Running head: EVIDENCE SYNTHESIS PAPER: PARENT PERSPECTIVES

Evidence Synthesis Paper:

Parent Perspectives of Occupational Therapy Using a Sensory Integration Approach
Gifty Frimpong and Melody Klatt
Touro University Nevada

EVIDENCE SYNTHESIS PAPER: PARENT PERSPECTIVES

Research Question
During fieldwork, many aspects of a sensory integration approach to treatment for
children were demonstrated in the outpatient clinic that we observed at. The children
participated in it and seemed to enjoy it, and the occupational therapists who worked with them
commented on the treatment methods effectiveness. One area of consideration that was not
directly addressed, however, was a direct commentary from the parents on how they viewed a
sensory integration approach to treatment for their child. Therefore, we posed a research
question: How do parents of children who participate in occupational therapy describe the
effectiveness of sensory integration treatment in improving quality of life for their children?
How does this study relate to your research question?
The qualitative study that we chose to address our research question directly related to the
subject that our question focused on. The question asked about parents viewpoints on the
sensory integration approach to treatment that their children receive in therapy, and the research
article entitled Parent Perspectives on Occupational Therapy Using a Sensory Integration
Approach was written about that very topic. It provided information that was gathered through
interviewing parents who had children who participated in sensory integration treatment, and this
supplied some insight into an answer for our research question.
What is the purpose of the study?
The purpose of the study was to gain a better understanding of parents perspectives
regarding their childrens participation in occupational therapy using a sensory integration
approach. To expand the understanding of outcomes of sensory integration treatment, it was
expressed that there is a need for more research to be conducted regarding perspectives from the
child and family (Cohn, 2001). This study was designed to interview parents and gather

EVIDENCE SYNTHESIS PAPER: PARENT PERSPECTIVES

information directly from their reports on how they view the treatment that their children had
received through sensory integration treatment in occupational therapy.
Were research questions asked? If so, what are the research questions?
The main research question that led to the purpose of this study had to do with a topic
that was very similar to the research question proposed in this paper: The topic of parents
perspectives on sensory integration treatment for their children in occupational therapy (Cohn,
2001). Aside from this, the author also identified other questions for future research at the end of
the article. The author felt that the study actually produced more questions that could be
answered by further research, and she identified potential premises, which will be discussed later
in this paper (Cohn, 2001).
What is the study design/ type of qualitative research?
The author stated in the article that she utilized a collective case study approach to gather
information from the participants in the study, and she also stated that she used a grounded
theory approach while analyzing the data that she gathered (Cohn, 2001). Her efforts to explore
the individual cases that each participant in the study presented supported the fact that she
utilized a case study approach, and the way that she worked with the actual data was very much
in line with a grounded theory approach (Cohn, 2001). According to authors Strauss and Corbin,
the grounded theory approach to research allows a researcher to create an explanation or theory
of a process, interaction, or action that is derived from the views of a number of participants
(1998). The approach focuses on examining the meaning of an experience that the participants
have had, and allows for an opportunity to explain something that occurred or provide a premise
for future research (Strauss & Corbin, 1998). The author of this study sought to discover
explanations and themes behind parents perspectives on a sensory integration approach to

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treatment, and this theoretical perspective allowed her to gather and study the data in a way that
would help her to support the purpose of the study (Cohn, 2001).
Technically, the study also could have been identified as a phenomenological study,
because the study was focused on examining individuals viewpoints on a specific experience,
but the author did not identify the research as being this type or design. She focused instead on
relaying the fact that she viewed her work with the parents as being more along the lines of a
case study approach, and the fact that she viewed her work with the actual data as being more
along the lines of a grounded theory approach (Cohn, 2001).
What is the theoretical perspective of the researcher for this study?
The author did not specifically state that she was following any particular theoretical
perspective while conducting the study, and it is therefore difficult to formulate a conclusion
about what theoretical approach she may have been using. The author may have been following
a theoretical perspective that was centered on occupational science to formulate her basic
assumptions, as she made the following statement in the article while discussing the purpose of
the study: I carry an underlying assumption that occupational therapy is effective and can
contribute to changes in children and the entire family system (Cohn, 2001, p. 287). She
described this as her basis for wanting to explore parents perspectives in relation to this part of
occupational therapy treatment, and though she didnt state it directly, this could have been the
theoretical perspective that she kept while she conducted the study (Cohn, 2001).
How were the participants recruited and selected?
The participants were recruited from parents who had children that received occupational
therapy, using a sensory integration approach, from a private clinic in a northeastern suburban
community in the United States (Cohn, 2001). The participants parents of 22 children were

