Skip to main content

Sensory Integration Therapy and DIR/Floortime

  • Chapter
  • First Online:
Handbook of Treatments for Autism Spectrum Disorder

Part of the book series: Autism and Child Psychopathology Series ((ACPS))

Abstract

Many methods in widespread use as treatments for ASD have very limited research support. Among these treatments are sensory integration therapies and DIR/Floortime. These two treatments focus on adjusting individuals with ASD to various sensory stimuli in their environments and creating enjoyable social experiences to lower rates of social isolation, respectively. Although research on these interventions is somewhat limited and often inconclusive, these treatments are still being explored as possible supplements and/or alternatives to ABA therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 379.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Academy of Pediatrics. (2012). Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics, 129(6), 1186–1189. https://doi.org/10.1542/peds.2012-0876

  • American Occupational Therapy Association. (2014). Research opportunities in the area of children and adolescents with challenges in sensory processing and sensory integration. American Journal of Occupational Therapy, 68(2), 242–244. https://doi.org/10.5014/ajot.2014.682003

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Book  Google Scholar 

  • Ayres, A. J. (1979). Sensory integration and the child. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Baranek, G. T. (2002). Efficacy of sensory and motor interventions for children with autism. Journal of Autism and Developmental Disorders, 32(5), 397–422. https://doi.org/10.1023/A:1020541906063

  • Baranek, G. T., Boyd, B. A., Poe, M. D., David, F. J., & Watson, L. R. (2007). Hyperresponsive sensory patterns in young children with autism, developmental delay, and typical development. American Journal on Mental Retardation, 112(4), 233–245. https://doi.org/10.1352/0895-8017(2007)112[233:HSPIYC]2.0.CO;2

  • Ben-Sasson, A., Hen, L., Fluss, R., Cermak, S. A., Engel-Yeger, B., & Gal, E. (2008). A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(1), 1–11. https://doi.org/10.1007/s10803-008-0593-3

  • Ben-Sasson, A., Carter, A. S., & Briggs-Gowan, M. J. (2009). Sensory over-responsivity in elementary school: Prevalence and social-emotional correlates. Journal of Abnormal Child Psychology, 37(5), 705–716. https://doi.org/10.1007/s10802-008-9295-8

  • Boyd, B. A., McBee, M., Holtzclaw, T., Baranek, G. T., & Bodfish, J. W. (2009). Relationships among repetitive behaviors, sensory features, and executive functions in high functioning autism. Research in Autism Spectrum Disorders, 3(4), 959–966. https://doi.org/10.1016/j.rasd.2009.05.003

  • Boyd, B. A., Baranek, G. T., Sideris, J., Poe, M. D., Watson, L. R., Patten, E., & Miller, H. (2010). Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Research, 3(2), 78–87. https://doi.org/10.1002/aur.124

  • Bundy, A. C., Lane, S. J., & Murray, E. A. (2002). Sensory integration: Theory and practice (2nd ed.). Philadelphia, PA: F. A. Davis.

    Google Scholar 

  • Casenhiser, D. M., Shanker, S. G., & Stieben, J. (2013). Learning through interaction in children with autism: Preliminary data from asocial-communication-based intervention. Autism, 17(2), 220–241. https://doi.org/10.1177/1362361311422052

  • Case-Smith, J., & Miller, H. (1999). Occupational therapy with children with pervasive developmental disorders. American Journal of Occupational Therapy, 53, 506–513.

    Article  PubMed  Google Scholar 

  • Case-Smith, J., Weaver, L. L., & Fristad, M. A. (2014). A systematic review of sensory processing interventions for children with autism spectrum disorders. Autism, 19(2), 133–148.

    Article  PubMed  Google Scholar 

  • Davis, T. N., Durand, S., & Chan, J. M. (2011). The effects of a brushing procedure on stereotypical behavior. Research in Autism Spectrum Disorders, 5(3), 1053–1058. https://doi.org/10.1016/j.rasd.2010.11.011

  • Dawson, G., & Watling, R. (2000). Interventions to facilitate auditory, visual, and motor integration in autism: A review of the evidence. Journal of Autism and Developmental Disorders, 30, 415–421.

