Environmental Enrichment Therapy for Autism: Outcomes with Increased Access

Background: While there are several behavioral therapies available for ASD treatment, these programs are inaccessible to many, are often costly, are typically less effective as patients age, are not reliably effective, and may address a narrow range of symptoms. A treatment that successfully addresses the limitations of current therapies therefore would be of great value. Two randomized clinical trials have shown that environmental enrichment can ameliorate the symptoms of ASD, but there was no evidence that this approach could ameliorate such symptoms under real-world circumstances.

Objectives: We therefore determined whether providing environmental enrichment via an online system could improve ASD symptoms.

Methods: 1,002 individuals, 1-18 years old were given daily environmental enrichment by their parents, guided by an online system, and assisted by occupational therapists, who communicated via phone or email. The parents were asked to assess the symptoms of their child with a comprehensive questionnaire every two weeks for 7 months and the therapy could be regularly customized by a computer algorithm, based on the specific needs of the child.

Results: An intention-to-treat analysis showed significant gains for a wide range of symptoms that included: learning, memory, anxiety, attention, motor skills, eating, sleeping, sensory processing, self-awareness, communication, social skills, mood, and core autism behaviors. The children of compliant caregivers had greater improvement in their symptoms than children of non-compliant parents. The treatment was effective across a wide age range and across all levels of initial symptom severity. There also was equal progress for males and females.

Conclusions:  Environmental enrichment in the form of Sensory Enrichment Therapy, delivered via an online system, appears to be an effective, low-cost, accessible means of treating ASD symptoms.