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OBJECTIVE. We investigated factors that influenced occupational therapists' beliefs about and use of sensory-based approaches for children with autism spectrum disorder (ASD).
METHOD. Occupational therapists working with children with ASD (N = 211 from 16 countries) completed an online survey addressing their work experience, training, use of sensory-based approaches, and beliefs and perceptions about the effects of the approaches. Linear regression was used to determine predictors of use of and beliefs about sensory-based approaches.
RESULTS. Most respondents (98%) used sensory-based approaches for children with ASD and would recommend the approaches for 57% of the children they treated. Having a mentor who promoted sensorybased approaches and practicing outside North America and Australia predicted greater use and perceived effectiveness of these approaches. Less than 5 yr of occupational therapy experience predicted less use of the approaches.
CONCLUSION. Respondents selectively used sensory-based approaches for children with ASD and were influenced by country of residence, clinical experience, and mentorship.
Occupational therapists work with children with autism spectrum disorder (ASD) to promote participation in daily activities. Their perspective on why participation is limited and how to best address this limitation guides their intervention (Polatajko & Cantin, 2010). Over the past two decades, occupational therapists have consistently reported sensory integration (SI) as the dominant theory guiding practice with these children (Ashburner, Rodger, Ziviani, & Jones, 2014; Kadar, McDonald, & Lentin, 2012; Watling, Deitz, Kanny, & McLaughlin, 1999). Two assumptions of SI therapy and sensorybased approaches grounded in SI theory (e.g., sensory stimulation approaches) include the perspective (1) that deficits in integrating or processing sensory information restrict participation and (2) that provision of carefully graded sensory inputs can improve a person's ability to process or modulate sensory input, leading to improved adaptive behavior and participation (Huebner & Dunn, 2001; Polatajko & Cantin, 2010).
Unusual sensory symptoms are common in children across the continuum of ASD severity, with prevalence estimated between 69% and 95% (Ben-Sasson et al., 2009; Hazen, Stornelli, O'Rourke, Koesterer, & McDougle, 2014). These symptoms are most often attributed to difficulties in modulating sensory information (Ben-Sasson et al., 2009), resulting in widespread use of sensory-based approaches. Although one systematic review reported moderate evidence supporting clinic-based SI therapy for individualized goals (Watling & Hauer, 2015), that same review and others concluded...