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Guideline Summary
Guideline Title
Best evidence statement (BESt). Use of sensory assessment tools with children diagnosed with autism spectrum disorder (ASD).
Bibliographic Source(s)
Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). Use of sensory assessment tools with children diagnosed with autism spectrum disorder (ASD). Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2009 Mar 29. 5 p. [13 references]
Guideline Status

This is the current release of the guideline.

Scope

Disease/Condition(s)
  • Autism spectrum disorder (ASD)
  • Sensory processing difficulties
Guideline Category
Assessment of Therapeutic Effectiveness
Evaluation
Screening
Clinical Specialty
Family Practice
Pediatrics
Physical Medicine and Rehabilitation
Intended Users
Advanced Practice Nurses
Nurses
Occupational Therapists
Physical Therapists
Physician Assistants
Physicians
Guideline Objective(s)

To evaluate which assessment tools are effective for assessing sensory processing abilities in children with autism spectrum disorder (ASD)

Target Population

Children up to 9 years of age who present with a diagnosis of autism spectrum disorder (ASD) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria

Note: Children with a diagnosis of the following subcategories of ASD are excluded from this guideline:

  • Rett syndrome
  • Childhood disintegrative disorder
Interventions and Practices Considered

Use of standardized tests for assessing sensory processing difficulties

  • Sensory Processing Measure for children age 5 to 12 years
  • Short Sensory Profile for children 37 months up to age 9
  • Infant/Toddler Sensory Profile for children between 7 and 36 months of age
Major Outcomes Considered
  • Reliability and validity of Sensory Processing Measure, Short Sensory profile, and Infant/Toddler Sensory profile
  • Standardized test scores for sensory processing ability

Methodology

Methods Used to Collect/Select the Evidence
Hand-searches of Published Literature (Primary Sources)
Hand-searches of Published Literature (Secondary Sources)
Searches of Electronic Databases
Description of Methods Used to Collect/Select the Evidence

Search Strategy

  1. Databases
    OVID MEDLINE
    OVID CINAHL
    Pedro
    All OVID EBM Reviews—Cochrane DSR, ACP Journal Club
    EBSCOHost
    www.otseeker.com External Web Site Policy
  2. Search Terms:
    Sensory, children, assessment, occupational therapy
  3. Limits and Filters: English, humans; additional articles from reference lists
Number of Source Documents

Not stated

Methods Used to Assess the Quality and Strength of the Evidence
Weighting According to a Rating Scheme (Scheme Given)
Rating Scheme for the Strength of the Evidence

Table of Evidence Levels

Quality Level Definition
1a† or 1b† Systematic review, meta-analysis, or meta-synthesis of multiple studies
2a or 2b Best study design for domain
3a or 3b Fair study design for domain
4a or 4b Weak study design for domain
5 Other: General review, expert opinion, case report, consensus report, or guideline

†a = good quality study; b = lesser quality study

Note: Full tables of evidence grades and strength of recommendations are available in separate documents (see the "Availability of Companion Documents" field).

Methods Used to Analyze the Evidence
Systematic Review
Description of the Methods Used to Analyze the Evidence

Not stated

Methods Used to Formulate the Recommendations
Expert Consensus
Description of Methods Used to Formulate the Recommendations

Not stated

Rating Scheme for the Strength of the Recommendations

Table of Recommendation Strength

Strength Definition
"Strongly recommended" There is consensus that benefits clearly outweigh risks and burdens (or vice-versa for negative recommendations).
"Recommended" There is consensus that benefits are closely balanced with risks and burdens.
No recommendation made There is a lack of consensus to direct development of a recommendation.
Dimensions: In determining the strength of a recommendation, the development group makes a considered judgment in a consensus process that incorporates critically appraised evidence, clinical experience, and other dimensions as listed below.
  1. Grade of the Body of Evidence
  2. Safety/Harm
  3. Health benefit to the patients (direct benefit)
  4. Burden to patient of adherence to recommendation (cost, hassle, discomfort, pain, motivation, ability to adhere, time)
  5. Cost-effectiveness to healthcare system (balance of cost/savings of resources, staff time, and supplies based on published studies or onsite analysis)
  6. Directness (the extent to which the body of evidence directly answers the clinical question [population/problem, intervention, comparison, outcome])
  7. Impact on morbidity/mortality or quality of life

Note: Full tables of evidence grades and strength of recommendations are available in separate documents (see the "Availability of Companion Documents" field).

