Teresa A. May-Benson, Susanne Smith Roley, Zoe Mailloux, L. Diane Parham, Jane Koomar, Roseann C. Schaaf, Annamarie Van Jaarsveld, Ellen Cohn; Interrater Reliability and Discriminative Validity of the Structural Elements of the Ayres Sensory Integration® Fidelity Measure©. Am J Occup Ther 2014;68(5):506–513. https://doi.org/10.5014/ajot.2014.010652
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© 2021 American Occupational Therapy Association
This study examined the reliability and validity of the structural section of the Ayres Sensory Integration® Fidelity Measure© (ASIFM), which provides a method for monitoring the extent to which an intervention was implemented as conceptualized in studies of occupational therapy using sensory integration intervention methods (OT–SI). We examined the structural elements of the measure, including content of assessment reports, availability of specific equipment and adequate space, safety monitoring, and integration of communication with parents and other team members, such as collaborative goal setting with parents or family and teacher education, into the intervention program. Analysis of self-report ratings by 259 occupational therapists from 185 different facilities indicated that the structural section of the ASIFM has acceptable interrater reliability (r ≥ .82) and significantly differentiates between settings in which therapists reportedly do and do not practice OT–SI (p < .001).
Does the structural section of the ASIFM show acceptable interrater reliability?
Does the structural section of the ASIFM demonstrate adequate discriminative validity in differentiating settings that provide OT–SI from those that do not?
Does the tentative total structural section cutoff score of 85 serve as a valid differential between settings that provide OT–SI and those that do not?
Do different types of practice settings that provide OT–SI yield structural section scores that differ from each other?
Do structural section scores differ between facilities that provide OT–SI in the United States and those that provide OT–SI in South Africa?
Researchers planning to study the outcomes of OT–SI should use both the structural and the process sections of the ASIFM to ensure that the OT–SI intervention delivered in the study demonstrates strong fidelity.
Researchers and occupational therapy practitioners who seek to evaluate the quality of evidence supporting OT–SI should examine whether structural and process aspects of the intervention have been systematically monitored in studies of OT–SI using instruments such as the ASIFM.
Occupational therapists who want to engage in best practice of OT–SI might use the ASIFM structural and process sections to evaluate and improve their own practice setting. For example, the structural section could be used to set criteria for therapist qualifications, to establish procedures for safety monitoring, to design or update OT–SI treatment spaces, or to thoughtfully select an array of equipment for use in intervention.
Consumers seeking OT–SI may be informed by the structural elements of the ASIFM to identify appropriately qualified therapists, to differentiate OT–SI from other services, and to better understand the significance of assessment methods, collaborative planning, safety, space, and equipment that are essential to the provision of OT–SI.
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