Date Presented 04/23/21
This poster presents the findings of a structured review of the published literature examining sensory interventions for children in early intervention. Participants will gain an understanding of evidence surrounding intervention approaches for children birth–3 years with sensory processing difficulties. Intervention approaches reviewed include parent-mediated methods, weighted vests, single-modal and multimodal sensory-based strategies, and Qigong Sensory Training.
Primary Author and Speaker: Elsa Froelicher
Additional Authors and Speakers: Sharon Medina, Consuelo Kreider
PURPOSE: Despite the over 1000 published studies investigating interventions for children with sensory processing difficulties, few of these studies examine such interventions for children ages birth-to-three years. The purpose of this literature review was to identify relevant studies and synthesize evidence examining interventions within the scope of occupational therapy for children birth-to-three with sensory processing difficulties.
DESIGN/METHOD: Systematic review methods were used to identify, appraise and synthesize relevant studies from the published literature. Two occupational therapy graduate students worked under the guidance of a faculty mentor experienced in systematic reviews to define the PICO question, develop the search strategy, critically review studies for inclusion, appraise each study, and synthesize findings. A research librarian provided guidance for the literature search. Using terms synonymous with intervention, sensory processing, and early intervention, the CINAHL, PubMed, PsycInfo, AJOT, and Google Scholar databases were searched. Initial hits found 1132 articles. After removing duplicates, abstracts of 1009 articles were screened. Of these, 925 were excluded based on not meeting the inclusion criteria. Another 65 were excluded after reviewing the full text of 84 articles, leaving a total of 19 articles for inclusion. All included studies involved children birth-to-three years with sensory processing difficulties. The final 19 articles were grouped by type of intervention implemented in order to facilitate synthesis of the evidence.
RESULTS: Five intervention types and approaches were identified in the 19 reviewed studies. These included parent-mediated, single-modal sensory-based, multi-modal sensory-based, weighted vest, and Qigong Sensory Training (QST). Despite frequent anecdotal reports of therapeutic brushing as an intervention for this population, no studies examining this approach were found. Studies of parent mediated interventions (n = 4) consistently reported improvements in parent and child outcomes. The two studies evaluating weighted vests reported contradicting findings related to child sensory processing. Single-modal sensory-based interventions tailored to the child's sensory needs (n = 3) demonstrated decreases in child irritability and sensory sensitivity behaviors. Studies of multi-modal sensory-based intervention approaches (n = 6) found positive effects on sensory processing difficulties and self-regulation (e.g., Lecuona, 2017; Pekcetin, 2016). QST, an infant massage protocol, was reported in 4 studies to improve both severe and less-severe sensory and self-regulation impairments when implemented by therapists or parents (Silva, 2008, 2011).
CONCLUSION: The bottom line for OT practice is that among the interventions examined in the literature, QST and sensory-based approaches, whether single- or multi-modal, are the most evidence-based interventions for children birth-to-three with sensory processing difficulties. Sensory approaches should be individually tailored to each child's specific needs with consideration of the context(s) in which they live, learn, and play. When working in early intervention settings, occupational therapy practitioners should use parent mediated approaches to implement interventions and improve parent-child relationships. Due to conflicting evidence surrounding the use of weighted vests and the lack of evidence for therapeutic brushing with this population, it is recommended that these techniques be used only when client evaluation data matches the theoretical postulates for change that underlie the techniques and that all clinical-decision making be data-driven. Both techniques should be further examined with rigorous research methodologies.
References
Lecuona, E., Jaarsveld, A. V., Raubenheimer, J., & Heerden, R. V. (2017). Sensory integration intervention and the development of the premature infant: A controlled trial. South African Medical Journal, 107, 976. https://doi.org/10.7196/samj.2017.v107i11.12393
Pekçetin, S., Aki, E., Üstünyurt, Z., & Kayıhan, H. (2016). The efficiency of sensory integration interventions in preterm infants. Perceptual & Motor Skills, 123, 411–423. https://doi.org/10.1177/0031512516662895
Silva, L. M. T., Ayres, R., & Schalock, M. (2008). Outcomes of a pilot training program in a qigong massage intervention for young children with autism. American Journal of Occupational Therapy, 62, 538–546. https://doi.org/10.5014/ajot.62.5.538
Silva, L. M. T., Schalock, M., & Gabrielsen, K. (2011). Early intervention for autism with a parent-delivered Qigong massage program: A randomized controlled trial. American Journal of Occupational Therapy, 65, 550–559. https://doi.org/10.5014/ajot.2011.000661
