Managing sensory challenges in daily routines for young children with autism: A single case experimental design

Abstract

Theorists and researchers have long recognised troublesome reactions to seemingly innocuous sensory features of everyday activities in individuals with autism. Sensory challenges interfere with daily routines that are the fabric of family life. The aim of this thesis was to explore the effectiveness of sensory-based interventions (SBIs) to manage problematic behaviours in the context of daily routines. I set the context through an appraisal of relevant research evidence. I then present three journal articles that address: (a) research design, (b) the development of an individualised visual analogue scale (VAS) as a repeated-measurement tool and (c) the results of a single case design (SCD) intervention study. I conclude with a chapter recommending considerations for future research. In the first paper, I present an overview of difficulties that are not easily overcome in intervention research with young children with autism. I explore the benefits and limitations of SCD research and propose design features for overcoming these limitations. In the second manuscript, I explore a novel application of a VAS for measuring effectiveness. Twelve mothers rated their own stress and their children’s behaviour, providing preliminary evidence that mothers can rate children’s behaviour distinct from their own stress levels. Further, I propose that VAS, applied at short intervals, provide a different perspective to single-point-in-time assessments. In the third article, I report on the findings of an ABA SCD evaluating the effects of a coaching-based SBI. Mothers selected a problematic behaviour linked with sensory challenges as the focus of four intervention sessions. They rated their children’s behaviour daily on a VAS. Visual and descriptive analyses revealed that the approach showed promise for changing the children’s behaviors; however, changes were variable and the degree and maintenance of the intervention effect varied. I conclude that, while the coaching-based, SBIs show promise for addressing problematic behaviours of young children with autism in the context of daily routines, the results are somewhat equivocal. Further, SCDs are a viable research tool with this population, but they must be carefully designed to avoid common pitfalls.