Occupational therapy for adults with intellectual disabilities and sensory processing challenges: a Delphi study exploring practice within acute assessment and treatment units

Purpose

Lack of research means guidance regarding the most effective sensory interventions for adults with intellectual disabilities is limited. Preliminary consensus evidence was created by gathering experienced occupational therapists’ views on practice. The purpose of this study was to establish important elements of practice when using sensory integration-informed approaches on assessment and treatment units.

Design/methodology/approach

A modified Delphi process was used to gather, explore and synthesise the views of 13 occupational therapists. Data was collected via online surveys and included quantitative importance ratings and qualitative comments.

Findings

An experienced panel was in strong agreement regarding many elements of practice they felt were important for use in this setting, and a list of important practice items was created. Two themes were identified: “Complexity” and “Pragmatism vs. Ideal World.” The themes highlight challenges to practice in this area and the complex clinical reasoning used to overcome these.

Research limitations/implications

Participants disagreed about the level of importance of a substantial number of items, therefore items that did not reach consensus may still be important.

Practical implications

This study indicates potentially helpful clinical tools, facilities and training and identifies support needed for occupational therapists working in these settings.

Originality/value

This study contributes to the body of knowledge regarding how occupational therapists do and could work with people with intellectual disabilities and sensory integration difficulties. Although this study takes a UK and Ireland perspective, similar agendas regarding care and support for those with intellectual disabilities internationally mean findings are relevant more widely.

The Effectiveness of Sensory Integration Therapy to Improve Functional Behaviour in Adults with Learning Disabilities: Five Single-Case Experimental Designs

This paper describes a research project using a single-case experimental design (A-B-A), which aimed to explore the impact of sensory integration therapy (SIT) on level of engagement and maladaptive behaviour (measured through timed scores) and function (using Goal Attainment Scaling, GAS) for five learning disabled adults with tactile sensory modulation disorder.

Each phase lasted 4 weeks and consisted of 24 measurements in total. Individually tailored SIT was given twice weekly for 4 weeks during the intervention phase (B), immediately prior to each individual's participation in his or her prescribed horticulture task. The changes between phases in engagement, maladaptive behaviours and function scores, measured as the difference between baselines and intervention, were analysed visually and statistically for each participant.

The intervention produced significant improvements in engagement for participant four, with a highly significant deterioration in scores for all five participants on withdrawal of SIT. All the participants' maladaptive behaviour decreased significantly on the introduction of SIT. Although there was no significant change to GAS scores for four participants, participant four's score improved significantly with SIT. The withdrawal of SIT resulted in a highly significant deterioration in GAS scores for participants one, two, four and five. This study may be the first to suggest that SIT is effective in improving functional performance in adults with a learning disability with a tactile sensory modulation disorder.

Research on the Efficacy of Sensory Integration Therapy: Past, Present and Future

Research on the efficacy of sensory integration therapy (SIT) is addressed in this article. Initially, past key reviews of intervention studies until 1994 are considered. Subsequently, more recent studies from 1994 until 2007 are examined. Consistent with numerous previous reviews, no robust evidence supporting the efficacy of SIT was found. Alternative and more parsimonious explanations for purported effects of SIT are considered. In light of the accumulated lack of evidence for the effectiveness of SIT, continued use of the technique outside of research contexts does not appear to be justified.

Occupational, speech and emotional therapy with students attending booster classes

The current study reviews the work being carried out in the Naomi Therapeutic Center in Kiryat Yam, Israel. The staff in this Center decided to provide a holistic response (which includes occupational therapy, speech therapy and art therapy) to 50 elementary school special education students in five booster classes. The goal of the study was to enable these students to improve their self-image, demonstrate fewer classroom adaptive behavioral problems and bring them to function better in class by the end of the school year. Findings demonstrate that in the study group, students' self-image scores were significantly higher at the end of the intervention program than they were prior to the intervention (p = 0.040). In addition, the study group demonstrated a significant difference in adaptive behavior scores before and after the intervention, indicating fewer adaptive classroom behavior problems towards the end of the intervention (p = 0.034). Finally, findings indicate that there was a significant improvement in students' functioning on all of the occupational therapy categories.