Cost Analysis

A formal cost analysis was not performed and published cost analyses were not reviewed.

Method of Guideline Validation
Peer Review
Description of Method of Guideline Validation

Reviewed by Clinical Effectiveness

Recommendations

Major Recommendations

The quality of the evidence (1a to 5) and strength of the recommendation (strongly recommended, recommended, or no recommendation) are defined at the end of the "Major Recommendations" field.

It is recommended that if a standardized test is to be administered to assess sensory processing difficulties, use one of the following tools:

  • Sensory Processing Measure for children age 5 to 12 years (Asher, 2007 [5]; Glennon et al., 2007 [5]; Miller-Kuhaneck et al., 2007 [5]; Parham et al., 2007 [5]; Local Consensus [5])
  • Short Sensory Profile for children 37 months up to age 9 (Tomchek & Dunn, 2007 [4a]; Asher, 2007 [5]; Dunn, 1999 [5]; McIntosh, Miller, & Shyu, 1999 [5]; Local Consensus [5])
  • Infant/Toddler Sensory Profile for children between 7 and 36 months of age (Dunn, 2002 [5])

Definitions:

Table of Evidence Levels

Quality Level Definition
1a† or 1b† Systematic review, meta-analysis, or meta-synthesis of multiple studies
2a or 2b Best study design for domain
3a or 3b Fair study design for domain
4a or 4b Weak study design for domain
5 Other: General review, expert opinion, case report, consensus report, or guideline

†a = good quality study; b = lesser quality study

Table of Recommendation Strength

Strength Definition
"Strongly recommended" There is consensus that benefits clearly outweigh risks and burdens (or vice-versa for negative recommendations).
"Recommended" There is consensus that benefits are closely balanced with risks and burdens.
No recommendation made There is a lack of consensus to direct development of a recommendation.
Dimensions: In determining the strength of a recommendation, the development group makes a considered judgment in a consensus process that incorporates critically appraised evidence, clinical experience, and other dimensions as listed below.
  1. Grade of the Body of Evidence
  2. Safety/Harm
  3. Health benefit to the patients (direct benefit)
  4. Burden to patient of adherence to recommendation (cost, hassle, discomfort, pain, motivation, ability to adhere, time)
  5. Cost-effectiveness to healthcare system (balance of cost/savings of resources, staff time, and supplies based on published studies or onsite analysis)
  6. Directness (the extent to which the body of evidence directly answers the clinical question [population/problem, intervention, comparison, outcome])
  7. Impact on morbidity/mortality or quality of life

Note: Full tables of evidence grades and strength of recommendations are available in separate documents (see the "Availability of Companion Documents" field).

Clinical Algorithm(s)

None provided

Evidence Supporting the Recommendations

References Supporting the Recommendations
Type of Evidence Supporting the Recommendations

The type of supporting evidence is identified and graded for each recommendation (see the "Major Recommendations" field).

Benefits/Harms of Implementing the Guideline Recommendations

Potential Benefits

The health benefit of these assessments tools includes gaining caregiver's perspective of sensory processing abilities resulting in improved treatment planning and patient care.

Potential Harms

Not stated

Qualifying Statements

Qualifying Statements

This Best Evidence Statement addresses only key points of care for the target population; it is not intended to be a comprehensive practice guideline. These recommendations result from review of literature and practices current at the time of their formulation. This Best Evidence Statement does not preclude using care modalities proven efficacious in studies published subsequent to the current revision of this document. This document is not intended to impose standards of care preventing selective variances from the recommendations to meet the specific and unique requirements of individual patients. Adherence to this Statement is voluntary. The clinician in light of the individual circumstances presented by the patient must make the ultimate judgment regarding the priority of any specific procedure.

Implementation of the Guideline

Description of Implementation Strategy

An implementation strategy was not provided.

Institute of Medicine (IOM) National Healthcare Quality Report Categories

IOM Care Need
Living with Illness
IOM Domain
Effectiveness

Identifying Information and Availability

Bibliographic Source(s)
Cincinnati Children's Hospital Medical Center. Best evidence statement (BESt). Use of sensory assessment tools with children diagnosed with autism spectrum disorder (ASD). Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2009 Mar 29. 5 p. [13 references]
Adaptation

Not applicable: The guideline was not adapted from another source.

