A Two-Fold Study: The Effects of Sensory Integration Therapy
On Behaviors of Children with Autism Spectrum Disorder
Cayetano Diabordo Polancos, Jr.
[Cell # 09217836340]
Special education teachers are daunted with characteristic behaviors of children with autism spectrum disorder in the classroom. Some of the SPED Teachers are compelled to use behavioral modification techniques to control these behaviors. However, some of the techniques will not work because these behaviors are embedded in the form of tactile, vestibular, and proprioceptive manifestation.
Children with autism spectrum disorder have high frequency of sensory integration dysfunction. In these scenarios where the child often has tactile problems and avoids group situations for fear of the unexpected touch; feels torture with every drop of rain or wind blowing on the skin; becomes frightened when touched from behind by someone; avoids using hands for play; and figures out inaccurately the physical characteristics of objects such as shape, size, texture, temperature or weight are tactile in nature and should be addressed with tactile interventions. In addition, vestibular problems are observed when the child frequently slumps, lies down, and leans head on hand or arm while working at his desk; and always in constant motion- running, jumping and hopping instead of walking. Often, the child loses balance easily and may appear clumsy due to poor gross motor skills. Moreover, proprioceptive problems are seen in the form of pushing or pulling, dragging objects, hitting, bumping, and pushing other children. The child always seems to be breaking objects, toys, and writing utensils because of the difficulty in regulating pressure when holding.
Key words: Autism; Sensory integration; Sensory integration therapy: Behavior
In the Philippines, autism spectrum disorder affects about one out of every 500 Filipino children. Children with autism spectrum disorder attend special education programs in self-contained special classes. The government has added special education schools and teachers to accommodate the needs of children with disabilities. Unfortunately, the Philippine legislation has overlooked the need for related services aside from special education. In the country, a child with autism spectrum disorder attends special education and then receives Occupational Therapy services separately. Moreover, training on sensory integration for special education classroom teachers is not initiated. In Mindanao, Davao City Children’s Welfare Code or Resolution No. 7725 provides a comprehensive children and family support system duly indorsed by the committee on Social Services headed by Councilor Leonardo R. Avila III. In order to achieve this goal, a partnership with the NGO’s is undertaken to ensure that services will be appropriately delivered through some local assistance and allocation of funds.
The beneficiaries of this study will be the children with autism spectrum disorder, parents, and special education teachers. It is hoped that a child with autism spectrum disorder can have improvement in tactile, vestibular and proprioceptive behaviors after sensory integration therapy; that parents will continue to practice sensory integration therapy at home; and that other researchers will have a benchmark data for future studies on sensory integration and behaviors of children with autism spectrum disorder.
Review of Related Literature
Ayres developed the theory of sensory integration to explicate potential relationships between the neural processes of receiving, modulating, and integrating sensory input and the resulting output: adaptive behavior. The theory postulates that adequate processing and integration of sensory information is an important substrate for adaptive behavior. Given its focus on adaptive behavior and functional skills, this approach is most frequently utilized by Occupational Therapists as part of the total program of occupational therapy (Schaaf & Miller, 2005). Functional problems associated with sensory integration dysfunction have been detailed in the literature. A study of Parham and Mailloux (2001) on sensory integration (cited in Ahn, Miller, Milberger & McIntosh 2004), there are five functional impairments associated with sensory integration dysfunction which include decreased social skills and participation in play occupations; decreased frequency, duration, or complexity of adaptive responses; impaired self-confidence or self-esteem or both; deficient adaptive or daily life skills; and diminished fine and gross motor skills and sensory-motor skills development.
The lack of ability to play successfully with peers is proposed to be related to a lack of participation in sensory and motor play from which cognitive and social skills emerge and develop (cited Bundy 2002 in Ahn, Miller, Milberger, & McIntosh 2004). The fear, anxiety or discomfort that accompanies everyday situations may significantly disrupt daily routines in the home environment (cited Parham and Mailloux 2002 in Ahn, Miller, Milberger, & McIntosh 2004). Therefore, the goal of sensory integration is to improve the ability to process and integrate sensory information and to provide a basis for improved independence and participation in daily life activities, play and school tasks (Schaaf & Miller, 2005).
