Research Article

Environmental Enrichment Therapy for Autism: Outcomes with Increased Access

Table 1

Specific questions for parental assessment.

Questions regarding symptom severity% affectedInitial scoreChange

Social skills
Basic skill
  Sitting still and waiting89%2.020.49
  Eye contact84%2.460.59
  Waiting for a turn82%2.450.50
  Interrupting a lot80%2.030.35
  Acknowledging people around him/her75%2.500.62
  Ability to entertain himself/herself51%2.450.51
Complex skill
  Making friends93%1.380.36
  Seems unable to pick up common social cues93%1.550.30
  Playing with other persons of the same age92%1.450.43
  Awkward in social situations88%1.880.30
  Can remember people’s names61%2.370.47
  Inappropriate signs of affection to loved ones51%2.550.41
  Showing inappropriate signs of affection to strangers49%2.540.34
  Can remember people’s faces45%3.140.43
  Lying or stealing25%3.030.49
  Making threats23%2.570.43
Personality trait
  Stubborn, cannot let it go74%2.350.33
  Inflexible opinions73%2.160.39
  Seeking attention72%2.350.33
  Sharing toys71%2.500.38
  Seems to not think before speaking70%2.430.31
  Obsessed with being in control62%2.380.27
  Shy59%2.670.41
  Being a sore loser54%2.400.45
  Suspicious or mistrusting of others36%2.880.30

Attention span
Basic skill
  Completes instructions84%2.130.51
  Attention span84%2.020.48
  Can keep focus83%1.880.44
  Able to concentrate83%2.090.51
  Squirms or fidgets82%2.000.41
  Pacing61%2.190.40
Complex skill
  Needs reminders85%1.810.33
  Cannot sit through something boring83%1.820.36
  Gets bored easily83%2.270.40
  Planning ahead83%1.460.40
  Finishes what they started82%1.770.40
  Can finish lengthy projects82%1.290.32
  Organizing self for an activity82%1.510.45
  Independently prepares for things81%1.450.44
  Cannot sit still81%2.090.41
  Accomplishes complicated tasks80%1.630.36
  Absent-minded79%1.830.43
  Constantly on the move78%2.000.38
  Loses or misplaces things73%2.090.37
  Has trouble deciding things71%2.180.48

Communication
Basic skill
  Sharing thoughts with words83%1.440.56
  Speaking in sentences79%1.340.48
  Pronunciation75%1.820.49
  Vocabulary75%1.530.51
  Repeating things over and over70%1.930.35
  Communicating needs with or without words66%2.560.63
  Uses the wrong words for things57%2.540.35
  Responding to his/her name46%2.960.55
  Stuttering18%2.410.48
Complex skill
  Understands what others are saying74%2.640.59
  Seems to just repeat what he/she heard69%2.080.43
  Uncontrolled swearing9%2.260.33

Learning
Basic skill
  Dressing self66%2.470.53
  Learning new concepts62%2.400.62
  Relating things together61%2.380.60
  Identifying patterns53%2.330.47
  Knows numbers31%2.220.49
  Knows the alphabet letters27%1.960.51
  Knows colors24%2.340.50
Complex skill
  Retells stories78%1.390.33
  Understands what is going on in a story77%2.010.42
  Follows a plot73%1.710.29
  Reads with expression72%1.550.28
  Tying shoelaces71%1.270.23
  Guesses words instead of sounding them out65%1.760.30
  Can learn abstract concepts64%1.610.41
  Understands concepts of time60%1.670.43
  Enjoys being read to60%2.140.40
  Understands denominations of money have different value60%1.490.36
  Basic math skills55%1.850.42
  Spelling54%1.840.41
  Understands what is not seen still exists45%2.190.47

Mood & behavior
Basic skill
  Giving in to cravings74%2.320.30
  Cannot interrupt favorite activities71%2.680.45
  Frequency of tantrums70%2.870.44
  Expressing emotion66%2.550.49
  Duration of tantrums59%2.940.50
  Unexplained bursts of laughter59%2.590.32
  Thrashing43%2.670.52
  Low energy levels38%2.820.50
  Hates spills on their clothes37%2.810.47
  Aggressive toward self37%2.850.43
  Cannot be away from primary caregiver32%2.930.53
Complex skill
  Severity of tantrums66%2.780.46
  Feels like mind is in a fog62%2.470.44
  Seems obsessed with one topic58%2.430.36
  Unreasonable fears42%2.960.39
  Unable to discard broken or worthless things36%2.700.50
  Cannot part with favorite blanket or object27%2.880.49
  Compulsive spending25%2.490.49
  Preoccupied with germs9%2.910.58
  Suicidal thoughts/side effects5%3.410.75
Personality trait
  Impulsive79%2.050.29
  Shouting instead of verbalizing66%2.350.34
  Feeling appropriate emotions66%2.770.38
  Getting overexcited easily65%2.570.30
  Screaming and screeching62%2.350.38
  Becoming discouraged easily62%2.570.35
  Ability to relax62%2.620.42
  Whining and complaining59%2.670.30
  Feeling serene59%2.720.38
  Crying57%2.960.35
  Aggressive toward others55%2.880.38
  Gets angry quickly and a lot53%2.790.38
  Cannot snap out of a bad mood43%3.010.43
  Regularly changes between overenthusiastic and miserable42%2.860.37
  Tendency to feel depressed33%3.080.37
  Obsessed with perfection29%2.980.41
  Panic attacks25%3.030.36
  Feeling guilty for no real reason22%3.160.33
  Preoccupied with tidiness20%3.040.37
  Obsession with death10%3.260.29

