Mills 2019 Reply to Novak and Honan 2019

OT is a profession. As a profession, robust and professional academic discourse and debate should be a marker of our profession’s ability to reflect on its history, contemplate current practices and evidence and consider, evaluate and when appropriate integrate new and emerging evidence from within and without the profession.

Recently the Novak article: Effectiveness_of_paediatric_occupational_therapy. has been singularly promoted and championed by some to the exclusion of many other recent and very relevant research publications about aspects of the practice of paediatric occupational therapy. A very narrow and biased understanding of ASI seemingly presented as fact and without regard to the consequences to those who seek to access our services.

It is being actively used to refute aspects of the practice of Ayres’ Sensory Integration based on a very narrow and limited view of this body of knowledge and its application in practice. Who will be accountable for services being denied to children and adolescents now and in the future on the back of this one article?

Mills et al 2019 have published a Letter to the Editor of the Australian Journal of Occupational Therapy that raises two concerns about this systematic review;

  • A correct definition is an important first step in evaluating the evidence of interventions”

“SI is defined incorrectly here as including sensory diets, brushing and weighted vests…

…reviews have highlighted the importance of correctly defining SI…

…Novak and Honan have included a number of studies in their systematic review, which claim to evaluate SI, but do not meet the fidelity criteria and are therefore not SI.”

Mills et al 2019

  • Novak and Honan (2019) ap- pear to have conflated the research evidence for children from different disabilities

Recent systematic reviews demonstrate effectiveness of SI for children with autism…

…Novak and Honan appear to have conflated SI and Bobath citing an editorial…

…which is relevant to Bobath for children with cerebral palsy.” 

Mills et al 2019

Research should be clear of bias. See more about bias here. Catalog of Bias

Very specific studies including by Schoen et al (2018) and Schaaf et al (2018)  demonstrate the considerable progress that this field of occupational therapy has made to provide the evidence necessary to support practice

Building Competency in SI_ Evidence-Bas…sing Ayres Sensory Integration® – AOTA

Kilroy et al 2019

Lane et al 2019


Schaaf et al 2018


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