Popular Autism Treatment Lacks Scientific Evidence

Nov. 19, 2012

AUSTIN, Texas — One of the most popular intervention therapies for children with autism spectrum disorders (ASD) lacks scientific support according to a literature review published by University of Texas at Austin professor Mark O’Reilly and an international team of scientists.

The researchers reviewed 25 major studies on sensory integration therapy (SIT) to see if the current evidence base supports use of this therapy in the education and rehabilitation of children on the autism spectrum. Their conclusion that research does not support the use of SIT means providers who work with children with ASD will need to reassess their education and treatment strategies.

Many agencies serving children on the autism spectrum are mandated to use research-based, scientifically valid interventions, but several previous surveys indicate SIT remains one of the most common intervention choices. In one study, 99 percent of interviewed occupational therapists reported using it.

“According to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, a person has to have severe communication and social deficits as well as restrictive and repetitive behaviors to be diagnosed with ASD,” said O’Reilly, interim chair of the College of Education’s Department of Special Education. “SIT was proposed as a way to help with these symptoms. Rigorous, methodologically sound studies do not indicate that it helps and, in fact, the majority of studies that were reviewed reported no benefits for children with ASD.”

Because many children on the autism spectrum have abnormal responses to auditory, visual, tactile and oral stimuli, sensory integration therapy is designed to offer specific forms of sensory stimuli in the appropriate amounts, with the aim of improving how the nervous system processes sensory stimuli. Therapists who use SIT may have a child with ASD wear a weighted vest, swing, sit on a bouncy ball, or be compressed between pillows, said Dr. Russell Lang, lead investigator in the SIT literature review.

"Many researchers have pointed out that SIT may actually lead to an increase in undesirable behavior because it gives children who exhibit unwanted behavior access to fun activities, more attention from therapists and breaks from less desirable tasks like schoolwork,” said Lang, executive director of Texas State University’s Clinic for Autism Research, Evaluation and Support. “It also can undermine the effectiveness of research-based behavioral interventions that the therapist is administering at the same time.”

According to experts, the only scientifically valid treatment and intervention for individuals on the autism spectrum is applied behavior analysis. The University of Texas at Austin’s Department of Special Education, of which Lang is an alumni, is one of only a few in the nation that trains graduate students in this therapy. With applied behavior analysis, the therapist teaches children age-appropriate skills and offers systematic, repetitious positive reinforcement for desired behaviors.

“The American Academy of Pediatrics, the premier professional organization for pediatrics, recently issued a policy statement which offers similar cautions regarding a lack of research support for SIT with this population,” said O’Reilly.

The literature review was published in the international journal Research in Autism Spectrum Disorders and was co-authored by scientists from the United States, Ireland, Italy, New Zealand and The Netherlands.

For more information, contact: Kay Randall, College of Education, 512 471 6033.

12 Comments to "Popular Autism Treatment Lacks Scientific Evidence"

1.  Jason said on Nov. 19, 2012

Always nice to see someone's opinion without any link to any of the research that you have cited. I have an autistic child and the one way we have found to avoid meltdowns is through "squeezing". He asks for this when he would otherwise need to be relocated due to overly stimulating environments. This is the problem with ASD research, and anyone who hasn't noted it has very little statistical sense. The umbrella is too large. Even though sensory therapy may not work for the majority, good job helping lead the charge to get it removed for the minority it does work for.

2.  kay said on Nov. 19, 2012

There's an abstract for the peer-reviewed piece in the journal Research in Autism Spectrum Disorders at http://www.sciencedirect.com/science/article/pii/S1750946712000074 and I can email the entire thing if you to give me your email address.

3.  Jenn Kramer said on Nov. 19, 2012

Very eager to see the research given how huge the implications are. I have been witness to the positive impact that sensory-based occupational therapy has on children with sensory processing disorders, whether or not they have been diagnosed with ASD. Given that ASD is a spectrum, it is undoubtedly challenging to parse out which interventions are helpful to which aspect of the disorder. I will withhold further comments until I can assess the research myself; thereafter, I'll comment further. Jennifer Kramer, LCSW, The Austin Area SPD Alliance

4.  Janet Leese said on Nov. 19, 2012

Will you please cite your sources, and provide a link for the literature review? I'd like to understand their findings in more detail.

