THE EFFECT OF OCCUPATIONAL THERAPY AND SENSORY INTEGRATION ON THE LEVEL OF SELF-CARE OF CHILDREN WITH AUTISTIC SPECTRUM DISORDERS
The purpose to assess the effectiveness of occupational therapy and sensory integration on the level of self-care of children with autism spectrum disorders in early childhood.
Materials and methods 60 patients (from 3 to 5 years) participated in the study. The control group (CG) underwent a standard correction program with the consultation of an occupational therapist for 6 months. The first main group (OG1) additionally received occupational therapy sessions 3 times a week, which were aimed at forming self-care skills. Children of the second main group (OG2) received sessions on sensory integration (2 times a week) in addition to OG1 therapy. In sessions on sensory integration, children formed and improved imitation abilities, orientation in space, coordination, and sensory perception. The study used a questionnaire for the assessment of children's disability. The self-care domain was used for the analysis. Evaluation was carried out by occupational therapists before the start of the intervention and after completion of the program.
Results Initial results revealed a rather low level of self-care in the patient groups. In all groups, the worst scores were obtained in the item that is responsible for fastening and unfastening fittings, and the best in the item that is responsible for the awareness of defecation. As for the final indicators, the item "fastening" remained with the lowest score in CG and OG1. The best score remained in the item "awareness of defecation". Analysis of the distribution of groups by gender did not establish differences between groups. The average age of the children was 3.85±0.63 years. The groups did not differ in age. Initial results revealed a fairly low level of self-care, but the groups were not statistically different. Indicators х̅±SD of the total domain score were 24.35±6.34 points in CG, 26.10±7.70 points in OG1, and 25.85±5.65 points in OG2. Comparison of the three groups according to the final results of the total score of the self-care domain established statistical differences. Conducted a posteriori test established the presence of statistical differences in all pairs of groups (p<0.001). Statistical indicators х̅±SD in CG were 30.85±6.71 points, in OG1 – 42.20±5.14 points, and in OG2 – 53.05±5.85 points. The results of the repeated assessment were statistically different from the initial ones in CG (t = -11.156, p<0.001), OG1 (t = -20.794, p<0.001) and OG2 (t = -23.875, p<0.001). These results are a consequence of the fact that statistically significant dynamics were observed in CG only in five points, namely those responsible for: consistency of food consumed, use of drinking vessels, nose care, hand hygiene, fasteners. On the other hand, among groups OG1 and OG2, statistically significant changes were found in all items of the domain, however, a pairwise comparison of the final results in the items of groups OG1 and OG2 revealed statistical advantages of the second in five items. At the same time, a pairwise comparison of the final results in the items of the CG and OG1 groups revealed statistical advantages of the latter in seven items.
Conclusions The addition of occupational therapy sessions to a standard remedial program improved the effectiveness of the intervention as measured by a number of items and the total score of the self-care domain of the Child Disability Assessment Questionnaire. However, adding occupational therapy and sensory integration to a standard correctional program had the best effect on self-care.
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