    Article  PubMed  Google Scholar 

  • Dawson, G., Jones, E. J. H., Merkle, K., Venema, K., Lowy, R., Faja, S., … Webb, S. J. (2012). Early behavioral intervention is associated with normalized brain activity in young children with autism. Journal of the American Academy of Child & Adolescent Psychiatry, 51(11), 1150–1159. https://doi.org/10.1016/j.jaac.2012.08.018

  • Devlin, S., Leader, G., & Healy, O. (2009). Comparison of behavioral intervention and sensory-integration therapy in the treatment of self-injurious behavior. Research in Autism Spectrum Disorders, 3(1), 223–231. https://doi.org/10.1016/j.rasd.2008.06.004

  • Devlin, S., Healy, O., Leader, G., & Hughes, B. M. (2010). Comparison of behavioral intervention and sensory-integration therapy in the treatment of challenging behavior. Journal of Autism and Developmental Disorders, 41, 1303–1320.

    Article  Google Scholar 

  • Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 580–587. https://doi.org/10.1016/j.jaac.2015.04.005

  • Fisher, A., & Murray, E. A. (1991). Introduction to sensory integration theory. In A. G. Fisher, E. A. Murray, & A. C. Bundy (Eds.), Sensory integration: Theory and practice (pp. 3–26). Philadelphia, PA: F. A. Davis.

    Google Scholar 

  • Gabriels, R. L., Agnew, J. A., Miller, L. J., Gralla, J., Pan, Z., Goldson, E., … Hooks, E. (2008). Is there a relationship between restricted, repetitive, stereotyped behaviors and interests and abnormal sensory response in children with autism spectrum disorders? Research in Autism Spectrum Disorders, 2(4), 660–670. https://doi.org/10.1016/j.rasd.2008.02.002

  • Goin-Kochel, R. P., Myers, B. J., & Mackintosh, V. H. (2007). Parental reports on the use of treatments and therapies for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 1(3), 195–209. https://doi.org/10.1016/j.rasd.2006.08.006

  • Green, V. A., Pituch, K. A., Itchon, J., Choi, A., O’Reilly, M., & Sigafoos, J. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities: A Multidisciplinary Journal, 27(1), 70–84.

    Article  Google Scholar 

  • Greenspan, S. I., & Wieder, S. (1999). A functional developmental approach to autism spectrum disorders. Research and Practice for Persons with Severe Disabilities, 24(3), 147–161.

    Article  Google Scholar 

  • Greenspan, S. I., & Wieder, S. (2006). Engaging autism: Using the floortime approach to help children relate, communicate, and think. Cambridge, MA: Da Capo Press.

    Google Scholar 

  • Greenspan, S. I., & Wieder, S. (2007). The developmental individual-difference, relationship-based (DIR/Floortime) model approach to autism spectrum disorders. In E. Hollander, E. Anagnostou, E. Hollander, & E. Anagnostou (Eds.), Clinical manual for the treatment of autism (pp. 179–209). Arlington, VA: American Psychiatric Publishing.

    Google Scholar 

  • Hazen, E. P., Stornelli, J. L., O’Rourke, J. A., Koesterer, K., & McDougle, C. J. (2014). Sensory symptoms in autism spectrum disorders. Harvard Review of Psychiatry, 22(2), 112–124. https://doi.org/10.1097/01.HRP.0000445143.08773.58

  • Hilton, J. C., & Seal, B. C. (2007). Brief report: Comparative ABA and DIR trials in twin brothers with autism. Journal of Autism and Developmental Disorders, 37(6), 1197–1201. https://doi.org/10.1007/s10803-006-0258-z

  • Iarocci, G., & McDonald, J. (2006). Sensory integration and the perceptual experience of persons with autism. Journal of Autism and Developmental Disorders, 36, 77–90.

    Article  PubMed  Google Scholar 

  • Individuals with Disabilities Education Improvement Act (2004) of 2004, 20 U.S.C. § 1400.

    Google Scholar 

  • Jasmin, E., Couture, M., McKinley, P., Reid, G., Fombonne, E., & Gisel, E. (2009). Sensori-motor and daily living skills of preschool children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 231–241.

    Article  PubMed  Google Scholar 

  • Joosten, A. V., & Bundy, A. C. (2010). Sensory processing and stereotypical and repetitive behaviour in children with autism and intellectual disability. Australian Occupational Therapy Journal, 57(6), 366–372. https://doi.org/10.1111/j.1440-1630.2009.00835.x

  • Kanner, L. (1943). Autistic disturbances of affective contact. Acta Paedopsychiatrica, 35(4), 100–136.

