Showing posts from August, 2014

Patient vs. Client - What could go wrong? Look around and see...

Thirty years ago there was an important philosophical debate in the occupational therapy profession.  That debate had to do with whether or not use of the term 'patient' or 'client' was more appropriate for occupational therapy. Reilly argued that a move away from the term 'patient' would equate to abandoning the moral base of the profession and in fact changes the entire purpose of the profession.  She considered the change as abandonment of our ethics around patient care, and without those ethics we would no longer be in a position to help people because we would instead have to focus on contractually serving the needs of our patron clients. Yerxa and Sharrott were also deeply concerned about abandoning patient-based ethics.  They outlined several problems with client-based ethics ( my numbering for organization purposes ): 1. A legalistic or rights-based medical ethic is untenable for several reasons. First, it would require that requests for medical c

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.