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. 2023 Oct 25:14:1269462.
doi: 10.3389/fpsyg.2023.1269462. eCollection 2023.

Effects of sensory integration training on balance function and executive function in children with autism spectrum disorder: evidence from Footscan and fNIRS

Junchen Deng  1 , Ting Lei  2 , Xiru Du  1
Affiliations

Effects of sensory integration training on balance function and executive function in children with autism spectrum disorder: evidence from Footscan and fNIRS

Junchen Deng et al. Front Psychol. .

Abstract

Introduction: This study investigates the efficacy of sensory integration training (SIT) in enhancing balance and executive functions in children with autism spectrum disorder (ASD), with the aim of highlighting its potential for organizing and processing sensory information in the brain.

Methods: Utilizing Footscan for biomechanical evidence and functional near-infrared spectroscopy (fNIRS) for neural activation, we engaged two participant groups: a control group (n = 9) and an experimental group (n = 9). Assessments involved the Sharpened Romberg Test (SRT) for balance under varied visual conditions and the Go/No-Go task for executive function.

Results: The SIT intervention significantly improved balance function, particularly in Visual Deprivation (VD) scenarios. Neurophysiological data revealed heightened activation in the right Inferior Frontal Gyrus (R-IFG) and right Middle Frontal Gyrus (R-MFG), suggesting enhanced executive function. The potential of R-IFG/MFG activation as a reliable biomarker for assessing executive function in ASD was identified.

Discussion: The study provides empirical evidence supporting SIT's effectiveness in enhancing balance and executive functions in children with ASD. The therapy not only improves sensory processing and motor skills but also appears to compensate for sensory deficits, particularly in vision, vestibular perception, and proprioception. Enhanced neural activation in specific PFC regions underscores SIT's role in improving cognitive aspects, including inhibitory control and cognitive flexibility. The multidisciplinary approach adopted for this research highlights the intricate interplay between sensory-motor functions and cognitive control in ASD, paving the way for integrated therapeutic strategies. Despite these advancements, the mechanisms through which SIT exerts these multifaceted effects require further exploration.

Keywords: Footscan; Go/No-Go; balance function; executive function; fNIRS; sensory integration training.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Enrollment, pre-test, intervention, and post-test procedures.
FIGURE 2
FIGURE 2
Sharpened Romberg Test and plantar pressure distribution system. (A) The SRT balance assessment comprises three stances: feet together, semi-tandem, and tandem. (B) The Footscan device from Rscan Company collected COPx, COPy, TTW, and EA when the participants’ feet were stationary and upright. COPx and COPy represent the displacement distances in the X- and Y-axis directions, respectively, caused by body offset during SRT, and are negatively correlated with balance ability. TTW denotes the total length of the moving trail generated by COPx and COPy during SRT tasks and is also negatively correlated with balance ability. Lastly, EA signifies the elliptical area surrounding 95% of the COP moving trail generated during SRT and is negatively correlated with balance ability (Mikolaizak et al., 2017).
FIGURE 3
FIGURE 3
Diagram of Go/No-Go testing conditions. The entire Go/No-Go task consisted of 48 trials, with 24 visual stimulus pictures for both the GO and Go/No-Go tasks. The target stimulus was presented randomly, with all visual stimuli having a duration of 1000 ms. The fixation point was represented as “+.” The interval between each visual stimulus was random, either 400, 600, or 200 ms. Participants were required to make judgments on the presented visual stimuli − pressing the space bar for Go stimuli and not responding to No-Go stimuli, with all keys pressed using the right hand. A practice session was conducted before the formal experiment, and the formal experiment was only initiated when the accuracy ratio (AR) reached 85%. Data with a task AR lower than 85% was discarded.
FIGURE 4
FIGURE 4
Alterations in ASD children’s balance ability in control and experimental groups pre- and post-intervention. “NV” represents Normal Visual, “VD” represents Visual Deprivation; *p < 0.05, **p < 0.01. COPxy: Distance traversed by the Centre of Pressure (COP) on the x- and y-axis during upright standing; TTW: Total length of the COP’s moving trail; EA: Elliptical area encapsulating 95% of the COP’s moving trail. (A) COPx Changes of participants before and after intervention. (B) COPy Changes of participants before and after intervention. (C) TTW changes of participants before and after intervention. (D) EA changes of participants before and after intervention.
FIGURE 5
FIGURE 5
Curve of plantar balance changes in control and experimental groups pre- and post-intervention. (A) The change curve of plantar balance in the control group before and after intervention. (B) The change curve of plantar balance in the experimental group before and after intervention.
FIGURE 6
FIGURE 6
Behavioral performance of ASD children and Go/No-Go task effects. **Indicates p < 0.01; n.s. indicates p > 0.05; AR denotes accuracy ratio; RT denotes reaction time; ASD denotes autism spectrum disorder. (A) RT Changes at each task level. (B) AR Changes at each task level. (C) Difference in Go/No-Go effects of RT before and after (D) Inter-task difference in Go/No-Go effects of RT.
FIGURE 7
FIGURE 7
Functional near-infrared spectroscopy (fNIRS) optode channels and activated regions of interest (ROIs) division in brain regions. The location distribution map of functional near-infrared spectroscopy (fNIRS) optodes, and the prefrontal lobe and several channels formed an activated region of interest (ROI); (A) Functional near-infrared spectroscopy (fNIRS) Optodes Location Decider (fOLD). (B) Distribution of optode channels in left and right brain regions. The schematic diagram of 44 channels on the Montreal Neurological Institute (MNI) space coordinate axes.
FIGURE 8
FIGURE 8
Levels of activation of oxy-Hb signals by sensory integration training (SIT) in ASD children. **Indicates P < 0.01; oxy-Hb denotes oxyhemoglobin; R-IFG denotes right inferior frontal gyrus; R-MFG denotes rostral middle frontal gyrus. (A) Changes of oxy-Hb signals in the R-IFG brain region (B) Changes of oxy-Hb signals in the R-MFG brain region. (C) Difference in Go/No-Go effects in the R-IFG brain region. (D) Difference in Go/No-Go effects in the R-MFG brain region.
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