Sensory Integration Therapy
One’s mind and body are superbly interwoven to meet the demands of today’s world. The feelings, thoughts and actions we experience occur through the complex actions of our brain (Nelson, 1999).
According to Watling and Dietz (2007), Ayres’ sensory integration has effects on the behavior and task engagement of young children with autism. Subjective data suggested that each child exhibited positive changes during and after intervention. In a study of Pfeiffer and Kinnealey (2008), children with autism spectrum disorder were assigned to the sensory-integration intervention group to reach goals specified by their parents and therapists. The children made progress toward goals in the areas of sensory processing/regulation, social-emotional, and functional motor tasks. It was heavily documented that children on the autistic spectrum disorder have differences in the way they process sensory information and respond motorically. A statistician randomly assigned the participants to groups; this information was provided to the project coordinator at the site. The primary researchers were blinded to group assignment and served as evaluators before and after the study. For their outcome data, the researchers used a series of scales that measure behavior.
Sensory integration therapy is a type of occupational therapy (OT) that places a child with autism spectrum disorder in a room specifically designed to stimulate and challenge all of the senses. During the session, the therapist works closely with the child to encourage movement within the room. Sensory integration therapy is driven by four key principles: first, the child must be able to successfully meet the challenges that are presented through playful activities; second, the child adapts his behavior with new and useful strategies in response to the challenges presented; third, the child will want to participate because the activities are fun; and fourth, the child’s preferences are used to initiate therapeutic experiences within the session (Ahn, et. al. 2004).
A study by Smith and Bryan (1999) on the effects of occupational therapy with sensory integration emphasis on preschool-age children with autism spectrum disorder, the researchers use single-subject research design with five preschool children with autism spectrum disorder. In the AB design, nonengagement, mastery play, and interaction were measured, using videotape clips of each child’s free play in the preschool. Following a 3-week baseline, an occupational therapist provided one-on- one sessions and consultation to teachers for 10 weeks. When baseline and intervention phases were compared, four children demonstrated decreased frequency on nonengaged behavior, and three demonstrated increased frequency of mastery (goal-directed) play. The results of the study support descriptions in the literature regarding the behavioral changes that children with autism spectrum disorder can make when participating in intervention using a sensory integration approach.
There were improvements in cognitive skills required to establish functional occupational roles as students in the classroom. These findings are consistent with clinical reports of improvements that therapists notice as a result of sensory integrative procedures (cited Fisher, Murray, & Bundy 1991 in Steer 1996)
Sensory integration therapy is based on the assumption that the child is either overstimulated or understimulated by the environment. Therefore, the aim of sensory integration therapy is to improve the ability of the brain to process sensory information so that the child will function better in his daily activities. While sensory integration therapy is not harmful, some forms of therapy may be uncomfortable for the child. Children with autism spectrum disorder can be especially sensitive to certain types of sensory stimulation; the therapist should respond appropriately.
Sensory Integration Therapy is a set of activities that challenge a child’s behavior. It is a combination of tactile, vestibular and proprioceptive stimulation to promote growth and mature response. It uses a variety of materials and activities to address specific problems particularly hyperactivity, incoordination, inattention and behavioral problems.
Ayres was the first researcher clinician from the therapy fields to define the impact of sensory processing on learning, emotions and behavior. Ayres also designed and standardized assessments that provide a comprehensive understanding of sensory integrative function and dysfunction (Roley, Mailloux & Erwin, 1999).
Tactile stimulation helps process information about touch received primarily through the skin. The tactile sense receives input from the skin receptors about touch, pressure, temperature, pain, and movement of the hairs on the skin. For example, tactile sense makes it possible for a person to find a flashlight in a drawer when the lights are out. Tactile sense also plays an important role in protection from danger such that it can signal the difference between the soft touch of a child’s fingers and the crawling legs of a venomous spider. The body is covered with very sensitive touch receptors. Through them we get information about hot and cold, hard and soft, smooth and rough, and pain and pleasure. When a person’s brain is receiving and analyzing this information from the tactile system correctly, he will quickly remove his hand from a hot stove and smile when receiving a hug from a loved one.
