Thesis (MScSportSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Autism Spectrum Disorder (ASD) has been described as a neuro-developmental disorder
influencing the social interaction and communication skills of individuals. Those with ASD
have been observed to experience sensory input challenges, which could result in motor
delays. Descriptive research was conducted with two case studies, who were boys aged 6-
and 8-years, diagnosed with ASD. The purpose of the study was to design and implement a
Sensory-Motor Integration (SMI) programme for each boy and to assess the effect it had on
the sensory motor skills of the boys over time.
At the start of the intervention, the boys were assessed with three neuro-developmental
and diagnostic evaluations (Social Communication Questionnaire, Autism Diagnostic
Interview Revised and Autism Diagnostic Observation Schedule-2nd Edition) conducted by a
psychiatrist to re-affirm their previous ASD diagnoses. The two boys (Subject A and Subject
G) participated in individualised sessions of 30 minutes each, twice a week for seven
months. The SMI programme focused on vestibular and somato-sensory (proprioceptor)
variables. The Quick Neurological Screening Test-3 (QNST III) and the Sensory Input Systems
Screening Test (SISST) were used to evaluate the latter at baseline. These were repeated
regularly, every 4 to 5 weeks, over the 7-month period and included a retention test of 5
weeks. Based on the results from the subtests of the motor skill tests, a self-designed SMI
programme was integrated into the planning of the intervention programme for each boy
according to their sensory-motor needs. Subject A showed improvement in the following vestibular subtests in the QNST-III: Stand on
one leg (67%) and Tandem walk (83%) and retaining his standard from the Post-test to the
Retention test. For muscle tone ability and proprioception, the Arm and leg extension
subtest also demonstrated improvement (67%) from the Pre-to the Post-test. The results of
the subtest were not retained over the retention period and increased only slightly being
33% from the baseline score.
The proprioceptive function of Subject A showed great improvement in the following QNSTIII
subtests: Finger to nose (67%), Rapidly reversing repetitive hand movements (88%) and
Left and right discrimination (67%). The results of vestibular-related subtests for Subject G
showed improvement in the following: Stand on one leg (33%) and the Arm and leg extension task (33%). Some of the scores of Subject G started in the functional category of
“severe discrepancy”; however there was improvement in the following proprioceptionrelated
subtests: Finger to nose (43%), Thumb and finger circles (20%), and Reversing
repetitive hand movements (86%). Although Subject G showed gradual improvement over
time, his two sensory systems struggled to integrate with the more complex tasks. The
outcome of the individualised SMI programmes showed that the sensory-motor skills
improved by enhancing the stimulation of their vestibular and somato-sensory
(proprioception) function.
Regarding the SISST, Subject A progressed from a ‘fail’ to ‘pass’, in the following test items:
the Tonic Labyrinthine Supine (TLS), Tonic Labyrinthine Prone (TLP), Positive Support Reflex
(PSR) and the Ocular Alignment test items. Results from the Vestibular test for both Subject
A and Subject G appeared to be ‘hypo-vestibular’ (under-stimulated) according to the Post-
Rotary Nystagmus test (PRN) score at baseline. These scores were inconsistent during the
intervention. The only test item to show positive improvement for Subject G was the
Equilibrium Reactions. Lastly, both Subject A and Subject G remained in the ‘fail’ category
for Kinaesthesis, which may indicate their ongoing poor proprioception and spatial
orientation.
There is a need for further research in the area of sensory-motor individualised programmes
for children with ASD. Suggestions for future research interventions are to conduct the
individualised programmes either over a longer period of time and more frequently at three
times a week. / AFRIKAANSE OPSOMMING: Outisme Spektrum Versteuring (OSV) word beskryf as 'n neuro-ontwikkelingsversteuring
wat die sosiale interaksie en kommunikasie van individue beïnvloed. Daar is waargeneem
dat diegene met OSV, uitdagings met betrekking tot sensoriese insette ervaar, wat kan lei
tot motoriese agterstande. Beskrywende navorsing is toegepas met twee gevalle-studies.
Die ouderdom van die twee seuns wat met outisme gediagnoseer was, was 6- en 8-jaar oud.
Die doel van die studie was om ʼn Sensories-Motoriese Integrasie (SMI) program te
ontwikkel en te implementeer as intervensie wat op elk van die seuns spesifiek toegespits is.
