Can sensory integration have a role in multi‐element behavioural intervention? An evaluation of factors associated with the management of challenging behaviour in community adult learning disability services

Abstract

Introduction: Adults with complex needs and severe learning disability present as a serious management problem within the community. Restrictive interventions are often used to manage adults with these issues, even though best practice recommends the use of positive behaviour support. Positive behaviour support involves functional analysis, but it does not specifically focus on sensory integration difficulties as a contributing factor to challenging behaviour. Methods:A systematic search of the literature was completed using a range of electronic databases, an electronic search, hand search and review of reference lists.Seven relevant studies were identified. These studies were critically appraised and analysed. However, the extent of research was limited and the procedural quality variable, some distinct themes, arose.Results: Out of the seven intervention studies included in this review, two studies used sensory integration therapy, three employed multi-element behavioural intervention, one utilised environmental stimulation within a multifactor behavioural intervention approach and one used sensory strategies within a structured behavioural intervention programme. The participants across the final seven papers reviewed | 143

Occupational therapy for adults with intellectual disabilities and sensory processing challenges: a Delphi study exploring practice within acute assessment and treatment units

“…Disagreement about the level of importance of items was particularly evident with assessments and outcome measures. This supports findings elsewhere in the literature, with mental health service users and staff agreeing a variety of tools are needed to successfully implement sensory interventions (Machingura, 2021) and a need for more suitable sensory assessments identified by McGill and Breen (2020). Challenges around gaining views of service users and using systematic tools to support this also corroborate previous study findings, where therapists used mainly informal techniques to gather feedback (Ball and Shanks, 2012).…”

“…Only Clarke (1978) and Soper and Thorley (1996) used separate control groups, with the majority of other studies using single-case experimental designs. Some behavioural studies have also successfully used sensory strategies, such as vibration and deep pressure, to reduce behaviours that challenge, leading McGill and Breen (2020) to conclude sensory techniques can have a useful role in multi-element behavioural intervention for those with intellectual disabilities.…”

“…Therapeutic strategies that improve quality of life and reduce restrictive practices are promoted as part of the international agenda to enhance care for this population (Bowen and Kemp, 2014). Some authors have suggested sensory approaches can support this (Gawlas and Blaskowitz, 2020; McGill and Breen, 2020); however, lack of research in this area means guidance is unavailable regarding the most effective sensory interventions for those with intellectual disabilities (NICE, 2015).…”

Occupational therapy interventions for adults with learning disabilities: evaluating referrals received pre and during the height of the COVID-19 pandemic

“…Concerning the engagement pathway, the study and application of sensory integration approaches is still a developing area (Watling & Hauer, 2015) and in recent years interventions utilising sensory approaches within learning disability services have begun to build up steam (Mc Gill & Breen, 2020), this is evident within our findings which show a rise in referrals for sensory interventions from 2019 to 2020. This being said, there is still controversy surrounding the benefit of sensory integration practices (Miller et al, 2007) and is an area that is still under-researched amongst adults with learning disability (May-Benson & Kinnealey, 2012).…”

Sensory approaches for adults with severe or profound and multiple learning disabilities: A systematic literature review

“…Whilst some systematic reviews report that sensory approaches improve behaviour, mood and engagement (Breslin et al, 2020; Chan et al, 2010) others report no significant outcomes (Leong et al, 2015). In the context of specialist multidisciplinary teams, however, sensory approaches have been found to be critical components of multi-element positive behavioural support programmes for learning disabilities and challenging behaviour (McGill and Breen, 2020).…”