Chiropractic Adjustments, Multisensory and Sensorimotor Integration in Children with Autism: A Feasibility and Pilot Study

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is estimated to affect one in 160 people worldwide and one in 100 New Zealanders. The diagnostic focus of ASD is on dysfunction in communication and social interaction, though evidence shows many children with ASD also have motor control and co-ordination issues. A growing body of evidence suggests these issues may be related to impaired sensorimotor integration (SMI) and multisensory integration (MSI). Chiropractic adjustments have been shown to have neuromodulatory effects on SMI and MSI in adult populations; however, this has yet to be explored in children with ASD. Objectives: The primary aim was to assess the feasibility of all trial processes. Secondary aims were to assess the feasibility of using a chiropractic intervention in children with ASD and to gather pilot data on preliminary efficacy. Methods: Eight children with ASD aged 7-15 years were recruited into a randomised controlled pilot study with a parallel group design. All study processes were assessed including recruitment, retention, completion rate and suitability of tasks. Data for preliminary efficacy was also collected. MSI was assessed using the sound-induced flash illusion. SMI was assessed using three subtests of the sensory integration and praxis tests, as well as a fine motor task. Children randomised into the intervention group received a single session of chiropractic adjustments. Those in the control group received a passive spinal range of motion intervention. Baseline and post-intervention measures were assessed on the same day. All sessions were approximately two hours in duration. Results: Feasibility aspects of this study highlighted challenges in recruitment, with eight children recruited over an eight and a half month period. Completion rates of the sound-induced flash illusion were low. Retention rate was 100%, as was compliance with the intervention and there were no adverse events reported. There were no between group differences on any of the outcome measures assessed. Conclusion: The current study protocol is not feasible for recruitment of children with ASD into a full-scale trial assessing associations between a chiropractic intervention and SMI and MSI in children with ASD. Further piloting would be necessary to determine the most successful recruitment methods and outcome measures to use in such a study