Die intervensie-program het voorsiening gemaak om aan die uitvoering van bepaalde
motoriese vaardighede aandag te skenk en om die uitwerking daarvan oor die 7-maande
tydperk te assesseer. Die twee seuns (Geval A en Geval G) het individuele sessies van 30
minute elk twee keer per week bygewoon. Die SMI program het op die vestibulêre en
somato-sensoriese (proprioseptor) sisteme gefokus om hul vermoë en vordering waar te
neem.
Aan die begin van die studie is drie neuro-ontwikkelings- en diagnostiese meetinstrumente
(SCQ, ADIR-R en ADOS) deur 'n psigiater gelei om die vorige OSV diagnose van die seuns te
bevestig. Die “Quick Neurological Screening Test” (QNST III) en die “Sensory Input Systems
Screening Test“ (SISST) is benut om hul aanvangsvermoë as basislyn te bepaal. Hierdie
toetse was gereeld herhaal, elke 4 tot 5 weke oor ʼn tydperk van 7 maande en het ʼn retensie
toets van 5 weke ingesluit. Op grond van die resultate van die sub-toetse van die vermelde
motoriese vaardigheidstoetse, is die self-ontwerpte SMI intervensie-program vir elke seun,
volgens sy persoonlike sensoriese-motoriese behoeftes, beplan. Geval A het verbetering getoon in die volgende QNST-III sub-toets: Staan op een been (67%)
en Tandemloop (83%), en handhaaf sy standaard vanaf die na-toets tot en met die retensie
toets. Vir spiertonus en propriosepsie, het die Arm- en been-ekstensie sub-toets ook ʼn
verbetering (67%) van die voor-toets tot die na-toets getoon. Die resultaat van hierdie subtoets
is nie oor die hele tydperk gehandhaaf nie, en het net effens verhoog (33%) van die
basislyn telling. Die proprioseptiewe funksie van Geval A het 'n groot verbetering in die
volgende QNST-III sub-toetse getoon: Vinger na neus (67%), Vinnige omkeer, herhalende
hand bewegings (88%) en Links en regs diskriminasie (67%). Geval G se resultate vir die vestibulêre-verwante sub-toetse het verbetering in die volgende getoon: Een been staan
(33%) en Arm- en Been-ekstensie (33%).
Sommige van die resultate van Geval G het op 'n ernstige diskripansie begin, maar daar was
verbetering in die volgende proprioseptiewe verwante sub-toetse: Vinger na neus (43%),
Duim en vinger sirkels (20%) en Vinnige omkeer, herhalende hand bewegings (86%). Ten
spyte daarvan dat Geval G ʼn geleidelike verbetering oor tyd getoon het, het sy twee
sensoriese stelsels gesukkel om met die meer komplekse take met mekaar te integreer. Die
uitkoms van die geïndividualiseerde SMI programme het getoon dat die sensoriesemotoriese
vaardighede by beide seuns verbeter as gevolg van die verbeterde stimulering
van hul vestibulêre en somato-sensoriese (proprioseptiewe) funksie.
Die SSIST resultate toon dat Geval A van ‘druip’ na ‘slaag’ in die volgende toetsitems
gevorder het: Tonic Labyrinthine Supine (TLS), Tonic Labyrinthine Prone (TLP), Positive
Support Reflex (PSR) en die Ocular Alignment toetsitems. Resultate van die vestibulêre
toets, blyk dit dat sowel Geval A as Geval G ‘hipo-vestibulêr’ (onder-gestimuleer) was
volgens die “Post-Rotary Nystagmus toets” (PRN) meting wat by die basislyn toetsing behaal
is. Hierdie tellings was veranderlik tydens die intervensie. Die enigste toetsitem wat ʼn
positiewe verbetering by Geval G getoon het, was die Ekwilibriumsreaksie. Laastens, beide
Geval A en Geval G het in die ‘druip’ kategorie vir Kinestese gebly wat daarop dui dat hul
swak propriosepsie en ruimtelike oriëntasie steeds teenwoordig was.
Daar is 'n behoefte aan verdere navorsing op die gebied van sensoriese-motoriese
individuele programme vir kinders met OSV. Toekomstige navorsing wat individuele
programme benut, moet oorweeg om die intervensie oor ʼn langer tydperk (bv. een jaar) te
laat geskied met meer sessies per week (bv. drie sessies).
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/96084 |
| Date | 12 1900 |
| Creators | Hagemann, Carla-Rae |
| Contributors | Africa, Eileen, Welman, Karen, De Vries, Petrus, Stellenbosch University. Faculty of Education. Dept. of Sport Science |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 372 p. |
| Rights | Stellenbosch University |
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