OTCATS: Occupational Therapy Critically Appraised Topics
Introduction Topics Project Summary EBP Links Media Releases

There is insufficient evidence (level 4) to support or refute the use of therapy balls as
an alternate form of seating for improving classroom behaviour of children with
autistic/behavioural disorders.

Prepared by:

Kristy Holman
Email: kristy_holman@hotmail.com.
4th year undergraduate occupational therapy student,
University of Western Sydney


May 2005

Review Date:

May 2007

Clinical Question:

Are therapy balls an effective form of alternate seating compared to typical classroom chairs in improving in class behaviour and attention of children with autistic/behavioural disorders?

Clinical Scenario:

 There is currently increasing emphasis on the evaluation of sensory integration therapy by occupational therapists, for children with autistic and concomitant behavioural disorders. Children with autistic and behavioural disorders frequently exhibit difficulty with engagement, attention and appropriate behaviours for productive performance in the  classroom. Therapists aim to provide these children with an opportunity to modulate sensory input, while maintaining appropriate levels of behaviour during school time.  Anecdotal reports suggest that therapy balls as an alternate form of seating may provide a child with autistic and/or behavioural disorders with an opportunity to maintain appropriate classroom behaviours. How effective is such a treatment approach in changing the classroom behaviours of children with autistic/ behavioural disorders?

Clinical Bottom Line:


For children with autism, therapy balls used for up to 10 minutes a day, for three weeks
as an alternate form of classroom seating may improve in-seat behaviour and attention
to class activities by as little as 25% or as much as 80%.


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