A systematic review of sensory processing interventions for children with autism spectrum disorders.
Skip weighted vests—only manualized, child-led sensory integration has small RCT support.
01Research in Context
What this study did
Case-Smith et al. (2015) hunted for every small, well-run trial on sensory treatments for kids with autism.
They kept only studies that followed a strict manual and measured results with numbers.
Weighted vests, brushing, and listening therapy sat in one pile. Child-led sensory integration sat in another.
What they found
Only clinic-based, child-directed sensory integration showed clear gains in tiny RCTs.
Sensory add-ons like vests or brushing rarely helped, and most lacked a clear plan.
Mixed means some hope, but also plenty of hype.
How this fits with other research
Baranek (2002) told us the same story years earlier, but with looser rules. Case-Smith et al. (2015) tightens the screws and still finds thin evidence.
Bottema‐Beutel et al. (2025) and Bottema-Beutel et al. (2024) show the field keeps using fuzzy labels and weak measures. The pattern holds across sensory and behavior studies.
Weber et al. (2025) adds that kids with coordination disorder also show tactile and motion avoidance. Together, the reviews say: measure first, treat second, and write down exactly what you did.
Why it matters
Before you buy a swing, brush, or weighted blanket, ask for the manual and the data. If the program is child-led, uses clear steps, and tracks progress, it may be worth a trial. If not, spend your hours on skills with stronger backing.
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02At a glance
03Original abstract
Children with autism spectrum disorders often exhibit co-occurring sensory processing problems and receive interventions that target self-regulation. In current practice, sensory interventions apply different theoretic constructs, focus on different goals, use a variety of sensory modalities, and involve markedly disparate procedures. Previous reviews examined the effects of sensory interventions without acknowledging these inconsistencies. This systematic review examined the research evidence (2000-2012) of two forms of sensory interventions, sensory integration therapy and sensory-based intervention, for children with autism spectrum disorders and concurrent sensory processing problems. A total of 19 studies were reviewed: 5 examined the effects of sensory integration therapy and 14 sensory-based intervention. The studies defined sensory integration therapies as clinic-based interventions that use sensory-rich, child-directed activities to improve a child's adaptive responses to sensory experiences. Two randomized controlled trials found positive effects for sensory integration therapy on child performance using Goal Attainment Scaling (effect sizes ranging from .72 to 1.62); other studies (Levels III-IV) found positive effects on reducing behaviors linked to sensory problems. Sensory-based interventions are characterized as classroom-based interventions that use single-sensory strategies, for example, weighted vests or therapy balls, to influence a child's state of arousal. Few positive effects were found in sensory-based intervention studies. Studies of sensory-based interventions suggest that they may not be effective; however, they did not follow recommended protocols or target sensory processing problems. Although small randomized controlled trials resulted in positive effects for sensory integration therapies, additional rigorous trials using manualized protocols for sensory integration therapy are needed to evaluate effects for children with autism spectrum disorders and sensory processing problems.
Autism : the international journal of research and practice, 2015 · doi:10.1177/1362361313517762