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•  Providing therapy within a multisensory environment with various clinical populations can be very advantageous (e.g. Fowler, 2008; Fava & Strauss, 2010; Lotan, & Merrick, 2004; Mays & Baird, 2015).

•  This offers various sensory experiences, within an atmosphere of trust and relaxation, promoting the stimulation of the senses.

•  This environment could lead to increased abilities in communication, attention and concentration in people with learning disabilities or other impairments.

•  Multisensory environments are common practices among the physiotherapy and occupational therapy fields.

•  This approach can apply to many different clients, young and old, with physical or sensory impairments, cognitive delay, as well as developmental and intellectual disabilities, such is the case with the foetal alcohol syndrome population (FAS) or Fetal Alcohol Spectrum Disorder (FASD) (e.g. Franklin, Deitz, Jirikowic, and Astley, 2008; Abele-Webster, Magill-Evans and Pei, 2012).

Context  

 Method  

 

Preliminary  results  

 

                                 

                                             

We would like to thank Santé Canada and the “Consortium national de formation en santé”(CNFS) for their financial contribution to this project.  1.  Abele-­‐Webster,  L.  A.,  Magill-­‐Evans,  J.  E.,  &  Pei,  J.  R.  (2012).  Sensory  processing  and    ADHD  in  children  with  fetal  alcohol  spectrum  disorder.  Canadian  Journal  of  Occupa0onal  Therapy,  79(1),  60-­‐63.  2.  Fava,  L.,  &  Strauss,  K.  (2010).  Mul/-­‐sensory  rooms:  Comparing  effects  of  the  snoezelen  and  the  s/mulus  preference  environment  on  the  behavior  of  adults  with  profound  mental  retarda/on.  Research  in  Developmental  Disabili0es,  31(1),  

160-­‐171.doi:  doi:10.1016/j.ridd.2009.08.006    3.  Franklin,  L.,  Deitz,  J.,  Jirikowic,  T.,  &  Astley,  S.  (2008).  Children  with  fetal  alcohol  spectrum  disorders:  problem  behaviors  and  sensory  processing.  American  Journal  of  Occupa0onal  Therapy,  62(3),  265-­‐273.  4.  Fowler,  S.  (2008).  Mul0sensory  rooms  and  environments:  Controlled  sensory  experiences  for  people  with  profound  and  mul0ple  disabili0es.  Jessica  Kingsley  Publishers.  5.  Lotan,  M.,  &  Merrick,  J.  (2004).  Reb  syndrome  management  with  snoezelen  or  controlled  mul/-­‐sensory  s/mula/on.  A  review.  Interna0onal  Journal  of  Adolescent  Medicine  and  Health,  16(1),  5-­‐12.    6.  Mays,  J.  &  Baird,  E.    (2015).  Children  with  Complex  Communica/on  Needs  in  the  Snoezelen  Room:  A  communica/on  and  Wri/ng  Aids  Service  «  CWAS  Snoezelen  group  Pilot  Project».    

 

 

Discussion  and  Conclusion  

Objectives

Lauren/an  University,  Sudbury  ON,  Canada  

Élisa  Langlois,B.Sc.S,  M.Sc.S.  student  Chantal  Mayer-­‐Cribenden,  Ph.D.  

   

Comparing  a  Mul/sensory  Approach  to  Tradi/onal  Speech  and  Language  Interven/on:  Effects  on  the  Language  Abili/es  of  Children  with  Fetal  Alcohol  Syndrome  (Preliminary  Results)  

 

ObjecFves  and  hypothesis    

Measures (dependent variables): 1)  Repeated measures (see table 1.) 2)  Standardized pre/post–treatment assessments (see table 2.)

Table 1. Repeated measures effect sizes *Effect sizes of 0.8 or larger indicate clinically significant change ** Covers: internal and external social-emotional behavior, compliance, motivation, attention, ability to attend to the task, etc.

 PROBLEMATIC  Research  showing  the  efficacy  of  a  mul/sensory  therapy  approach  in  the  field  of    speech  and    language  pathology  is  scarce.  There  is  a  lack  of  in-­‐depth  knowledge    and  research  on  the  effects    of  this  mul/sensory  approach.  The  maintenance  and  construc/on  of  a  mul/sensory  room    requires  considerable  financial  investment.    

1  •  To  compare  the  short  terms  effects  of  a  mul/-­‐sensory  approach  on  children's  communicaFon,  behaviour,  moFvaFon,  aIenFon  and  language  with  a  tradi/onal  approach  in  SLP.  

