differentiated effects of sensory activities as abolishing...

Differentiated Effects of Sensory Activities as AbolishingOperations via Non-contingent Reinforcement on Academic

and Aberrant Behavior

G. Richmond MancilLouisiana Tech University

Todd HaydonUniversity of Cincinnati

Marty BomanWestern Kentucky University

Abstract: The purpose of the study was to evaluate the effectiveness of sensory activities used as antecedentinterventions on the percentage correct on academic tasks and rate of aberrant behavior in three elementary agedchildren with Autism Spectrum Disorders (ASD). Study activities were conducted in an after school program forchildren with ASD where program personnel acted as change agents regarding strategy implementation. Analternating treatment design was used with each participant to evaluate the differentiated effects of three activities.Results varied across participants regarding the sensory related activity that had the greatest effects on producingcorrect academic responses and reduction in aberrant behavior. In addition, sensory activities had greater effects thancontrol sessions across all participants. A discussion of limitations and future research directions is included.

Autism spectrum disorder (ASD) is a complexdevelopmental disability affecting the lives ofover 1.5 million Americans. According to theCenters for Disease Control and Prevention(2014), 1 in 68 children born today will even-tually be diagnosed with ASD. In sum, theincidence and prevalence rates of ASD appearto be growing at high rates. Described first byLeo Kanner in 1943 through the case historiesof 11 children, these individuals differed sig-nificantly from other children; therefore, herecommended that a separate diagnosis wasnecessary to describe their unique character-istics. Since Kanner’s first description of au-tism, the disorder has evolved into a spectrumdisorder (i.e., ASD) with the percentage ofdiagnosed individuals increasing each year(Autism Society of America, 2007).

The essential features of ASD include signif-icant impairments in social interaction, com-munication skills and a highly restricted areaof activities and interests (American Psychiat-

ric Association, 1994). The latter category maybe more specifically analyzed in terms of re-stricted, repetitive, and stereotyped patternsof behavior, interests, and activities. Childrenwith ASD often demonstrate a preoccupationwith idiosyncratic interests to a level consid-ered abnormal in intensity and focus (Ameri-can Psychiatric Association, 1994). For example,a child may know about the makes and modelsof trains and sustain conversations related to thistopic for hours, but remain unable to engage inconversations about other topics. Further, manychildren with ASD have stereotyped and repeti-tive motor mannerisms (e.g., hand flapping).For example, a child may engage in repeatedhand flapping, for no apparent functional pur-pose such as attention or escape. Several re-searchers have hypothesized that the function ofthese stereotyped behaviors are due to difficul-ties in processing sensory information and mayresult in other aberrant behaviors which chil-dren engage in to regulate environmental stim-ulation (Baranek, Foster, & Berkson, 1997;Paluszny, 1979). Significant unusual reactions tovarious types of sensory experiences in individ-uals with ASD have been discussed in the liter-ature for decades (Baranek, Wakefield, & David,2008) and hypothesized to the result of differ-

Correspondence concerning this article shouldbe addressed to G. Richmond Mancil, LouisianaTech University, 1910 West California Avenue, Rus-ton, LA 71270. E-mail: [email protected]

Education and Training in Autism and Developmental Disabilities, 2016, 51(1), 93–104© Division on Autism and Developmental Disabilities

Sensory Activities as Abolishing Operations / 93

ences in the brain structure and central nervoussystem of individuals with ASD. Researcherswithin the behavior analytic field have pur-ported that behaviors related to these areas areautomatically reinforced (Hanley, Iwata, & Mc-Cord, 2003; Iwata et al., 1994). When determin-ing the function of these behaviors, social medi-ation (e.g., access to tangible, attention, escapefrom task demand) are ruled out (Querim,Iwata, Roscoe, Schlichenmeyer, Ortega, &Hurl, 2013). When this occurs, the functionof the behavior is considered to be automat-ically reinforced either through automaticpositive reinforcement (i.e., seeking sensoryinput) or automatic negative reinforcement(i.e., escaping sensory input).

