Sensory Enrichment Therapy Does Not Cure Autism

 


Sensory enrichment is a great thing. Autistic adults recommend it for autistic children to help them regulate. It can be great when it is autistic led. 

 Quacks have taken it one step further. They claim it "improves by 5 points or more on the Childhood Autism Rating Scale." In this case it is parent or therapist led. They do not follow the notion that behavior is communication. 

Mendability was founded based on the work by Claudie Pomares. She organized and adapted protocols used in animals studies into therapeutic games that parents could do with their children and then she began to implement programs in daycares and schools in France. Pomares is the Chief Science Officer of Medability. 

In 2011, Eyal Aronoff invested in the development of Mendability. The basis of Medability is a system of therapy protocols custom tailored to a specific age, "symptom" and capabilities. They also build a web app to implement therapy over the internet. "When I found Sensory Enrichment Therapy, Claudie Pomares was the only provider and it was expensive. I built Mendability around the idea that it should be easy to access and affordable." 

In April of 2014, Medability was incorporated in the United states. RIch Bohne was nominated as the company's CEO. He has 25 years of experience in sales management in the software industry, mostly with Dell Computers. He has an autistic daughter. He has NO CLINICAL EXPERIENCE. 

There are no autistic people on the board of Mendability. 


What is Sensory Enrichment Therapy?

"By using Sensory Enrichment, we can stimulate the brain plasticity in a way that enables the brain to make new connections."

Environmental Enrichment is the stimulation of the brain by its surroundings. There are three components:

  1. Social Enrichment
  2. Activity Enrichment
  3. Sensory Enrichment
Sensory Enrichment is a form of therapy that uses two or more senses concurrently, which results in a significant reduction of the discomfort that the autistic brain is experiencing. This is true, sensory stimulation can reduce anxiety, sensory overload and feeling overwhelmed. Sensory needs differ from person to person. 

Medical Disclaimer

They have a medical disclaimer. If they truly believed in what they were doing, why would they need this disclaimer: 

"The statements on this website have not been evaluated by the US Food and Drug Administration. 

This product and all products sold through or by Medability LLC or by any of its affiliates are not intended to diagnose, treat, cure or prevent any disease or medical condition. Results may vary."

What Medability Claims

They claim that science has been reminding people that nature offers the best solutions to help people feel less anxious, overwhelmed or disconnected. "Mendability has been able to develop an effective treatment for the core symptoms of autism."

They draw people in by showing a picture of a flower. "Can you smell this picture? It feels amazing, doesn't it?" 

Medability has a video of a child in a meltdown. The reason why the child is melting down is not disclosed. The parent shoves a vial of scented oil by their nose and they start to calm down. This obviously has not been designed by autistic adults who have been though meltdowns themselves. Shoving anything in an autistic's face mid meltdown would only escalate them further. 

It is unknown whether or not these children are autistic or if they are actors for this particular video. In the video, it is unclear. To potentially protect the dignity of their children, the video will not be included here. 

The website encourages parents to try this at home themselves. "Grab an orange or a perfume you really like and see how the smell makes you feel. And smell is just one of the senses that we can use to stimulate the brain! Imagine what you can do when you combine two or even three senses!"

"How does this simple method relate to autism? When treating autism, repetition and a structred schedule are critical. Medability combines the two: repetitive sensory stimulation."

As an autistic adult, this to me, seems like it would induce sensory overload. 

Medability promises within a few weeks the autistics behavior will change and "simplicity with gradually return to your daily tasks." They put the emphasis on the parents not the child. Very typical of these type of programs. 

To make matters worse, they use Temple Grandin to promote their therapy. 

Medability even offers a parent training online course for $50. Parents know what kind of sensory stimuli that their child prefers. Again, sensory enrichment is a great thing but it will not cure anything. 

Pricing:

Self Guided : $49 per month with a $250 startup fee. Paying a lot of money for something the parents can be doing on their own. 

