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Cox, A. L., Gast, D. L., Luscre, D., & Ayres, K. M. (2009). Effects of Weighted Vests on Appropriate In-Seat Behaviors of Elementary-Age Students With Autism and Severe to Profound Intellectual Disabilities. Focus on Autism and Other Developmental Disabilities, 24(1), 17-26. The purpose of this study was to evaluate the impact of weighted vests on the amount of time 3 elementary-age students with autism, intellectual disabilities, and sensory processing abnormalities engaged in appropriate in-seat behavior. An alternating treatments design was used to examine the duration of appropriate in-seat behavior under three conditions: baseline or no vests (A), vests with no weights (B), and weighted vests (BC). Because weighted vests did not have an effect on appropriate in-seat behavior for any participant, a second experiment was conducted. Noncontingent reinforcement (NCR) was assessed within the context of a withdrawal design. NCR had an optimal effect on the participants' in-seat behavior.

Davis, T. N., Dacus, S., Strickland, E., Copeland, D., Chan, J.M., Blenden, K., Scalzo, R., Osborn, S., Wells, K., & Christian K. (2013). The effects of a weighted vest on aggressive and self-injurious behavior in a child with autism. Developmental Neurorehabilitation, 16(3), 210-215. Weighted vests are a commonly implemented form of sensory integration therapy, frequently used as a treatment for disruptive behaviors associated with autism spectrum disorder [Stephenson J, Carter M. The use of weighted vests with children with autism spectrum disorders and other disabilities. Journal of Autism and Developmental Disabilities 2009;39:105-114]. However, the current findings support previous literature which states that the use of weighted vests does not appear to decrease challenging behavior.

Hodgetts, S., Magill-Evans, J., & Misiaszel, J. E. (2011). Weighted vests, stereotyped behaviors and arousal in children with autism. Journal of Autism Developmental Disorder, 41, 805-814. Six children with AU were selected for this study involving the impact of weighted vests on stereotyped behaviors. Weighted vests did not decrease motoric stereotyped behaviors in any participant. Verbal stereotyped behaviors decreased in one participant. Weighted vests did not decrease heart rate. Heart rate increased in one participant.


Murdock, L. C., Dantzler, J. A., Walker, A. N., & Wood, L. B. (2014). The Effect of a Platform Swing on the Independent Work Behaviors of Children With Autism Spectrum Disorders. Focus on Autism & Other Developmental Disabilities, 29(1), 50-61. A randomized pretest–posttest control group design was utilized to measure the effects of a platform swing on independent work behaviors of 30 children with Autism Spectrum Disorders (ASD). Participants engaged in two 5-min intervals of independent work. Between the intervals, participants in the treatment group received 5 min of vestibular stimulation using a platform swing and children in the control group watched a video. No significant differences were evidenced between the treatment and control groups on engagement, on-task behavior, stereotyped/repetitive behavior, or out-of-seat behavior. Changes noted for individual participants could not be linked to age, diagnosis, or sensory profile patterns.

Schilling, D. L., & Schwartz, I. (2004). Alternative seating for young children with autism spectrum disorder: Effects on classroom behavior. Journal of Autism and Developmental Disorders, 34, 4, 423-432. A single subject, withdrawal design was used to investigate the effects of therapy balls as seating on engagement and in-seat behavior of young children with Autism Spectrum Disorder (ASD). In addition, social validity was assessed to evaluate teachers' opinions regarding the intervention. During baseline and withdrawal (A phases) participants used their typical classroom seating device (chair, bench or carpet square). During the intervention (B phases) participants sat on therapy balls. Results indicated substantial improvements in engagement and in-seat behavior when participants were seated on therapy balls. Social validity findings indicated that the teachers' preferred the therapy balls. This study suggests therapy balls as classroom seating may facilitate engagement and in-seat behavior and create opportunities to provide effective instruction.

Wuang, Y., Wang, C., Huang, M., & Su, C. (2010). The effectiveness of simulated developmental horse-riding program in children with autism. Adapted Physical Activity Quarterly, 27, 113-126.This study investigated the effectiveness of a 20-week Simulated Developmental Horse-Riding Program (SDHRP) by using an innovative exercise equipment (Joba®) on the motor proficiency and sensory integrative functions in 60 children with autism (age: 6 years, 5 months to 8 years, 9 months). In the first phase of 20 weeks, 30 children received the SDHRP in addition to their regular occupational therapy while another 30 children received regular occupational therapy only. The arrangement was reversed in the second phase of another 20 weeks. Children with autism in this study showed improved motor proficiency and sensory integrative functions after 20-week SDHRP (p < .01). In addition, the therapeutic effect appeared to be sustained for at least 24 weeks (6 months).


