Visual and Auditory Systems

The presence of unusual visual or auditory behaviors has been consistently reported in children with autism (Dahlgren and Gillberg, 1989; Gillberg et al., 1990). Even though visual-spatial skills (e.g., completing complex puzzles) are a relative strength, many children with autism demonstrate unusual visual-spatial behaviors, such as visual stereotypies, atypical interest in visual stimuli, or unusual visual gaze behavior. Many children with autism exhibit exaggerated sensitivity to common environmental noises, such as dishwashers, hairdryers, and garbage disposals. This hypersensitivity is also evident when children are in a busy or crowded area, such as an amusement park.

INTERVENTION TECHNIQUES

There is little rigorous research on intervention techniques for the sensory symptoms of children with autistic spectrum disorders. In general, the quality of research in the existing assessments of the efficacy of sensorimotor interventions for autistic spectrum disorders has been relatively strong in external validity and the selection and definition of samples (see Figure 1–2 in Chapter 1) in comparison with studies in other areas. Because this area is small, the few published studies that included random assignment represent a relatively high proportion of the literature. Criteria for internal validity, including the use of prospective methods and evaluation of blind procedures, were also met for a higher proportion of published studies in the sensorimotor area than any other area than communication (as shown in Figure 1–1 in Chapter 1), though, as in other areas, 50 percent of studies did not meet fairly minimal standards in this area (see Box 1–1 in Chapter 1). Studies that included measures of generalization were very rare (see Figure 1–3 in Chapter 1). The limited consideration of generalization is also of concern, but one that holds true, though to a lesser extent, for other areas of research. Overall, it is clear that high quality research can be done in this area, but that it is very rare, and many widely publicized treatments have not received careful, systematic study. Thus, the following discussion of these methods must be primarily descriptive (see Dawson and Watling [2000] and Goldstein [1999] for a recent review and commentary).

Sensory Integration Therapy

By focusing a child on play, sensory integration therapy emphasizes the neurological processing of sensory information as a foundation for learning of higher-level skills (Ayres, 1972). The goal is to improve subcortical (sensory integrative) somatosensory and vestibular functions by



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