Evidence to practice commentary: Is more therapy better?
Novak, I. (2012). Evidence to practice commentary: Is more therapy better? Physical and Occupational Therapy in Pediatrics, 32(4), 383-387. doi:10.3109/01942638.2012.726894
Parents seek sustained intense “hands-on” therapy for their children based on a belief that “more is better” (Aarts, Jongerius, Geerdink, van Limbeek, & Geurts, 2010; Arpino, Vescio, De Luca, & Curatolo, 2010). Since the core objective of evidence-based practice (EBP) is: to do the right things, for the right child, at the right time, and to optimize intervention outcomes, it is vital to know what the literature says about how much therapy to provide? In fact, it is very difficult to draw firm conclusions from the literature about the optimal intensity of pediatric therapy. When evaluating the body of evidence using the Evidence Alert Traffic Light Grading System (Bower, McLellan, Arney, & Campbell, 1996), the assigned traffic code is Yellow, that is, conflicting evidence exists; therefore, we should measure the outcomes of intervention carefully. One of the reasons for the difficulty in interpreting the therapy intensity literature is the vast variations in practice and the major shifts in underpinning theories that have evolved over time. If you were to attempt to synthesize studies published 15 years ago with current literature, you would not be comparing apple with apples. Let me explain.