perception and improved behavior or performance by shifting the field of vision through an angular displacement of 1 to 5 degrees (base up or base down). Only one study investigated the use of prism lenses in children with autism, almost half of whom also had strabismus (Kaplan et al., 1996; Kaplan et al., 1998). Results indicated some short-term positive behavioral effects with less improvement at later follow-up. Performance on orientation and visual-spatial tasks was not significantly different between conditions. As with auditory integration therapy, studies have not provided clear support for either its theoretical or its empirical basis.

SENSORY AND MOTOR DEVELOPMENT AND EDUCATIONAL PROGRAMMING

Motor development plays an important role in learning—young children typically use motor skills to explore the environment, engage in social interactions, engage in physical activities, and develop basic academic skills, such as handwriting. Unusual sensory responses (e.g., hypo-and hyperresponses, preoccupations with sensory features of objects, paradoxical responses to sensory stimuli) are common concerns in children with autistic spectrum disorders. Given that most educational environments involve many sensory demands (e.g., the noise level of a regular classroom) and stimuli that may seem unpredictable (e.g., fire alarms), interventions may need to address the individualized sensory processing needs of children who have such difficulties. However, exactly how this should be done has not been addressed in scientific investigations.

Praxis is an area of particular interest; several studies note that both younger and older children with autism may demonstrate difficulties with aspects of motor planning. These difficulties are exaggerated in tasks that require execution of a social imitation, either motor or object related, but they may also be present in non-imitated, simple, goal-directed motor tasks. Such difficulties would affect many daily aspects of early childhood, such as games and sports (e.g., throwing a ball, riding a bicycle), crafts (e.g., using scissors), and performing gestures. Although it is possible that the formulation of motor plans is deficient in children with autistic spectrum disorders, it is also possible that simple motor planning is intact but that the use of externally guided visual feedback is diminished. If so, the quality of motor control, postural stability, and effective sequencing would all be affected.

Classical sensory integration therapy provides a child-centered and playful approach that is often appealing to even the most unmotivated or disengaged child. In the case of the other treatments based on sensory integration, a child must be able to tolerate various sensory applications or physical manipulations. For some children with autism, structure and



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