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Collaboration: The Key to Research Success
By Sarah A. Schoen, PhD, OTR
Elliot Hedman, MS
Since 2000, the Sensory Processing Disorder (SPD) Foundation has spearheaded the campaign for recognition of Sensory Processing Disorder in the revised DSM-5, which will be published in 2013. The SPD Foundation has invested heavily in research and has facilitated complementary studies at premier research institutions across the country and internationally. Advancing research on Sensory Processing Disorder would not be possible without funding provided by the Wallace Research Foundation initiative that has supported over 15 scientists investigating issues related to the etiology, neuropathology, signs and symptoms, developmental course and treatment effectiveness of SPD. The SPD Foundation research team sends a special thank you to Henry Wallace for his unending generosity.
This article describes a recent collaboration between the Massachusetts Institute of Technology Media Lab and the Sensory Processing Disorder Foundation. Elliot Hedman, a master's student at MIT, has made great strides in moving this research forward, under the direction and guidance of Dr. Rosiland Picard, Dr. Lucy Miller, the SPD Foundation research team and STAR Center occupational therapy staff.
Elliot has been exploring the use of a new device called, iCalm, (now known as the Affectiva Q) developed by the MIT Media Lab. iCalm is a small, wireless sensor that measures electrodermal activity (EDA) a marker of sympathetic nervous system arousal. It is housed in a sweatband-package that can be worn on the wrist or above the ankle when children or adults participate in specific activities. His research seeks to understand whether informative changes in arousal can be detected in children with Sensory Processing Disorder (SPD), in response to specific occupational therapy activities.
Elliot's initial question was "How could knowing a child's arousal affect occupational therapy?" Last summer, Elliot and his interns, spent 10 weeks collecting data from STAR Center clients during multiple regularly scheduled OT treatment sessions. In fact, they measured the arousal of twenty-two children (ages 3-12) participating in over 85 hours of occupational therapy. EDA was measured from four locations: child's left and right ankles and occupational therapist's (OT's) left and right ankles, with concurrent video recordings so that activities could be labeled and associated with EDA. Each therapy session averaged one hour of sensor wear, allowing both qualitative and quantitative investigation of the effect various occupational therapy activities had on each child's EDA.
The data /observations were quite varied; for example, some children seemed to calm down when lying in a ball pit, others seemed more aroused; some children's arousal increased when swinging and others were calmed. In light of these findings, Elliot's question focused more on whether different pieces of therapeutic equipment had a differential effect on children's arousal. He first applied his mathematical and statistical background, by running inter-individual analyses and comparing changes in arousal from specific pieces of equipment. Unfortunately, he concluded that the statistical significance obtained for the average of all observed responses to some specific pieces of equipment was spurious at best. Instead, he more closely looked at individual cases and found that most pieces of equipment could serve a dual purpose depending how they were used. That is, the same piece of equipment could increase or decrease a child's arousal. He even saw the same piece of equipment increased a child's arousal and decreased the arousal during the same one-hour session. Thus, the question isn't really about the equipment per se but rather about the intent of the therapist during the treatment session and the activity they design to address a specific child's needs. Needed are more studies to evaluate what happens on an individual level and provide evidence that changes in arousal levels are related to therapist intent.
This is the first study of the effects of OT activities in-situ in a naturalistic setting using objective physiologic measures and suggests that careful case-study analysis and future carefully designed studies of the relation between therapeutic activities and arousal may inform clinical practice.
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