A sensory-motor integration programme for boys with autism spectrum disorder : two case studies

[摘要] ENGLISH ABSTRACT: Autism Spectrum Disorder (ASD) has been described as a neuro-developmental disorderinfluencing the social interaction and communication skills of individuals. Those with ASDhave been observed to experience sensory input challenges, which could result in motordelays. Descriptive research was conducted with two case studies, who were boys aged 6-and 8-years, diagnosed with ASD. The purpose of the study was to design and implement aSensory-Motor Integration (SMI) programme for each boy and to assess the effect it had onthe sensory motor skills of the boys over time.At the start of the intervention, the boys were assessed with three neuro-developmentaland diagnostic evaluations (Social Communication Questionnaire, Autism DiagnosticInterview Revised and Autism Diagnostic Observation Schedule-2nd Edition) conducted by apsychiatrist to re-affirm their previous ASD diagnoses. The two boys (Subject A and SubjectG) participated in individualised sessions of 30 minutes each, twice a week for sevenmonths. The SMI programme focused on vestibular and somato-sensory (proprioceptor)variables. The Quick Neurological Screening Test-3 (QNST III) and the Sensory Input SystemsScreening Test (SISST) were used to evaluate the latter at baseline. These were repeatedregularly, every 4 to 5 weeks, over the 7-month period and included a retention test of 5weeks. Based on the results from the subtests of the motor skill tests, a self-designed SMIprogramme was integrated into the planning of the intervention programme for each boyaccording to their sensory-motor needs.Subject A showed improvement in the following vestibular subtests in the QNST-III: Stand onone leg (67%) and Tandem walk (83%) and retaining his standard from the Post-test to theRetention test. For muscle tone ability and proprioception, the Arm and leg extensionsubtest also demonstrated improvement (67%) from the Pre-to the Post-test. The results ofthe subtest were not retained over the retention period and increased only slightly being33% from the baseline score.The proprioceptive function of Subject A showed great improvement in the following QNSTIIIsubtests: Finger to nose (67%), Rapidly reversing repetitive hand movements (88%) andLeft and right discrimination (67%). The results of vestibular-related subtests for Subject Gshowed improvement in the following: Stand on one leg (33%) and the Arm and leg extension task (33%). Some of the scores of Subject G started in the functional category of'severe discrepancy; however there was improvement in the following proprioceptionrelatedsubtests: Finger to nose (43%), Thumb and finger circles (20%), and Reversingrepetitive hand movements (86%). Although Subject G showed gradual improvement overtime, his two sensory systems struggled to integrate with the more complex tasks. Theoutcome of the individualised SMI programmes showed that the sensory-motor skillsimproved by enhancing the stimulation of their vestibular and somato-sensory(proprioception) function.Regarding the SISST, Subject A progressed from a 'fail' to 'pass', in the following test items:the Tonic Labyrinthine Supine (TLS), Tonic Labyrinthine Prone (TLP), Positive Support Reflex(PSR) and the Ocular Alignment test items. Results from the Vestibular test for both SubjectA and Subject G appeared to be 'hypo-vestibular' (under-stimulated) according to the Post-Rotary Nystagmus test (PRN) score at baseline. These scores were inconsistent during theintervention. The only test item to show positive improvement for Subject G was theEquilibrium Reactions. Lastly, both Subject A and Subject G remained in the 'fail' categoryfor Kinaesthesis, which may indicate their ongoing poor proprioception and spatialorientation.There is a need for further research in the area of sensory-motor individualised programmesfor children with ASD. Suggestions for future research interventions are to conduct theindividualised programmes either over a longer period of time and more frequently at threetimes a week.

[发布机构] Stellenbosch University