Unlimited coaching: $159 per month

Platinum: one time $6000

What Medability Claims to Improve:


  • Better focus on classwork
  • complete assignments and homework
  • improved success in school and home life
  • better concentration 
  • improved control of impulsive behavior 
  • better grades at school
  • less arguing at home
  • increased self worth and self esteem
  • holding a train of thought
  • following though on a task
  • concentrating on one activity at a time
  • following spoken directions
  • processing information quickly
  • keeping up in conversation
  • Improvement in math homework
  • improvements in memory, attention and language
  • faster processing number concepts
  • increased confidence in math class
  • Improvement in sports or gym class
  • improvement in playing musical instruments
  • better pencil grip
  • better handwriting
  • improvement performing sequential movements 
  • combing hair and performing other life skills
  • Easier time leaving home
  • more relaxed
  • can cop with transitions and change
  • fewer incidents in public places
  • more confidence in challenging situations
  • sleeping in their own bed
  • no more self injury
  • fewer meltdowns
  • develop spontaneous happiness
  • Remembering story lines
  • improvement in memory
  • improvement in reading levels
  • better spelling and writing
  • increased self confidence at school
  • clearer thinking.
  • improvement in social skills
  • better at problem solving or thinking logically
  • improvement in language and literacy skills
  • gain in independent living skills
  • Improves anxiety about grades, recreational participation, school performance, punctuality, organizational skills, personal hygiene, friendships
  • Development of vocabulary
  • communicating in sentences
  • making friends
  • better pronunciation
  • social interactions with family and peers
  • improved learning and attention
  • fewer tantrums
  • understanding social rules
  • more interest in social interactions
  • understanding body language
  • appropriately greeting people and requesting information
  • improved self control skills
  • taking turns
  • keeping emotions in check
  • increased ability to interact with peers
  • managing aggression
  • remaining calm in crowded spaces
  • eating a variety of textured foods
  • use loud hair dryers without discomfort 
Instead of using sensory enrichment to benefit the autistic person, they are using it to make a child appear neurotypical. They are not having the child lead the sensory play, the parents are leading it. This can cause the autistic to become overwhelmed and send them straight into sensory overload. They completely ignore the fact that behavior is communication. Once the parent figures out why their child is acting that way, they will fix the behavior. It is that simple. 

A Flawed Study

A study was published in the APA journal of Behavioral Neuroscience. The participants were 28 autistic boys. They were aged from 3-12. The researchers divided the children into two groups. This was based on age and "severity." For 6 months the boys participated in ABA but one group underwent daily sensory enrichment exercises. 

Each family received a kit that contained essential oil fragrances to stimulate smell. For touch, the kit contained squares of plastic door mat, smooth foam, a rubber sink mat, aluminum, fine sandpaper, felt and sponges. The kit also had pieces of carpet, hard flooring, pillows, cardboard and bubble wrap that parents put on the floor to create a multi textured walkway. Items for manipulation included a piggy bank with plastic coins, miniature plastic fruits and small fishing pole with a magnetic hook. Some household materials were used to hold water at different temperatures for a child to dip in a hand or foot and metal spoons that the parent would warm or cool and touch the child's skin. 

The parents of the enrichment group were to conduct two sessions a day of four exercises involving different combinations of stimuli for touch, temperature, sight and movement. Each session was 15 to 30 minutes. The children also listened to classical music once a day.

42 percent of the children in the enrichment group significantly "improved" in behaviors such as relating to people and responding to signs and sounds. This is compared to 7% of the standard care group. 

The data was collected using parents checklists

Problems with the study

It was not a controlled study because the enrichment group was not only participating in sensory enrichment activities. They were continuing therapy they were already receiving. They did not attribute the "improvement" the child was showing as a direct result of the child working hard at a particular skill. They give the child zero credit. The child might be progressing and there is no room in this study to recognize that. 

This study also does not leave room for the child's individual sensory needs. Every autistic is different. Some are avoiders, some are seekers and others are a combination of the two depending on stimuli. 

This study also only included boys. There were no girls included with this study. This study is skewed due to this fact. 

Conclusion

Sensory enrichment is a great thing. It is very helpful for many autistics. It's only helpful if it is autistic led. If it is not autistic led, it can cause sensory overload. Sensory overload often leads to meltdowns. The program claims to "improve" many autistic behaviors but at the same time has a disclaimer that says that they do not. If they have such a disclaimer, they must not believe in their program. Sensory enrichment should not structured as Mendability is doing. It should be open to how the autistic person feels and how they want to do sensory enrichment, not how the neurotypical parent or professional leads them. 

Sources:
https://www.apa.org/news/press/releases/2013/05/autism-treatment
https://www.mendability.com/pricing/
https://www.mendability.com/how-it-works/
https://www.mendability.com/science/sensory-enrichment-therapy/
https://www.mendability.com/science/clinical-data/
https://www.mendability.com/fda-medical-disclaimer/
https://www.mendability.com/about/the-mendability-story/


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