2  • To  determine  the  feasibility  of  this  type  of  study  by  creaFng  a  mulFsensory  room  within  a  budget  of  $1500  (Canadian  dollars),  making  it  more  accessible  to  clinicians  from  various  seongs.  

Hypotheses  1:  

If  various  clinical  popula/ons  benefit  from  a  mul/sensory  approach  then  it  is  postulated  that  greater  gains  in  communica/on  will  be  made  by  the  children  diagnosed  with  FASD  in  the  mul/sensory  approach  group  in  comparison  to  those  made  by  the  children  in  the  tradi/onal  group  and  the  delayed  therapy  group.  

Hypotheses  2:  

Since  the  access  to  mul/sensory  materials  and  equipment  is  now  readily  available  on  various  online  centralized  networks  (i.e.  Kijiji)  and  since  there  are  many  do-­‐it-­‐yourself  projects  within  this  type  of  environment,  the  crea/on  of  a  mul/sensory  room  for  $1500  should  be  feasible.    

    P1    (MulF  sensory)  

P2    (TradiFonal)  

P3    (Delayed)  

Test   Pre-­‐test                  Post-­‐test   Pre-­‐test                   Post-­‐test   Pre-­‐test                   Post-­‐test  

SLDT-­‐MI   78   95   80   83   87   N/A  SLDT-­‐IN   76   84   <60   63   77   N/A  SLDT-­‐MI   75   95   75   75   85   N/A  SLDT-­‐SP   65   85   91   85   92   N/A  SLDT-­‐Total   68   82   67   67   79   N/A  CELF5-­‐SC   6   5   9   1   5   N/A  CELF5-­‐WS   2   3   7   -­‐-­‐   4   N/A  CELF5-­‐FS   2   4*   5   5   1   N/A  EVT   75   80   76   78   88   N/A  PPVT   74   84*   92   90   88   N/A  ENNI-­‐A1   <1   7   <1   <1   <1   N/A  ENNI-­‐A2   <1   <1   <1   <1   <1   N/A  ENNI-­‐A3   <1   3   7   7   2   N/A    

    P1  (mulF  sensory)   P2  (tradiFonal)   P3  (delayed)  

Task   Type                    Effect  size   Type                            Effect  size   Type                        Effect  size  Sentence  repeFFon   d    -­‐0,62   d    0,85*   d    N/A  

SMDbaseline    -­‐0,27   SMDbaseline    0,27   SMDbaseline    N/A  SMDpooled    -­‐0,46   SMDpooled    0,35   SMDpooled    N/A  

Rapid  AutomaFc  Naming    (Fme)  

d    -­‐0,45   d    -­‐0,27   d    N/A  SMDbaseline    -­‐0,32   SMDbaseline    0,69   SMDbaseline    N/A  SMDpooled    -­‐0,05   SMDpooled    0,28   SMDpooled    N/A  

Rapid  AutomaFc  Naming  (errors)  

d    1,10*   D    -­‐1,35   d    N/A  SMDbaseline    0,93*   SMDbaseline    -­‐1,88   SMDbaseline    N/A  SMDpooled    0,58   SMDpooled    -­‐0,63   SMDpooled    N/A  

ObservaFon    checklist**   d    2,20*   d    -­‐1,41   d    N/A  SMDbaseline    1,44*   SMDbaseline    -­‐1,34   SMDbaseline    N/A  SMDpooled    1,46*   SMDpooled    -­‐0,47   SMDpooled    N/A  

Sustained  AIenFon     d    0,97*   d   1,61*   d    N/A  SMDbaseline    0,66   SMDbaseline   0,76   SMDbaseline    N/A  SMDpooled    0,69   SMDpooled   1,02   SMDpooled    N/A  

VISUAL  STIMULATION       AUDITORY  STIMULATION   TACTILE  STIMULATION    •  Fiber  op/c  lights  •  Mul/ple  light  effects  •  Light  projectors  •  Disco  ball  •  Mirrors  •  Lava  lamp  •  Aquarium  with    LED  light,  fish  and  bubbles    •  Interac/ve  carpet  with  op/cal  fibers  •  Veiled  tent    •  Glow  stars  

•  Relaxa/on  Music  •  Background  noise  •  Bubble  

               

•  Giant  beanbag  •  Panel  with  tac/le  sensa/on  (sos,  rough,  

smooth,  hard…)  •  Variety  of  toys  •  Kine/c  sand  •  Fan  •  Colorful  rice  play-­‐tub  •  Water  play-­‐tub  •  Sos  pillows      

