Sensor y-based inter ventions for

sleep dist urbances in children

diagnosed with Autism

(www.autisticaspergers.com)

https://www.verywellhealth.com/night-terrors-2632369

ZSUZSA KENEZ, MS, OTR/L

University of St. Augustine for Health Sciences
Capstone II
(http://drsazini.com/benefits/) Spring, 2018/2019
 Introduction

Ø Your presenter: Zsuzsa Kenez, MS, OTR/L, PPOTD

student
Ø Peer Education Capstone Project

Ø Autism and Sensory Processing Disorder

Ø Significance of practice problem

Ø Synthesis of evidence

Ø Practice recommendation

Ø Implementation
 Peer Education P roject

Ø Post-professional doctorate of Occupational Therapy

(PPOTD)
Ø University of Saint Augustine for Health Sciences

Ø Capstone Project

Ø Peer Education

(https://www.usa.edu)
 Peer Education
Lear ning Objectives

Ø Objective#1: Educate

Ø Objective#2: Enable

Ø Objective#3: Engage

Ø Objective#4: Enrich (https://www.scuolainforma.it/2017/11/23/peer)

 What is Autism Spectrum Disorder
(ASD)?

Ø Definition
(DSM-5th
th edition, 2013 as cited by Frazier et al., 2017, p. 95)

Ø Perseveration (https://mimqc.com/)

Ø Decreased participation

Ø Incidence of sleep disturbances

(Krakowiak et al., 2008)

(http://unothegateway.com/)
 Discussion:
Autism Spectrum Disorder (ASD)

Ø Characteristics and significant features of ASD

(https://www.verywellhealth.com/)

(https://www.friend2friendsociety.org/)
(https://raisingchildren.net.au/autism/)
 What is Sensory Processing?

Ø The unique ability to receive, process, integrate all

incoming internal and external sensory information
and form an adequate adaptive response in order to
function optimally within our environment
•
•

(childsuccesscenter.com)
(wikihow.com)
What is Sensory Processing Disorder
(SPD)?

(https://ilslearningcorner.com/2015-12-north-shore-pediatric-therapy-provides-resource-sensory-processing-disorders/)
 Signif icance of practice
problem
Ø Prevalence of autism and sleep
disturbances Connection between
sensory processing disorder and
atypical sleep patterns
Ø Effects of the lack of quality sleep

Ø Rest and Sleep (OTPF, 2015)

Ø Speech and Language Services of the

Treasure Coast, Stuart, FL

(Mazurek & Petroski, 2015

The Occupational Therapy Domain and Process 3 rd edition, AOTA, 2015)
 Ev idence-based research
process

Analysis of
Formulation current Practice
of PICOT scientific recommendat
question evidence ion

Inclusion/ Synthesis of
exclusion empirical
criteria evidence
 The PICOT question
In autistic children who present with sleep
disturbances are sensory-based interventions
more effective to improve overall participation in
meaningful occupations, including sleep, compared
to any conventional interventions after 2 - 20
weeks?
Ø Population

Ø Timing

Ø Intervention

Ø Comparison
(https://hpu.libguides.com/c.php?g=303393&p=2024600)
Ø
 Synthesis of ev idence
Ø Weighted blankets: fair and inconsistent
findings
(Gee, B. M., Peterson, T. G., Buck, A., & Lloyd, K., 2016;
Gringas, P., Green, D., & Wright, B., 2014)

Ø
Ø Massage: promising, but mixed empirical
findings
(Piravej, K., Tangtrongchitr, P., Chandarasiri, P., Paothong, L., & Sukprasong, S., 2009;
Silva, L. M., Schalock, M., Ayres, R., Bunse, C., & Budden, S., 2009;
William, T., 2006)

Ø
Ø Sound-to-Sleep mattress system: statistically
significant findings
(Frazier et al., 2017)

Ø iLS Dreampillow system: statistically

significant findings
Ø
Ø Sensory Integration (manualized protocol):
significant effects sleep
 Alter native inter ventions (Compar ison)

Ø Physical exercise: statistically significant

findings
(Magnusson, Cobham & McLeod 2012)

