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Sensorimotor Intervention Group for Children with ADHD and Sensory Processing Difficulties: A Feasibility Study

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Abstract

Many children with Attention-Deficit/Hyperactivity Disorder (ADHD) also have sensory processing difficulties, yet there are few evidence-based interventions that target both. We explored the feasibility of a 4-week group intervention using “How Does Your Engine Run?”®—The Alert Program for Self-Regulation (AP) for children with ADHD and sensory processing difficulties. Sixteen children (aged 8–12 years) and their parents were randomly assigned to an active treatment or a delayed treatment control group. The AP taught families to recognize child arousal states and to use sensorimotor strategies to manage levels of alertness. Parent-reported ratings of child outcomes were completed at pre-treatment, post-treatment, and 3-month follow-up. Treatment acceptability and satisfaction were high. Compared to pre-treatment and control group, large effects were found in which families increased their knowledge and use of sensorimotor strategies, and improved child ADHD symptoms after participating in the AP, and these effects were maintained at 3-month follow-up. Families that reported greater knowledge and use of strategies were those with children that had greater underresponsive/sensory seeking profiles and those with children with greater conduct problems. This study shows preliminary support for the AP for children with ADHD and sensory processing difficulties, to be further examined with larger sample sizes and methodological enhancements.

Highlights

  • We explored the feasibility of the “How Does Your Engine Run?”®—The Alert Program for Self-Regulation.

  • Sixteen children with ADHD and sensory processing difficulties and their parents participated in a 4-week group intervention.

  • Treatment was highly acceptable and satisfactory, with large effects for improved knowledge and use of sensorimotor strategies and ADHD symptoms.

  • Future directions are discussed to improve on limitations such as small sample size and parent-reported outcomes.

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Acknowledgements

We thank the children and parents who participated, Helen Kennett-Bacon (nurse clinician who aided in the group intervention), and the research assistants: Megan MacPherson and Dana Cochrane. This study was made possible with in-kind support from B.C. Mental Health and Substance Use Services (BCMHSUS) and the Data Management team of the Child & Family Research Institute (CFRI).

Author Contributions

J. W. T. M. designed the study, analyzed the data, and wrote the paper. M. D. designed and executed the study.

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Authors and Affiliations

  1. BC Children’s Hospital, 4500 Oak Street, Vancouver, V6H 3N1, BC, Canada

    Janet W. T. Mah & Miranda Doherty

Authors
  1. Janet W. T. Mah
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  2. Miranda Doherty
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Correspondence to Janet W. T. Mah.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of British Columbia—Children’s & Women’s Health Centre of British Columbia Research Ethics Board (CW13-0263/H13-01822) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Appendix

Appendix

Sensory and Motor Strategies Questionnaire

Instructions: Using the scale below, please indicate how much you and your child knows and uses each sensory/motor strategy for self-regulation within the past month. It is understandable to have little or no knowledge/use of the strategies before participating in the Alert Program Group.

1 = 0% = None or Not at all

2 = 25% = A Little bit or 1–2×/wk

3 = 50% = Some or 3–4×/wk

4 = 75% = Good understanding or 5–6×/wk

5 = 100% = Excellent or 7×/wk

1. How much do you know about the Engine Levels Terminology?

2. How much does your child know about the Engine Levels Terminology?

3. How much does your child currently use the Engine Level Terminology?

4. How independent is your child in using the Engine Level Terminology?

5. How much do you know about using Engine Speedometers for showing Engine Levels?

6. How much does your child know about using Engine Speedometers for showing Engine Levels?

7. How much does your child currently use an Engine Speedometer or other version of a speedometer to show Engine Levels during the day?

8. How independent is your child in using an Engine Speedometer or other version of a speedometer to show Engine Levels during the day?

9. How much do you know about using the Tools for the Mouth (eg., Chewing gum) to change Engine Speeds?

10. How much does your child know about using the Tools for the Mouth to change Engine Speeds?

11. How much does your child currently use the Tools for the Mouth to change Engine Speeds?

12. How independent is your child in using the Tools for the Mouth to change Engine Speeds?

13. How much do you know about using the Tools for the Body (eg., Climbing) to change Engine Speeds?

14. How much does your child know about using the Tools for the Body to change Engine Speeds?

15. How much does your child currently use the Tools for the Body to change Engine Speeds?

16. How independent is your child in using the Tools for the Body to change Engine Speeds?

17. How much do you know about using the Tools for the Hands (eg., Squeeze Ball) to change Engine Speeds?

18. How much does your child know about using the Tools for the Hands to change Engine Speeds?

19. How much does your child currently use the Tools for the Hands to change Engine Speeds?

20. How independent is your child in using the Tools for the Hands to change Engine Speeds?

21. How much do you know about using the Tools for the Eyes (eg., Dim the lights) to change Engine Speeds?

22. How much does your child know about using the Tools for the Eyes to change Engine Speeds?

23. How much does your child currently use the Tools for the Eyes to change Engine Speeds?

24. How independent is your child in using the Tools for the Eyes to change Engine Speeds?

25. How much do you know about the Tools for the Ears (eg., Ear plugs) to change Engine Speeds?

26. How much does your child know about the Tools for the Ears to change Engine Speeds?

27. How much does your child currently use the Tools for the Ears to change Engine Speeds?

28. How independent is your child in using the Tools for the Ears to change Engine Speeds?

29. How much do you know about using the Engine Tool Kit to change Engine Speeds?

30. How much does your child know about using the Engine Tool Kit to change Engine Speeds?

31. How much does your child currently use the Engine Tool Kit to choose appropriate Tool(s) to change Engine Speeds in a challenging situation?

32. How independent is your child in using the Engine Tool Kit to choose appropriate Tool(s) to change Engine Speeds in a challenging situation?

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Mah, J.W.T., Doherty, M. Sensorimotor Intervention Group for Children with ADHD and Sensory Processing Difficulties: A Feasibility Study. J Child Fam Stud 30, 447–459 (2021). https://doi.org/10.1007/s10826-021-01900-y

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