Freeman, R. D., Soltanifar, A., & Baer, S. (2010). Stereotypic movement disorder: easily missed. Developmental Medicine & Child Neurology, 52(8), 733-738. Forty-two children (31 males, mean age 6y 3mo, SD 2y 8mo; 11 females, mean age 6y 7mo, SD 1y 9mo) consecutively diagnosed with SMD, without-self-injurious behavior, intellectual disability, sensory impairment, or an autistic spectrum disorder (ASD), were assessed in a neuropsychiatry clinic. A list of probe questions on the nature of the stereotypy was administered to parents (and to children if developmentally ready). Questionnaires administered included the Stereotypy Severity Scale, Short Sensory Profile, Strengths and Difficulties Questionnaire, Repetitive Behavior Scale – Revised, and the Developmental Coordination Disorder Questionnaire. The stereotyped movement patterns were directly observed and in some cases further documented by video recordings made by parents. The probe questions were used again on follow-up at a mean age of 10 years 7 months (SD 4y 4mo).

Gal, E., Dyck, M. J., & Passmore, A. (2010). Relationships Between Stereotyped Movements and Sensory Processing Disorders in Children With and Without Developmental or Sensory Disorders. American Journal of Occupational Therapy, 64(3), 453-461. Stereotyped movements (SM) are a defining characteristic of autism but are also present in children with a range of sensory and developmental disorders. We examined whether the severity of sensory processing disorders (SPD) was associated with the severity of SM and whether SPD accounted for between group differences in SM. SPD may be a source of SM, but functional connections between these phenomena will need to be tested in future research. Implications for occupational performance are addressed.

Oriel KN, George CL, Peckus R, Semon A. (2011). The Effects of Aerobic Exercise on Academic Engagement in Young Children with Autism Spectrum disorder. Pediatric Physiology Therapies, 23(2), 187-93. Study to determine whether participation in aerobic exercise before classroom activities improves academic engagement and reduces stereotypic behaviors in young children with autism spectrum disorder. a within-subjects crossover design, using a treatment condition (aerobic exercise) and a control condition, across 4 classrooms. The treatment condition included 15 minutes of running/jogging followed by a classroom task. The control condition included a classroom task not preceded by exercise. The number of stereotypic behaviors, percentage of on-task behavior, and correct/incorrect responses were measured. The Wilcoxon signed rank test was used to compare differences between conditions. Statistically significant improvements were found in correct responding following exercise (P < .05). No significant differences were found for on-task behavior or stereotypic behaviors.


Evers K, Noens I, Steyaert J, Wagemans J (2011) Combining strengths and weaknesses in visual perception of children with an autism spectrum disorder: Perceptual matching of facial expressions. Res Autism Spectr Disord 5: 1327–1342. doi: 10.1016/j.rasd.2011.01.004 Children with an autism spectrum disorder (ASD) are known to have an atypical visual perception, with deficits in automatic Gestalt formation and an enhanced processing of visual details. In addition, they are sometimes found to have difficulties in emotion processing. In matching faces with emotional expressions, children with ASD were not able to show superior processing of details in any of the three experiments. They were able to compensate their inferior processing of emotions in some of the experiments (e.g., by using a slower, more sequential processing style). However, when stimulus complexity (e.g., dynamic facial expressions) or task demands (e.g., extracting and remembering the relevant stimulus dimension) increased, they were no longer able to do so, and they did show performance deficits.

Koldewyn K, Whitney D, Rivera SM (2010) The psychophysics of visual motion and global form processing in autism. Brain 133: 599–610. Several groups have recently reported that people with autism may suffer from a deficit in visual motion processing and proposed that these deficits may be related to a general dorsal stream dysfunction. In order to test the dorsal stream deficit hypothesis, we investigated coherent and biological motion perception as well as coherent form perception in a group of adolescents with autism and a group of age-matched typically developing controls. If the dorsal stream hypothesis were true, we would expect to document deficits in both coherent and biological motion processing in this group but find no deficit in coherent form perception. Using the method of constant stimuli and standard psychophysical analysis techniques, we measured thresholds for coherent motion, biological motion and coherent form. We found that adolescents with autism showed reduced sensitivity to both coherent and biological motion but performed as well as age-matched controls during coherent form perception. Correlations between intelligence quotient and task performance, however, appear to drive much of the group difference in coherent motion perception. Differences between groups on coherent motion perception did not remain significant when intelligence quotient was controlled for, but group differences in biological motion perception were more robust, remaining significant even when intelligence quotient differences were accounted for. Additionally, aspects of task performance on the biological motion perception task were related to autism symptomatology. These results do not support a general dorsal stream dysfunction in adolescents with autism but provide evidence of a more complex impairment in higher-level dynamic attentional processes.

