Practice-Based Evidence Approach to Studying the Effectiveness of Therapeutic Listening ®

PURPOSE: This study used a practice-based evidence approach to examine the effects of Therapeutic Listening^® (TL) on self-regulation and arousal, activities of daily living (ADLs), social–emotional skills, and sensorimotor skills in children with sensory processing disorders.

BACKGROUND: TL is frequently used as a complement to sensory integration intervention in children with sensory processing disorders. Occupational therapists (OTs) often report positive results using TL (Frick, 2006). However, there is sparse research supporting the effectiveness of this widely used therapy (Bazyk, Cimino, Hayes, Goodman, & Farrell, 2010; Hall & Case-Smith, 2007). Practice-based evidence (PBE) examines the effectiveness of clinical practice within the actual clinical context (Horn & Gassaway, 2010; Swisher, 2010). PBE capitalizes on using customary procedures and measures to establish clinical outcomes. The outcomes of TL were examined in a clinic setting under the guidance of clinical experts using commonly used assessment tools.

DESIGN: A pretest–posttest exploratory design examined the effects of TL intervention on self-regulation and arousal, ADLs, social–emotional skills, and sensorimotor skills. Measures included the Canadian Occupational Performance Measure (COPM), the Sensory Processing Measure (SPM), Clinical Observations of Motor and Postural Skills (COMPS), the Beery–Buktenica Developmental Test of Visual–Motor Integration (Beery VMI), and the Functional Listening Questionnaire (FLQ). Participants were eight children (enrollment ongoing until Fall 2016) with sensory processing disorders deemed to benefit from TL after an initial evaluation by OTs with advanced clinical expertise in Therapeutic Listening.

METHOD: At pretest, OTs administered the COMPS and Beery VMI, and parents completed the SPM and FLQ. Parents completed the COPM with OTs and established and rated goals in the four key domains. The intervention consisted of a 15- to 20-min session of Therapeutic Listening–Quickshift (TL–Q) twice daily for a total of 8 wk. During intervention, parents kept weekly logs of their child’s behavior in the four key domains. OTs kept logs on TL–Q music selections and the clinical reasoning for those choices. At posttest, parents completed the SPM, while OTs readministered the COPM, the Beery VMI, and the COMPS. Preliminary data analysis included a visual analysis of individual changes in the pretest and posttest measures. Later analysis will use paired t tests to determine if group pretest–posttest changes differ significantly (p < .05).

RESULTS: Preliminary results indicate the assessments were able to track progress during intervention. The COPM was particularly sensitive to changes. The parent logs provided additional insight into changes in behaviors. Consistent application of the TL–Q was a strong predictor of progress.

CONCLUSION: Preliminary evidence supports the use of TL as a complementary approach to sensory integration intervention for improving self-regulation and arousal, ADLs, social–emotional skills, and sensorimotor skills in children with sensory processing disorders.

IMPACT STATEMENT: More than 10,000 clinicians have been trained in the use of Therapeutic Listening worldwide. Evidence is sorely needed. This study demonstrates that clinicians can reliably measure outcomes of interventions in a clinical context using a PBE approach. This approach can be applied widely across occupational therapy to provide much-needed evidence for practice. The methodology used can provide an important means of gathering clinical evidence. The study also addresses intervention for emotional and physiological responses to sensation.

References

Bazyk, S., Cimino, J., Hayes, K., Goodman, G., & Farrell, P. (2010). The use of Therapeutic Listening with preschoolers with developmental disabilities: A look at the outcomes. Journal of Occupational Therapy, Schools, and Early Intervention, 3, 124–138. https://doi.org/10.1080/19411243.2010.491013

Frick, S. M. (2006). Therapeutic Listening evidence brief. Retrieved from http://www.catalysttherapy.com/wp-content/uploads/2012/08/Therapeutic-Listening_Evidence-Based-Brief.pdf

Hall, L., & Case-Smith, J. (2007). The effect of sound-based intervention on children with sensory processing disorders and visual–motor delays. American Journal of Occupational Therapy, 61, 209–215. https://doi.org/10.5014/ajot.61.2.209

Horn, S. D., & Gassaway, J. (2010). Practice based evidence: Incorporating clinical heterogeneity and patient-reported outcomes for comparative effectiveness research. Medical Care, 48(6), S17–S22. https://doi.org/10.1097/MLR.0b013e3181d57473

Swisher, A. K. (2010). Practice-based evidence. Cardiopulmonary Physical Therapy Journal, 21(2), 4.