Sensory integration therapy is a well-established treatment for autism spectrum disorder. Unfortunately, the understanding of its effectiveness is more of a knee-jerk, intuitive response than any type of scientific fact. As will be seen, it just seems like it should work, but actually might not do much. Autism is a difficult problem to study, especially insofar as it gets better by itself as the child ages. Sensory integration disorder is thought to contribute to the disease, with comorbidity estimated at 42-88% (Baranek, 2002). “Sensory integration theory is used to explain why individuals behave in particular ways, plan intervention to ameliorate particular difficulties, and predict how behavior will change as a result of intervention” (Murray et al., 2001, p.5)
The basic idea is that there is a problem with processing information from the five senses, and this leads to the characteristic withdrawal and antisocial behavior associated with autism. A. Jean Ayers developed the theory in the 1970’s and describes it as “the neurological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment’’ (2005). This is extremely vague. It’s basically a description of generic human experience. Moreover, the theory is based on outmoded concepts. The idea comes from an old, disproven belief that because sensory processing preceded higher level human intelligence in evolution, that it is somehow necessary for the higher intelligence to develop (Devlin et al., 2011).
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The therapy mostly focuses on the sense of touch, and seems reminiscent of swaddling. It uses tight vests and hammocks to enhance the sensation of touch, but it also simulates human contact such as hugging. Since autism is a disorder of the social experience, the simulated human contact would make sense. However, theoretically sensory integration therapy is grounded in the concept of the senses and doesn’t recognize the social aspect.
The theory has come under scrutiny for its failure to demonstrate tangible results. It’s very popular for use with autism, and also very expensive, costing upward of $100 a session. The primary issue is that there is no evidence that it actually works. To be fair, such evidence would naturally be hard to come by. Autism is a poorly understood disorder, and each case is somewhat unique. To this is added the fact that autism usually improves over time on its own. At any rate, here are some facts.
First and foremost is how the theory views the problem. Basically, they believe that autistic children have a higher sensory/behavior threshold. This means that they need more sensory input to achieve a behavioral response. They believe that this is the primary cause of autistic behavior. According to the theory, people with autism have
difficulty processing information from the vestibular, proprioceptive, and tactile senses. The vestibular system relays sensory input regarding the body’s movement through space. Symptoms of vestibular impairment include bad posture and trouble with planning and executing motor activities. The proprioceptive system gives sensory information for muscles and joints. Impairment in this system is thought to show through certain body movements like hand flapping. Finally, troubles with the tactile system are manifested by lack of sensitivity or oversensitivity to stimuli. Sensory input therapy attempts to restore proper neurological functioning by improving each of these sensory systems.
Besides the passive sensory support from hugging vests and hammocks, there are active methods that focus on sensory enhancement. These include rocking, jumping on a trampoline, and the use of scooter boards. However, in recent years sensory input therapy has come under scrutiny, and has been described a classic case of “pseudoscience” (Polenick & Flora, 2012). This is largely due to its basis in old, disproven concepts, and the lack of substantive proof indicating its effectiveness. This criticism may be unfair, because it could be argued that the nature of autism precludes any such “proof.” There are no adequate benchmarks to consistently measure improvement in autistic children, and there is certainly no way to determine the cause of any improvement. Typically autism improves with age, so it’s nearly impossible to isolate what actually works.
Overall, while very popular with use in autistic children, sensory input therapy seems outmoded. It has foundations in theory from the 1970’s, and seems somewhat illogical. Still, its methods have a genuine intuitive appeal. Autism seems like a problem with sensory input. Oversensitivity or lack of sensitivity to stimuli are the classic signs of the disease. Moreover, the treatment sensory input therapy uses makes intuitive sense. The frustrating aspect is that it is very difficult to determine if these measures are actually effective. However, there are few alternatives with any better track records. This fact, along with the intuitive logic of the therapy ensure that sensory input therapy will continue its popularity well into the future. It is also harmless, and not uncomfortable for the child, so besides cost there is very little downside.
- Ayres, A. Jean (2005). Sensory integration and the child : understanding hidden sensory challenges. Pediatric Therapy Network : Los Angeles, CA.
- Baranek G. Efficacy of sensory and motor interventions in children with autism. Journal of Autism and Developmental Disorders. 2002;32(5):397–422.
- Devlin, S., Healy, O., Leader, G., Hughes, B.M. (2011). Comparison of behavioral intervention and sensory-integration therapy in the treatment of challenging behavior. Journal of Autism Spectrum Disorder, 43, 1303-1320.
- Polenick, C.A., Flora, S.R. (2012). Sensory integration and autism: Science or pseudodcience? Skeptic, 17(2), 28-64.
- Murray, A. C.; Lane, S. J., Murray, E. A. (2001). Sensory integration. Philadelphia: F.A. Davis.