Individuals with ASD demonstrate socialparticipation challenges that involves func-tions that are associated with an atypical cen-tral nervous system (Bauman, & Kemper,2003; Courchesne, Carper, & Akshoomoff,2003). Increasingly, the literature describesthe way in which the brain differentiates sen-sory integration and praxis dysfunction(Crane, Goddard, & Pring, 2009; Dawson &Lewy, 1989; Dawson & Watling, 2000; Smith &Bryson, 1994). Rogers & Ozonoff (1994) re-port significant incidences of sensory sensitivi-ties and sensory perception deficits in a sampleof individuals with autism, suggesting neurolog-ical abnormalities in higher cortical sensory per-ception. Using a meta-analysis of sensory modu-lation symptoms, Ben-Sasson et al. (2009)reported that 14 different studies have shownsensory differences between individuals withASD and typically developing individualswith the greatest difference in under-re-sponsivity, followed by over-responsivity andthen sensation seeking. Researchers and cli-nicians have observed changes in personswho seem to react strongly to everyday sen-sory input, particularly individuals on theautism spectrum who generally have morefrequent and intense reactions to externalsensory stimuli. Some researchers and clini-cians have hypothesized that a person withASD typically has trouble processing infor-mation from the outside world because sen-sory problems make it difficult to under-stand what is being seen, heard, andtouched. Although the severe reactions tovarious external sensory stimuli have beendiscussed in the literature for decades

(Baranek, Wakefield, & David, 2008), a sys-tematic process for identifying the precisesensory problems have not been identifiedand only a few cases of empirical evidence ofeffective interventions have been (Van Rie &Heflin, 2009).

One study evaluated antecedent exercise ef-fect on behavior maintained by automatic re-inforcement (Morrison, Roscoe, & Atwell,2011). In the study problem behavior de-creased during post intervention for three ofthe four participants; however, the effectscould not be attributed to only exercise forone participant. In another study, Saylor andcolleagues found that noncontingent auditorystimulation reduced vocal stereotypy in twochildren with autism (Saylor, Sidener, Reeve,Fetherston, & Progar, 2012). Further, onlyone study has examined the effects of sensoryinterventions on academic performance (VanRie & Heflin, 2009). Van Rie and Heflin em-ployed an alternating treatment design toaccess the effects of linear swinging, bounc-ing on a ball, and listening to a story oncorrect responding on academic tasks. Theparticipants in their study engaged in theactivities prior to performing their respec-tive academic tasks. The results for the par-ticipants were mixed. For example, one par-ticipant’s results were undifferentiated,while others responded better to differentsensory interventions. In addition to themixed results, Van Rie and Heflin notedlimitations such as time constraints (breakin schedule such as holidays) and changingresponses during the intervention. Thus,the purpose of the current study is to extendthe research on sensory interventions withindividuals with ASD by adding another ac-tivity and addressing the noted limitations.In addition, this study is designed to addressthe sensory issues from a behavior analyticperspective. Specifically, analyzing the ac-cess to sensory seeking activities via non-contingent reinforcement procedures to de-termine if they create an abative effect onoff task and aberrant behavior. The currentstudy is designed to determine the effects ofspecific sensory related interventions, suchas linear swinging, and the effect on aber-rant behavior and correct response percent-ages during academic related tasks.

94 / Education and Training in Autism and Developmental Disabilities-March 2016

Method

Participants

Selection criteria for participants were basedon academic difficulties and sensory chal-lenges. Information on participants were col-lected by direct observations during instruc-tion/academic work time. Academic samplesand information on sensory challenges werecollected by indirect interviews from parentsand school staff.

Three male participants ranging in agefrom 8-10 years were recruited from an after-school autism program in central Kentuckythat provided services for children and theirfamilies. These students were selected becauseof their difficulty completing academic tasksduring instructional periods. They often didnot complete and/or did poorly on assign-ments. Two of the students were in self-con-tained classrooms and one student was in a gen-eral education elementary classroom.

