RESEARCH |
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LINKS:
1.) Position Paper Resource Links References
2.) "Single Case Research Designs" by Howard Kaplan, PhD
3.) "Is a Paradigm Shift Occurring?: The Impact of Evidence Based Practices on Multi
Sensory Environmental Therapies" by Jason Staal, Psy.D.
4.) "The Effects of Snoezelen (Multi-sensory Behavior Therapy) and Psychiatric Care on
Agitation, Apathy, and Activities of Daily Living in Dementia Patients on a Short Term
Geriatric Psychiatric Inpatient Unit. "Jason A. Staal, Psy.D.
5.) "Influence of Adapted Environment of Medically Treated Children with Developmental Disability." Michele Shapiro, OT, MSc, Harold D. Sgan-Cohen, DMD, MPH, Shula Parush, OT, PhD, and Raphael N. Melmed, MD, FRCP
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AAMSE RESEARCH POSITION PAPER
American Association of MultiSensory Environments’ Proposed Initial Model of Practice: Building An Intellectual Asset Base
Multi sensory environment (MSE)-based therapy, also known as Snoezelen® has a growing research literature base to support its use with diverse groups of individuals who suffer from dementia, chronic pain, job stress, psychiatric illness, developmental disabilities and acquired brain injury. The use of MSEs is found in hospitals, psychiatric institutions, schools and even in private homes. While implementation of MSEs is not strictly a medical intervention, the validity of any clinical practice paradigm must be
based upon a sound foundation of evidence. Medical interventions have begun to be evaluated under the rubric of “evidence-based practice guidelines”, and in general, this greatly aids in determining the appropriate indications, interventions and outcome measures for a given condition. However, it must also be realized that the gold standard of evidence-based practice, the double-blind randomized controlled clinical trial (RCT), can not always be performed due to issues related to the design, clinical disorder,
patient population and type of intervention (for example, it would not be ethical to include a post-brain injury control group that gets no intervention to compare with an MSE intervention). Quality research that would constitute ‘evidence’ for a practice guideline could legitimately come from RCTs, quasi-experimental studies, case control investigation, co relational research, careful observational work and even single subject studies. This position paper will outline the goals of the AAMSE with regards to research
in the field of MSEs. In addition, it will summarize the types of research that may serve to establish practice guidelines in the field of MSE, as well as identify common characteristics between studies that would serve to make the results of different studies more generalizable and comparable.
Immediate focus
The initial focus will be to utilize existing assets to develop the research committee in line with our mission statement. This includes developing a network outside of the committee that will have abilities that complement the organization’s focus (lean organization/robust networks). By building this network via the web site, the AAMSE can promote intellectual exchange of ideas, which will then increase the value of the Association to its members. It will be important to start by clarifying the research, science,
practice and education aspects of the AAMSE, beginning with this series of position papers.
Strategic outlook
A longer-term goal of the AAMSE will be to transfer existing intellectual knowledge of MSEs and encouraging further research to foster MSEs as a viable therapeutic intervention. The use of MSEs may have different uses based on the target population, the person providing the service and the context the service is provided in. These efforts will create sustainable value for the Association by linking research (value) into outputs which may then be utilized by the training committee to generate revenue for the association
from training and membership.
Step 1: Solidify the base
The scientific paradigm of committee will include the adoption of scientific instrumentalism – a non-adversarial inclusive approach that advocates theoretical development, the integration of parts into a whole, generation of new ideas and the opportunity for open but candid discussion and debate regarding new evidence. Open discussion of alternative viewpoints on potentially controversial but high quality research should not be construed as adversarial; rather, it is the necessary intellectual exercise required
to ensure a sound foundation of data and forge a meaningful organizational consensus towards the development of practice guidelines. It is the stated goal of the AAMSE to be open to and indeed encourage research that achieves certain standards. It will also be important for AAMSE to distinguish between objective, well designed studies and biased or underpowered ‘opinion’ studies.
While utilization of MSEs may not always fit into neat categories of evidence-based practice, the first step towards defining therapies supported by empirical data includes review of Chambless and Hollon’s criteria of what an empirically supported treatment is and how MSE fits into these definitions (Chambless, D., & Hollon, S. [1998]; Journal of Consulting and Clinical Psychology, Vol 66, No.1. pp7-18). Another source of guidance in determination of data quality comes from Gersten, et. al. [2005]; Exceptional
Children, Vol 71, No. 2). Our goal is to develop acceptance of MSEs based on research criteria that has been validated by the field, not solely by our committee. It is also important to emphasize recent quality research, much of which comes out of the United States, without devaluing earlier research or research from international sources.
Step 2: Growth by building the base
The AAMSE should create a forum where users of MSEs (both members and nonmembers) can exchange ideas regarding important clinical needs that may be addressed by organized research (such as treatment efficacy or practical outcome measures). By fostering excellence in research related to MSEs, the AAMSE will have the potential to provide both a central repository of useful data for clinical practice guidelines to MSE users as well as set a high standard for MSE research that will promote acceptance of MSE among
more traditional medical providers and investigators. It is recognized that quality research has the opportunity to grow the practice and study of MSEs not only among current participants/members, but also expand this base into the realm of medical patient care and empirical research. For this to occur, the goal of the organization to promote the use of MSE must be tempered by a diligent effort to avoid even the appearance of conflicts of interest or bias. Credibility is hard to gain but easy to lose.
