Abstract
OTs are obliged to adhere to evidence-based principles. This qualitative study investigated OTs’ choices to implement sensory-based therapies in the face of conflicting evidence related to these approaches. Primary motivations related to the sensory processing difficulties not being adequately addressed by other interventions. Passionate beliefs in the effectiveness of sensory-based therapies, grounded in a nontraditional hierarchy of evidence, were identified.
Primary Author and Speaker: Tanya Rihtman
Contributing Authors: Diane Bird
Pressure is increasing on occupational therapists (OTs) to offer evidence-based interventions, challenged by a simultaneous surge in research demonstrating conflicting information (Rodger, Ashburner, & Hinder, 2012; Schaaf, Dumont, Arbesman, & May-Benson, 2018; Zimmer & Desch, 2012) about the efficacy of Ayres Sensory Integration® (ASI) and other sensory-based therapies. Despite the on-going debate in the literature, ASI and other sensory-based therapies are commonly implemented by OTs around the world.
This study aimed to investigated factors impacting upon OTs’ choices to implement sensory-based therapies in the face of conflicting views regarding the evidence base for ASI and sensory-based therapies, including: perceptions of the ASI evidence-base, impacts of potentially contentious opinions regarding ASI and sensory-based therapies on practice, factors informing sensory-based and ASI-related clinical decision-making, and factors motivating OTs to offer sensory-based therapies.
After receipt of ethical approval, purposive sampling was used to recruit six UK based OTs with postgraduate qualifications in ASI. Semi-structured, in-depth interviews (lasting 45 minutes on average) were held with each participant. Interviews which comprised two key questions with prompts were audio-recorded and transcribed verbatim. Qualitative thematic coding analysis (Robson & McCartan, 2016) was used to analyse the results.
Primary motivations for practicing sensory-based therapies related to the identification of sensory processing difficulties not being adequately addressed by other interventions. Additionally, a passionate belief in the effectiveness of sensory-based therapies, grounded in a non-traditional hierarchy of evidence which included personal clinical experiences, was identified.
The implications of drawing on clinical experience as a key source of evidence is that the ‘sensory goggles’ (referred to metaphorically as helping to address clients’ difficulties) could be perceived by others as ‘sensory blinkers’. OTs need to adopt a critical approach to their own clinical practice in which they routinely challenge their own predilections.
These findings have the potential to inform OT practice (in relation to sensory-based practices as well as other clinical areas) as they provide insight into factors that may impact upon the objectivity of how evidence-based practice is adopted in the ‘front line’ of clinical practice.
Robson, C., & McCartan, K. (2016). Real World Research, 4th Edition. Chichester, UK: Wiley.
Rodger, S., Ashburner, J., & Hinder, E. (2012). Sensory Interventions for Children: Where does our Profession Stand? Australian Occupational Therapy Journal, 59 (5), 337-8. doi: 10.1111/j.1440-1630.2012.01032.x.
Schaaf, R. C., Dumont, R. L., Arbesman, M., & May-Benson, T. A. (2018). Efficacy of occupational therapy using Ayres Sensory Integration®: A systematic review. American Journal of Occupational Therapy, 72, 7201190010. doi: 10.5014/ajot.2018.028431.
Zimmer, M., & Desch, L. (2012). Sensory Integration Therapies for Children with Developmental and Behavioral Disorders. Pediatrics, 129 (6), 1186-1189. doi: 10.1542/peds.2012-0876