Date Released
2009 Mar 29
Guideline Developer(s)
Cincinnati Children's Hospital Medical Center - Hospital/Medical Center
Source(s) of Funding

Cincinnati Children's Hospital Medical Center

Guideline Committee

Not stated

Composition of Group That Authored the Guideline

Division of Occupational Therapy and Physical Therapy: Rebecca D. Reder, OTD, OTR/L, Senior Clinical Director, Occupational Therapy and Physical Therapy

BESt Development Team: Aurora Hoobler, OTR/L, MS, Team Leader, Division of Occupational Therapy and Physical Therapy; Christa Aylward, OTR/L, Division of Occupational Therapy and Physical Therapy; Carol Burch, PT, DPT, Division of Occupational Therapy and Physical Therapy; Karen Kovacs, OTR/L, MHS, Division of Occupational Therapy and Physical Therapy; Vicki McQuiddy, OTR/L, MHS Division of Occupational Therapy and Physical Therapy

Reviewed by: Jamie Donovan, MOT, OTR/L, Division of Occupational Therapy and Physical Therapy; Amy Johnson, OTR/L, Division of Occupational Therapy and Physical Therapy; Kathy Krebs, OTR/L, Division of Occupational Therapy and Physical Therapy; Patricia Manning-Courtney, MD, Associate Professor of Clinical Pediatrics, University of Cincinnati College of Medicine; Pediatric Developmental Specialist; Medical Director, The Kelly O'Leary Center for Autism Spectrum Disorders, Division of Developmental Disabilities; Donna Murray, PhD, CCC-SLP, Assistant Professor of Clinical Pediatrics, University of Cincinnati College of Medicine; Director of Clinical Services, Division of Developmental and Behavioral Pediatrics; Co-Director, The Kelly O'Leary Center for Autism Spectrum Disorders, Division of Developmental Disabilities

Division of Health Policy & Clinical Effectiveness Support: Eloise Clark, MPH, MBA, Guidelines Program Administrator; Barbarie Hill, MLS, Pratt Library

Ohio State University: Reviewed by Alison Lane, PhD, OTR/L, Assistant Professor, School of Allied Medical Professions, College of Medicine

Financial Disclosures/Conflicts of Interest

All team members and clinical effectiveness support staff listed in the original guideline document have signed a conflict of interest declaration and none were found.

Guideline Status

This is the current release of the guideline.

Guideline Availability

Electronic copies: Available from the Cincinnati Children's Hospital Medical Center External Web Site Policy.

Print copies: For information regarding the full-text guideline, print copies, or evidence-based practice support services contact the Cincinnati Children's Hospital Medical Center Health James M. Anderson Center for Health Systems Excellence at EBDMInfo@cchmc.org.

Availability of Companion Documents

The following are available:

  • Judging the strength of a recommendation. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2008 Jan. 1 p.
  • Grading a body of evidence to answer a clinical question. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 1 p.
  • Table of evidence levels. Cincinnati (OH): Cincinnati Children's Hospital Medical Center; 2008 Feb 29. 1 p.

Print copies: For information regarding the full-text guideline, print copies, or evidence-based practice support services contact the Cincinnati Children's Hospital Medical Center Health James M. Anderson Center for Health Systems Excellence at EBDMInfo@cchmc.org.

Patient Resources

None available

NGC Status

This NGC summary was completed by ECRI Institute on July 23, 2010.

Copyright Statement

This NGC summary is based on the original full-text guideline, which is subject to the following copyright restrictions:

Copies of this Cincinnati Children's Hospital Medical Center (CCHMC) External Web Site Policy Best Evidence Statement (BESt) are available online and may be distributed by any organization for the global purpose of improving child health outcomes. Examples of approved uses of the BESt include the following:

  • Copies may be provided to anyone involved in the organization's process for developing and implementing evidence based care.
  • Hyperlinks to the CCHMC website may be placed on the organization's website.
  • The BESt may be adopted or adapted for use within the organization, provided that CCHMC receives appropriate attribution on all written or electronic documents.
  • Copies may be provided to patients and the clinicians who manage their care.

Notification of CCHMC at EBDMInfo@cchmc.org for any BESt adopted, adapted, implemented or hyperlinked by the organization is appreciated.

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