Vestibular stimulation helps process information about movement, gravity and balance, primarily received through the inner ear. A person with improper functioning of the vestibular senses may be hyper-responsive (over-reactive) to movement, or hypo-responsive (under-reactive) to movement. Hyper-responsiveness to movement may cause a person to experience motion sickness in the car or on an amusement park ride. This person may be afraid of heights or dislike being upside down, which is referred to as gravitational insecurity. This person may seem stiff, and even hold his head upright, to avoid excessive movement. A child with these difficulties may struggle on the playground or in physical education classes, where they may be expected to swing, go on a merry-go-round, hang upside down, or run. On the other hand, hypo-responsiveness to movement may result in a child who is always moving: spinning, swinging, rocking, flapping her hands, and fidgeting. These children often exhibit poor balance, and may have difficulty navigating around objects, bumping into walls and tripping over chairs.
They might enjoy hanging upside down, and appear able to spin without becoming dizzy. While a child with sensitivity to movement is going to be presented with many frustrations outdoors, hyperactive children are likely to be more challenged indoors, especially during times when they are expected to be quiet, focused and attentive. The vestibular sense responds to body movement through space and change in head position. It automatically coordinates the movement of one’s eyes, head and body. If this sense were not functioning well, it would be impossible for a student to look up at the blackboard and back down at his paper without losing his place. It would be difficult to walk along a rocky path without falling, or to balance on one foot long enough to kick a soccer ball. The same vestibular sense is central in maintaining muscle tone, coordinating the two sides of the body, and holding the head upright against gravity.
Proprioceptive stimulation deals with body position and helps in the awareness of body in space and it helps process information about body position received through the muscles, ligaments and joints. When the proprioceptive sense functions properly, it allows one to sit down onto a chair without falling, walk up and down stairs without watching our feet, close a door with just the right amount of effort, squeeze a glue bottle just hard enough to squirt out a small dot of glue, and walk down a crowded sidewalk without bumping into anyone. However, if there are problems with proprioceptive sense, the person will not know how far his arm extends and may end up hitting someone as he reaches for an object. This person may step on someone’s foot as he walks, not realizing that a foot was in his way. He may slam doors, or close them so lightly that they do not latch. He may be clumsy, and may be unable to climb a piece of playground equipment or walk up stairs without difficulty, perhaps needing to watch his feet to see where to place them. Problems with the proprioceptive senses can be the main contributor to difficulties with motor planning, which is the ability to figure out how to use one’s body. For example, when walking under a low doorway, most people know just how far to bend down to avoid hitting the head. A person with motor planning difficulties may bend over too far, or not far enough. This person may not know how to climb up the monkey bars on the playground, or may not be able to get down once he is up there. Routine tasks such as dressing, tying shoes, eating with utensils, and writing can be challenges for people with motor planning difficulties. It is proprioceptive sense that makes it possible for a person to skillfully guide his arm or leg movements without having to observe every action. It allows objects such as pencils, buttons, spoons, and combs to be skillfully manipulated by the hand.
All the activities in developing the tactile, vestibular and proprioceptive senses are designed to meet a child’s specific needs for development. The activities will also be designed to gradually increase the demands upon a child to make an organized, more mature response. Emphasis is placed on automatic sensory processes in the course of a goal-directed activity, rather than instruction or drilling the child on how to respond. Parent or teacher involvement is crucial to the success of the child’s development and improved sensory processing. The therapist or paraprofessionals may make suggestions to the parent or teacher about how to help the child in the home or school environment.
Treatment is most successful when geared toward the individual’s particular needs. Intervention programs are also more effective when parents are actively involved and taught appropriate strategies for dealing with their parents (Inciong 2005). The characteristics of Sensory Integration therapy include active participation of the child, child-directed and therapist-guided, individualized treatment, purposeful activity, need for adaptive responses and an activity rich in tactile, vestibular and proprioceptive input.
Applicable domains in which change in response to Sensory Integration Therapy may be demonstrated include organization, learning rate, attention, affect, exploratory behavior, biologic rhythm (sleep-wake cycle), sensory responsivity, play skills, self-esteem, peer interaction and family adjustment. Clinical observation has indicated that treatment affects factors such as the child’s attention and organization (cited Reilly, Nelson and Bundy 1983 in Cermak & Henderson 1990).
Behavior modification to reinforce specific desired behaviors is a frequently used approach in both psychology and education. If the skills is of some use in everyday life or could serve as morale booster and if the program succeeds in inculcation the skill, then the exercise does have merit. But it has to be kept in mind that the benefit achieved will not generalize beyond the specific skill acquired. (cited Kinsbourne & Caplan 1979 in Cermak, Henderson1990).
