Abstract
Date Presented 4/8/2016
This pilot study provides preliminary support for the effectiveness of the Integrated Listening Systems program for children with sensory overresponsivity and auditory processing problems. Gains in individualized functional goals were an important outcome, as were physiological changes in arousal and reactivity.
Primary Author and Speaker: Sarah Schoen
Additional Author and Speaker: Lucy Jane Miller
PURPOSE: The purpose of this pilot study was to examine the effectiveness of the Integrated Listening Systems (iLs) Focus™ Series sensory-motor program on arousal and functional skills in children with sensory processing challenges.
RATIONALE: Because occupational therapists often use auditory programs that involve listening to processed musical selections, evaluation of their effectiveness is warranted. In spite of the evidence supporting the beneficial effects of listening to music, controversy still exists regarding the effects of auditory programs that use processed music. A newly developed auditory program known as iLs, not previously investigated, was the focus of the present study.
DESIGN: This study employed a single-subject, nonconcurrent, multiple-baseline, repeated-measures across-subjects AB design. The 40-session intervention period delivered the iLs program 5 days/wk for 8 wk, 4 times at home and once in the clinic. Performance on individualized family goals, adaptive functioning, problematic behaviors, and physiological arousal was evaluated.
PARTICIPANTS: Seven children ages 5–12 yr with significant sensory processing impairments, reported to be interfering with performance at home or school, participated in this study. Confirmation was provided by an occupational therapist trained in using the Sensory Processing Scale Assessment. Additionally, all had parent report of auditory overresponsivity or auditory processing problems.
MEASURES: The repeated measure was individualized goals converted into a visual analog scale (VAS). Outcomes were also measured by parent report using the Adaptive Behavior Assessment System (ABAS–II) and the Behavior Assessment System for Children (BASC–2) before and after treatment. Physiological arousal and reactivity were evaluated before and after participation using a well-established laboratory paradigm, the Sensory Challenge Protocol (SCP).
ANALYSIS: VAS goals for each participant were examined using graphic analyses. Nonparametric tests were utilized for all statistical analyses. Physiological changes were reported as difference scores from pre- to postadministration of the SCP. Subjective feedback from parents (via interview) on the feasibility and utility of the iLs program was aggregated and summarized.
RESULTS: All participants showed improvement in individualized goals. Changes in physiologic arousal were noted in 5 of 7 participants’ responses to sensory challenges or in the no-stimulation baseline and recovery phases of the SCP. All of the dimensions of the BASC–2 and ABAS–II changed in the predicted direction. Wilcoxon matched pairs signed-rank test showed significant changes in all composite scores of the BASC–2 with large effect sizes (r = .7).
CONCLUSION: The iLs program helped participants achieve individualized functional changes prioritized by their parents. Standardized scales measuring behavioral and emotional dimensions demonstrated sensitivity, suggesting utility in future studies of treatment effectiveness. Physiological changes in arousal and reactivity to sensory challenges were noted after intervention. Overall, parents had a positive reaction to participation in the program and expressed satisfaction with their child’s progress. Further study of this auditory program is warranted.
IMPACT STATEMENT: This study impacts clinical practice by providing knowledge about the iLs home program for children with sensory processing impairments, including auditory overresponsivity or auditory processing problems. Single-subject methodology and VAS were useful for the study of treatment effectiveness.