Nackaerts E, Wagemans J, Helsen W, Swinnen SP, Wenderoth N, et al. (2012) Recognizing Biological Motion and Emotions from Point-Light Displays in Autism Spectrum Disorders. PLoS ONE 7(9). One of the main characteristics of Autism Spectrum Disorder (ASD) are problems with social interaction and communication. Here, we explored ASD-related alterations in ‘reading’ body language of other humans. Accuracy and reaction times were assessed from two observational tasks involving the recognition of ‘biological motion’ and ‘emotions’ from point-light displays (PLDs). Eye movements were recorded during the completion of the tests. Results indicated that typically developed-participants were more accurate than ASD-subjects in recognizing biological motion or emotions from PLDs. No accuracy differences were revealed on two control-tasks (involving the indication of color-changes in the moving point-lights). Group differences in reaction times existed on all tasks, but effect sizes were higher for the biological and emotion recognition tasks. Biological motion recognition abilities were related to a person’s ability to recognize emotions from PLDs. However, ASD-related atypicalities in emotion recognition could not entirely be attributed to more basic deficits in biological motion recognition, suggesting an additional ASD-specific deficit in recognizing the emotional dimension of the point light displays. Eye movements were assessed during the completion of tasks and results indicated that ASD-participants generally produced more saccades and shorter fixation-durations compared to the control-group. However, especially for emotion recognition, these altered eye movements were associated with reductions in task-performance.


Hall, L., & Case-Smith, J. (2007). The effect of sound-based intervention on children with sensory processing disorders and visual–motor delays. American Journal of Occupational Therapy, 61, 209–215. This study investigated the effects of a sensory diet and therapeutic listening intervention program, directed by an occupational therapist and implemented by parents, on children with sensory processing disorders (SPD) and visual–motor delays. A convenience sample was used of 10 participants, ages 5 to 11 years, with SPD and visual–motor delays. In the first phase, each participant completed a 4-week sensory diet program, then an 8- week therapeutic-listening and sensory diet program. The Sensory Profile was completed by the participants’ parents before and after both study phases. The Draw-A-Person test, Developmental Test of Visual Motor Integration (VMI), and Evaluation Tool of Children’s Handwriting (ETCH) were administered before and after each phase. Over 12 weeks, the participants exhibited significant improvement on the Sensory Profile, increasing a mean of 71 points. Parents reported improvements in their children’s behaviors related to sensory processing. Scores on the VMI visual and ETCH legibility scales also improved more during the therapeutic listening phase. Therapeutic listening combined with a sensory diet appears effective in improving behaviors related to sensory processing in children with SPD and visual–motor impairments.

Nwora, A. J., & Gee, B. M. (2009). A case study of a 5-year-old with pervasive developmental disorders-not otherwise specified using sound-based interventions. Occupational Therapy International, 16(1), 25-43. The aim of this study was to determine the efficacy of The Listening Program (TLP), an auditory integration program, in treating a child with PDD-NOS. Using a single-subject case study design, one child with PDD-NOS was administered a 20-week TLP intervention. Results of the study indicated improved behavior and sensory tolerance, receptive/expressive listening and language, motor skills, and behavioral/social adjustment at the post-intervention assessment.

Sinha Y, Silove N, Williams K, Hayen A. (2004) Auditory integration training and other sound therapies for autism spectrum disorders. Cochrane Database of Systematic Reviews 1 54-71 Auditory integration therapy (AIT) was developed as a technique for improving abnormal sound sensitivity in individuals with behavioral disorders including autism. Other sound therapies bearing similarities to AIT include the Tomatis Method and Samonas Sound Therapy. No trials assessing sound therapies other than AIT were found. Six RCTs of AIT, including one cross-over trial, were identified with a total of 171 individuals aged 3 to 39 years. Four trials had fewer than 20 participants. Allocation concealment was inadequate for all studies. Seventeen different outcome measures were used. Only two outcomes were used by three or more studies. Meta-analysis was not possible due to very high heterogeneity or presentation of data in unusable forms. Three studies did not demonstrate benefit of AIT over control conditions. Three trials reported improvements at three months for the AIT group based on improvements of total mean scores for the ABC, which is of questionable validity.