5.  Emily said on Nov. 19, 2012

I am disappointed that the university that taught ME "what starts here can change the world," would take such a narrow view on the approach used to support such a diverse population. While applied behavior analysis typically focuses on teaching certain skills to children, occupational therapy focuses on areas thought to be motivating to clients (and families) to promote optimal function in a child's daily life. Every child, both typically developing and developmentally delayed, deserve to have their actions respected as meaningful. This is why OTs typically focus on fun and meaningful activities as an avenue for teaching skills and providing necessary sensory input for calming and regulation. Dr. Lucy Jane Miller of the STAR Center in Denver, Colorado, and the Interdisciplinary Council of Developmental and Learning Disorders (ICDL) have been providing research to support sensory based strategies and relationship based intervention for children and adults with Autism.

6.  Colleen Herst said on Nov. 19, 2012

I think it's pretty surprising that they say that ABA is the only treatment that has been legitimized and then go on to state that they are one of the few departments of special education that trains students in this. Seems fishy. Especially in light of the lack of actual "research" noted in the article. To articulate all of the ways in which I KNOW my child has benefitted from OT explicitly would take sometime. I have told my OT on numerous occasions that she saved my child and our family and it's no joke. He was primarily non-verbal and downright dangerous (seeker) when we showed up on her door after 6 months of speech. Within months of calming down his sensory system (and without speech or ABA), he was pretty much on target verbally with his same age peers. It was clear that he had been unable to focus long enough due to his extreme sensory seeking to be able to process and utilize speech. I also found it pretty offensive that they stated "it gives children who exhibit unwanted behavior access to fun activities, more attention from therapists and breaks from less desirable tasks like schoolwork".

7.  Elizabeth said on Nov. 19, 2012

How about interviewing people with Autism and their family members / caregivers? Many, many people credit SIT with changing lives. Surely you've heard of Temple Grandin?

8.  Pat said on Nov. 19, 2012

My grandchild has benefitted greatly from occupational therapy and the loving support given in understanding "meltdowns". Years ago, Dad's were not allowed in delivery rooms . Now it is accepted and is good. Hope more research, and unbiased, will be given from many fields, and not just academic. Talk with the parents.

9.  Mary Kay said on Nov. 20, 2012

Was this a double blind study? Where can the actual research be found? Many therapist use SIT along with other types of treatments according to what the child needs. Maybe someone should tell Dr. Temple Grandin it does not work.

10.  MK said on Nov. 20, 2012

Ditto. My son with ASD has received great, great outcomes via an auditory training program called the Berard Method of auditory integration training. It is frustrating to read that you authoritatively espoused that SIT is for fun and encouraged misuse of playground equipment. My son did not have fun on the swing. He hated it. He lacked the ability to motor plan in order to propel his body so that his brain could connect that swinging is an event to be enjoyed. I am not an OT. Also my son finally learned how to ride a bike at age 12. These are wonderful gains my son received as a result of SIT. For that his quality of life has greatly improved. Unfortunately these outcomes do not fit within your research protocol.

11.  Sarah Cross said on Nov. 20, 2012

The article says that "SIT was proposed as a way to help with these symptoms. Rigorous, methodologically sound studies do not indicate that it helps and, in fact, the majority of studies that were reviewed reported no benefits for children with ASD." I will look it up, but I am fairly certain that SIT was not proposed as a way to treat the symptoms of ASD, but to treat the often times acute sensory difficulties that hitch a ride along with ASD, as well as other developmental disordres, such as Downs Syndrome, Fragile X Syndrome, and Prader-Willi Syndrome. I don't think anyone claims that SIT is a way of treating any of the above. I will be requesting a copy of the review to read the methodology and results of the studies.

12.  linda said on Nov. 21, 2012

As a mother of a son with autism, I learned long ago to take each autism study with a grain of salt until multiple, peer-reviewed studies prove it right or wrong. Thousands of studies contradict one another. On a personal level, sensory therapy has been very beneficial to my son.