Comments re: recent RCT on sensory integration
I received several emails asking me about the dialogue that was recently published in the Journal of Autism and Developmental Disorders regarding the Schaaf, et. al (2013) study. A kind colleague forwarded the comments to me and I had the chance to review them.
Ashburner, Rodger, Ziviani, and Hinder (2014) made some comments about the original research. They basically outlined concerns with the parent report measures, lack of blinding, and confounding impact of invested time for the parents. They also expressed concerns with dosage and non-equivalent treatment conditions between groups.
The original authors (Schaaf et al, 2014) thanked them for their comments and expressed that a treatment manual would be published later this year that might help others replicate the interventions. They also expressed that they are following a step-wise method of progression from case study to feasability study to RCT. They state that future studies will address some of the concerns raised. The authors defended the non-blinded and non-equivalent design, stating that using blinded evaluators was enough to address concerns and that treatment effects were large.
The concerns raised by Ashburner, Rodger, Ziviani, and Hinder are very similar to what was posted in this blog in December, right after the original study was published. There really are not any new concerns. Now they are just formally published concerns.
As I indicated in December, if there are true differences to be measured because of sensory integration treatment we will find them after we design studies that are not so vulnerable to criticism. I blogged about the design as soon as I read it because the problems seemed rather obvious. The fact that a group of academics and researchers bothered to write formal comments to the journal would seem to validate the concerns.
Ashburner, J.K., Rodger, S.A., Ziviani, J.M., Hinder, E.A. (2014). Comment on "An intervention for sensory difficulties in children with autism: A randomized trial by Schaaf et al. (2013)." Journal of Autism and Developmental Disorders, 44, 1486-1488.
Schaaf, R. et al (2013). An intervention for sensory difficulties in children with autism: A randomized trial. Journal of Autism and Developmental Disabilities, published online at http://link.springer.com/article/10.1007%2Fs10803-013-1983-8/fulltext.html
Schaaf, R. et al (2014). Response from authors to comments on "An intervention for sensory difficulties in children with autism: A randomized trial." Journal of Autism and Developmental Disorders, 44, 1489-1491.