Sophie Molholm, Albert Einstein College of Medicine – Sensory Integration Therapy

On Albert Einstein College of Medicine Week:  Applied Behavioral Analysis might not be the only way to treat autism.

Sophie Molholm, professor of pediatrics, discusses a new option.

Dr. Sophie Molholm is professor of pediatrics, of neuroscience, and of psychiatry and behavioral sciences at Albert Einstein College of Medicine. She is also associate director of the Rose F. Kennedy Intellectual and Developmental Research Center at Einstein. She also directs the Human Clinical Phenotyping Core.

Dr. Molholm is interested in how the brain works, and gives rise to our experience in the world. She studies basic processes such as how the human brain processes and integrates sensory inputs to impact perception and behavior, mechanisms of attention, how speech processing is achieved, and higher-order cognition related to executive function.

Her work involves characterizing these processes in healthy adults, charting their developmental course over childhood, and translating these findings to understand the neurobiology of developmental and neuropsychiatric disorders, with an emphasis on autism, schizophrenia, and rare disorders such as 22q11.2 deletion syndrome and Rett syndrome. Non-invasive high-density recordings of the electrical activity of the brain, intracranial recordings in patients, psychophysics, magnetic resonance imaging, sometimes in combination with neuropsychological assessments of cognition and clinical diagnoses, are her primary tools of investigation. For example, using electrophysiological and behavioral measures, she and her colleagues have shown that the brain integrates multisensory inputs at very early as well as at later stages of information processing, and that how and where this is achieved is dependent on the stimulus type and the task being performed. They have also shown that multisensory integration, which relies on intact connectivity across anatomically segregated brain areas, has an extended developmental trajectory, and that it is impaired in autism.

Sensory Integration Therapy

Many children with autism have difficulty processing and integrating sensory information. Their sensory impairments affect behavior and their ability to manage skills like dressing and sitting down to eat and they may be overwhelmed with noise and sights.  

Parents of children with autism often use a therapy known as applied behavioral analysis, or ABA.  ABA therapists work on directly addressing an autistic child’s specific behavior. They focus on breaking down skills into steps and using prompts and reinforcements to improve a child’s performance of a skill.

Some researchers have found another therapy, called Sensory Integration Therapy, also is effective. In sensory therapy, a child participates in activities that are rich in sensory and motor experiences.  The goal is to help the child’s brain integrate and use sensory information as a foundation for higher skills.

A pilot study from our colleagues at Jefferson University found that sensory integration therapy helped children improve certain skills and meet behavioral goals. Now we need to build on this research and discover the neurobiological mechanisms underlying this therapy.

Our study is the first to compare ABA and sensory integration therapy in a randomized, clinical trial. We’re conducting neuropsychological assessments and evaluations, including measuring the brain’s electrical activity before and after therapy.

Autism spectrum disorders affect 1 in 59 children. Treatment across the lifespan is estimated to be $3.2 million.

That’s why it’s important to better understand how various therapies work. With our findings, we hope to discover how autism treatments affect brain function, and sensory processing and integration. Most importantly, we look forward to learning what treatments may be best for some children.