A Polyvagal and Sensory Integration Approach to Autism in Early Intervention

Originally published in the Open Journal of Occupational Therapy in 2026, this study examined how integrating the Safe and Sound Protocol (SSP) within an occupational therapy-sensory integration framework can support autonomic regulation, engagement and functional skill development in young children with autism in an early intervention setting.

Below is an overview of this study. The full publication can be downloaded at the Open Journal of Occupational Therapy website.

Background

Children with autism spectrum disorder (ASD) often face challenges in autonomic nervous system regulation and sensory processing, which can impede their sense of safety and ability to engage with their environment. This study explores how the Safe and Sound Protocol (SSP) supports regulation and engagement within an early intervention (EI) setting.

Method

Design: Retrospective, multiple-subject, pre-post test pilot study

Participants: Five children with ASD, ages 2-3 years, enrolled in an early intervention program center.

Intervention

Delivery Model: Each child received individualized SSP listening (Connect and Core pathways) integrated with Occupational Therapy using a Sensory Integration (OT/SI) approach.

Duration: Participants received two to three 30-minute sessions per week over a period of 10 to 12 weeks. Due to the participants’ young age, music was played over speakers rather than headphones.

Assessment: 

• Canadian Occupational Performance Measure (COPM): Completed by the children’s teachers to measure perception of performance and satisfaction in areas like self-care and social interaction.
• Goal Attainment Scale (GAS): Used to measure progress on specific goals drawn from each child’s Individualized Family Service Plan (IFSP).
• Qualitative data was gathered through analysis of therapists’ daily session notes to identify behavioral changes and themes.

Results

Quantitative Findings

The study reported significant improvements across all quantitative measures.

Canadian Occupational Performance Measure (COMP): There was a statistically significant difference between pre- and post-intervention scores for both performance (z = 3.97, p < .001) and satisfaction (z = 3.99, p < .001)

Goal Attainment Scale (GAS): 100% of the scaled goals were met, with 20% of goals exceeding the expected outcome.

Qualitative Findings

Analysis of session notes revealed two primary themes regarding the children’s development:

1. Dynamic Integration of Regulation, Attention, and Engagement:  Improved attention facilitated deeper engagement with peers and therapists while significantly reducing instances of dysregulation during environmental transitions.

2. Exploration Supporting Praxis and Skill Development:  Increased comfort in exploring novel activities and toys demonstrated improved motor planning (praxis) and the emergence of independent language skills, such as labeling items.

References

Cavaliere, C., Rust, N., Rogowski, M., Calderone, A., Marash, R., Zdrodowski, A., & Damiao, J. (2026). A polyvagal and sensory integration and processing approach to supporting development in young children with autism. The Open Journal of Occupational Therapy, 14(1), 1–13. https://doi.org/10.15453/2168-6408.2367