Ahearn WH, Castine T, Nault K, Green G.(2001) An assessment of food acceptance in children with autism or pervasive developmental disorder-not otherwise specified. J Autism Dev Disord 31:505– 511. Some children with autism and pervasive developmental disorder-not otherwise specified (PDD-NOS) have been reported to have atypical feeding behavior, such as sensitivity to food texture and selective preferences for particular foods. No systematic studies of feeding behavior in this population have been published. Munk and Repp (1994) developed methods for assessing feeding problems in individuals with cognitive and physical disabilities that allow categorization of individual feeding patterns based on responses to repeated presentations of food. In this study, we systematically replicated the Munk and Repp procedures with children with autism and PDD-NOS. Thirty children, ages 3 to 14 years, were exposed to 12 food items across 6 sessions. Food acceptance, food expulsion, and disruptive behavior were recorded on a trial-by-trial basis. Approximately half of the participants exhibited patterns of food acceptance, indicating selectivity by food category or food texture. Others consistently accepted or rejected items across food categories. Whether these patterns of food acceptance are atypical remains to be determined by comparison with the feeding patterns of typically developing children and other children with developmental delays.

Nadon G, Ehrmann D, Feldman, WD, Gisel E. (2011) “Association of Sensory Processing and Eating Problems in Children with Autism Spectrum Disorders,” Autism Research and Treatment, “Selective” or “picky eating” is a frequent problem in children with autism spectrum disorders (ASD). Many of these children do not treat sensory input, particularly olfactory, auditory, visual, and tactile information in the same manner as their typically developing peers of the same age. The purpose of this paper was to examine the relationship between problems of sensory processing and the number of eating problems in children with ASD. Of 95 children with ASD, 3 to 10 years of age, 65 percent showed a definite difference and 21 percent a probable difference in sensory processing on the total score of the Short Sensory Profile. These results were significantly related to an increase in the number of eating problems measured by the Eating Profile. These results could not be explained by age, sex, mental retardation, attention deficit disorder, or hyperactivity. Timely interventions focusing on the sensory components of eating must now be developed.

Schreck KA, Williams K. (2206) Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Research Developmental Disability 27:353–363. Autism spectrum disorders (ASDs) comprise a complex set of related developmental disorders that are characterized by impairments in communication, social interaction, and repetitive behaviors. Impairments in sensory processing are also extremely common. The prevalence of ASDs is increasing and is currently estimated to affect 1 in 150 children. ASDs are considered to be a major health and educational problem, affecting many areas of daily living, including eating. Children with ASDs are often described as picky or selective eaters. This paper provides a comprehensive narrative review of the empirical literature over the last 25 years on food selectivity and nutritional adequacy in children with ASDs. The possible contributions of sensory factors, such as sensory sensitivity, to food selectivity are discussed. The need for an interdisciplinary approach to managing atypical eating patterns in children with ASD is highlighted.


Hrdlička M, Vodička J, Havlovičová M, Urbánek T, Blatný M, Dudová I. (2011) Significant Differences in Perceived Odor Pleasantness Found in Children with ASD, Journal of Autism and Developmental Disorders. 524-527 The aim of the study was to explore possible differences in estimation of odor pleasantness in children with autism spectrum disorders (ASD) compared to controls. Thirty-five patients with Asperger’s syndrome and high functioning autism were compared with 35 healthy control subjects. Odor pleasantness was assessed on a 5-point scale using the Sniffin’ Sticks test (Identification part of the test). Patients with ASD, compared to healthy controls, perceived the smell of cinnamon and pineapple as significantly less pleasant (p<0.05); at the trend level, the same was true of cloves (p<0.1). The possibility of olfactory dysfunctions as an autism biomarker is discussed.

Suzuki Y, Critchley HD, Rowe A, Howlin P, Murphy DGM.(2003) Impaired olfactory identification in Asperger's syndrome. J Neuropsychological Clinical Studies 15:105–107. The authors measured odor detection threshold and odor identification in 12 males with Asperger’s syndrome and 12 matched control subjects. Relative to control subjects, Asperger’s syndrome subjects were not impaired at odor detection but were significantly impaired at olfactory identification.

Tavassoli T, Baron-Cohen S (2012) Olfactory detection thresholds and adaptation in adults with autism spectrum condition. J Autism Dev Disord 42(6):905–909 Sensory issues have been widely reported in Autism Spectrum Conditions (ASC). Since olfaction is one of the least investigated senses in ASC, the current studies explore olfactory detection thresholds and adaptation to olfactory stimuli in adults with ASC. 80 participants took part, 38 (18 females, 20 males) with ASC and 42 control participants (20 males, 22 females). A subgroup of participants (N = 19 in each group) also conducted an adaptation task. Standardized “Sniffin’ Sticks” were used to measure olfactory detection levels and adaptation. Adults with and without ASC showed similar olfactory detection thresholds, and similar adaptation to an olfactory stimulus. Since diminished adaptation in ASC has been previously suggested, future research needs to examine adaptation in other modalities as well.