Measuring the Outcomes of Therapeutic Listening in Children With Learning and Developmental Disabilities

Abstract

Date Presented 4/20/2018

Daily individualized use of Therapeutic Listening Quickshifts (TL-Q) is proposed to improve occupational performance in children with learning and developmental disabilities. This study identified a standardized practice-based evidence procedure to measure the outcomes of TL-Q in occupational therapy practice.

Primary Author and Speaker: Hannah Tashjian

Additional Authors and Speakers: Donielle Hair, Phoebe Taasan, Julia Wilbarger

PURPOSE: Thousands of occupational therapy practitioners worldwide use sound-based therapies despite limited evidence to support these interventions. Even fewer studies examine the effects of Therapeutic Listening (TL), an intervention proposed to improve skills such as sensory processing, visual–motor integration, and emotional regulation (Frick & Hacker, 2001). This study identified a standardized procedure to evaluate the effectiveness of TL as an intervention for children with learning or developmental disabilities.

TL is proposed to improve function through an individualized daily listening program of modified music. The music program is implemented at home as an intensive intervention designed to stimulate neuroplasticity across hemispheres, eliciting behavioral changes and improved neurological responses (Wink et al., 2017). This intervention is applied as a supplement to typical occupational therapy treatment.

Evidence-based practice requires establishment of TL as an effective intervention; however, given the individualized nature of TL programs, meeting the requirements of a randomized controlled trial, including random assignment and use of a control group, is difficult (Bazyk et al., 2010). Furthermore, traditional randomized controlled trials may not fully represent the effectiveness of TL because of the individualized nature of TL and the variability in practitioner-directed clinical reasoning and client goals. Therefore, a practice-based evidence (PBE) approach may be most appropriate for measuring the outcomes of TL because PBE allows for any data collected during standard treatment to be procured as synthesized results to clarify guidelines for practice.

METHOD: Using a multicenter, multiple case study design, this study evaluated changes in sensorimotor skills, self-regulation, maladaptive behavior, and activities of daily living (ADLs) in a convenience sample of 20 children aged 3–12 yr with learning and developmental disorders recruited from seven pediatric clinics across the United States. A PBE approach was used to measure the specific outcomes of a 12-wk Therapeutic Listening Quickshifts (TL-Q) home program.

The protocol consisted of pretest and posttest clinical assessments and semistructured parent interviews. The interview included the Canadian Occupational Performance Measure (COPM), adapted to measure social, emotional, self-regulation, communication, sensorimotor skills, and occupational performance in the context of ADLs and family life. Qualitative data were collected from weekly parent and therapist progress logs. Additionally, the Sensory Processing Measure, Beery–Buktenica Developmental Test of Visual–Motor Integration, Peabody Developmental Motor Scales or Bruininks–Oseretsky Test of Motor Proficiency, and a modified Clinical Observation Assessment were administered to the participants.

RESULTS: Preliminary results indicate positive changes in behavior and perceived improvement in sensory processing as measured by the COPM and parent logs. The symptoms and behaviors disabling participation were shown to diminish through the use of the TL protocol in the identified population.

CONCLUSION: The benefits of TL-Q are promising as a supplement to intervention for children receiving occupational therapy services for learning and developmental disabilities. Further, this study demonstrates that a PBE approach is feasible and productive for examining the effectiveness of occupational therapy interventions. A PBE approach has the potential to broadly impact effectiveness research in many areas of occupational therapy practice.

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., & Hacker, C. (2001). Listening with the whole body. Madison, WI: Vital Links.

Horn, S. D., DeJong, G., & Deutscher, D. (2012). Practice-based evidence research in rehabilitation: An alternative to randomized controlled trials and traditional observational studies. Archives of Physical Medicine and Rehabilitation, 93(8 Suppl.), S127–S137. https://doi.org/10.1016/j.apmr.2011.10.031

Wink, S., McKeown, L., & Casey, J. (2017). Parents’ perspectives of using a therapeutic listening program with their children with sensory processing difficulties: A qualitative study. Journal of Occupational Therapy, Schools, and Early Intervention, 10, 147–170. https://doi.org/10.1080/19411243.2017.1304839