Date Presented 4/17/2015
Goal attainment scaling (GAS) was used to identify functional changes following sensory integration therapy (SIT) for 5 preschool-age children seen for occupational therapy in northern California. Results indicate positive outcomes of SIT when measured with GAS for preschool-age children.
SIGNIFICANCE: Addressing sensory issues, especially for children with autism, is crucial (Lang et al., 2012; Pfeiffer, Koenig, Kinnealey, Sheppard, & Henderson, 2011). The extensive use of sensory integration therapy (SIT) within pediatric occupational therapy warrants a need for more sensitive outcome measures and additional research on fidelity and efficacy as well as a need for more sensitive outcome measures (Schaaf, Benevides, Kelly, & Mailloux-Maggio, 2012). Research on goal attainment scaling (GAS) as an outcome measure is limited, but its ability to measure short-term changes in functional performance makes it an appealing tool for documentation (Mailloux et al., 2007).
INNOVATION: This pilot investigation reports on an innovative collaboration between faculty and students at a university with an experienced occupational therapist (OT) at a clinic to implement the use of GAS as an outcome measure for children receiving SIT.
APPROACH: The study attempted to answer the following research question: Can GAS be used as a feasible, reliable, and valid outcome measure to detect functional changes in children receiving SIT in a clinic setting? Outcome measures need to show clinical utility to foster evidence-based practice. GAS shows potential to be used in clinical settings, but limited use has been reported to date.
METHOD: A one-group, pretest–posttest design was used in this investigation. A northern California pediatric clinic designed to support the use of SIT served as the setting. A convenience sample of 5 children identified with sensory processing difficulties and receiving SIT participated in this investigation. Outcomes were measured with GAS. The primary investigator (PI) has extensive training in the use of GAS and, with two graduate occupational therapy students, collaborated with the treating OT to develop GAS gradations. The Ayres Fidelity Measure (Parham et al., 2011) was used to confirm the use of SIT during intervention sessions. GAS scores were collected after 8 wk of SIT. Parents independently rated their child’s outcomes using GAS, and an exit interview was conducted with the OT to determine the usefulness of GAS within a clinic setting. The GAS data were analyzed with SPSS, and significant improvement (.01) in skills was noted after 8 wk of SIT. Parents independently reported similar changes using GAS.
RESULTS AND CONCLUSION: Results support the use of GAS as an outcome measure for OTs providing SIT. Additionally, the participating OT reported positive experiences using GAS in professional practice. Although these findings have limited generalizability due to the small sample size, the results do contribute to the evidence of the effectiveness of SIT using GAS as the outcome measure.
References
Lang, R., O’Reilly, M., Healy, O., Rispoli, M., Lydon, H., Streusand, W., . . . Giesbers, S. (2012). Sensory integration therapy for autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 6, 1004–1018. http://dx.doi.org/10.1016/j.rasd.2012.01.006
Mailloux, Z., May-Benson, T. A., Summers, C. A., Miller, L. J., Brett-Green, B., Burke, J. P., . . . Schoen, S. A. (2007). Goal attainment scaling as a measure of meaningful outcomes for children with sensory integration disorders. American Journal of Occupational Therapy, 61, 254–259. http://dx.doi.org/10.5014/ajot.61.2.254
Parham, L. D., Roley, S. S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J. P., . . . Schaaf, R. C. (2011). Development of a fidelity measure for research on the effectiveness of Ayres Sensory Integration® intervention. American Journal of Occupational Therapy, 65, 133–142. http://dx.doi.org/10.5014/ajot.2011.000745
Pfeiffer, B. A., Koenig, K., Kinnealey, M., Sheppard, M., & Henderson, L. (2011). Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. American Journal of Occupational Therapy, 65, 76–85. http://dx.doi.org/10.5014/ajot.2011.09205
Schaaf, R. C., Benevides, T. W., Kelly, D., & Mailloux-Maggio, Z. (2012). Occupational therapy and sensory integration for children with autism: A feasibility, safety, acceptability, and fidelity study. Autism, 16, 321–327. http://dx.doi.org/10.1177/1362361311435157
