Fidelity in sensory integration intervention research.
OBJECTIVE
We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles).


METHODS
We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements.


RESULTS
Most studies described structural elements related to therapeutic equipment and interveners' profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than half of the process elements. Intervention descriptions in 35% of the studies were inconsistent with one process element, therapist-child collaboration.


CONCLUSIONS
Validity of sensory integration outcomes studies is threatened by weak fidelity in regard to therapeutic process. Inferences regarding sensory integration effectiveness cannot be drawn with confidence until fidelity is adequately addressed in outcomes research.
Parham
L Diane
LD
Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street-CHP 133, Los Angeles, CA 90089, USA. Lparham@usc.edu
Cohn
Ellen S
ES
Spitzer
Susan
S
Koomar
Jane A
JA
Miller
Lucy Jane
LJ
Burke
Janice P
JP
Brett-Green
Barbara
B
Mailloux
Zoe
Z
May-Benson
Teresa A
TA
Roley
Susanne Smith
SS
Schaaf
Roseann C
RC
Schoen
Sarah A
SA
Summers
Clare A
CA
D006801:Humans; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care / Q000592:standards*; D020886:Somatosensory Disorders / Q000628:therapy*; D014481:United States