Within pediatric occupational therapy, they identify two different philosophical orientations. One is focus on underlying ability, and is identified in approaches such as neurodevelopmental therapy and sensory integration therapy that focus on influencing the processing and organization of the nervous system. The second approach is skill development, including both the teaching of specific skills and the design of, and training in the use of equipment and adaptations to the environment (Cermak, Henderson, 1990).
Improvements, as perceived and rated by parents and teachers were variable across a number of children. Parents perceived the most dramatic improvements to be in the occupational performance areas of self maintenance and rest, and viewed the children as establishing functional roles in these dimensions. This is consistent with early claims made by Ayres (1972) who suggested that appropriate balance of excitation and inhibition of sensory processing is required for organization of arousal and attention. As yet, however, few studies have looked at the relationships between rest and sleep occupations and sensory integrations that are seen clinically (cited Ayres & Tickle, 1980 in Steer 1996).
Autism Spectrum Disorder
Autism Spectrum Disorder is a developmental disability that affects approximately 1 out of 150 Filipino children (Inciong p 279). It is a spectrum disorder of which impairments are extremely diverse among individuals; therefore, levels of functioning vary greatly. The diagnosis of autism is behaviorally based. It was discovered by Dr. Leo Kanner in 1943. There is no specified age of onset; however, for a diagnosis of autism to be warranted, delays in specified areas – social interaction, language as used in social communication, and symbolic or imaginative play, must be present before the age of 3 (Siegel, 1996). Sensory disorders in autism may have abnormal responses to sensory input and may have trouble reacting appropriately to the environment. Autism spectrum disorder is 3 to 4 times more prevalent in males than in females. Children with autism have a difficult time staying on task, understanding simple questions or directions, and may become overstimulated by light and noise. These behaviors can often interfere with normal classroom activities.
Sensory integration dysfunction can adversely affect many areas of a child’s development including emotional and social. Sometimes behavior problems are the first indications. The child may lack flexibility, be explosive, or have difficulty with transitions (Stephens, 1997).
Tactile Stimulation Behavior
Problems in the tactile system may result in difficulty with fine motor skills for feeding, dressing, and writing; problems articulating sounds due to inadequate information from touch receptors in and around the face and mouth; difficulty with accurate visual perception and basic concepts; impaired awareness of body scheme; and inefficiency in how one tactually explores an object or the environment in order to gain additional cues which may give meaning about the object or environment. Dysfunction in the tactile system may result in interpreting ordinary contact as threatening. Some may react with flight/fright/or fight – these behaviors may be physical or verbal. Some feel too much; some feel too little. Some may have a high tolerance for pain because they do not accurately know what is happening to them. They may not react to being too cold or too hot because they are unaware of temperature (Ricketts, 2008).
One of the most common sensory disorders is tactile defensiveness. With this condition, a child is over or “hyper” sensitive to different types of touch. Light touch is one of the most upsetting types of touch to the child. A gentle kiss on the cheek may feel like they are having coarse sandpaper rubbed on their face. They also may dislike feeling sand, grass or dirt on their skin. Getting dressed may be a struggle as different clothing textures, tags and seams may cause them great discomfort (Woodward, 2006).
Vestibular Stimulation Behavior
The limbic system which generates emotionally based behavior must receive well modulated input from the vestibular system in order for the emotions to be balanced and developed. A disorganized system can slow down speech development as well as emotional development. There are two types of vestibular disorders: the under-reactive and over-reactive vestibular system. The under-reactive vestibular system may tolerate an enormous amount of movement (merry-go-round, swinging, and spinning) without getting dizzy or nauseous. It has poor integration of the two sides of the body and is easily confused by directions or instructions. The hands and feet do not work well together.
The over-reactive vestibular system is hypersensitive to vestibular input resulting in gravitational insecurity, which is a feeling of anxiety or stress when assuming a new position, or when someone else tries to control his movement or position; swings, merry-go-rounds, and other playthings that move the body in non-ordinary ways may feel terrifying. It is intolerance to movement that discomfort during rapid movement might be threatening and nauseous.