EVIDENCE SYNTHESIS PAPER: PARENT PERSPECTIVES

randomly selected from parents of 42 children who met the inclusion criteria for the study (Cohn,
2001). These parents were sent a letter that explained the purpose of the research study that was
to be conducted, and they were offered an opportunity to have their name removed from the
proposed list of participants (Cohn, 2001). The parents who chose to allow their names to be
included in the list were contacted by phone to schedule a time to be interviewed by the author
(Cohn, 2001).
How many participants were in the study?
16 parents were included in the study (Cohn, 2001). There were 14 mothers and two
fathers; the fathers were part of a husband-wife couple that interviewed together (Cohn, 2001).
All of them agreed to participate in the requirements and were interviewed for the research study.
How are the participants described?
As stated previously, only two families who scheduled interviews included both a mother
and a father. In general, the parents had residences in single-family homes in suburban
communities, and all participants were in the ethnic classification of White (Cohn, 2001). The
parents were all in the moderate-to-affluent socioeconomic range, and all parents, with the
exception of one, had college degrees; half had masters degrees (Cohn, 2001). All were parents
of children who were four-to-10 years of age, and the children had formal diagnoses of a type of
sensory integration dysfunction (Cohn, 2001).
The children of the parents had participated in at least 32, one-hour therapy sessions, and
all of them had stopped therapy at least one-month-to-two-years before the interview took place
(Cohn, 2001). This was the criteria that was established for the purpose of the study.
What is the relationship of the researcher to the participants?

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The author did not state any specific ways that she had a relationship with the participants
of the study. She did mention that all participants were recruited from the same private clinic,
however, which may be an indication that the author was connected in some way to the clinic
(Cohn, 2001). In the actual process of conducting the research, the author acted as the
interviewer and contact for the participants.
What are the sources for data?
The sources for the data in this study were interviews that took place in the homes of the
participants with a duration time that spanned from one-to-two hours. According to Cohn, the
participants were asked questions during the interview that had to do with what constituted a
typical day for their child, what led the participants to seek occupational therapy for their child,
and what benefits they hoped to see from therapy (2001). The author used an audiotape and
transcribed each interview that was conducted. In order to make sure that the gathered
information was accurate, the researcher also reviewed the results by comparing the transcripts
with the original audiotape that had recorded the interview.
How are the findings reported?
The findings of the study were reported in themes that the author identified from the data
that she collected during the interviews. The themes were formulated based on common ideas
that had surfaced during the interviews while the parents were reporting on their experiences,
and the author was able to identify these themes after reviewing the data. The author also
specified that the themes were divided into two categories: child-focused outcomes, and parent
outcomes (Cohn, 2001).
What are the findings?

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The findings of the study were categorized into themes that the author identified based on
the interviews that she conducted and the data that she reviewed. The child-focused outcomes
were centered on benefits that parents identified in terms of what their children gained from
participation in therapy, including abilities, activities, and reconstruction of self-worth (Cohn,
2001, p. 285). For parent outcomes, themes were reported based on the parents report of their
experiences, including the fact that parents valued understanding their childrens behavior in
new wayshaving their parenting experience validated, and being able to support and advocate
for their children (Cohn, 2001, p. 285). Overall, the parents reported that their childs
participation in this type of occupational therapy was beneficial, and that they saw improvements
for both their child and themselves after taking part in this treatment.
How do the findings relate to previous research as described in the literature review?
The literature review that the author conducted focused on previous research studies that
examined the effectiveness of sensory integration approaches in increasing childrens motor,
sensory processing, and academic skills (Cohn, 2001). The author reported that a few other
studies also specifically examined parent perspectives on the effectiveness of sensory integration
treatment, which directly relates to what she was attempting to describe in her study (Cohn,
2001). The findings of this study relate to the outcomes of these previous studies, in that the
findings focused on both the effectiveness of sensory integration treatment and also the
perspectives that parents have on the treatment.
Does the author state any clinical implications for the findings?
The author stated several clinical implications for the findings of this study. She
identified that understanding parents perspectives on this type of treatment is a significant
indicator of whether or not the treatment truly has a positive effect on a childs life, and that

EVIDENCE SYNTHESIS PAPER: PARENT PERSPECTIVES

reflecting on a childs experience in occupational therapy is a critical component to evaluating its

effectiveness (Cohn, 2001). The author also mentioned that the themes within the findings can
help shape the focus of some aspects of occupational therapy treatment. For example, she stated
that the theme of reconstruction of self-worth that was identified by the parents as being
important in regards to the childrens experience in occupational therapy can help remind
practitioners to monitor how our young consumers perceive themselves across the various
contexts of their everyday lives (Cohn, 2001, p. 292).
What are the limitations that the author identifies?
One of the significant limitations of the study that the author identified was the fact that
the participants only represented a White, middle-and-upper-class socioeconomic status, and
were therefore not representative of a more diverse population (Cohn, 2001). Another identified
limitation was the fact that the children themselves did not provide their perspective of the
sensory integration approach (Cohn, 2001). A third limitation was identified in the fact that
teachers were not interviewed for the study, and due to the fact that teachers are so heavily
involved in a childs daily life, the author believed that having their perspectives added to the
data would have been beneficial (Cohn, 2001).
Does the author discuss implications for future research?
At the conclusion of the study, the author discussed several implications that were
proposed for future research in regards to this topic. One of the implications included a
suggestion to elaborate on parents perspectives, as the author felt that many unanswered
questions remained after the interviews were conducted (Cohn, 2001). A second suggestion was
to conduct this study with participants from different socioeconomic statuses and backgrounds in
the interest of making the results more generalizable (Cohn, 2001). To add to this as stated

