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Research Article  |   March 2007
Fidelity in Sensory Integration Intervention Research
Author Affiliations
  • L. Diane Parham, PhD, OTR/L, FAOTA, is Associate Professor, Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street—CHP 133, Los Angeles, CA 90089; Lparham@usc.edu
  • Ellen S. Cohn, ScD, OTR/L, FAOTA, is Clinical Associate Professor, Boston University, Sargent College of Health and Rehabilitation Sciences, Boston
  • Susan Spitzer, PhD, OTR/L, is Adjunct Assistant Professor, University of Southern California; and in private practice, Pasadena, CA
  • Jane A. Koomar, PhD, OTR/L, FAOTA, is Owner and Executive Director, Occupational Therapy Associates— Watertown, P.C.; and Board President, The SPIRAL Foundation, Watertown, MA
  • Lucy Jane Miller, PhD, OTR, FAOTA, is Associate Clinical Professor, Departments of Rehabilitation Medicine and Pediatrics, University of Colorado at Denver and Health Sciences Center; Director, Sensory Therapies and Research (STAR) Center; and Director, KID Foundation Greenwood Village, CO
  • Janice P. Burke, PhD, OTR/L, FAOTA, is Professor and Chair, Department of Occupational Therapy; and Dean, Jefferson School of Health Professions, Thomas Jefferson University, Philadelphia
  • Barbara Brett-Green, PhD, is Assistant Professor, University of Colorado at Denver and Health Sciences Center; and Senior Researcher, KID Foundation, Greenwood Village, CO
  • Zoe Mailloux, MA, OTR/L, FAOTA, is Director of Administration, Pediatric Therapy Network, Torrance, CA
  • Teresa A. May-Benson, ScD, OTR/L, is Research Director, The SPIRAL Foundation; and Clinical Specialty Director, Occupational Therapy Associates, Watertown, MA
  • Susanne Smith Roley, MS, OTR/L, FAOTA, is Project Director, USC/WPS Comprehensive Program in Sensory Integration, University of Southern California, Los Angeles
  • Roseann C. Schaaf, PhD, OTR/L, FAOTA, is Associate Professor, Vice Chair, and Director of Graduate Studies, Department of Occupational Therapy, Thomas Jefferson University, Philadelphia
  • Sarah A. Schoen, PhD, OTR, is Clinical Instructor, University of Colorado at Denver and Health Sciences Center; Director of Occupational Therapy, STAR Center; and Senior Researcher, KID Foundation, Greenwood Village, CO
  • Clare A. Summers, MA, OTR, is Occupational Therapist, The Children’s Hospital, Denver, CO
Article Information
Sensory Integration and Processing / Sensory Integration Treatment
Research Article   |   March 2007
Fidelity in Sensory Integration Intervention Research
American Journal of Occupational Therapy, March/April 2007, Vol. 61, 216-227. doi:10.5014/ajot.61.2.216
American Journal of Occupational Therapy, March/April 2007, Vol. 61, 216-227. doi:10.5014/ajot.61.2.216
Abstract

OBJECTIVE. We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles).

METHOD. We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements.

RESULTS. Most studies described structural elements related to therapeutic equipment and interveners’ profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than half of the process elements. Intervention descriptions in 35% of the studies were inconsistent with one process element, therapist–child collaboration.

CONCLUSION. Validity of sensory integration outcomes studies is threatened by weak fidelity in regard to therapeutic process. Inferences regarding sensory integration effectiveness cannot be drawn with confidence until fidelity is adequately addressed in outcomes research.