Comparison of the Effects of Sensorimotor Integration and Cognitive Restructuring on Executive Functions and Social Skills in Individuals with Autism Spectrum Disorder

Abstract

This study aimed to compare the effectiveness and durability of sensorimotor integration and cognitive restructuring interventions in improving executive functions and social skills among children with autism spectrum disorder (ASD). This quasi-experimental study employed a pretest–posttest design with a two-month follow-up and a control group. The statistical population consisted of children aged 7–12 years with ASD in Kerman, Iran, during the 2024–2025 academic year. Forty-five eligible children were selected through purposive sampling and randomly assigned to three groups of 15 participants: sensorimotor integration, cognitive restructuring, and control. The two experimental groups received their respective interventions in six 45-minute sessions, whereas the control group received no intervention. Data were collected using the Behavior Rating Inventory of Executive Function (BRIEF) and the teacher form of the Elliott and Gresham Social Skills Scale. Repeated-measures analysis of variance and post hoc comparisons were conducted using SPSS version 26. The overall between-group effect on the dependent variables was significant (F=6.14, P<0.01). A significant effect of time was observed for executive functions (F=13.90, P<0.01, η²=0.54) and social skills (F=9.90, P<0.01, η²=0.44). The time×group interaction was also significant for both outcomes (P<0.01), indicating different patterns of change across the groups. Post hoc comparisons demonstrated that both interventions significantly improved executive functions and social skills compared with the control group (P<0.05), while sensorimotor integration produced significantly greater improvements than cognitive restructuring. At the follow-up assessment, significant between-group differences remained for executive functions (F=17.87, P<0.01, η²=0.45) and social skills (F=12.57, P<0.01, η²=0.37), confirming the persistence of the intervention effects. Both sensorimotor integration and cognitive restructuring can produce sustained improvements in executive functions and social skills among children with ASD. However, sensorimotor integration demonstrated greater effectiveness and durability across both outcomes, supporting its application as a potentially useful component of educational and rehabilitation programs for children with autism spectrum disorder.