Proprioceptive Stimulation Behavior
When there is a communications breakdown, or when improper information is supplied by one or more of these sensors, efficiency of movement decreases. This is harmful and possibly injurious to the muscles and joints, and results in problems with postural coordination and/or joint alignment. Beyond being just an annoyance, faulty coordination or misalignments can also be the source of chronic pain (Christensen, 2003).
Dysfunction in proprioception results in slower, clumsy body movements. Muscle exertion is either too much or not enough when manipulating objects. There is difficulty feeling the weight of objects and planning body movements while performing gross or fine motor activities (getting on or off a riding toy, buttoning clothes or turning on a faucet).
Theories / Concepts
This study is anchored on the theory of Dr. A. Jean Ayres that sensory integration is a neurobiological process that organizes sensation from one’s own body and from the environment and makes it possible to use the body effectively within the environment. Sensory Integration was coined in the 1960’s by Ayres of the University of Southern California and the Brain Research Center of UCLA, which she used in her practice of Occupational Therapy. Sensory Integration theory was a product of systematic investigation on the nature of the way the brain processes sensory information so that it can be used for learning, emotions and behavior.
It is said that sensory integration is information processing. The effectiveness of organism-environment transaction in promoting human development is partially dependent up on the inherent plasticity of the central nervous system. The brain, especially the young brain, is naturally malleable; structure and function become more firm and set with age. The formative capacity allows person-environment interaction to promote and enhance neurointegrative efficiency. A deficiency in the individual’s ability to engage effectively in this transaction at critical periods interferes with optimal brain development and consequent overall ability. Identifying the deficient areas at a young age and addressing them therapeutically can enhance the individual’s opportunity for normal development.
Theoretical and Conceptual Framework
Statement of the Problem
This study dealt with the sensory integration therapy and its effect on behaviors of children with autism. This is a two-fold study. This study started with training of SPED Teachers and its implementation in its effects of the behaviors of children with mild autism. Specifically, the study sought answers to the following questions:
1. What is the level of competency of SPED Teachers before and after the
training of sensory integration therapy?
2. Is there a there significant difference on the level of competency of SPED
Teachers before and after the training?
3. What is the level of improvement in the behavior of children with autism spectrum disorder in the following areas:
4. Is there a significant difference in the level of behavior of children with autism
before and after the application of sensory integration therapy?
The research study has the following as null hypotheses and will be tested at the 0.05 alpha level of significance:
Ho 1. There is no significant difference on the level of competency of SPED Teachers before and after the training.
Ho 2. There is no significant difference in the level of behavior of children with autism spectrum disorder before and after the training.
The study uses a pretest-posttest or before-after survey research design. It is called one-group design because there is only one group involved in the study. There is no control group or control variable. A pretest is conducted before the treatment or invention is introduced (O1). After sometime, a test is again repeated (O2). Then the results of the pretest and the posttest are compared to determine the change.
It explains the tools to be used such as the researcher-made questionnaire and observation checklist to be given as pre-test for baseline data and post-test for the extent of knowledge and behaviors respectively. It uses the mean and t-test to determine the significant difference between the pretest and posttest mean scores of SPED teachers trained on sensory integration therapy and the behaviors of children with autism respectively. And it describes the outputs which are the pool of trained teachers of sensory integration therapy and the improvement of the behaviors of children with autism.
In the gathering of data, the researcher formally wrote a letter addressed to the heads of Maharlika Charity Foundation Incorporated and Pag-Asa ng Batang may Kapansanan Incorporated to ask permission to conduct a study on sensory integration therapy and behaviors of children with special needs. In this endeavor, the researcher requested the school administration of the said centers some teachers to join in the three-day training on sensory integration therapy. Before the start of the training, the teachers were given a pretest and this was followed by an invited speaker who talked on tactile, vestibular and proprioceptive stimulation activities with demonstration to enable the trainees understand and acquire the skills. After the inputs of the resource speaker, the trainees were encouraged to ask questions to clarify the concepts or activities which were not clearly understood. In the afternoon, a return demonstration with the pupils was done by the teachers and this was evaluated by the teacher respondents themselves, researcher and occupational therapist. A posttest was administered to the SPED teachers to determine the effectiveness of the trainings on sensory integration therapy.