Anxiety
Basic skill
  Repetitive mannerisms73%2.200.32
  Watching the same show over and over70%2.010.42
  Repetitive motion all the time61%2.330.36
  Flaps hands when excited59%2.200.47
  Repetitive motion can be interrupted51%2.960.45
  Taps, clicks, pops, sniffs, or other tics43%2.370.43
  Grinding teeth42%2.580.67
  Twitches or other motor tics35%2.650.36
  Rocking back and forth28%2.680.55

Sensory processing
Basic skill
  Sensitive to loudness78%2.350.47
  Sensitive to busy loud crowds76%2.250.50
  Cannot handle transitions75%2.580.50
  Does not prepare for cold or warm68%2.380.44
  Sensitive to certain tastes63%2.640.38
  Accepts to wear a blindfold60%2.180.48
  Sensitive to electric motor sound59%2.410.51
  Sensitive to certain voices57%2.470.42
  Sensitive to certain textures57%2.810.57
  Hates brushing his/her teeth53%2.570.60
  Seems insensitive to cold48%2.770.51
  Bothered by water in his/her ears48%2.680.53
  Sensitive to clothing46%2.860.52
  Sensitive to light45%2.980.44
  Does not seem to feel pain44%2.890.56
  Sensitive to certain smells43%2.980.46
  Sensitive when touched42%3.010.50
  Quality of the sense of smell40%3.220.63
  Sensitive to feeling motion37%2.980.48
  Can discern different flavors36%3.130.53
  Can breathe in deeply33%2.970.54
  Hates wearing shoes32%2.800.66
  Sensitive to moving objects32%3.120.47
  Sensitive to dark31%3.060.43
  Ability to detect sounds28%3.160.52
  Looks flushed and overheated26%3.250.44
  Can feel and locate light touch26%3.230.54
  Sensitive to silence19%3.170.44
  Experiences unexplained tingling sensation16%3.500.06
  Can see well (with vision aids if needed)14%3.410.34
  Sweating suddenly for no reason13%3.080.54
Complex skill
  Seems unaware of threatening situations75%2.210.45
  Sensitive to certain pitches72%2.310.38
  Hates having haircuts64%2.130.56
  Scared of heights42%3.010.43
  Hears things that are not there19%3.080.48
  Sees things that are not there19%3.100.51

Eating
Basic skill
  Tries new foods62%1.920.57
  Tolerates different food textures62%2.150.43
  Leaves dinner table60%2.170.34
  Use of utensils 59%2.560.42
  Eats a variety of foods58%2.050.46
  Accepts food45%2.470.58
  Consistency of BM40%2.700.46
  Regular bowel movements36%2.720.52
  Gagging34%2.660.59
  Flatulence33%2.980.33
  Eats too little30%2.550.44
  Can feed himself/herself28%2.930.51
  Eats too much22%2.930.34
  Ability to chew20%2.880.56
  Ability to swallow13%3.150.58

Self-awareness
Basic skill
  Imaginary play61%1.960.53
  Unaware of surroundings57%2.760.55
  Unaware of self53%2.820.50
  Talking to himself/herself52%2.320.36
  Bladder control at night44%1.940.51
  Daytime bladder control34%2.020.64
  Daytime bowel movement control34%1.760.63
  Does not want to shower or bathe31%2.830.55
  Bowel movement control at night23%1.710.58
Complex skill
  Grooming and caring for appearing neat68%2.320.26
  Things do not seem real to him/her35%3.070.30
  Experiences “déja-vu”26%2.760.41
  Real life seems like it is a dream26%3.050.30
  Talking to people who are not there19%2.680.45
Personality trait
  Daydreaming53%2.520.28