Each child had a diagnosis of Autism ob-tained independently from a physician or li-censed psychologist. In addition, the SocialCommunication Questionnaire (SCQ; Rutter,Bailey, & Lord, 2003) and the Autism Diag-nostic Interview-Revised (ADI-R; LeCouteur,Lord, & Rutter, 2003) was administered toobtain additional scores indicating a diagnosisof ASD. A doctorate level teacher educatorand autism specialist trained to conduct theassessments for research purposes adminis-

tered both instruments to all participants inthe study (see Table 1).

Cadmar. Cadmar was a Caucasian malewith a chronological age of 8.5 years. Diag-nosed at the age of four, he received servicesfrom a psychologist (dosage not available),speech therapist (30 minutes a week) and oc-cupational therapist (1 hour a week). Cadmarread at an 8.0 grade level, but struggled withhis math skills. He often talked during instruc-tional periods and individual work time. Par-ents, teachers, and the occupational therapistreported that he had several sensory integra-tion and modulation issues, particularly atschool when required to remain in his seat(e.g., bouncing up and down, falling out of hisseat). This also was observed in the afterschoolautism program. He obsessed about specialinterests such as dinosaurs and cartoon char-acters to the extent that he had exhibitedtheir characteristics, such as (e.g., walkingaround the room in a ‘dinosaur’ motion and‘growling’ like a dinosaur).

Chuck. Chuck was a Caucasian male with achronological age of 10.6 years. He was diag-nosed with ASD at the age of two, and hadbeen in therapy with a neurologist (no longerreceiving), psychologist (dosage not avail-able), speech pathologist (30 minutes a week)and occupational therapist (1 hour a week)within the past year. His verbal language waslimited, but he was able to pronounce a sev-eral words to access tangible items such as toys

TABLE 1

Participants’ Information

Student Diagnosis Chronological AgeAutism DiagnosticInventory-Revised

Social CommunicationQuestionnaire

Cadmar AutisticDisorder

8.5 ReciprocalCommunication: 22

22

Communication: 12Repetitive Behavior: 7

Chuck AutisticDisorder

10.6 ReciprocalCommunication: 16

17


Hernando AutisticDisorder

9 ReciprocalCommunication: 14

25



or edibles. He was friendly (e.g., hugging ev-eryone, trying to sit in the laps of others), butexhibited challenging behaviors (e.g., spit-ting) for access to preferred items or to escapetask demands. He also had been diagnosedwith seizures, which were controlled by medi-cation (the exact medication name was notrevealed in school records or from parents).His main sensory issues, according to the par-ents, occupational therapist, and observed inthe afterschool autism program, was spinningin circles around the room.

Hernando. Hernando was a Caucasianmale with a chronological age of 9.0 years. Hewas diagnosed with ASD at the age of threewhen he did not begin to speak. He had ther-apy with a speech pathologist (1 hour a week),occupational therapist (1 hour a week). Hewas quite verbal, but struggled with pragmat-ics and social situations (e.g., turn taking dur-ing board games, initiating conversations).His younger sister also had been diagnosedwith ASD, and was non-verbal except for a fewutterances. Hernando was very protective ofhis sister, which resulted in challenging behav-iors at times (e.g., hitting other students whenperceived to ‘pick’ on his sister). He also en-joyed a number of sporting activities such assoccer and Tae Kwon Do as well as quiet ac-tivities including music and movement (e.g.,dance to slow music). According to parentsand occupational therapists, his main sen-sory issues included spinning around, hop-ping up and down while running back andforth in the rooms.

All aberrant behaviors listed were con-firmed during direct observations by two in-dependent observers. The observations werecompared and reliability of duration and fre-quency of aberrant behavior between observ-ers was 98%.