The trained teachers implemented the sensory integration therapy to the children with autism for twelve days. Before the formal implementation of the intervention, the teachers evaluated the behaviors of the pupils based from the items found in the checklist. The SPED Teachers and the researcher also conducted training for the parents of children with autism spectrum disorder. It was done so that there would be a continuity of the program especially during non-school days. It was documented by the journal notebooks that were provided for the parents to have a constant monitor on the behaviors and the application of the said intervention. The designed topics during the implementation were finished within twelve days and on the last implementation, the teachers conducted the post evaluation on the behaviors of children with autism spectrum disorder.
The competency level of special education teachers before is very low and after the training of sensory integration therapy; it yields a very high score. These SPED teachers underwent seminars/trainings and the competencies developed in the mentioned training are centered on tactile, vestibular and proprioceptive activities. In the tactile activities, the obtained pretest mean score of tactile activities is in a very low level but this value increases to a very high level after the conduct of seminars/trainings to the special education teachers. This implies that the teachers found the trainings effective since they learned the concept of sensory integration therapy. This means that the said teachers did not have any idea or knowledge about tactile activities for children with autism before the training on sensory integration therapy. Thus these SPED teachers after the seminars are already equipped with knowledge and skills on performing Indian Milking Massage, using surgical brush correctly, performing sandwiching activity, giving instruction to retrieve objects under the box filled with sand or rice and manipulating highly tactile materials. Data imply that the training in which special education teachers are involved help them in the acquisition of knowledge and skills concerning tactile activities. The teacher respondents successfully learned the activities relating to the sense of touch after the seminar on sensory integration therapy. In the vestibular activities, the data gathered on vestibular activities yield a pretest mean value that is very low and the mean rating of this item after the conduct of trainings is in a very high verbal description. This implies an effective learning experience of the SPED teachers during the said trainings. This further implies that after the seminar teachers are already capable of facilitating a rolling movement in the mat, of moving the hammock for swinging, of facilitating movement using vestibular ball in prone and sitting positions, of facilitating jumping movement in the trampoline and they are capable of initiating the different variations of movements like dancing, turning, rotating, spinning or marching in an area. The training therefore has caused teachers more equipped with various skills involving vestibular activities. In the proprioceptive activities, the data on this indicator result to a pretest mean value that is in a very low level and its posttest mean score is in a very high level. Data imply a great improvement of the respondents on skills relating to proprioceptive activities after the training. In particular, the SPED teachers learned to add weight using vest to body, to add weight to the joints using Velcro straps, to utilize plastic tunnels or tables crawling, to perform a joint compression technique properly and they learned to create an obstacle course. Data further imply that the acquisition of the teacher respondents on skills especially those that relate to position and movement of the body is attributable to the training on sensory integration therapy they attended. The overall pretest mean score for sensory integration therapy is very low level and the posttest mean score is very high level which implies better results of the seminars initiated by the researcher.
There is a significant difference in the competency of SPED teachers before and after the training. The mean difference between the pretest mean score and posttest mean score was tested using the t-test for correlated samples. It means that a significant difference exists between the pretests and posttest mean values of the two groups of respondents. This implies that the conduct of the trainings/seminars for SPED teachers on sensory integration therapy particularly tactile, vestibular and Proprioceptive activities is effective since the teachers significantly increase their competency from very low to very high results in the acquisition of skills. This means that there is really a significant difference between the two sets of scores in favor of the posttest. This further implies that the trainers are capable of translating their knowledge and skills to the participants during the seminars. The null hypothesis therefore is rejected. With the great improvement of SPED teachers after the intervention on sensory integration therapy, the researcher is assured that these SPED teachers are ready to implement their acquired skills to the children with autism spectrum disorders.
