Case-Smith Jane, Weaver Lindy L, Fristad Mary A
The Ohio State University, USA
The Ohio State University, USA.
Autism. 2015 Feb;19(2):133-48. doi: 10.1177/1362361313517762. Epub 2014 Jan 29.
Children with autism spectrum disorders often exhibit co-occurring sensory processing problems and receive interventions that target self-regulation. In current practice, sensory interventions apply different theoretic constructs, focus on different goals, use a variety of sensory modalities, and involve markedly disparate procedures. Previous reviews examined the effects of sensory interventions without acknowledging these inconsistencies. This systematic review examined the research evidence (2000-2012) of two forms of sensory interventions, sensory integration therapy and sensory-based intervention, for children with autism spectrum disorders and concurrent sensory processing problems. A total of 19 studies were reviewed: 5 examined the effects of sensory integration therapy and 14 sensory-based intervention. The studies defined sensory integration therapies as clinic-based interventions that use sensory-rich, child-directed activities to improve a child's adaptive responses to sensory experiences. Two randomized controlled trials found positive effects for sensory integration therapy on child performance using Goal Attainment Scaling (effect sizes ranging from .72 to 1.62); other studies (Levels III-IV) found positive effects on reducing behaviors linked to sensory problems. Sensory-based interventions are characterized as classroom-based interventions that use single-sensory strategies, for example, weighted vests or therapy balls, to influence a child's state of arousal. Few positive effects were found in sensory-based intervention studies. Studies of sensory-based interventions suggest that they may not be effective; however, they did not follow recommended protocols or target sensory processing problems. Although small randomized controlled trials resulted in positive effects for sensory integration therapies, additional rigorous trials using manualized protocols for sensory integration therapy are needed to evaluate effects for children with autism spectrum disorders and sensory processing problems.
患有自闭症谱系障碍的儿童常常表现出同时存在的感觉加工问题，并接受针对自我调节的干预措施。在当前的实践中，感觉干预应用了不同的理论架构，关注不同的目标，使用多种感觉模态，且涉及明显不同的程序。以往的综述在考察感觉干预的效果时，并未承认这些不一致之处。本系统综述考察了2000年至2012年期间针对患有自闭症谱系障碍及并发感觉加工问题的儿童的两种感觉干预形式，即感觉统合疗法和基于感觉的干预的研究证据。总共审查了19项研究：5项考察了感觉统合疗法的效果，14项考察了基于感觉的干预的效果。这些研究将感觉统合疗法定义为基于诊所的干预措施，使用富含感觉的、以儿童为导向的活动来改善儿童对感觉体验的适应性反应。两项随机对照试验发现，感觉统合疗法使用目标达成量表对儿童表现有积极影响（效应大小范围为0.72至1.62）；其他研究（III-IV级）发现对减少与感觉问题相关的行为有积极影响。基于感觉的干预的特点是基于课堂的干预措施，使用单一感觉策略，例如加重背心或治疗球，来影响儿童的觉醒状态。在基于感觉的干预研究中几乎未发现积极效果。基于感觉的干预研究表明它们可能无效；然而，它们未遵循推荐的方案，也未针对感觉加工问题。尽管小型随机对照试验对感觉统合疗法产生了积极效果，但仍需要使用感觉统合疗法的标准化方案进行更多严格试验，以评估对患有自闭症谱系障碍和感觉加工问题的儿童的效果。
