Efectos de un programa de estimulación multisensorial en la conducta de los niños con trastorno del espectro autista

Abstract

The Aim of this work is to design, apply and validate a multisensory stimulation intervention program for students with ASD (across all its spectrum). Students with autism often present hyper or hypo sensitivity, as well as hypo or hyper reactivity to environments. Which translates into maladaptive behaviors, as a consequence of these sensory alterations that may have an exterioceptive origin (based on an alteration in the reception of the stimulus), or an interioceptive origin; or proprioceptive (such as pain) (Morán Holgado, 2014). The thesis includes aspects of autism in the theoretical framework. Firstly, a historical-bibliographic review was carried out on the evolution of the concept of autism from its beginnings to the present day, in order to better understand what autism is and what is comorbid to it. Secondly, a complete historical review has been carried out of what sensory alterations in ASD entail and how these were already described since the first research on the subject. Thirdly, to try to understand these alterations, a rigorous study has been carried out on the sensations: how they are perceived and processed. We have delved into the afferent pathways of the stimulus and its path from when it is received, it is transduced so that the CNS decodes it and transmits it to the cerebral cortex. Fourthly, previous studies that have used the Snoezelen room methodology have been reviewed, analyzing 23 investigations. Fifthly, the intervention program is described, establishing the premises of Snoezelen-based therapy, the principles on which this type of intervention rests, the diversity of rooms that can be chosen and why we designed ours accordingly to our objectives. The empirical study is described in the sixth chapter. 30 students diagnosed with ASD (grades 1, 2 and 3) participated in this research. Diferente measures will be used in the pretest and postrest situation: The behavioral scales Vineland Adaptive Behavior Scale-3 (Sparrow et al. 2016); The Sensory Profile-2 (Dunn, 2014) and the Repetitive Behavior Scale-Revised (Bodfish et al, 2000), in addition, grade 2 and grade 1 students completed the CARAS test (attention) and the Memory test of the WISC-IV scale. In addition, the satisfaction of parents and teachers with the program was collected through a questionnaire designed ad hoc. Regarding the results before the program, we found that grade 3 students are the ones who show the worst scores in adaptive development. Grade 2 students show a broader spectrum of scores in the areas measured by the Vineland-3, showing more heterogeneity in their levels of adaptive development. Regarding the results on the effectiveness of the program, the results show slight changes in development (Vineland-3) when the direct scores of the variables are compared. In our case, improvements in sensory processing are also verified. These improvements are statistically significant for students in grade 1 and 3. In the case of students in grade 2, these improvements are not statistically significant, although a trend towards more normalized processing can be seen. The data about parents’ and teachers’ satisfaction were very positive, and even on some occasions contravened the results found when using the scales. For example, in the case of repetitive behaviors, adults report that these have improved; although when they are assessed through Bodfish scale the results do not agree.