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previously the author suggested that sources from other disciplines be interviewed as well,
especially teachers, because of how much time they spend with these children during the day
(Cohn, 2001). Thirdly, the author suggested that future research should explore and consider the
reasons why some parents reportedly did not see any changes in their childrens abilities,
activities, and self-worth after participating in this type of treatment (Cohn, 2001). Overall, the
author seemed to feel that there is a great deal of potential for more data to be collected and
analyzed in regards to this topic.
What are potential sources of bias on the part of the researcher? Did the researcher
describe methods for avoiding bias?
The author identified that there were potential sources of bias on her part during the
process of this study. She acknowledged the fact that, as both a parent and an occupational
therapist who has provided sensory integration treatment, her background may have been
influential while conducting this study (Cohn, 2001). She also acknowledged the fact that she
carries an underlying assumption that occupational therapy is effective and can contribute to
changes in children and the entire family system which certainly may have been a potential for
bias (Cohn, 2001, p. 287). She did not describe any methods that she had implemented to avoid
bias in the study, though she did describe methods that she had utilized to establish
trustworthiness and credibility for the data she collected, which will be discussed later in this
paper.
Is there a rationale for the participant selection? Are the participants credible
(believable)?
The participants that were selected for this study were credible and suitable, given the
fact that they were parents of children who had participated in occupational therapy that used a

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sensory integration approach. Inclusion criteria for these participants were previously discussed
in this paper. The participants reported on their own experiences and perspectives, and as parents
and caregivers are widely considered to be an accurate source of information in regards to their
children, their statements regarding their childrens experiences can be considered believable and
credible.
How does the researcher use methods to establish trustworthiness of the data? Do these
methods seem adequate?
The author identified several means that she had implemented to strengthen credibility
and minimize inaccuracy in this study. She discussed the fact that not only did she utilize several
different methods for collecting and analyzing the data (the process of triangulation), but she
also conducted the process of member checking by preparing written summaries of the
interviews she had conducted and sending them back to the participants so that they could review
them (Cohn, 2001). She also reported that she utilized the process of peer examination to verify
the themes and categories that had emerged after her analysis of the data (Cohn, 2001). She
stated that she asked a group of eight occupational therapists to analyze the interview transcripts
and discuss the evolving concepts, and she reported that each therapist had more than five years
of experience in providing sensory integration treatment in occupational therapy (Cohn, 2001).
Based on these facts and the nature of the study, these methods to establish trustworthiness of the
data seem adequate.
Are the themes presented consistent with the data presented? Do the conclusions make
sense to you or do you think the researcher was reading into the findings (or trying to find
what he/she wanted to find)?

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The themes that the authors presented seemed to be consistent with the data that was
presented. The conclusions made sense based on what the parents reportedly said, and nothing
seemed to have been fabricated on the basis of the authors own opinion. The author was the
primary conductor of the research, so she did have an idea of what she wanted to find through
the interviews that she led, but she took measures to ensure that she analyzed the data and
produced the themes for the study in an accurate, trustworthy, and effective manner.
Was the researcher flexible in the data collection process? Did he/she allow the data to
guide the process?
The author took precautions to ensure that the data she gathered was accurate, as stated
previously, and she clearly formulated her conclusions based on that data. She did not establish
any themes that were inconsistent with the information that the parents reported, and she
provided opportunities for the data to be verified by multiple sources, including other
occupational therapists and the parents who had supplied the raw data. Though she had an idea
of what she was looking for in the study, she did seem to allow the actual data to guide the
process.
How would you use this article as a therapist?
As a therapist, we would use this article to gain a better understanding of parents
perspectives on sensory integration treatment. Having this understanding would help us to better
understand and utilize their goals in therapy, and would also shape the values that we have in
terms of outcomes for children in sensory integration treatment. Overall, this article gives us a
better understanding and knowledge of the effectiveness of sensory integration treatment, and
also gave us some insight into the perspectives that parents may have in regards to it.

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How does this article support/not support participation in occupation and the field of
occupational therapy?
This article supports participation in occupation and the field of occupational therapy
because it focuses on childrens participation in occupational therapy treatment, and how sensory
integration treatment affects their performance in occupations and quality of life. The findings of
the study provided evidence to support the fact that occupational therapy has a positive impact
on the lives of those who participate in it, and that conducting this type of research has great
value.

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References
Cohn, E. S. (2001). Parent perspectives of occupational therapy using a sensory integration
approach. American Journal of Occupational Therapy, 55, 285294.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research. Newbury Park, CA: Sage.

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