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Koomar, Jane, PhD, OTR/L, FAOTATitle: Executive DirectorInstitution: Spiral Foundation Mailing Address: 24 Watertown St., Watertown, MA, 02472 Phone: (617) 923-4410 Website: www.thespiralfoundation.org Research InterestsDr. Koomar is the owner and co-founder of OTA-Watertown and the President of the Board of the Spiral Foundation. Dr. Koomar is particularly interested in the study of Sensory Processing Disorder (SPD) and affective and post-traumatic stress disorders.SPD Research SummaryDrs. May-Benson and Koomar run the Spiral Foundation research program which has a two-fold goal: one) to examine information to define signs, symptoms and etiology of SPD, and two) to examine outcomes related to sensory integrative intervention for SPD. To investigate our first goal area, we conducted a retrospective record review of the birth and early childhood developmental histories of 1000 children aged 3 – 14 years of age who were identified with sensory processing problems. In the area of pre-natal and birth-related factors, children with SPD were found to have a moderate prevalence of mothers with pre-natal problems with 25% complications during pregnancy and 42% complications during labor or delivery. Other birth/delivery problems were greater than available national averages and included 34% assisted deliveries (e.g. vacuum, suction and forceps); 13% pre-term at 37 weeks gestation or less and 5 % umbilical cord insults including cord wrap/ prolapse. In the area of developmental factors, children with SPD demonstrated characteristic differences in development of early childhood skills with 47% not going through terrible two's; 37 % reported by parents to have brief or absents crawling phases, and 31-32% had sleep or feeding problems. In the area of early childhood health problems, children with SPD demonstrated an increased prevalence of health problems including 62% with chronic ear infections; 27% having serious injuries or illness; 25% jaundice at birth; and 20% colic as infants. No one problem was common to all children but clusters of these difficulties were commonly reflected. To investigate our second goal, we conducted a multi-site reliability and validity study on Goal Attainment Scaling, a procedure for writing scaled individualized client goals that can be quantified and compared across individuals and groups. The purpose of this study was to examine whether therapists were able to write goals that correctly identify goal areas important to families and clients, accurately identify the client's projected outcome, correctly scale the objectives and accurately rate performance at follow-up after intervention. These issues had to be examined before GAS may be accepted as a valid and reliable research methodology. Results of the study found that, based on parent interview, therapists are able to reliably identify parent goals, rank their importance to parents, and identify children's progress nearly 80% of the time. Similarly, there was good inter-rater agreement between two therapists in identifying and writing intervention goals and objects based on parent interview over 60% of the time. Experienced therapists were able to conduct qualitative interviews with parents and, from those interviews, accurately identify and rank parent concerns for their child's sensory integrative-based intervention. In addition, therapists were able to accurately rate a child's progress on meaningful and functional goals based on parent report. Similarly, two therapists, from different clinical sites who were unfamiliar with the child, were able to identify, write and rank GAS goals and objectives based on the same parent interview demonstrating good inter-rater reliability between clinical therapists. This study presents very promising preliminary reliability and validity evidence for the use of GAS as a meaningful outcome of sensory integrative-based occupational therapy intervention, which may be applicable as an outcome measure in a formal intervention study.Back to SPD-SWG Participants Mail this page to a friend | |
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