Comprehensive Effects of Occupational Therapy Using Ayres Sensory Integration® in Children With ADHD: A Randomized Controlled Trial

Abstract

Importance: Limited information exists on the effects of occupational therapy based on the principles of Ayres Sensory Integration® (OT-ASI) in children with attention deficit hyperactivity disorder (ADHD). Therefore, there is a need for a detailed examination of its effects in areas such as sensorimotor functions, attention, executive functions, emotional regulation, and participation.

Objective: To perform a comprehensive evaluation of the effects of OT-ASI in children with ADHD.

Design: Randomized controlled study, including pretest-posttest and single-blind designs.

Setting: Individual occupational therapy clinic.

Participants: Ninety-four children (ages 6-8 yr) with ADHD (intervention group, n = 47; control group, n = 47).

Intervention: The intervention group received OT-ASI (three sessions per week for 10 wk). The control group was placed on a 10-wk waiting list.

Outcomes and measures: The Sensory Integration and Praxis Test; Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Brief Form; and goal attainment scaling were used as primary outcome measures. The Childhood Executive Functioning Inventory; Stroop Color and Shape Matching Test, TBAG Form; Emotion Regulation Checklist; and Participation and Environment Measure for Children and Youth were used as secondary outcome measures.

Results: Postintervention, the intervention group showed a statistically and clinically significant improvement in all outcome measure results (p < .001, η2 > .25). The control group did not show a statistically significant improvement (p > .05).

Conclusions and relevance: OT-ASI can improve sensorimotor, attention, and executive functions; emotional regulation; and participation in children with ADHD. Therefore, it is an evidence-based occupational therapy approach that occupational therapists may prefer in working with children with ADHD. Plain-Language Summary: This study was conducted to comprehensively evaluate the effects of occupational therapy using Ayres Sensory Integration® (OT-ASI) in children with attention deficit hyperactivity disorder (ADHD). In children with ADHD, OT-ASI improved sensorimotor skills such as praxis, balance, and coordination; cognitive skills such as attention and problem-solving; emotional skills such as coping with negative emotions and impulse control; and participation skills such as independence in home, school, and community activities. This study shows that OT-ASI is an evidence-based occupational therapy approach that can be applied to children with ADHD. Therefore, OT-ASI is recommended as one of the intervention approaches that occupational therapists may prefer in working with children with ADHD.