Step 3: Prioritizing Growth in MSEs
Reducing time to mainstream acceptance As stated in step 2, research represents the one domain of the association, when combined with public relations, which can increase the growth of MSEs in the U.S.A. Assessment of other assistive technologies that have become mainstream reveals this dynamic. The more quality research generated, the faster the acquisition by clinicians. The more clinicians trained, the broader the use of MSEs, leading to more rapid acceptance of MSEs relative to reimbursement and medical legitimacy.
The association needs to develop self-sustaining mechanisms to activate research growth and investment in MSE research.
A potential mechanism for the association is to act as a network that can generate and/or connect new and existing research with funding networks to work singularly or in unison. A good example would be multi site research using the same research protocol for the same population of clinical interest. Such activities would expand evidenced based practice of MSEs. The larger the sample sizes studied using gold standards of research e.g., experimental and/or control group, double blind placebo controlled, the faster
journals will publish and the degree of journal prestige may increase as well. This, in turn, will increase awareness of MSEs among clinicians reading about MSEs, utilizing our web site and participating in accredited training programs.
Our goal is to become the recognized hub for the comprehensive generation of and pooling of existing intellectual property related to MSEs.
Presenting data
It will be important to post-publish all work that meets the society’s standards, whether it supports specific modalities of therapy or not. Once a sufficient base of data exists for a given topic, editorial opinion pieces can be written (perhaps by research committee members) to help summarize and reconcile conflicts in the field. Credibility will come with balanced reporting of the research in the field.
Research or references or links to references may be posted on the website as permitted by copyright law. For published materials that require permission, the organization will assist authors in obtaining the appropriate clearance from the publisher. Much of this can actually already be done through publishers’ websites, and it should not prove to be a major difficulty. In some cases, research study authors may be requested by the AAMSE organization to provide a specific synopsis or review for posting on the
website.
Here our goal again is to be the central place where people check for new or existing research (intellectual property). The underlying rationale is that this consolidation of research work will bring people to the web site and keep them coming back for what’s new. Furthermore, it will enrich the discussion and debate about cutting edge issues in our field.
Web site
The website should be easy to navigate and provide practical information for the viewer. A “research news” section should be created. Potential concepts for research news part of the website: 1) grant opportunities, 2) research topic forums for specific areas (such as program evaluations [school], single case designs, descriptive [families], subject recruitment, conferences, Institutional Review Boards, how to apply research from the current data sets on MSEs, 3) an experts column, 4) research trial notices /
patient recruitment and even 5) a place for investigators to post summaries of their own peer-reviewed research.
Step 4: Seek new and innovative approaches
The association should actively look for promising new technologies and person-oriented approaches that fit our mission statement and will potentially provide measurable benefit for the Association and, in turn, the field of MSEs. This would include reviews of new therapies, products and manuals/books. Additional areas of interest could include research into the use of MSEs for purposes such as medical interventions, education, rehabilitation, wellness and perhaps even recreation.
Step 5: Develop a professional identity
The Association and the field can be enhanced by brand development of AAMSE. The more research and science-oriented the AAMSE, the greater the chance it will strengthen the reputation of the organization and further extend the brand name through quality performance. The organization can best support MSE use by providing dispassionate and objective data in a readily understandable format that will appeal to a broad range of potential individuals. Patients, practitioners, referring physicians and researchers all
stand to benefit from such an organizational goal. In return, the AAMSE will become the focal point for MSE-related research and practice guidelines. With this focus and objectivity comes credibility, and with credibility, the field will grow and flourish.
RESOURCE LINKS
These resources are intended to provide access to publicly available information on issues related to MSE topics. AAMS does not endorse or assume any liability or responsibility for the information or recommendations contained or presented in the following information websites or links.
www.SPDnetwork.org -
Information on SPD, conferences, workshops, scientific research and parent connections
www.jkp.com -
An independent publisher of accessible, professional and academic books in the social and behavioral sciences
www.cdhaf.org -
A non-profit organizatations whose mission is to enrich the lives of individuals with cognitive, physical and emotional impairments through MSE
www.eparent.com -
Exceptional Parent Magazine
www.lmessbauer.com -
MSE Training
www.autisminspiration.com -
Features new articles surveys and training and fact sheets relating to autism spectrum disorders
www.sensoryconference.com -
Website for the “Come To your Senses: conference.
www.wrongplanet.net -
An online resource and community for those with Asperser’s Syndrome. The site features forums, chat rooms, blogs and photo gallery.
www.ablelink.org -
a free internet community were kids with disabilities or illness can meet role models, mentors and friends
www.kidfoundation.org -
focuses on research, education and advocacy related to Sensory Processing Disorders.
www.isna.de -
International Snoezelen® Association
www.worldwidesnoezelen.com -
Worldwide Snozelen Association
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