Edgington, Louise Jane; (2014) The design and implementation of a new cognitive behavioural therapy (CBT) based intervention for the management of sensory experiences in adolescents with autism. Doctoral thesis , Institute of Education, University of London.

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Abstract

Background. There is growing recognition of the impact of sensory difficulties in autism. However, traditional ‘sensory integration therapies’ lack empirical support and behaviour-based measures may misrepresent some sensory experiences in autism, meaning that sensory atypicalities are poorly understood and supported. There is therefore a need for a new self-regulatory approach to understanding and managing sensory experiences, which is consistent with theory, and draws upon self-reports of individuals with autism. Aims. 1) To expand the evidence base of self-reports of sensory experiences of adolescents with autism. 2) To evaluate the effectiveness of a new 8-week CBT-based group intervention for self-regulation of sensory experiences. Methods. Twelve adolescents aged 11 to 16 years with diagnoses of autism and IQs above 70, from one mainstream secondary school completed the study. A randomised controlled trial (RCT) design was used. To address Aim 1, self-reports were elicited pre-intervention, in a semi-structured interview and analysed thematically. To address Aim 2, quantitative measures of sensory behaviours, anxiety and repetitive behaviours were taken at baseline, post-intervention and follow-up, together with qualitative interview data from experimental groups and parents, post-intervention. Results. Aim 1) Thematic analysis revealed 5 main themes: ‘need for control’, ‘resonance with stimulus affects reactivity’, ‘self in-relation-to others’, ‘barriers to coping relate to consciousness’, and ‘features of adaptive coping strategies’. Aim 2) Quantitative analysis revealed no significant intervention effects, although qualitative reports indicated the intervention raised meta-conscious awareness of sensory experiences, expression and use of language, sense of self in-relation-to others, and adolescents’ use of new coping behaviours. Conclusion. Striking qualitative data suggest the intervention was effective in raising meta-conscious awareness and self-regulation. Results indicate the future need for larger sample sizes, and for the development of more sensitive and valid sensory measures. Implications for EPs include facilitating supportive group dynamics, and developing parent and staff understanding.

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