Effects of Integrative Autism Therapy on Multiple Physical, Sensory, Cognitive, and Social Integration Domains in Children and Adolescents with Autism Spectrum Disorder: A 4-Week Follow-Up Study
Round 1
Reviewer 1 Report (Previous Reviewer 1)
It is importantin in the future to select the group in terms of cognitive and communication abilities , and to extend the study over time.
Author Response
Thanks for your favorable response.
Reviewer 2 Report (New Reviewer)
The paper presents an important comparison between CAT and IAT and this subject can be developed further in future articles.
My comments related to the article are:
1. Reference 2 in cited but nor present in the paper
2. English correction
3. Incomplete sentence: “The sSP assesses sensory processing dysfunction in children and adolescents with 139 impairments in the body structure and function domains of the ICF model. On 2.3.2 section”
4. Please, correct this paragraph’s alignment: “The sSP con- 140 sists of 38 items, including 7 functions of sensory processing (taste, tactile, smell, move- 141 ment, visual, and auditory sensitivity and under-responsiveness/sensation 142 seeking) -> also please put refereance or enumerate the 38 items.” + the English
5. Provide more details in the following sections: 2.3.1 – 2.3.7
6. In section: 2.5. Statistical analyses -> please provide the equations used
Author Response
Point 1: The paper presents an important comparison between CAT and IAT and this subject can be developed further in future articles.
My comments related to the article are: 1. Reference 2 in cited but nor present in the paper
Response 1: Please note that reference number 2 was cited in the introduction section of the manuscriprt (line 32).
Point 2:. English correction
Response 2: We have used a professional English editor as we prepare our manuscript. Please find the attached letter from the English editing service used for our manuscript.
Point 3:. Incomplete sentence: “The sSP assesses sensory processing dysfunction in children and adolescents with impairments in the body structure and function domains of the ICF model. On 2.3.2 section”
Response 3: The sentence is complete because “The sSP” is the subject and “assesses” is the verb.
Point 4:. Please, correct this paragraph’s alignment: “The sSP con- 140 sists of 38 items, including 7 functions of sensory processing (taste, tactile, smell, move- 141 ment, visual, and auditory sensitivity and under-responsiveness/sensation 142 seeking) -> also please put refereance or enumerate the 38 items.” + the English
Response 4: As the reviewer suggested, the paragraph was revised (lines 148-150).
Point 5:. Provide more details in the following sections: 2.3.1 – 2.3.7
Response 5: As the reviewer suggested, more detailed information was provided (section 2.3.1 - 2.3.7) in the method section.
Point 6:. In section: 2.5. Statistical analyses -> please provide the equations used
Response 6: The corresponding equations were provided for the statistical analysis implemented (section 2.5) in the method section.
Author Response File: 
Author Response.pdf
Reviewer 3 Report (New Reviewer)
A study of great disciplinary interest for therapists of people with Autism Spectrum Disorder is presented, which facilitates the selection of therapies according to the results found. However, it is important to describe in greater detail the previous characterization of the children that made up the study sample. It is also relevant to add the ethical approval, and the informed consent of the parents, for the conduct of the study, this because it is working with children and adolescents.
The methodology applied during the study is detailed and widely presents the details of implementation and theoretical justification and procedure performed.
Author Response
Point 1: A study of great disciplinary interest for therapists of people with Autism Spectrum Disorder is presented, which facilitates the selection of therapies according to the results found. However, it is important to describe in greater detail the previous characterization of the children that made up the study sample. It is also relevant to add the ethical approval, and the informed consent of the parents, for the conduct of the study, this because it is working with children and adolescents.
The methodology applied during the study is detailed and widely presents the details of implementation and theoretical justification and procedure performed.
Authors Response 1: The more detailed demographic characteristic information was provided in Table 1 (line 304).
“The ethical approval, and the informed consent of the parents” informations are presented in “2.1. Participants” section (line 109-113).
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
Article properly edited. The Authors have maintained a high methodological correcteness, correct sampling. It is important in the theoretical part of the article to describe the tests and samples used in the study for better understanding by the reader. It is necessary to think aobut possibility of continuing research in this area in the long term.
Author Response
Introduction was revised (line 91). Thanks for your favorable comments.
Reviewer 2 Report
In the manuscript, the authors reported potential interestingly preliminary data on the comparison between the effects of conventional autism therapy (CAT) and integrative autism therapy (IAT) in children and adolescents with autism spectrum disorder (ASD). Notwithstanding, the wide age range of the participants ( age range 1-16 years) and the lack of a description of the overall functioning of these patients (IQ level; Language level; adaptive functioning; behavioural problems) represent, in my opinion, a major limit in the study construction, because of the age of intervention and the functioning level in the wide spectrum of autistic disorder represent the basis for a personalized therapeutic treatment. Thus, I would suggest reconsidering the manuscript after major revision in materials and methods.
Author Response
Demographic data was revised (line 248: Table 1). We added intellectual level in the childhood autism rating scale (CARS), communication (comprehension and expression), and social cognition (social interaction, problem solving, and memory) in the functional independence measure (FIM). Our study established individualized goals using Canadian occupational performance measure (COPM), counseling, and focus group interviews, and provided an interventional approach by synthesizing the results of pretests. Data acquirement and analysis on an intellectual level, communication, and cognition have been conducted. We have utilizied the individualzied participants and parents centered COPM in setting individualized goals because the wide range of age and diagnois associated developmental problems were presented. However, the age and gender variables were relatively matched between the groups, which is unlikely affect the results of the study.
Round 2
Reviewer 2 Report
In the manuscript, the authors reported potential interestingly preliminary data on the comparison between the effects of conventional autism therapy (CAT) and integrative autism therapy (IAT) in children and adolescents with autism spectrum disorder (ASD). Notwithstanding, main limitations in the study could be represented, in methods, by the assessment tools (CARS; FIM), represented by observation-based rating scales, with partial descriptions of the neurocognitive profile and adaptive functioning of these children.
