•  
  •  

ScholarWorks > HHS > OT > OJOT > Vol. 14 > Iss. 1 (2026)

 

Credentials Display

Catherine Cavaliere, PhD, OTR/L; Nadia Rust, OTD,OTR/L; Michelle Rogowski; Alyssa Calderone, COTA; Rebecca Marash, COTA; Amy Zdrodowski; John Damiao, PhD, OTR/L

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.

Comments

The authors declare that they have no competing financial, professional, or personal interest that might have influenced the performance or presentation of the work described in this manuscript.

Download

Share

COinS