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This systematic review examines the literature published from January 2006 through April 2013 related to the effectiveness of Ayres Sensory Integration® (ASI) and sensory-based interventions (SBIs) within the scope of occupational therapy for people with autism spectrum disorder to improve performance in daily life activities and occupations. Of the 368 abstracts screened, 23 met the inclusion criteria and were reviewed. Moderate evidence was found to support the use of ASI. The results for sensory-based methods were mixed. Recommendations include performing higher level studies with larger samples, using the Fidelity Measure in studies of ASI, and using carefully operationalized definitions and systematic methods in examination of SBIs.
Descriptions of children with autism spectrum disorder (ASD) often include behaviors such as hand flapping, spinning, withdrawal, rocking, ear covering, and intense staring. These behaviors, frequently referred to as sensory features, are present in more than 80% of people with ASD (Baranek, 2002; Ben-Sasson et al., 2009; Dawson & Watling, 2000) and have received increased attention in recent years. In fact, recognition of the prevalence of over- or underresponsiveness to sensory stimuli among people with ASD led to inclusion of these behaviors in the diagnostic criteria for the disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013).
Sensory Features in Autism Spectrum Disorder
When Kanner first described autism in 1943, he noted fascination with light, oversensitivity to sound, and oversensitivity to moving objects. Other early researchers also documented sensory features including unusual visual focus; hypoand hyperreactivity to auditory, visual, and tactile sensory input (Ornitz, 1974; Wing, 1969); negative responses to loud sounds; fascination with visual stimuli (Dahlgren & Gillberg, 1989); insensitivity to pain; and tactile defensiveness (Rapin, 1991). Subsequent investigations (e.g., Baranek, David, Poe, Stone, & Watson, 2006; Ben-Sasson et al., 2009; Liss, Saulnier, Fein, & Kinsbourne, 2006) also reported differences in sensory responding among people with ASD and categorized these behaviors as hyporesponsiveness, hyperresponsiveness, and paradoxical or fluctuating sensory responsiveness.
As researchers have refined their ability to identify ASD, increased attention has been given to the sensory features of the disorder as well as to understanding the impact that these behaviors have on the daily lives of people with ASD. Associations have been found among unusual sensory responding...