An Exploratory Study of the Safe & Sound Protocol in Young Children With Autism

The purpose of this study was to explore the impact of the Safe and Sound Protocol, in conjunction with traditional OT, on regulation and skill development in young children with ASD receiving EI. This was a mixed-methods, retrospective exploratory multiple case study with a pretest-posttest design. The participants consisted of a convenience sample (n=5) of 2–3-year-olds with ASD receiving OT services and attending an urban EI center. An adapted COPM, as reported by the participants’ teachers, as well as goals scaled using GAS, were used as outcome measures. Qualitative data was collected via structured session notes by the treating therapist. The Wilcoxon Signed Rank Test was used to determine statistical differences in COPM scores pre/post program. The GAS scores were assessed based on achievement. Detailed session notes were analyzed, and qualitative thematic coding was completed by researchers. There was a significant difference noted between pre-performance (M = 3.56, SD = 1.18) and post-performance scores on the COPM (M= 5.5, SD = 1.43) (z = 3.97, p < .001) and between pre/post satisfaction (M = 2.85, SD = .93) (M = 5.8, SD = 1.24) indicating a statistical significance (z = 3.99, p < .001). All of the participants met, or exceeded, all of their goals. The four major themes that emerged from the analysis of the session notes, over the course of the program, included attention, regulation, engagement, and novelty. This included attention and engagement to others, the environment, and to tasks, supporting the development of novels skills not previously attained. Included in this is the capacity for, and seeking out others, to support regulation. Both qualitative and quantitative findings suggest the use of the SSP in conjunction with traditional OT, with young children with ASD in an EI setting supports the development of functional skills by enhancing nervous system regulation and fostering a sense of felt safety.

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