The level of negative behaviors displayed by the children with autism spectrum disorder before the application of the sensory intervention therapy was very high and after a 12-day duration from March 8-19, 2009 for the students in Maharlika Charity Foundation, Inc. and from March 9-20, 2009 for the students in Pag-Asa Ng Batang May Kapansanan. Data generally imply that the conduct of the intervention program for children with autism spectrum disorder has helped them in the acquisition of some basic life skills and it caused the children to display a more desirable behavior. Specifically, for the tactile behaviors the mean score for this indicator before the intervention is very high in terms of disruptive behaviors but this value is decreased to a very low manifestation of disruptive behaviors of children with autism spectrum disorder. Data imply that the intervention of teachers on sensory integration therapy has caused better modification of the behaviors of children with autism spectrum disorder. This further implies that after the children were exposed to the intervention program, they learned to mingle with the group members and they are no longer fearful of the unexpected touch; they develop a normal feeling and they do not react negatively on every drop of rain, water from the shower, wind or blowing on the skin; they are no longer frightened when touched from behind; they demonstrate willingness to use their hands for play and they find no difficulty in figuring out physical characteristics of objects, shapes, size, texture, temperature and weight. The negative behaviors of students become more desirable after they were exposed to sensory integration therapy. Thus, the intervention is very effective in causing the children with autism to behave and live just like the normal individuals. For vestibular behaviors of children with autism spectrum disorder, the mean score of this item before the intervention display a very high level of negative behavior and after the children’s exposure to the sensory integration therapy it decreased to a very low level. This implies improvement of the children’s vestibular behavior. Hence the children with autism spectrum disorder learned to display better behavior while they are working on their desk; they learned to walk properly; they gradually developed balance in themselves; they demonstrate improvement in their motor skills; and they learned to minimize constant motion while inside the classroom. Data further imply that the improvement in the behaviors of children with autism spectrum disorder can be attributed to the sensory integration therapy introduced by the special education teachers. In the children’s proprioceptive behaviors, the obtained data for this indicator are very high display of negative behaviors before the intervention and a very low display of negative behavior after the intervention. This implies better impact of the sensory integration therapy on the behaviors of the pupil respondents. After the intervention, the children with autism spectrum disorder developed some desirable behaviors like refraining from pushing/pulling/dragging objects; they learned to minimize hitting or pushing one another; they developed attitude of controlling their emotions by not breaking toys and other objects; they learned to regulate pressure when writing or when drawing; and they gradually developed skill of judging the weight of an object like a glass of juice and the amount of force they exert that is proportional to the weight of the said object. Data further imply a better medication of the children’s behaviors after the intervention. Thus, the conduct of the sensory integration therapy is beneficial to the children who have negative display of behaviors.
There is a significant difference in the behaviors of children with autism spectrum disorder before and after the sensory integration therapy in favor of the displayed behaviors after the said respondents were exposed to the intervention. The t-test for correlated or dependent samples was employed in testing the mean difference between the data before and after the conduct of sensory integration therapy. After the hypothesis testing, it is safe to conclude that the sensory integration therapy is effective in the medication of the negative behaviors of children with autism spectrum disorder. The results of the SPED teachers’ evaluation on the behaviors of the pupil respondents proves that the children with autism are capable of learning especially when they are exposed to a more appropriate learning experience. The change in the behaviors of children with autism spectrum disorder is attributable to the intervention called sensory integration therapy. The null hypothesis therefore is rejected. The finding of the study corroborates with the theory of Nelson (1999) that sensory integration is normal developmental process involving the ability of the central nervous system to organize sensory feedback from the body and the environment in order to make successful adaptive responses.
There is a significant difference in the competency of SPED teachers between before and after the intervention in favor of the posttest. Therefore, the training of teachers on the sensory integration therapy is effective since it causes improvements on the skills of the teacher respondents.
There is a significant difference in the behaviors of the children between before and after the sensory intervention therapy in favor of the displayed behaviors after the intervention. The conduct of sensory integration therapy for the children with autism spectrum disorder is effective since it causes improvements in their tactile, vestibular and proprioceptive behaviors.
The study found that the sensory integration therapy is effective in modifying the behaviors of children with autism spectrum disorder. It is recommended that teachers of these children will undergo trainings on sensory integration therapy and that they will be encouraged to use this technique in their classroom.
SPED teachers of children with autism spectrum disorder are persuaded to be trained to make them more responsive to the learning needs of the children with autism spectrum disorder. The administrators of SPED schools would consider having their teachers be involved in the trainings on sensory integration therapy and that there should be a regular monitoring on the implementation of the said intervention program.
The Department of Education should consider the learning needs of special children by providing SPED teachers with appropriate trainings based on their field of specialization.
Parents of children with autism spectrum disorder are hoped to be trained so that there will be a follow-up of these therapeutic activities at home. To ensure durability of changes both SPED teacher and children with autism spectrum disorder should have periodic evaluation for at least six months after the posttest.
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