     A  single  subject  design  (SSD)  was  used.  At  the  outset,  8  par/cipants  were  included  in  the  study.  Two  par/cipants   didn’t   meet   the   inclusion   criteria,   two   par/cipants   didn’t   complete   the   interven/on  sessions  which  lead  to  the  elimina/on  of  a  control  subject  to  balance  out  the  groups,  leaving  us  with  3  par/cipants.            ParFcipants:            Measures:    Two   types   of   measures  were   used   in   this   study:   repeated   measures   and   pre-­‐post   standardized  assessments.   Five   repeated  measures  were   used   track   progress   in   targeted   skills   at   baseline   and  across  the  treatment  period.      Environment                

Groups   P1     P2     P3    Age   7;08   7;01   8;02  Gender   Male   Male   Male    Leiter  (IQ)    79    87    85  Diagnosis     ARND   Full  FASD   Par/al  FSAD  

P1   The  first  par/cipant  received  speech  and  language  therapy  in  an  mul/sensory  environment  (8  sessions;  twice  a  week)  

P2   The  second  par/cipant  received  tradi/onal  speech  and    language  therapy    (8  sessions;  twice  a  week)  

P3   The  third  par/cipant  (control)  will  receive  interven/on  aser  the  two  first    groups  (delayed):  control  group  

• Standard  room  (suitable  for  this  purpose):  table  &  chairs    TradiFonal  environment  

• Mul/-­‐sensory  s/muli  were  presented  simultaneously  through  sensory  modali/es  of  vision,  hearing  and  touch  

 MulF-­‐sensory  environment  

q   FASD:  Fetal  alcohol  spectrum  disorder  q   ARND:  Alcohol-­‐Related                    Neurodevelopmental  Disorder    q   pFAS:  Par/al  Fetal  Alcohol  Syndrom  

Collec/on  of  these  data  are  currently  in  process  

References  

The creation of this multi-sensory room: Included in this room were items we purchased from various online centralized networks (e.g. Kijiji), materials created in-house (e.g. Panel with tactile sensation) as well as items that our speech language pathology clinic already owned (i.e. objects commonly found in clinical settings).

20  

30  

40  

50  

60  

70  

80  

90  

100  

1   2   3   4   5   6   7   8   9   10   11   12  

%  W

ords  Correct  

Session  

Sentence  RepeFFon  Tradi/onnal  

Mul/  sensory  

Control  

0  5  

10  15  20  25  30  35  40  45  50  

1   2   3   4   5   6   7   8   9   10   11   12  

Items  fou

nd  /  30  secs  

Session  

Substained  AIenFon  Tradi/onnal  

Mul/  sensory  

Control  

Baseline  

0  20  40  60  80  

100  120  140  160  

1   2   3   4   5   6   7   8   9   10   11   12  

Time  (sec)  

Session  

RAN/Time   Tradi/onnal  

Mul/  sensory  

Control  

0  1  2  3  4  5  6  7  8  9  

1   2   3   4   5   6   7   8   9   10   11   12  

#  of  errors  

Session  

RAN/Errors   Tradi/onnal  

Mul/  sensory  

Control  

 Table 2. Pre- and post-test scores for standardized language tests    

* Post-test score exceeds the 90% confidence interval surrounding the pre-test score when available

 

The results obtained in the pre and post- evaluations showed that participant 1 made more gains than participant 2. More gains were made post-test by participant 1 who receive intervention in the multi-sensory environment on tests that assessed pragmatic skills, narrative skills and receptive vocabulary. For the repeated measures, pragmatic abilities improved significantly over time for P1 but not for P2. In fact, P2 regressed in this area. P1 also showed gains in lexical processing efficiency (RAN). P2 showed gains in sentence repetition. It should be noted that P1 had a lot of difficulty with this task. Both participants made gains in sustained attention. However, since we are still missing a few data from participant 3 (currently in process), we are unable to confirm with certainty hypothesis 1, though the preliminary results are very promising. Hypothesis 2 can be accepted. The multisensory room was created within a budget of $1500.  

0  10  20  30  40  50  60  70  80  90  

100  

P1  (MulF  sensory)  Pre-­‐test   Post-­‐test  

0  10  20  30  40  50  60  70  80  90  

100  

P2  (TradiFonal)  Pre-­‐test   Post-­‐test  

Collec/on  of  these  data  are  currently  in  process  

Acknowledgement  

Baseline  

Baseline   Baseline  

Treatment  

Treatment  

Treatment  

Treatment