Sensory Integration Therapy in Autism: Mechanisms and Effectiveness

Autism Spectrum Disorders (ASD) are among the most common neurodevelopmental disorder with
estimated costs of treatment across the lifespan of $3.2 million. A common feature of ASD is
over or under sensitivity to the environment and difficulty putting sensory information
together in an orderly way, referred to here as sensory issues. Such sensory issues are now
included in the diagnostic criteria in the DSM5 under the Restrictive and Repetitive
Behaviors and Interests Criteria. These sensory issues have a deleterious effect on
functional skills and limit participation in work, education, and social activities for
individuals with ASD and their family. Building on previous work, this study seeks to extend
understanding of Sensory Integration Therapy (SIT) as a non-invasive intervention to improve
functional skills in children with ASD and sensory issues, and to test its efficacy in
comparison to commonly used applied behavioral treatments. Further, the investigators will
explore the proposed neurobiological mechanisms by which this intervention may work, and
phenotypic moderators of outcome. This study utilizes a randomized trial to compare SIT to a
commonly used behavioral intervention to evaluate outcomes on functional skills as a basis
for improved independence over the lifetime. A total of 180 children with ASD and sensory
issues in the greater New York City Metropolitan area will complete this study.

Inclusion Criteria:

1. Between the ages of 6.0 and 8.5 at the time of enrollment

2. Have a diagnosis of ASD that is confirmed by our research certified licensed
psychologist based on clinical impression, DSM-5 criteria, and cut off scores from the
Autism Diagnostic Schedule -2 (ADOS) and the Autism Diagnostic Interview - Revised
(ADI-R)

3. Has a non-verbal cognitive level of 70 or above (IQ cutoff is based on feasibility
study data

4. Demonstrate difficulty processing and integrating sensory information as measured by
the Sensory Profile (SP; 3 or more subscales or total test score in the definite
difference range; or the Sensory Integration and Praxis Test -SIPT-; score of -1.0 on
3 or more subtests)

5. Guardians willing to attend 3 weekly sessions for the duration of the period and to
refrain from initiation of any new behavioral, therapeutic or alternative treatments
during the study period

6. If on psychotropic medication, they are at a point where dosage and treatment are
stabilized for the duration of the study.

Exclusion Criteria:

- Children who are receiving > 12 hours/week of ongoing ASD-related services(excluding
their educational programing), or who are receiving more than one hour per week of
services that closely approximate the experimental intervention, will be excluded.
Additionally, for safety reasons, children with significant medical co-morbidities
(e.g., major heart problems, blindness, deafness, cerebral palsy, Fragile X or Down
Syndrome, or tuberous sclerosis) will not be allowed to participate.