The use of multisensory environments in children and adults with autism spectrum disorder: A systematic review

Abstract

Multisensory environment is a setting designed with activities and tools that offered sensory stimulation. Despite their widespread use, no evidence-based guidelines are currently available. The aim of this systematic review was to assess the impact of multisensory environment interventions in autism and to provide guidelines. We included all studies of multisensory environment interventions for autistic individuals retrieved from PubMed, Web of Science, and Science Direct up to 30 September 2024. Two researchers appraised the included literature and extracted the data. A total of 1247 unique records were screened for eligibility, and 10 studies were included. Data extraction included demographic characteristics, type of intervention, target symptoms, and outcome measures. Quality assessment tools included the Newcastle-Ottawa Scale and the Cochrane Risk of Bias for randomized controlled trials. The studies were synthesized narratively based on target symptoms. Four studies reported reductions in stereotypic behavior frequency in children and adults; while other studies suggest positive effects on sustained attention, and aggressive and sensory behaviors. Overall, there was insufficient evidence due to the paucity of literature, the significant variation between interventions, and the small sample sizes. Future research should aim to develop a structured intervention approach to address the common limitations of the included designs.Lay abstractMultisensory rooms, also known as multisensory environments, are widely used in clinical practice and schools for autistic people. Despite their widespread use, their usefulness or effectiveness in achieving specific improvements is still unclear. We carry out a comprehensive and systematic quality assessment of all available studies to test the effectiveness of multisensory environment interventions in autism spectrum disorder and to explore what type of targeted intervention is needed to improve both core symptoms and associated features. The results show that multisensory environment could be a useful tool to modulate aggressive and stereotyped behaviors in autistic individuals. Although there is insufficient evidence to conclude on the efficacy of multisensory environment for other types of targets, overall, the results may provide valuable insights for the development of future studies concerning the utility of multisensory environment in therapeutic intervention.

Keywords: Snoezelen®; autism; autism spectrum disorders; intervention; multisensory environment; multisensory room; rehabilitation; sensory rooms; systematic review.

Figure 1.

Prisma flow diagram for literature search strategy. From: Page et al. (2021). The figure outlines the search and review process with the total number of articles included and excluded in this review.