Hey readers! It’s time for another journal club discussion. This week I want to talk about another article that was assigned to my peers and I at school. This one is called “Specific Sensory Techniques and Sensory Environmental Modifications for Children and Youth With Sensory Integration Difficulties: A Systematic Review” by Stefanie C. Bodison & L. Diane Parham. AOTA members can check it out here!
This article was SO interesting to me! I am really interested in sensory integration techniques and I hope that when I am a licensed OT I will be able to practice in a setting that has things like swings and ball pits. I mean, how fun would that be?!
The authors define children with sensory integration (SI) difficulties as “children who [have] difficulty organizing and using sensory information to accomplish everyday activities yet [do] not have a medical history, intellectual disability, or a history of environmental deprivation that could account for their behavioral, learning, or motor coordination challenges” (as cited in Bodison & Parham, 2018, p. 1). Approximately 5% of kindergarteners have SI difficulties, and that number increases exponentially among children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) (Bodison & Parham, 2018).
Occupational therapists often treat children with SI difficulties through remedial and compensatory interventions, specifically using either the Ayres Sensory Integration (ASI) technique or specific sensory techniques and environmental modifications. The ASI technique is widely used and advocated for in the field, yet some OTs use specific intervention techniques instead. For this reason, the authors sought to determine the effectiveness of various specific sensory interventions on function among children and youth.
- Qigong Massage: The results show strong evidence for the effectiveness of this intervention technique. With guidance and extensive training by the OT, parents who use this technique daily may see results such as improved self-regulation, tactile abnormalities, ASD symptoms, and parenting stress (Bodison & Parham, 2018).
- Weighted Vests: There is limited evidence available demonstrating the effectiveness of weighted vests among children with ADHD. One study did show, however, that classroom behavior and attention may improve using a weighted vest calibrated to 10% of the child’s body weight (Bodison & Parham, 2018). There is insufficient evidence on the effectiveness of weighted vests among children with ASD.
- Slow Linear Swinging: There is limited evidence on the effect of this intervention among children with ASD, however arousal state prior to intervention was not assessed in the study used for this review. For that reason, the researchers did not find sufficient evidence for improved on-task behavior and reduced levels of arousal after slow linear swinging.
- Sensory Enrichment in Preschool: Insufficient evidence is available to support integrating tactile, proprioceptive, and vestibular activities into preschool daily routines (Bodison & Parham, 2018). The study used for this systematic review had a very small sample size and design limitations, which may be a reason for the results.
- Other Specific Sensory Techniques: Research studies regarding the Wilbarger brushing protocol, therapy ball chairs, sensory diets, auditory stimulation programs, and integrated listening systems did not meet inclusion criteria and therefore were not included in this systematic review.
- Environmental Modifications: There is moderate evidence available that shows improvement in function using environmental adaptations, specifically altering the auditory and visual environments (Bodison & Parham, 2018). The study used in this review was specifically in a dental setting among children with ASD.
What I Think
I think that much more research needs to be done before we can determine without a doubt whether or not these interventions work. I have seen many of these interventions done in practice during my pre-OT school observation hours, and I do believe that they actually worked for the children I observed. Limitations in the studies reviewed may have led to the results that were found, such as small sample sizes, potential issues with internal validity, and specific search terms used for the systematic review that left out many other articles and specific sensory techniques.
Be sure to check out the article to read the implications for OT research and for OT practitioners!
Question of the Week: Do you use any of these interventions in practice? If so, do you see improvements in your clients?
Citation: Bodison, S. C. & Parham, L. D. (2018). “Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: A systematic review.” American Journal of Occupational Therapy, 72. https://doi.org/10.5014/ajot.2018.029413