A Comparative Trial of Occupational Therapy Using Ayres Sensory Integration and Applied Behavior Analysis Interventions for Autistic Children

Many autistic children demonstrate sensory integration differences that impact their participation in daily living activities and tasks. Occupational Therapy using Ayres Sensory Integration (OT-ASI) is an evidence-based intervention for autistic children that addresses the sensory integrative factors impacting daily living skills and participation in a variety of tasks and activities. Applied Behavior Analysis (ABA) is the recommended evidence-based practice for autism to improve a range of developmental domains. This study compared Occupational Therapy using Ayres Sensory Integration, Applied Behavior Analysis, and no treatment on daily living skills and individualized goals for autistic children who also show sensory differences. A parallel arm comparative effectiveness trial design with participants randomized equally to OT-ASI, ABA, or no treatment. Intervention consisted of 30 one-hour sessions. Significant gains in individualized goals, measured by Goal Attainment Scaling, were found in both treatment arms over the no treatment group. Both the OT-ASI and the ABA groups improved in daily living skills measured on the Pediatric Evaluation of Disabilities Inventory; although the improvements over the no treatment group were not significant. Both OT-ASI and ABA improved individualized goals and daily living skills at comparable levels. These findings are discussed in light of their implications for intervention. Trial Registration: NCT02536365.