repetition are positive factors whereas passive application of stimulation may not be.

In general, interventions based in natural environments that teach or attempt to change behaviors in the context in which they would typically occur have been found to be most effective (see Chapters 10, 11, and 12). Thus, ways of helping children with autistic spectrum disorders cope with unusual sensory responses within their ordinary environments or modifications to these environments might be expected to have more effects than would specific, one-to-one therapies (e.g., individual sensory integration treatment or individual sensory diets) or group treatments with unique stimuli (e.g., auditory integration therapy). This is particularly likely, given the many questions that arise about the theoretical bases for these sensory interventions. However, even if the results of sensory approaches are not specific, children may benefit from techniques that elicit social engagement, attention, and the use of toys and other materials at home and within classroom settings.

FROM RESEARCH TO PRACTICE

There is no consistent evidence that sensory-based treatments have specific effects; in many cases, the theories underlying such approaches have not withstood careful consideration (Dawson and Watling, 2000; Goldstein, 1999). A lack of empirical data does not necessarily demonstrate that a treatment is ineffective, but only that efficacy has not been objectively demonstrated (Rogers, 1998). There were some nonspecific positive findings in the studies of interventions reviewed, and there is a need to address at least functional aspects of motor difficulties, particularly as they affect social, adaptive, and academic functioning.

Future research in these areas needs to include well controlled, systematic studies of effectiveness. Only such research can answer not only what is effective, but with whom and under what conditions. Because most sensory- and motor-oriented interventions augment comprehensive educational programs, it is critical to know whether or not these approaches facilitate progress as additional interventions or hinder it by taking away valuable instruction time. It will be important to investigate to what degree specific treatments can be altered to fit an inclusive education model while still retaining their essential therapeutic elements and purported benefits. Comparisons of such treatments need to be systematically investigated in future efficacy research.



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