A Polyvagal and Sensory Integration and Processing Approach to Supporting Development in Young Children with Autism

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Authors: Catherine Cavaliere, Nadia Rust, Michelle Rogowski, Alyssa Calderone, Rebecca Marash, Amy Zdrodowski, John A. Damiao
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Abstract

Background: The polyvagal theory presents a framework for understanding the autonomic nervous system’s role in influencing behavior, engagement, and connection. Children with autism experience regulation and sensory integration and processing differences that impact their sense of felt safety and engagement in their environment. The Safe and Sound Protocol (SSP) is an auditory program designed to stimulate the vagal system and support nervous system regulation. Methods: A retrospective multiple subject pretest-posttest design was used to examine the impact of the SSP on regulation, engagement, and skill acquisition in children with autism ages 2 to 3 enrolled in an early intervention center (n = 5). Quantitative outcome measures used were the Canadian Occupation Performance Measure (COPM) and Goal Attainment Scaling (GAS). Therapist session notes served as qualitative data. Results: Quantitative analysis of COPM scores pre/post SSP indicate a significant difference between pre and postperformance (z = 3.97, p < .001) and pre and postsatisfaction (z = 3.99, p < .001). Discussion: Two themes emerged from the qualitative data: Dynamic integration of regulation, attention, and engagement supporting participation; and exploration supporting praxis, engagement, and skill development. Results support the positive impact of using the SSP in conjunction with OT/SI for young children diagnosed with ASD.

Fields of Study & Subjects

Autism Spectrum Disorder Research Music Therapy and Health Occupational Therapy Practice and Research

Publication details

Journal / source
The Open Journal of Occupational Therapy
Volume
14
Issue
1
Pages
1–13
Publication date
15 January 2026
Language
EN