    Google Scholar 

  • Lang, R., O’Reilly, M., Healy, O., Rispoli, M., Lydon, H., Streusand, W., … Giesbers, S. (2012). Sensory integration therapy for autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 6(3), 1004–1018. https://doi.org/10.1016/j.rasd.2012.01.006

  • Leekam, S. R., Nieto, C., Libby, S. J., Wing, L., & Gould, J. (2007). Describing the sensory abnormalities of children and adults with autism. Journal of Autism and Developmental Disorders, 37(5), 894–910. https://doi.org/10.1007/s10803-006-0218-7

  • Lofthouse, N., Hendren, R., Hurt, E., Arnold, L. E., & Butter, E. (2012). A review of complementary and alternative treatments for autism spectrum disorders. Autism Research and Treatment, 2012, 1–21. https://doi.org/10.1155/2012/870391

  • Mason, S. A., & Iwata, B. A. (1990). Artifactual effects of sensory-integrative therapy on self-injurious behavior. Journal of Applied Behavior Analysis, 23, 361–370.

    Article  PubMed  PubMed Central  Google Scholar 

  • Masse, J. J., McNeil, C. B., Wagner, S. M., & Chorney, D. B. (2007). Parent-child interaction therapy and high functioning autism: A conceptual overview. Journal of Early and Intensive Behavior Intervention, 4(4), 714.

    Article  Google Scholar 

  • Matson, J. L., & Smith, K. R. M. (2008). Current status of intensive behavioral interventions for young children with autism and PDD-NOS. Research in Autism Spectrum Disorders, 2(1), 60–74. https://doi.org/10.1016/j.rasd.2007.03.003

  • Matson, J. L., Tureck, K., Turygin, N., Beighley, J., & Rieske, R. (2012). Trends and topics in early intensive behavioral interventions for toddlers with autism. Research in Autism Spectrum Disorders, 6, 1412–1417. https://doi.org/10.1016/j.rasd.2012.02.010

  • Metz, B., Mulick, J. A., & Butter, E. M. (2005). Autism: A late-20th-century fad magnet. In J. W. Jacobson, R. M. Foxx, & J. A. Mulick (Eds.), Controversial therapies for developmental disabilities: Fad, fashion and science in professional practice (pp. 237–263). Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Miller, V. A., Schreck, K. A., Mulick, J. A., & Butter, E. (2012). Factors related to parents’ choices of treatments for their children with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(1), 87–95.

    Article  Google Scholar 

  • National Board for Certification in Occupational Therapy. (2004). A practice analysis for entry-level occupational therapists registered and certified occupational therapy assistant practice. Occupational Therapy Journal of Research, 24(Suppl. 1), 1–31.

    Google Scholar 

  • Pajareya, K., & Nopmaneejumruslers, K. (2011). A pilot randomized controlled trial of DIR/Floortime parent training intervention for pre-school children with autistic spectrum disorders. Autism, 15(5), 563–577. https://doi.org/10.1177/1362361310386502

  • Parham, L. D., & Mailloux, Z. (2010). Sensory integration. In J. Case-Smith, A. S. Allen, & P. N. Pratt (Eds.), Occupational therapy for children. (5th ed., pp. 356–411). St. Louis, MO: Elsevier.

    Google Scholar 

  • Parham, L. D., Cohn, E. S., Spitzer, S., Koomar, J. A., Miller, L. J., Burke, J. P., … Roley, S. S. (2007). Fidelity in sensory integration intervention research. The American Journal of Occupational Therapy, 61(2), 216.

    Article  PubMed  Google Scholar 

  • Parham, L.D., Roley, S.S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J.P., … Schaaf, R.C. (2011). Development of a fidelity measure for research on the effectiveness of the Ayres Sensory Integration(R) Intervention. American Journal of Occupational Therapy, 65(2), 133–142. https://doi.org/10.5014/ajot.2011.000745

  • Paterson, H., & Peck, K. (2011). Sensory processing ability and eating behaviour in children with autism. Journal of Human Nutrition and Dietetics, 24(3), 301–301. https://doi.org/10.1111/j.1365-277X.2011.01175_31.x

  • Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 60–69. https://doi.org/10.1016/j.rasd.2010.03.011

  • Polatajko, H. J., & Cantin, N. (2010). Exploring the effectiveness of occupational therapy interventions, other than the sensory integration approach, with children and adolescents experiencing difficulty processing and integrating sensory information. American Journal of Occupational Therapy, 64(3), 415–429. https://doi.org/10.5014/ajot.2010.09072

  • Reichow, B. (2011). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(4), 512–520. https://doi.org/10.1007/s10803-011-1218-9

  • Rogers, S. J., & Ozonoff, S. (2005). Annotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidence. Journal of Child Psychology and Psychiatry, 46(12), 1255–1268. https://doi.org/10.1111/j.1469-7610.2005.01431.x

