Smelling essential oils, walking across textured surfaces, immersing hands in warm water - these are just some of the therapeutic experiences that boys with autism had while participating in a small new study.
The scientists wanted to learn how "sensory-motor" therapy compared to traditional behavioural therapy methods in boys with autism.
Twenty-eight boys aged 3 to 12 and their parents participated in the six-month-long study. The boys were split into two groups. Both groups of children participated in daily behavioural therapy, but 13 of the boys also received environmental enrichment, another term for sensory-motor therapy.
The environmental enrichment therapy had a significant positive effect on these children with autism, the study authors said.
"What we've done here for the first time is give humans a sensory-enriched environment and found out that a neurological disorder - autism - responds favourably. We saw a 600% greater likelihood of having a positive clinical outcome in individuals that had enriched environments compared to those receiving the standard care that children have been receiving for autism up to this point," said study author Michael Leon, a professor of neurobiology and behaviour at Center for Autism Research and Treatment at the University of California, Irvine.
However, an autism expert who wasn't part of the study cautioned that other sensory-based therapies showing early promise haven't proven effective so far.
How the study was done
For the new study, parents of the children in the sensory enrichment group were given a kit that contained a broad range of materials aimed at stimulating their child's senses of smell, temperature, texture, sight and movement. Vials of essential oils scented of apple, lavender, sweet orange and vanilla, were among the items. Squares of different textured materials included smooth foam, hardwood flooring, sponges, felt and sandpaper.
The children were also given the opportunity to play with objects: beads, a small piggy bank with plastic coins, pictures of famous art, a can of Play-Doh, a bowl to hold warm or cool water and more.
The researchers asked parents to conduct two therapy sessions a day with their child, and to run four to seven different exercises during each session that involved different combinations of the items in the kit. Sessions ranged from 15 to 30 minutes. The children also listened to classical music once a day.
Start the treatments early
As the six-month period progressed, parents were encouraged to offer more complex enrichment exercises. For example, a child would be given the chance to select a textured square and in addition to feeling it would be encouraged to match it to another square of the same material.
By the end of the six months, Leon said the enrichment group children had significantly improved compared to the children who received standard therapy alone. He said 42% of the boys in the enrichment group improved in their ability to relate to other people and in their ability to respond to sights and sounds, compared with 7% of the standard care group.
The boys in the enrichment group also improved on scores for so-called cognitive function - which involves thinking and reasoning skills - while the standard care group had a decrease in their average scores. And improvement in overall autism symptoms was reported by two-thirds of parents with children in the enrichment group compared to one-third of parents with kids in the standard care group.
"We were surprised at how well the children responded to this. And we were appropriately sceptical at the start of the study," Leon said.
Another positive point, Leon noted, is that while standard behavioural therapy is more effective the earlier a child receives it, the sensory enrichment therapy appears to be effective even in older children.
Autism affects about 1 in 88 children, according to the US Centers for Disease Control and Prevention. It's one of a group of serious developmental conditions that fall under the term "autism spectrum disorders." Symptoms can vary widely, but kids with autism generally have difficulty communicating and interacting with others.
"You really have to start these other treatments early. The median age at which autism is diagnosed in this country is 5 years old, but even if they're diagnosed early, it often takes many months before they are finally in treatment, sometimes up to a year," Leon said, adding that the cost can tally up to as much as $100 000 annually.
Dr Andrew Adesman, chief of developmental and behavioural paediatrics at Cohen Children's Medical Center in New Hyde Park, NY, pointed out that while the study suggests that a novel and relatively simple form of environmental enrichment performed at home twice daily for 30 minutes or less can lead to significant improvement in children with autism, it's too soon to draw such conclusions.
"Parents and professionals should know that all other treatment approaches focusing on sensory stimulation, despite promising initial reports, have not proven to be effective thus far in helping children with autism," Adesman said.
He added that while there was a "control group," there was no "blinding" with respect to treatment status (meaning it was obvious who was and who wasn't receiving the new therapy). "It is possible that the group of kids who improved with the sensory stimulation may have simply benefited from placebo effects and/or other nonspecific benefits from increased parent-child interaction," Adesman explained.
"Despite the limitations of the research study's design, environmental enrichment focusing on an autistic child's senses of smell and touch most definitely deserves further study as a relatively simple and affordable treatment," Adesman said.
Study author Leon also said more research is needed, but noted that environmental enrichment is a low-cost, at-home therapy option for parents. "It's quite feasible for parents to engage with their children and improve the probability of a clinically significant improvement in their autism symptoms," he said.
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