwood, LM & Rutherford, EM. (1980). Sensory integrative
therapy as an intervention procedure with grade on "at
risk" readers - a three-year study. Exceptional Child,
27(1), 52-61.
No abstract available for this record
Ayres, AJ. (1979). Sensory integration and the child. Los
Angeles, CA: Western Psychological Services.
No abstract available for this record
White M. (1979). A first-grade intervention program for children
at risk for reading failure. Journal of Learning Disabilities,
12(4), 231-237.
No abstract available for this record
Ayres, AJ. (1977). Cluster analysis of measures of sensory
integrative therapy. The American Journal of Occupational
Therapy, 31, 362-366.
No abstract available for this record
Montgomery, P & Richer, E. (1977). Effect of sensory
integrative therapy on the neuromotor development of retarded
children. Physical Therapy, 57, 799-807.
No abstract available for this record
Ayres, AJ. (1977). Effect of Sensory Integrative Therapy
on the Coordination of Children with Choreoathetoid Movements.
The American Journal of Occupational Therapy, 31, 291-293.
No abstract available for this record
Ayres, AJ. (1976). The effect of sensory integrative therapy
on learning disabled children : The final report of a research
project supported by The Center for the Study of Sensory Integrative
Dysfunction and the Valentine-Kline Foundation 1974-1975-1976.
Los Angeles, CA: University of Southern California.
Ayres, AJ. (1972). Improving academic scores through sensory
integration. Journal of Learning disorders, 5, 339-343.
No abstract available for this record
Morrison D, & Pothier P. (1972). Two different remedial
motor training programs and the development of mentally retarded
pre-schoolers. American Journal of mental Deficiency, 77(3):251-8.
Compiled by Mary Binderman, MSLS
American Occupational Therapy Foundation
Bethesda, MD.
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