The Research Institute

With the inclusion of sensory abnormalities in the DSM-V criteria for autism, the multifocal touch/pain abnormalities reported in young children with autism are no longer comorbid symptoms, and it has become an urgent priority to identify their nature and significance. A recent study differentiated children with autism from typical and otherwise developmentally delayed groups on the two-fold basis of mixed allodynia and hypoesthesia, and severe global self-regulatory delay. In this study, we retrospectively analyzed case records for 266 pre-school children with autism and typical development to verify recent findings, assess the prevalence and location of tactile abnormalities in the autism group, and explore the relationship between tactile abnormalities and self-regulatory delay. Results differentiated the autism group by severity of tactile abnormality [F(1,262) = 172.8, p < .001] and self-regulatory delay [F(1,262) = 232.8, p < .001]. Allodynia was reported in 100% of the autism group by parent report and 98% by therapist report; hypoesthesia was present in 65% by parent report. Tactile abnormalities were directly, linearly related to self-regulatory delay (r = .727, p < .001) in both groups. The sense of touch has not been fully evaluated in autism, and there is insufficient quantitative evidence to conclude that it is intact. Mixed allodynia and hypoesthesia are typical signs of sensory neuropathy. Evidence of their near universal presence in young children with autism, and direct relationship to self-regulatory delay underscores the urgent need to fully evaluate the sense of touch in autism and rule out sensory neuropathy.

A Medical Qigong protocol was applied to a group of 8 autistic children under the age of 6. The children received Medical Qigong Massage twice weekly from the physician and daily Qigong Massage from the parents for a five week period, followed by daily parent massage for an additional four weeks. Standardized tests showed a decrease in autistic behaviors and increase in language development in all the children, as well as improvement in motor skills, sensory function and general health.

Objective To present a model for autism showing that impairment of sensory and self-regulation is the core deficit that underlies delays in social/language skills and abnormal behavior in autism; and to demonstrate the efficacy of a treatment for autism based on Chinese medicine. Methods Children with autism under 6 years of age were assigned to treatment or wait-list conditions. A total of 130 children were treated and the results compared with 45 wait-list controls. Treatment is a tuina methodology directed at sensory impairment—Kai Qiao Tuina. The treatment was a five-month protocol that was implemented daily by trained parents via trained support staff. The effects of treatment on the main symptoms, autistic behavior, social/language delay, sensory and self-regulatory impairment, as well as on parenting stress, were observed and compared. Results The treatment had a large effect size (P<0.0001) on measures of sensory and self-regulation. The evaluations done by pre-school teachers demonstrated improvement in the measures of autism (P<0.003), and were confirmed by evaluations done by parents (P<0.0001). There was a large decrease (P<0.0001) in parenting stress. Conclusions Sensory and self-regulatory impairment is a main factor in the development and severity of autism. Treatment of young children with autism with Kai Qiao Tuina resulted in a decrease in sensory and self-regulatory impairment and a reduction in severity of measures of autism.

Tactile abnormalities are severe and universal in preschool children with autism. They respond well to treatment with a daily massage protocol directed at tactile abnormalities (QST massage for autism). Treatment is based on a model for autism proposing that tactile impairment poses a barrier to development. Two previous randomized controlled trials evaluating five months of massage treatment reported improvement of behavior, social/communication skills, and tactile and other sensory symptoms. This is the first report from a two-year replication study evaluating the protocol in 103 preschool children with autism. Parents gave daily treatment; trained staff gave weekly treatment and parent support. Five-month outcomes replicated earlier studies and
showed normalization of receptive language (18%, 𝑃 = .03), autistic behavior (32%, 𝑃 = .006), total sensory abnormalities (38%, 𝑃 = .0000005), tactile abnormalities (49%, 𝑃 = .0002), and decreased autism severity (medium to large effect size, 𝑃 = .008). In addition, parents reported improved child-to-parent interactions, bonding, and decreased parenting stress (44%, 𝑃 = .00008). Early childhood special education programs are tasked with addressing sensory abnormalities and engaging parents in effective home programs. Until now, they have lacked research-based methods to do so. This program fulfills the need. It is recommended to parents and ECSE programs (ages 3–5) at autism diagnosis.

Autism is commonly associated with disturbances of the sensory nervous system, digestion and
sleep. This manuscript presents a randomized controlled study evaluating the effect of a fivemonth
intervention directed towards improving measures of sensory impairment, digestion and
sleep in 46 children with autism under six years of age. The intervention, Qigong Sensory
Training (QST) is a qigong massage intervention based in Chinese Medicine. It is two-pronged,
with trainers working with children directly 20 times over the five months, and parents giving the
daily massage protocol to their children. Improvement was evaluated in two settings: the preschool
and home, by teachers (blind to group) and parents. Teacher evaluations showed that
children receiving the QST intervention had significant classroom improvement of
social/language skills, and reduction in autistic behavior compared to wait-list controls. Parent
data confirmed the findings in the teacher data, indicating that the gains had generalized across
contexts. A model for understanding and treating sensory and self-regulation problems in autism
is advanced, outcomes data supporting the model are presented, and the limitations of the
research discussed.

Sensory and self-regulatory symptoms make up most of the comorbid symptoms in autism and
are associated with increased autism severity. We validated a parent–caregiver measure of
comorbid symptoms in autism, the Sense and Self-Regulation Checklist (SSC), in 265 children <
6 yr with typical development (n = 138), autism (n = 99), or other developmental delay (n = 28);
Cronbach’s α was .87. We report two new findings discriminating autism from other groups: (1)
multifocal tactile sensory impairment, characterized by hyporeactivity to injurious stimuli and
hyperreactivity to noninjurious stimuli (F [2,262] = 86.8, p < .001) and (b) global self-regulatory
delay (F [2,262] = 122, p < .001). Both findings suggest an explanation for social delay in
children with autism. The SSC reports a prevalence of sensory and self-regulatory findings
approaching 100% in the autism group (96% and 98% respectively), raising the possibility that
sensory and self-regulatory difficulties represent a core part of autism.

Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age six. Cronbach's alpha was .827. As a measure of parenting stress specific to core and co-morbid symptoms of autism, the APSI is unique. It is intended for use by clinicians to identify areas where parents need support with parenting skills, and to assess the effect of intervention on parenting stress. Mean parenting stress in the autism group was four times that of the typical group and double that of the other developmental delay group [F(2,272) = 153; p \ 001]. An exploratory factor analysis suggested three factors impacting parenting stress: one relating to core deficits, one to co-morbid behavioral symptoms, and one to co-morbid physical symptoms.