Settings

Sessions were conducted at a local autism pro-gram at the same time and place every otherday (twice a week: Tuesday and Thursday) for15 total sessions. The sensory modulation in-terventions targeted in this study were imple-mented in a separate room in an attempt toprevent as little disruption to other students aspossible. This classroom was adjacent to thehome classroom that the corresponding stu-

dents attended. The adjacent classroom wasused by the participants for other group activ-ities throughout the day; thus, decreasing thepotential effects of novel environments on be-haviors. The academic tasks were completedin the classroom of each respective student(no two students were in the same room forthe academic tasks).

Target Behaviors

The target behaviors for the three participantswere identified during observations, parentinterviews, and analysis of academic perma-nent products (e.g., math sheets, other datasheets). These included: reading passages forCadmar, shape and color identification forChuck, and math equations for Hernando.These activities were of equal high interest forthe respective participants, but required fur-ther practice for retention. Further, the aca-demic tasks for participants were at the sameresponse effort level across all sessions for re-spective participants. For example, each read-ing passage was of similar vocabulary and thesame grade level across tasks for Cadmar,while math problems were of similar difficultyacross tasks for Hernando.

The target aberrant behaviors differed intopography across participants. Cadmar’s ab-errant behavior consisted of walking back andforth in rooms while growling and making‘dinasour’ sounds. Chucks aberrant behaviorinvolved spinning in circles around the room.Hernando’s aberrant behavior entailed spin-ning around, hopping up and down whilerunning back and forth in the rooms.

Materials

The materials required for the sensory inter-ventions included a sit and spin, linear swing,and a Hippity hop© ball (i.e., exercise ballwith a handle on top).

Independent Variable

The independent variable for this researchwas the sensory intervention/activity or con-trol activity (i.e., no intervention), which wasimplemented for five minutes. The three sen-sory interventions included slow linear swing-ing, fast bouncing on the Hippity hop© ball,


and slow spinning on the sit and spin. Consis-tent with the Van Rie and Heflin study (2009),slow linear swinging was conducted with asling-seat swing attached to the ceiling. Theactivities chosen were based on ones that maygive the same input as the aberrant behaviorsfor the participants (e.g., spinning in circles-sit and spin, etc.) The research assistantpushed each participant in slow linear pat-terns for five minutes. For the bouncing ball,participants sat on a 65-centimeter Hippityhop© ball and held the hand on the ball whilethey bounced up and down for five minutes.Students sat on the sit and spin and used thecircular handle in the middle to slowly spinaround for five minutes both counterclock-wise and clockwise (time for direction was notcontrolled). Consistent with the Van Rie andHeflin study, a control activity was used tocontrast with the sensory interventions. Simi-lar to their study, the participants in this studychose a story-book and listened to a reading bythe research assistant (attempting to rule outeffects of attention). The control activity wasconducted in the same area as the swingingand bouncing activities.

Dependent Variable

The dependent variable was the percentage ofcorrect responses on academic tasks (imple-mented immediately following the sensory in-tervention or control activity). As previouslyoutlined under target behaviors, each partici-pant completed his/her respective academictasks. These academic tasks were selectedbased on participants’ skill development andwhat each were focusing on in the after schoolprogram (determined from review of educa-tional records, parent interviews, and perma-nent work products).

Additional variables analyzed included off-task behavior and aberrant behavior. Off taskbehavior was recorded if the participant was notactively working on the assigned academic taskfor a period greater than 3 seconds. Each aber-rant behavior for the respective participants arediscussed in the target behavior section.

Data Collection Procedures

After the collection of baseline data, each par-ticipant was asked to implement the interven-

tion for a five-minute interval session. This wasfollowed by the completion of academic tasksincluding: a book with comprehension ques-tions, activities with shapes and colors, andmath equations.

Reliability checks were conducted by thegraduate assistant who was trained to observeand record the occurrences of the target be-haviors. Total calculations were completed foreach agreement/disagreement for each ses-sion between the two observers. Finally, theseoccurrences were divided by the number ofagreements plus disagreements multiplied by100 (Kennedy, 2005). The mean IOA acrossall study phases was 95%, 93%, and 94% forCadmar, Chuck, and Hernando, respectively.

