Why Sensory Therapy in Autism Must Be Used as Breaks, Not the Core Intervention: Dr Kondekar Concerns it becoming the only therapy forced by many

Why Sensory Therapy in Autism Must Be Used as Breaks, Not the Core Intervention

Dr Santosh V Kondekar


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Introduction

Sensory-based strategies have become widely used in autism intervention because they help regulate arousal, reduce distress, and improve attention. Movement, deep pressure, and proprioceptive input can prepare children to engage with their environment and support participation (1,2).

However, an important distinction must be made: regulation is a preparatory state, not the endpoint of development.

Autism is fundamentally characterized by differences in social communication and restricted patterns of behavior. While sensory differences are part of this profile, meaningful developmental progress depends on engagement with people, language, and shared experiences (3).

Dr kondekar argues that sensory strategies should be used as short, purposeful breaks that support learning rather than replacing opportunities for listening, interaction, and communication.


Understanding the Role of Sensory Experiences
Sensory regulation stabilizes the nervous system and supports attention, allowing children to become available for interaction (1). 
However, sensory input alone does not develop language, social understanding, or cognitive skills.
Development occurs when children engage with people, interpret language, and participate in shared meaning-making (4).
Thus, sensory strategies should function as preparation for learning rather than as the primary therapeutic focus.


When Sensory Becomes the Only Therapy: A Concerning Trend

A concerning trend has emerged in some settings where sensory therapy dominates intervention time, sometimes to the exclusion of language-based or social learning opportunities.

When therapy consists largely of prolonged sensory routines without progression toward interaction, children may spend limited time:

Listening to language

Practicing communication

Developing understanding

Engaging socially


While such approaches may produce calmness, they risk leaving core developmental needs insufficiently addressed.

Regulation without progression is not intervention.


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The Ethical Responsibility of Intervention

Professionals have an ethical responsibility to ensure therapy addresses the primary developmental challenges of autism — communication, social engagement, and learning.

While sensory regulation is valuable, it cannot serve as a standalone intervention when opportunities for language exposure and interaction are limited.

Children deserve interventions that support their ability to connect, understand, and communicate, rather than approaches confined to regulation alone (3,5).


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Sensory as Breaks, Not the Core

Sensory strategies are most effective when used as brief breaks between learning sessions. Short sensory input can regulate arousal and improve attention, allowing the child to re-engage with communication tasks.

A practical framework is:

Stop → Look → Listen → Understand → Copy → Participate → Break

After a brief break:

Stop → Look → Listen → Learn

This cycle ensures sensory input supports engagement rather than replacing it.


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From Repetition to Connection

Restricted and repetitive behaviors in autism often involve sensory seeking. While these behaviors provide comfort, development depends on expanding beyond repetition toward connection with people and language (3).

Therapy should therefore prioritize:

Awareness of people

Looking at others

Listening

Emotional connection

Understanding meaning

Communication



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The Core Principles of Learning

Human learning is inherently social. Language develops through interaction and shared attention, not through sensory experience alone (4,6).

When therapy focuses primarily on sensory activities, children may remain regulated but disconnected from opportunities for communication.

Sensory prepares the brain — interaction builds the mind.


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Balanced Perspective

This perspective does not dismiss sensory therapy. Evidence supports sensory strategies as effective tools for regulation and participation (1,2). However, research also demonstrates that developmental and language-based interventions are critical for improving communication outcomes (5,7).

An integrated approach that combines regulation with language-rich interaction provides the most comprehensive support.


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Clinical Case Illustrations

Case 1: Sensory-Dominant Therapy With Limited Progress

A 4-year-old child received therapy primarily consisting of movement and deep pressure activities for several months with minimal language-based interaction.

Observation: Child appeared calmer but showed limited progress in communication.

Intervention Change: Therapy shifted to short sensory breaks followed by structured interaction and listening activities.

Outcome: Increased verbal attempts and improved engagement within three months.

Insight: Regulation alone did not support communication until language opportunities were introduced.


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Case 2: Balanced Sensory and Language Approach

A 3-year-old with sensory dysregulation received brief sensory preparation followed by play-based language therapy.

Outcome: Improved joint attention, increased response to name, and emerging expressive language.

Insight: Sensory input enhanced readiness for learning.


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Case 3: Overreliance on Sensory Routines

A child with autism spent most therapy sessions in sensory play with minimal interaction demands.

Outcome: Minimal progress in social communication.

Intervention: Increased conversational play and reduced sensory duration.

Result: Improved engagement and comprehension.


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Case 4: Parent-Mediated Listening Intervention

Parents were guided to use sensory breaks briefly at home followed by conversation and shared play.

Outcome: Improved attention and receptive language over four months.


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Implications for Practice

Clinicians should consider:

Using sensory strategies as preparation, not replacement

Limiting sensory duration

Prioritizing listening and interaction

Increasing language-rich engagement

Monitoring progress in communication


Therapy time should reflect developmental priorities.


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Conclusion

Sensory strategies are valuable tools but are not the destination of intervention. They prepare the nervous system, but development occurs through listening, interaction, and communication.

When sensory therapy becomes the primary focus, opportunities for language and social growth may be reduced. When used as brief supports within a broader framework of learning, sensory strategies enhance developmental outcomes.

The responsibility of intervention is not simply to calm children, but to help them grow.


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Key Messages

👉 Sensory prepares the brain; learning builds the mind.
👉 Sensory therapy should support, not replace, communication intervention.
👉 Development depends on listening, interaction, and connection.
👉 Regulation without progress is not intervention.




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