Creating Sensitive, Objective Measurements to Demonstrate Positive Outcomes of Ayres Sensory Integration

Poor motor coordination can impact participation in age-appropriate occupations and affect self-confidence in children (Grajo, Guzman, Szklut & Philibert, 2020). Parents seeking occupational therapy intervention identify self-confidence as one of the most important treatment outcomes (Cohn, Kramer, Schub, & May-Benson, 2014). Further evidence is warranted to ensure intervention effectively addresses this parent priority. To examine the impact of Ayres Sensory Integration Intervention on motor coordination and self-confidence, researchers developed specific outcome measures in preparation for completing a multiple baseline single subject design study. In single-subject design studies, recurring tasks (probes) should be conducted throughout a study to continuously measure predicted outcomes, while ensuring that a practice effect would not increase performance over time. Researchers must also consider how to measure data objectively and reliably, as well as the sensitivity of a probe to change (Orsmond & Cohn, 2015). To measure improvements in coordination, investigators developed a variety of hopscotch sequences. The order of the sequence is changed each administration to prevent a practice effect. Sequences were designed to be of equal difficulty. This was verified through assessing two 7-year-old children with typical motor development, who completed all sequences equally well. To create an objective measure of motor coordination, investigators developed a rating form, which measures errors based on specific definitions. Two researchers established 92% reliability with this form by separately coding videos. To assess changes in self-confidence, researchers developed a Parent Perception of Child’s Self-Confidence form utilizing a visual analog scale. By preventing a practice effect, measuring data objectively and reliably, and developing probes which are sensitive to change, researchers can develop high-quality progress measures for treatment outcom

References

Andelin, L., Reynold, S., & Schoen, S. (2021). Effectiveness of occupational therapy using a sensory integration approach: A multiple-baseline design study. American Journal of Occupational Therapy, 75, 1-14. https://doi.org/10.5014/ajot.2021.044917

Cohn, E. S., Kramer, J., Schub, J. A., & May-Benson, T. (2014). Parents’ explanatory models and hopes for outcomes of occupational therapy using a sensory integration approach. American Journal of Occupational Therapy, 68, 454–462. http://dx.doi.org/10.5014/ajot.2014.010843

Orsmond, G.I., & Cohn, E. (2015). The Distinctive Features of a Feasibility Study: Objectives and Guiding Questions. Occupational Therapy Journal of Research (OTJR): Occupation, Participation and Health, 35, 169-177. https://doi.org/10.1177/15394492155786

Grajo, L.C., Guzman, J, Szklut, S. E., & Philibert, D. B. (2020). Learning disabilities and developmental coordination disorder. In Lazaro, R.T., Reina-Guerra, S.G. & Quiben, M.U. (Eds.), Umphred’s neurological rehabilitation 7th Edition. (pp. 321-351). St. Louis, Missouri: Elsevier.