Fidelity for the sessions was recorded by theresearcher, who remained consistent for eachsensory intervention. The mean treatment fi-delity was 100% for Cadmar and Hernandofor all three interventions, while Chuck scoreswere lower at 100% for only two of the inter-ventions (‘sit and spin’ and bouncing ball).During the data collection, he exhibited nochange (0%) for the linear swing interven-tion, he often jumped from the swing andattempted to push the linear swing. Althoughhe was redirected to sit in the swing, he wouldnot remain in the swing for an entire 5 min-utes and would engage in challenging behav-iors (e.g., spitting, hitting) when redirected tosit in the swing. Thus, the authors determinedthat forcing him to sit in the swing was notethically or clinically appropriate. Despite hismodifications to one of the interventions,Chuck continued with the academic tasks cor-rectly as outlined in the protocol as reflectedby his scores in Figure 3. When Chuck was notprovided with any sensory stimulation, he re-fused to perform any of the academic tasks,which are recorded on the graph.

Experimental Design

Prior to conducting the noncontingent rein-forcement protocol, a functional analysis wasconducted on each individual to determinethe validity that the hypothesized automaticreinforcement function was accurate. Theconditions included in the functional analysiswere: contingent attention, contingent es-cape, contingent tangible, control (free play),and alone conditions.


Following the identification, an alternatingtreatment design was implemented to show afunctional relationship to the identified inter-vention compared to the three other interven-tions (Kennedy, 2005). During the first threesessions, baseline data were collected followedby nine sessions where sensory stimulations wasprovided and two sessions during which no sen-sory stimulation was provided according to theresearch protocol. These final sessions of alter-nating treatment and withdrawal of stimulus oc-curred randomly so that the participants wereunaware regarding which intervention was go-ing to be implemented each day. All sessionswere videotaped and then coded independentlyby a research assistant and subsequently codedby the first author to check for interobserveragreement (IOA) for 35% or greater of all ses-sions across all study phases.

Data Analysis

This study focused on direct observations ofindividuals with ASD interacting with varioussensory stimuli, and included an alternatingtreatment design (ATD) with three participants.Baseline data was collected on the participantsusing behavioral coding of the child’s observedcommunication, social interaction, challengingbehaviors, and academic behaviors during inter-actions with staff for three sessions. These datawere collected during 10 minutes of observation

per day, two times per week. For this paper onlythe academic behaviors are discussed. The staffimplemented the various interventions, whilegraduate assistants collected data during thespecified time sequences. During the review ofthe videotaped session, behaviors were codedusing real time collection sheets. The data anal-ysis was completed using Microsoft Excel. Fur-ther, permanent products of academic workwere collected and checked for accuracy. Datalines were graphed for each intervention, andpresented in time-series graphs for each partic-ipant. Data analysis was based on visual inspec-tion of the trend of data lines, and magnitudeand rate of behavior change between condi-tions (Kennedy, 2005). Summative data wasreported on the fidelity of treatment data.

Results

In this study the research evaluated the effec-tiveness of three sensory activities as anteced-ent interventions on the percentage correcton aberrant behavior, off task behavior, andacademic tasks with three elementary age chil-dren diagnosed with ASD.

Prior to implementing the intervention, afunctional analysis was conducted on each par-ticipant. Results of the functional analysis foreach participant were undifferentiated, whichindicates the aberrant behaviors were likely

Figure 1. Cadmar’s Functional Analysis.


maintained by automatic reinforcement (Smith,Vollmer, & Pipkin, 2007), (see Figures 1, 2, 3).