  • Rogers, S. J., Hepburn, S., & Wehner, E. (2003). Parent reports of sensory symptoms in toddlers with autism and those with other developmental disorders. Journal of Autism and Developmental Disorders, 33(6), 631–642. https://doi.org/10.1023/B:JADD.0000006000.38991.a7

  • Schaaf, R. C., Toth-Cohen, S., Johnson, S. L., Outten, G., & Benevides, T. W. (2011). The everyday routines of families of children with autism: Examining the impact of sensory processing difficulties on the family. Autism, 15, 373–389. 1362361310386505. https://doi.org/10.1177/1362361310386505

  • Schopler, E., Reichler, R. J., & Renner, B. R. (1986). The childhood autism rating scale (CARS): For diagnostic screening and classification of autism. New York, NY: Irvington.

    Google Scholar 

  • Solomon, R., Necheles, J., Ferch, C., & Bruckman, D. (2007). Pilot study of a parent training program for young children with autism: The PLAY project home consultation program. Autism, 11(3), 205–224. https://doi.org/10.1177/1362361307076842

  • Spitzer, S., Roley, S. S., Clark, F., & Parham, D. (1996). Sensory integration: Current trends in the United States. Scandinavian Journal of Occupational Therapy, 3, 123–138.

    Article  Google Scholar 

  • Tarbox, J., Dixon, D. R., Sturmey, P., & Matson, J. L. (Eds.). (2014). Handbook of early intervention for autism spectrum disorders. New York, NY: Springer New York.

    Google Scholar 

  • Wagner, A. L., Wallace, K., & Rogers, S. (2014). Developmental approaches to treatment of young children with autism spectrum disorder. In J. Tarbox, D. Dixon, P. Sturmey, & J. L. Matson (Eds.), Handbook of early intervention for autism spectrum disorders. New York, NY: Springer.

    Google Scholar 

  • Wan Yunus, F., Liu, K. P. Y., Bissett, M., & Penkala, S. (2015). Sensory-based intervention for children with behavioral problems: A systematic review. Journal of Autism and Developmental Disorders, 45(11), 3565–3579. https://doi.org/10.1007/s10803-015-2503-9

  • Watling, R., & Hauer, S. (2015). Effectiveness of Ayres sensory integration and sensory-based interventions for people with autism spectrum disorder: A systematic review. American Journal of Occupational Therapy, 69(5), 6905180030p1. https://doi.org/10.5014/ajot.2015.018051

  • Watling, R., Deitz, J., Kanny, E. M., & McLaughlin, J. F. (1999). Current practice of occupational therapy for children with autism. American Journal of Occupational Therapy, 53(5), 498–505. https://doi.org/10.5014/ajot.53.5.498

  • Wetherby, A. M., Watt, N., Morgan, L., & Shumway, S. (2007). Social communication profiles of children with autism spectrum disorders late in the second year of life. Journal of Autism and Developmental Disorders, 37(5), 960–975.

    Article  PubMed  Google Scholar 

  • Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floortime/interactive play. Autism, 7(4), 425–435.

    Article  PubMed  Google Scholar 

  • Wilbarger, P., & Wilbarger, J. (1991). Sensory-defensiveness in children ages 2–12. An intervention guide for parents and other caretakers. Denver, CO: Avant Educational Programs.

    Google Scholar 

  • Wilbarger, J., & Wilbarger, P. (2002). Alternative and complementary programs for intervention. In A. C. Bundy, S. J. Lane, & E. A. Murray (Eds.), Sensory integration: Theory and practice (pp. 333–370). Philadelphia, PA: F A Davis.

    Google Scholar 

  • Wong, C., Odom, S.L., Hume, K.A., Cox, A.W., Fettig, A., Kucharczyk, S., … Schultz, T.R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. https://doi.org/10.1007/s10803-014-2351-z

  • Worley, J. A., Fodstad, J. C., & Neal, D. (2014). Controversial treatments for autism spectrum disorders. In J. Tarbox, D. R. Dixon, P. Sturmey, & J. L. Matson (Eds.), Handbook of early intervention for autism spectrum disorders (pp. 487–509). New York, NY: Springer.

    Chapter  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jasper A. Estabillo .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Estabillo, J.A., Matson, J.L. (2017). Sensory Integration Therapy and DIR/Floortime. In: Matson, J. (eds) Handbook of Treatments for Autism Spectrum Disorder . Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-319-61738-1_19

Download citation

Publish with us

Policies and ethics