Senita

A pragmatic randomised controlled trial of sensory integration therapy versus usual care for sensory processing difficulties in autism spectrum disorder in children, and its impact on behavioural difficulties, adaptive skills and socialisation.

Background

Autism spectrum disorder (ASD) is a common lifelong condition affecting 1 in 100 people. ASD affects how a person relates to others and the world around them. Difficulty responding to sensory information (noise, touch, movement, taste, sight) is common in ASD. This might include feeling overwhelmed or distressed by loud or constant low-level noise eg in the classroom.

Affected children may also show little or no response to these sensory cues. These sensory processing difficulties are associated with behaviour and socialisation problems, and affect education, relationships, and participation in daily life.

Sensory integration therapy

Sensory integration therapy (SIT) is a type of face-to-face therapy or treatment provided by trained occupational therapists (OT) who use play-based sensory-motor activities to influence the way the child responds to sensation, reducing distress and improving concentration and interaction with others.

Research suggests SIT might be helpful for some children. We are therefore interested in whether, compared to treatment normally offered to families (‘usual care’), SIT improves children’s behaviour socialisation and daily functioning.

Usual care could involve some contact with an occupational therapist (OT), who might give parents or carers strategies to practice at home with their child. It is much less common to be offered the kind of structured one-to-one regular contact involved in SIT (26 face-to-face sessions over 26 weeks in this study).

Recruitment

We will recruit 138 children and assess behaviour, daily functioning, socialisation, and parent/carer stress at six and 12 months. Participants will be allocated at random to either receive SIT or usual care. Discussion groups for therapists and carers will be organised before approaching people to take part for ‘usual care’ to be mapped out. Carers will use diaries to record their contact with NHS and other services (eg social care).

Study design

A sample of carers will be interviewed at six months to gain their views and experiences of taking part and of their child’s sensory problems.

Therapists will also be interviewed to get a sense of what intervention was actually provided. The cost of providing this type of treatment, compared to usual care will be assessed. Once approximately 10% of study participants have completed the six-month assessment, a sample of carer diaries will be examined to see whether SIT is different (in content or amount of contact) to usual care.

The study will only continue if this is confirmed. We will also look at the number of people willing to take part and whether they continue to participate in all sessions and assessments.

Results

At the end of the trial, an event for affected families will be organised to publicise the results. A summary will also be made available to organisations like The National Autistic Society (NAS) to include on their websites and for dissemination via social media.