For the intervention, researchers imple-mented an alternating treatment design toevaluate the differentiated effects of the sen-sory interventions. Although results variedacross participants regarding particular sensoryactivities that had the greatest effects on theacademic correct responses, all participantsdemonstrated a marked increase in their aca-demic performance as compared to the baselinedata after the introduction of the three stimuli(Figures 4, 5, 6). The degree of their perfor-mance varied among the participants as well astheir preference for one stimulus as comparedto another. Further, aberrant behavior for each

participant decreased during intervention withthe highest decrease corresponding to the samecondition as the highest increase in correctresponding (Figures 7, 8, 9).

Cadmer. Cadmer completed three ses-sions for his academic completion baselineuntil it was determined that the data werestabilized at 40% (Figure 1). This process wasfollowed by three sessions for each of thethree sensory interventions randomly admin-istered. Although all three sensory interven-tions showed an increase in performance, thelinear swing was most effective for Cadmer’sacademic completion with 100% accurate re-sponses during all three trials of this sensorystimulus. This was followed by an increase with

Figure 2. Chuck’s Functional Analysis.

Figure 3. Hernando’s Functional Analysis.


the sit and spin of 86.7% for these sessions.The Hippity hop© ball intervention demon-strated the least increase of 66.7% (Figure 4)as compared to the baseline although this was amarked increase from the baseline. Duringthese sessions there were no overlapping datapoints with the baseline data. Further, the mosteffective intervention as indicated by the datadid not overlap with any other intervention orthe control. In conclusion, both the linear swingand the sit and spin resulted in academic scoresat 80% or higher, which many educators con-sider acceptable performance.

Chuck. Chuck completed three sessions forhis baseline with an average of 10% on his aca-

demic completion. The sit and spin interventionsessions were most effective with 100% comple-tion of correct academic responses. Chuck hadto be prompted often during the sensory inter-ventions to continue to engage with the task asthe protocol required. For example, he chose towalk around the sit and spin with his handsgrasping the center turning device rather thansitting on the device with his legs crossed. De-spite this modification, he demonstrated an in-crease in his performance as recorded on Figure2, which would be classified as “highly effective”(Scruggs & Mastropieri, 1998). During the Hip-pity hop© ball interventions, Chuck increased to46.7% from his baseline sessions, and again clas-

Figure 4. Cadmar’s Percentage of Correct Responses.

Figure 5. Chuck’s Percentage of Correct Responses.


sified as “highly effective”. Chuck’s performanceafter the linear swing intervention remained at16.7% and was considered consistent with thebaseline data. This intervention did not showany deviation from the baseline recordings asrecorded on Figure 5, and was not effective.Further, the most effective intervention as indi-cated by the data did not overlap with any otherintervention or the control. In conclusion,only the sit and spin resulted in acceptableperformance levels, all other sensory interven-tions resulted in ‘failing’ grades.

Hernando. Hernando’s baseline was estab-lished at 26.7% correct responding after threetrials as displayed in Figure 3. His results from

the implementation of the three sensory inter-ventions demonstrated the most consistencyamong the data collected across all sensoryactivities: sit and spin at 90%, linear swing at80% and Hippity hop© ball at 73.3% (Figure6). All interventions were in the highly effec-tive range, and indicated that all of the sen-sory interventions did impact the academicperformance. However, only the sit and spinand linear swing resulted in performances con-sidered acceptable for mastery (i.e., 80% orabove). Further, the sit and spin was more effec-tive, stable, and ended in an upward trend ascompared to the other interventions, but didhave one overlapping data point with each of

Figure 6. Hernando’s Percentage of Correct Responses.

Figure 7. Cadmar’s Aberrant Behavior.


the other sensory interventions and magnitudein change between the sit and spin and theother two sensory interventions was small.

