Environment Enrichment as Treatment for Autism: A Randomized Controlled Trial

Psychological, Educational, and Therapeutic Interventions

Environmental Enrichment

Woo, C. C., & Leon, M. (2013). Environmental enrichment as an effective treatment for autism: A randomized controlled trial. Behavioral Neuroscience. doi: 10.1037/a0033010

Reviewed by: Antonia Giannakakos, Caldwell College

Why research this topic?

Researchers conducting basic research with animals have found that an enriched sensorimotor environment enables rodents to compensate for neurological deficits. For example, rodents with autism-like symptoms who are exposed to an enriched environment tend to show milder symptoms. More than 90% of individuals with autism exhibit sensory deficits (e.g., over selectivity, unresponsiveness); therefore, the researchers in this study sought to translate the findings by animal research into a potential treatment for humans.

What did the researchers do?

Twenty-eight male children diagnosed with autism, ranging in age from 3-12 years, served as the participants in this study. Participants were randomly assigned to a treatment group that received environmental enrichment or a control group that received no intervention. Children in the treatment group were exposed to a variety of smells, musical sounds, and textures by their parents for 15-30 minutes, two times a day, over a 6-month period. The sensorimotor tasks grew in their complexity every two weeks and included such tasks as rubbing the children’s bodies with different textures (e.g., felt, fine sandpaper, aluminum foil), putting scented cotton balls in their pillows while they slept, and having the children draw shapes on a paper, while their parents drew imaginary shapes on their backs. All participants were tested at entry to the study and at the end of the 6-month period.

What did the researchers find?

Although children in the treatment and control groups were similar at entry in the study, children in the treatment group showed larger gains than children in the control group at the end-of study assessment on: (1) a visualization and reasoning test, (2) a test of symptom severity, and (3) parent ratings of symptom severity.

What are the strengths and limitations of this study?

A strength of this study is that the researchers randomly assigned children to two groups that appeared similar at entry to the study. However, a limitation is that the researchers did not describe how they selected the different sensorimotor activities, making it impossible to determine if there is any scientific basis for the selection. The researchers also did not provide a detailed description of the types of behaviors that were reported to decrease in severity, which makes it hard to discern precisely what the effects were. Finally, all of the children in the study were receiving other forms of intervention (e.g., applied behavior analysis, speech therapy, occupational therapy) and it is unclear whether the effects of sensorimotor enrichment would be the same in the absence of those other therapies.

What do the results mean?

The results of this study indicate that sensorimotor therapy may alleviate some skill deficits associated with autism in some children. However, further research is necessary to test whether the results of this study can be replicated and maintained, and whether sensorimotor therapy can be used successfully on its own or needs to be combined with other therapies. Thus, sensorimotor enrichment is not recommended as a treatment for autism until further research has been conducted and the potential benefits of this treatment are fully investigated.