Wednesday, August 09, 2006

More on the need for more rigorous evidence-based practice in pediatric OT

Today a colleague pointed out to me that there was such a thing as 'Sensory Stories.' During a conversation on the ABC Therapeutics discussion board she asked about 'Sensory Stories' and I thought she was talking about Carol Gray's Social Stories.

Turns out that some folks have tweaked the Social Story concept and are now marketing products. For more information on Sensory Stories you can buy them here or read information from the authors here. It seems that these are customizable stories that employ sensory-based strategies to help children learn to cope with hyper-responsivity to certain sensory information. In addition to the sensory strategies the authors suggest repetitive reading of the story, perhaps setting up a cognitive-behavioral script to help establish a coping routine to an upsetting situation.

The authors provide recommendations for how often the stories should be read, and make statements about their research - although this is all just weasel-worded - there is no published research on Sensory Stories - there isn't even much research yet on social stories (scroll to bottom of page of this link).

I was really hoping to find some reference to Carol Gray - even a tip of the hat, or perhaps a statement of permission to use the concept. I couldn't find anything. I am certain that Carol Gray does not need me watching her back, but not seeing the references to her original work kind of bothered me.

Of course the argument to be made is that Sensory Stories are different enough in concept that they should not be confused with Social Stories. But if I confuse them in concept, and automatically attribute the concept to Social Stories, isn't the question of intellectual property a valid question?

Besides all that - do we need another sensory-based intervention program out there that will make my phones ring off the hook - but never really conduct and publish the research to support that these ideas even work? Parents will hear about this. They will call and want us to implement these strategies. Sometimes they will work and sometimes they won't. When they don't work we will have angry parents who think we don't know how to implement the stories successfully. Then we will also receive ridicule from other professionals who will question why we make such bold statements about our interventions without having supporting research. Then, in the final link of this chain of events, I will have no response to the insurance company when they deny occupational therapy services for children because the interventions are still 'experimental.'

I am tired of the never ending stream of new interventions that are marketed heavily and never researched. Brain Gym, Therapeutic Listening, Wilbarger Protocol, etc., etc..

I volunteer my clinic to anyone who wants to conduct research on social stories, sensory stories, or chicken soup stories. Call the stories whatever you want. Just please lets do research before they become the latest craze on the money-making OT continuing education lecture circuit.

1 comment:

Amy Carlson said...

Thanks for your thoughts on this topic.

I am currently pursuing an OT protocol for my daughter. She is receiving traditional OT interventions at a clinic in town for sensory integration dysfunction and they have suggested the Wilbarger Protocol.

I'm an engineer. My background tells me that there is a reason for scientific research - no one wants to just take my word for it that a steel bridge will stand, they would really like me to prove it before they drive over (or under) it.

I hear glowing reviews of the Wilbarger Protocol. I want to believe but I don't understand why a very popular technique doesn't seem to have the research to back it up.

I understand that it is hard to get funding for research that isn't pharmacologically based. Still I have to wonder why something with seemingly so much anecdotal support doesn’t warrant some hard hitting research from somewhere.

I continue my digging (just one article in one journal please!!) and I thank you for your thoughts.