The Effectiveness of Sensory Integration-Based Early Intervention in Developing Health and Environmental Skills in Children with Autism Spectrum Disorder in Early Childhood: A Multiple-Baseline Study

Abstract

Existing literature indicates that children with Autism Spectrum Disorder (ASD) face significant challenges in acquiring fundamental skills, particularly personal health hygiene and the ability to adapt to daily environmental demands factors that critically impact their independence and quality of life. Despite growing evidence supporting the efficacy of Sensory Integration (SI) interventions in improving functional performance, Arabic research in this area, particularly focusing on early childhood, remains limited. This study aimed to evaluate the effectiveness of a structured and standardized early intervention program based on Ayres Sensory Integration® (ASI). The program consisted of 20 sessions designed to develop health and environmental skills in three Saudi children diagnosed with ASD (aged 4.5 to 5.5 years) at a government autism center in Al-Ahsa. The study employed a single-case experimental design specifically a multiple baseline across participants. Standardized tools were used to measure the children’s performance in handwashing, tooth brushing, and face washing, in addition to environmental adaptation skills, adaptive behavior, and sensory processing. Findings revealed that all three participants transitioned from low and stable baseline levels to significant and clinically meaningful improvements following the intervention. Very large effect sizes were observed, ranging from 0.83 to 0.92 according to the Tau-U index. Furthermore, standard scores for daily living skills on the Vineland Adaptive Behavior Scales increased by 12 to 14 points per child. Significant reductions were also noted in sensory processing issues across tactile, auditory, and vestibular domains. The results suggest that early sensory integration intervention, when applied within a naturalistic preschool environment, is a highly effective and culturally adaptable approach for developing health and environmental skills among Saudi children with ASD. These findings support the broader implementation of such programs in special education curricula and applied research across Saudi Arabia and the wider Arab world.