Comparison of behavioral intervention and sensory-integration therapy in the treatment of challenging behavior.
Function-based behavioral intervention beats sensory-integration therapy for reducing challenging behavior in autistic kids.
01Research in Context
What this study did
Cowie et al. (2011) compared two treatments for challenging behavior in autistic children.
They used an alternating-treatments design. Each child got both sensory-integration therapy and a function-based behavioral plan on different days.
Four kids with autism joined the study. The team counted how often each child hit, screamed, or bolted during each type of session.
What they found
Function-based behavioral intervention won. Challenging behavior dropped sharply on the days it was used.
When sensory therapy ran alone, problem behavior stayed high. Gains grew even bigger when behavioral intervention ran by itself later.
How this fits with other research
Davis et al. (2018) later rounded up 12 newer studies on the same topic. Their review keeps the 2011 paper in the must-read pile for anyone treating autism.
Chiang (2008) showed that many non-verbal autistic kids use challenging acts to ask or refuse. Sarah’s team built on that idea by first asking “What is this behavior for?” then teaching a better way to get the same thing.
Barton et al. (2019) found that sensory hypersensitivity fuels repetitive behaviors. This sounds like a win for sensory therapy, yet Sarah’s sensory sessions still failed. The gap hints that easing sensory discomfort alone is not enough; you still need to teach a replacement skill.
Why it matters
You now have clean data to show parents and OTs why a functional plan beats sensory play. Start with a quick functional assessment, teach one simple communicative replacement, and watch problem minutes shrink. The session-by-session data give you a ready graph to share at team meetings.
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02At a glance
03Original abstract
The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder. For each of the participants a functional assessment was conducted to identify the variables maintaining challenging behavior. Results of these assessments were used to design function-based behavioral interventions for each participant. Recommendations for the sensory-integration treatment were designed by an Occupational Therapist, trained in the use of sensory-integration theory and techniques. The sensory-integration techniques were not dependent on the results of the functional assessments. The study was conducted within an alternating treatments design, with initial baseline and final best treatment phase. For each participant, results demonstrated that the behavioral intervention was more effective than the sensory integration therapy in the treatment of challenging behavior. In the best treatment phase, the behavioral intervention alone was implemented and further reduction was observed in the rate of challenging behavior. Analysis of saliva samples revealed relatively low levels of cortisol and very little stress-responsivity across the SIT condition and the behavioral intervention condition, which may be related to the participants' capacity to perceive stress in terms of its social significance.
Journal of autism and developmental disorders, 2011 · doi:10.1007/s10803-010-1149-x