Understanding How School-Based OT Practitioners (OTPs) Perceive Sensory Integrative and Sensory-Based Interventions: Knowledge Base and Practical Application

Abstract

Date Presented 03/28/20

Recent literature has defined therapist-led and therapist-supported categories of how OTPs provide sensory supports. This session will provide an overview of how, when, and where school-based OTPs support children with sensory-processing difficulties. Discussion will include how OTPs gained their sensory knowledge, utilize current terminology, and are able to implement physical and process elements of ASI fidelity components.

Primary Author and Speaker: Rochele Charles

Contributing Authors: Tara Glennon

Recent literature [1] described categories of sensory-based OT interventions, including Therapist-Led Sensory Integration Intervention (TL-SII), Therapist-Led Sensory-Based Intervention (TL-SBI), Environmental Supports and Adaptations, and Caregiver/Teacher Mediated Interventions. However, it is unclear if school-based OTPs were using this terminology and/or understanding the conceptual differences between providing direct SI intervention (Ayres Sensory Integration [ASI]) or more general sensory-based interventions. Therefore, the purpose of this investigation was to understand how/why school-based OTPs used sensory terms and concepts. Specifically, the perceptions, practices, facilitators, and barriers to implementing direct OT services categorized as ASI or sensory-based interventions in order to support children with sensory processing concerns.

RQ: How do school-based OTPs conceptualize, describe, and implement therapeutic support provided to children with sensory processing concerns?

DESIGN/METHOD: Non-experimental, survey via SurveyMonkey. The researcher-developed survey (following extensive literature review) was piloted (n=5) for clarity, organization, and comprehensiveness of content. The final survey included 4 demographic queries (setting, experience); and 10 Likert scale formatted questions related to knowledge level, knowledge acquisition, practice/application principles and concepts (direct services, sensory strategies, environmental adaptations), frequency of carry-over activities in the classroom, physical qualities of the OT space; physical and process elements of ASI; and barriers to implementation of sensory interventions.

PARTICIPANTS: Following IRB approval, participants were recruited via social media postings, publically available email blasts from OT professional organizations and state associations, AOTA’s OTConnect, and snowballing. Inclusion criteria was state licensure, NBCOT certification, practice within the US, and currently working 75% in school-based practice, as well as access to the internet.

DATA ANALYSIS: Descriptive statistics (frequencies and percentages) and cross-tabulation was used to further understand the perceptions, knowledge base, and practices of demographic classifications.

RESULTS (n=284):

KNOWLEDGE ACQUISITION

1) TL-SII (ASI): college course (60%), OT Journals (52%), Cont Ed (34%)

2) TL-SBI: Cont Ed (64%), OT Journals (60%), college course (52%)

TL-SII: I have heard of ASI fidelity measure but do not know the specifics (51%); knowledgeable about ASI (25%); not aware of ASI (24%)

CLASSROOM SUGGESTIONS: Movement breaks (53%); alternative seating (36.68%); visual organization and decreased distraction (23.91%); and minimize auditory distractions (23.58%); with less than 25% suggesting fidget toys, sensory corner, headphones, and weighted tools.

PHYSICAL ATTRIBUTES OF OT ROOM: designated room less than 12’x12’ (25%); greater than 12‘x12’ (44%)

EQUIPMENT: suspended equipment (44.81%); trampoline (58.49%); therapy balls (84.91%); mats, cushions, or pillows (75.94%); scooter board (76.42%); weighted objects (76.89%); vibrating toys (50.00%); spandex/lycra fabric (51.89%); tactile material (79.72%); and visual targets (55.66%).

CONCLUSION: This study provides a better understanding of how school-based OTP conceptualize and implement sensory-based interventions. While 60% stated learning about ASI in college, professional literature [2] suggested that professional education lacks structure and consistency across universities. At least 79% or above implemented each process element of the ASI Fidelity Measure [3]. These findings provide the profession with useful information in understanding how school-based OTPs implement sensory support for children, as well as future domains for support.

References

Bodison, S. C. (2018). A comprehensive framework to embed sensory interventions within occupational therapy practice. SIS Quarterly Practice Connections, 3(2), 14-16.

Baltazar Mori, A., Carrasco Koester, A., Holland, D., Fernandes, P., Gray Rogers, R., Roley, S. S., & Soechting, E., VanJaarsveld, A. (2017). Building competency in SI: Evidence-based guidelines for occupational therapy using Ayres Sensory Integration®. OT Practice, 22(12), 8-13.

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 the Ayres Sensory Integration® intervention. American Journal of Occupational Therapy, 65(2), 133-142. doi:10.5014/ajot.2011.000745