Term Paper on "Fidelity in Sensory Integration Intervention"

Term Paper 6 pages (2055 words) Sources: 4 Style: APA

[EXCERPT] . . . .

Furthermore, they used fidelity checks to do two things in the research: monitor and improve the procedures, and ensure the external validity of the trial. They used Parham et al.'s Fidelity Measure and found that raters were consistently able to distinguish the manualized interventions from other intervention approaches with 92% accuracy, after establishing a fidelity threshold of 80% (Schaaf et al., 2013). What their study made clear, and Parham et al.'s failed to adequately describe, was that fidelity was not necessarily measured by treatment outcomes, but by the extent to which a researcher adhered to an established protocol. They did acknowledge that they were limited by the prior existing research and that further research is needed.

Examining the study, the reviewer found it impossible to suggest a fidelity instrument that could have been better employed for the study. In the terms of a stand-alone study, a fidelity instrument that measures adherence to an intervention that has been manualized lends itself to the tool described by Parham et al. much better than the meta-analysis review that they used to create their original tool. In fact, while the ultimate tool would establish control scenarios measuring outcomes for interventions, as well as therapist adherence to only those interventions, the reality is that it would be virtually impossible to limit research in that manner because it would require limiting interventions outside of the research environment as well.

As this review demonstrates, there is little research into the role of fidelity in sensory integration interventions. This has made it difficult for professionals to determine which interventions are likely to be useful and which are less likely to be useful, because the research that has been conducted may not be measuring the interventions that it purports to measure. This has an impact on both the internal and external validity of the conclusions drawn by that research. However, there is a caution about the research that has focused on fidelity; there is tremendous overlap between the authors and they tend to use the same instrument to measure fidelity or base their instruments on that instrument. It would be a bonus for fidelity research to have an additional, reliable, and valid measure to use in assessment.

References

Miller, L.J., Schoen, S.A., James, K., & Schaaf, R.C. 2007. Lessons learned: A pilot study on occupational therapy effectiveness for children with sensory modulation disorder. American Journal of Occupational Therapy, 61(2), 161-9.

http://www.spdfoundation.net/pdf/Miller_Schoen.pdf

Parham, L.D., Cohn, E.S., Spitzer, S., Koomar, J.A., Miller, L.J., Burke, J.P., Brett-Green, B.,

Mailloux, Z., May-Benson, T.A., Roley, S.S., Schaaf, R.C., Schoen, S.A., & Summers,

C.A. (2007). Fidelity in sensory integration intervention research. American Journal of Occupational Therapy, 61(2), 216-227. http://ajot.aotapress.net/content/61/2/216.full.pdf+html

Schaaf, R.C., Benevides, T., Kelly, D., & Mallioux-Maggio, Z. 2012. Occupational therapy and sensory integration for children with autism: A feasibility, safety, acceptability, and fidelity study. Autism, 16(3), 321-7. doi:10.1177/1362361311435157

http://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1013&context=otfp

Schaaf, R.C., Benevides, T., Mailloux, Z., Faller, P., Hunt, J., van Hooydonk, E., Freeman, R.,

Leiby, B., Sendecki, J., & Kelly, D. 2013. An intervention in sensory difficulties in children with autism: A randomized trial. Journal of Autism and Developmental Disorders. doi: 10.1007/s10803-013-1983-8.

http://link.springer.com/article/10.1007%2Fs10803-013-1983-8/fulltext.html READ MORE

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