Ø Pharmaceutical interventions: mixed empirical

evidence
Ø Cognitive-behavioral therapy: statistically
significant findings (Kodiak & Piazza, 2008; Vriend, Corkum, Moon &
Smith, 2011; Vriend, Corkum, Moon, & Smith, 2011 )
Sensor y Integration Therapy and Sensor y-based
inter ventions

Sensory Integration Therapy (SIT)

https://www.youtube.com/watch?
v=Haw5m3Zxvy4
Sensory-based therapy (SBT)
https://www.youtube.com/watch?
v=T9j6rQ4rtQY
Ø
 P ractice Recommendations

Ø Incorporation of massage and Sensory Integration Therapy

Ø Development of strict and detailed protocol
Ø Recommendations and home program based on feasibility
for each individual patient (STS mattress technology or
iLS Dream Pillow)
Ø Continuous check of feedbacks and recommendations
Ø Training and education of occupational therapists
Ø
•

(https://integratedlistening.com)

(http://www.bestpracticepeds.org/2016/01/effectiveness) (http://triwou.org/library/page/180/qigong-massage)-
 Case St ud y

• AJ is a 5-year old boy who was diagnosed with ASD a year ago. His
parents are struggling to establish a consistent bedtime routine. Both
AJ and his parents are stressed out due to the lack of sleep, which has
been an increasing source of problems recently. AJ’s negative
behavioral patterns (aggression, meltdowns, poor self-regulation) at
school and at home has been escalating. His participation in daily
basic and instrumental activities has been gradually decreasing and he
needs more assistance with falling asleep and staying in bed. His
parents requested an OT evaluation and turn to you for advice and any
possible suggestions you might have.
•
 The plan for EBP change

STETLER’S MODEL OF CHANGE

Preparation

Validation

Comparative evaluation/Decision
making
Translation/ application

Evaluation

(National Collaborating Centre for Methods and Tools,

 Conclusion

Clinical expertise

Synthesis of
Evaluation
evidence

EBP
PRACTICE

Client’s Practice
preferences recommendation
 AOTA resources
1. American Occupational Therapy Association. (n.d.). Critically Appraised Topic:
Effects of Ayres Sensory Integration® for Children with Sensory
Processing Challenges. Retrieved from:
https://www.aota.org/Practice/Children-Youth/Evidence-based/CAT-SI-Ayres
.aspx
2. American Occupational Therapy Association. (n.d.). Critically Appraised Topic:
Effect of Education and Coaching Interventions to Support Participation of
Children with Sensory Processing Challenges. Retrieved from:
https://www.aota.org/Practice/Children-Youth/Evidence-based/CAT-SI-Coac
hing-Education.aspx/Evidence-based/CAT-SI-Strategy.aspx
3. American Occupational Therapy Association. (n.d.). Critically Appraised Topic:
Effects of Sensory-Based Strategies to Support Function of Children with
Sensory Processing Challenges. Retrieved from:
https://www.aota.org/Practice/Children-Youth/Evidence-based/CAT-SI-Strat
egy.aspx
4. American Occupational Therapy Association. (n.d.). Critically Appraised Topic:
Effect of Cognitive Interventions to Support Function and Participation for
Children with Sensory Processing Challenges. Retrieved from:
Questions
 References
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 References

Frazier, T. W., Krishna, J., Klingemier, E., Beukemann, M., Nawabit, R., & Ibrahim, S. (2017). A
randomized, crossover trial of a novel sound-to-sleep mattress technology in children with autism
and sleep difficulties. Journal of Clinical Sleep Medicine: JCSM: official publication of the
American Academy of Sleep Medicine, 13(1), 95.
Gee, B. M., Peterson, T. G., Buck, A., & Lloyd, K. (2016). Improving sleep quality using weighted
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Krakowiak, P., GOODLIN‐JONES, B. E. T. H., HERTZ‐PICCIOTTO, I. R. V. A., Croen, LA., & Hansen, R. L.
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autism. Developmental Neurorehabilitation, 19(2), 123-134.
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Piravej, K., Tangtrongchitr, P., Chandarasiri, P., Paothong, L., & Sukprasong, S. (2009).
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 References

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