Memory
Basic skill
  Can remember instructions54%2.220.45
  Can remember what happened yesterday42%2.250.47
  Visual memory32%2.990.37
Complex skill
  Can give directions to where they put something50%1.420.33
  Can remember directions to go find something46%2.170.43
  Can remember dates44%1.430.34
  Can remember facts43%1.910.40
  Can remember events40%2.150.41
  Can remember important events years ago38%1.860.29
  Can remember sequence of numbers36%2.290.38
  Can remember sequence of letters34%2.170.37
  Can remember songs28%2.830.53

Motor skills
Basic skill
  Balance on the left leg53%2.570.45
  Balance on the right leg52%2.580.43
  Balance in general44%2.950.54
  Tongue control44%2.690.45
  Accident prone43%2.860.43
  Walks into things43%2.870.47
  Tripping41%3.010.48
  Falling36%3.050.50
  Can keep his/her eyes on a moving target35%3.160.41
  Muscles are limp31%2.760.53
  Can scan with his/her eyes, left to right, top to bottom31%3.100.46
  Jumping30%2.690.48
  Strength of right arm28%3.010.43
  Strength of left arm28%3.030.43
  Walks on tippy toes27%2.450.51
  Control of fingers of left hand26%2.890.49
  Control of fingers of right hand26%2.890.51
  Strength of right leg26%3.080.42
  Strength of left leg26%3.100.44
  Running22%3.010.38
  Strength of neck21%3.210.43
  Involuntary movement occurs in the body in general20%2.930.58
  Right leg muscles are always tight20%2.920.43
  Left leg muscles are always tight19%2.940.44
  Control of right hand19%3.110.46
  Control of left hand19%3.080.47
  Drooling17%2.920.62
  Control of right leg16%3.100.51
  Control of left leg16%3.100.51
  Can go downstairs16%2.910.59
  Control of right arm15%3.090.49
  Control of left arm15%3.150.45
  Right arm muscles are always tight14%3.240.41
  Left arm muscles are always tight14%3.280.41
  Involuntary movements occur in fingers of right hand14%2.930.50
  Involuntary movements occur in fingers of left hand13%2.950.49
  Involuntary movements occur in right hand13%2.950.52
  Involuntary movements occur in left hand13%3.030.57
  Can go upstairs12%2.950.70
  Control of neck12%3.120.47
  Involuntary movements occur in right arm12%3.030.55
  Involuntary movements occur in left arm12%3.100.53
  Involuntary movements occur in right leg10%3.220.55
  Involuntary movements occur in left leg10%3.220.54
  Sitting up10%3.030.56
  Shakes all the time9%3.140.58
  Crawling8%2.960.49
  Walking6%2.890.63
  Standing on own4%2.360.61
  Standing being supported3%2.970.79
Complex skill
  Writing penmanship77%1.730.44
  Stays in the lines when coloring74%1.740.41
  Drawing ability73%1.850.46
  Scissor control71%2.230.43
  Catching with one hand66%1.890.27
  Catching with two hands58%2.470.45
  Ability to do push-ups57%2.130.25
  Clumsiness56%2.740.45
  Throwing skill55%2.700.44
  Ability to do sit-ups51%2.260.24
  Riding a bicycle49%1.690.36
  Control of facial expression48%2.780.39
  Kicking a ball48%2.780.40
  Posture45%2.910.37
  Ability to do squats44%2.510.30
  Strength of left hand37%2.890.40
  Strength of right hand36%2.860.43
  Riding a tricycle36%2.120.44
  Climbing skills32%2.970.47
  Control of right ankle17%3.030.41
  Control of left ankle17%3.020.42

Sleep
Basic skill
  Falls asleep right away53%2.550.41
  Has difficulty going back to sleep48%2.660.48
  Will not stay asleep43%2.750.46
  Wakes up grumpy34%3.040.55
  Sleeps in own bed30%2.220.46
  Sleeps in28%2.850.43
  Wakes up screaming at night18%3.210.61
  Falls asleep unexpectedly7%3.200.57
Complex skill
  Has bad dreams29%3.410.44

Other
 Is in physical pain17%3.270.19
 Frequency of absence episodes5%3.220.79
 Duration of absence episode5%3.570.47
 Difficulty to interrupt an absence episode4%3.030.77
 Frequency of convulsions3%2.930.77
 Intensity of convulsions3%3.240.80
 Unexplained body stiffening episodes3%3.240.22
 Duration of convulsions2%3.570.62
 Recovery time after an absence episode2%3.320.74
 Recovery time after a convulsion2%3.530.57
 Unexplained eye-rolling episodes2%3.180.68
 Unexpected loss of muscle tone1%2.860.76
 Feeling outside of body1%3.82−0.30
 Unexplained buzzing feeling1%3.71−0.43
 Unexpected loss of consciousness0%3.250.47
 Unexpected blackouts0%3.501.00