Discussion

Sensory activities were implemented regularlyat the center where this research was con-ducted. The purpose of this study was to eval-uate the effect of three activities (linear swing-ing, bouncing on a therapy ball and rotatingon a ‘sit and spin’) on academic performance

(reading comprehension, color and shapeidentification, solving math equations) andaberrant behavior. Results were somewhat var-ied as to which sensory stimulation impactedthe academic outcomes for the participants.Cadmar had greatest gains in academic per-formance (100%) when the linear swing wasimplemented, followed by the sit and spin(86.7%) and the Hippity hop© ball (66.7%).Chuck increased his academic performanceon the sit and spin (100%) followed by theHippity hop© ball (44%). No change was ob-

Figure 8. Chuck’s Aberrant Behavior.

Figure 9. Hernando’s Aberrant Behavior.


served with the linear swing as he chose toreject the protocol of sitting on the swing anddecided to push it linearly, therefore resultingin no change in academic performance. Itshould be noted that Chuck did not followprotocol with the Hippity hop© ball as hechose to run around the ball while he heldonto the handle rather than sitting on the balland bouncing. Hernando had greatest gainsin academic performance on the sit and spin(100%), followed by the linear swing (80%)and the Hippity hop© ball (70%).

The present study adds to the current re-search regarding the use of sensory stimulatingactivities by using non-contingent reinforce-ment procedures to determine if they create anabative effect on off task and aberrant behavioron the academic performance for individualsdiagnosed with ASD. Also, the data from thisstudy give some support to the theory that dif-ferent stimulation responses results in a varietyof outcomes for individuals diagnosed withASD. Two of the three participants were viewedby the staff of the center to be more excitablethan other participants at the center. One par-ticipant (Hernando) tended to be hyposensitiveto sensory stimulation except when this stim-ulation was presented in a manner as toimpact his sister’s state of mind.

For targeted interventions, this informationcan be used to explore (a) whether an iden-tified stimulus intervention is likely to succeedin order to increase academic performanceand (b) whether minor modifications can bemade to assist with other academic tasks. Inthis study, the results indicated an increase inacademic performance; therefore, giving sup-port that these sensory stimuli should be im-plemented prior to the introduction of newacademic information so that individualsidentified with ASD can have maximum out-comes.

A few limitations became apparent duringthis study. The autism program was staffed byindividuals highly trained to work with chil-dren on the autism spectrum, which couldeffect overall performance and ease of newinterventions being implemented.

Another limitation was the variety of theseverity of the diagnosed ASD for the threeparticipants (see Table 1). This was a repre-sentation of the heterogeneity of this popula-tion, which could have affected the different

outcomes for each of the interventions. How-ever, this was addressed somewhat by match-ing academic tasks to functioning level of re-spective participants. Also, it should be notedthat some of the participants were comfort-able with the interventions, while one strug-gled to follow the protocol for the variety ofsensory activities.

Another limitation is the sensory interven-tions themselves. Each intervention requiredsome level of physical activity; thus, the effectson academic performance could be attributedto engaging in physical activity before an aca-demic task and not the sensory interventionitself. However, since the data indicated a dif-ference between interventions, this may notbe the case. Nonetheless, future researchshould include activities such as runningaround or some other type of physical activityto rule out these concerns and distinguishbetween the effects of typical physical activitiesand sensory interventions.

The current study focused on a targetedintervention that has demonstrated significantadvantages for three participants. The simplesensory strategies have positive implicationsfor staff and teachers who work with individ-uals identified with autism. These strategiescan be modified according to the individual’sperformance, and can be implemented for alow cost to schools. These results are tentative,but the strategies should be explored in dif-ferent settings where participants are asked tofocus for an extended period of time.

In conclusion, in this study, sensory stim-ulation suggested that academic perfor-mance could be increased dependent on themethod implemented; however, the studywas conducted with only three participantsin one after school program. Further re-search is needed to determine if the resultswill be consistent in different settings suchas schools. Also, a variety of different sen-sory stimulations should be presented ac-cording to the needs of the individuals todetermine the overall impact on academicperformance and other behaviors (i.e., chal-lenging behaviors, social interactions).

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Received: 19 March 2015Initial Acceptance: 28 May 2015Final Acceptance: 10 July 2015


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