Metacognitive Self-regulated Learning and Sensory Integrative Approaches for Children With Autism Spectrum Disorders
Condition: Autism Spectrum Disorder
MeSH terms: Autistic Disorder; Autism Spectrum Disorder; Child Development Disorders, Pervasive
Study type: Interventional

Summary: 
      Children with Autism Spectrum Disorder (ASD) are increasing each year. There are about 1 in
      160 children for the age group of 6-12 years old in Australia are diagnosed with ASD.
      Children with ASD have impairment in two common areas including: i) social and communication
      and ii) repetitive and stereotypical patterns of behaviours. These common features result in
      behavioural problems which negatively impact children's participation in school, activities
      of daily living and social engagement.

      Therefore, there is a need for effective interventions to overcome the behavioural problems
      in children with ASD.

      The purpose of the study is to investigate the effect of sensory integration (SI) and
      self-regulated learning versus an activity-based control programme in reducing behavioural
      problems in children with ASD that interfere with their daily livings, school, and social
      engagement.

      The study will adopt a randomized controlled trial design with three intervention groups: I)
      self-regulated learning, II) sensory integration and III) activity-based intervention as the
      control group.
    

Detailed description: 
      Children with Autism Spectrum Disorder (ASD) are commonly associated with behavioural
      problems which may negatively impact on their participation in school, activities of daily
      livings and social engagement. In order to minimise the impact on the daily functioning of
      these children, overcoming the behavioural problems in these children is essential.

      Two intervention approaches will be used in this study. These are i) self-regulated learning
      and ii) sensory integration. Sensory integration is commonly used for children with
      developmental problems. Self-regulated learning has been used to promote children's
      self-directed learning and in people with brain injuries.

      However, the evidence towards the effectiveness of these two interventions in alleviating the
      effects of behavioural problems on participation in school, daily and social activities for
      children with ASD is limited and inconclusive.

      Self-regulated learning theory:

      The origin of self-regulated learning approach came from Albert Bandura's social cognitive
      theory. The theory states that intervention affects one's learning by modifying the personal,
      environmental and behavioural factors. The personal factor refers to one's beliefs and
      attitudes. The environment factor comprises of feedback, instructions, information gathered
      from teachers or instructors and also from the assistance of parents and peers. The
      behavioural factor includes past performance that are socially unacceptable. The key of
      self-regulated learning is to ensure that children make use of a cognitive strategy to
      facilitate behaviour learning by helping them to bring problems and solutions towards own
      consciousness. Several studies had used self-regulated learning in children and adults
      population. It was found a significant improvement in task performance for children with
      Attention Deficit Hyperactive Disorders (ADHD). The positive effect was also shown in another
      study showing improvements in performance measures of reading and intelligence quotient among
      children with moderate learning disabilities. Similar results were also seen in adults with
      brain injury in various studies. They suggested that self-regulated learning could enhance
      the active learning of participants.

      Children with ASD were reported to commonly associate with self-regulation problems affecting
      their behaviour and learning ability. However, there is no study using self-regulated
      learning for this group of children to alleviate the effect of behavioural problems on their
      school, daily and social participation.

      Sensory integration intervention theory:

      Sensory integration theory was developed in 1960s and 1970s. The theory was developed to
      target on the neurological processing of sensory information. The theory suggests that
      purposeful behaviours may be interrupted when there is an interference of neurological
      processing and integration of sensory information. Sensory integration interventions have
      been widely used in varieties of settings among children with development problems. However,
      despite the vast amount of literature that exists on the effectiveness of sensory integration
      intervention, the overall evidence on the effectiveness on children with ASD and behavioural
      problems remains inconclusive. Some studies showed that sensory integration was an effective
      intervention given a positive result, but others showed no benefit or inconclusive findings.

      Studies previously used sensory integration intervention seemed not using the fidelity
      measures in the intervention design to ensure that the intervention met the requirement of
      sensory integration theory. This could be one of the reasons for the inconclusive finding
      made on its effectiveness. Furthermore, most of the studies used a single-case study design
      with small sample sizes. In addition, previous studies using sensory integration did not
      focus on alleviating the effects of behavioural problems on function in the daily livings,
      school and social engagement for children with ASD.

      This study, will therefore, adopt a randomised controlled trial (RCT) design to investigate
      the effect of sensory integration and self-regulated learning interventions (comparing with
      activity-based control intervention) in reducing the effects of behavioural problems on daily
      living, school and social engagement in children with ASD.
    

Intervention name(s): Meta-cognitive self-regulated learning intervention; Sensory integration intervention; Activity-based intervention
Intervention type(s): Other; Other; Other
Intervention description(s): It is a 12-week intervention programme with one 60 minutes sessions per week.; It is a 12-week intervention programme with one 60 minutes sessions per week.; It is a 12-week intervention programme with one 60 minutes sessions per week.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Children