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Sometimes a normal problem. . . resists [solving,] revealing anomalies (problems). . .then begins the extraordinary investigations that lead the profession at last to a new set of commitments, a new basis for the practice of science: a scientific revolution. . .tradition-shattering compliments to the tradition-bound activity of normal science. (Kuhn, 1970, p. 6)
We are honored to be the guest editors for this issue of the American Journal of Occupational Therapy, which explores the evidence for occupational therapy for children and adolescents experiencing difficulties processing and integrating sensory information. Occupational therapy using a sensory integrative approach (OT/SI) is one of the most used and researched approaches within occupational therapy (American Occupational Therapy Association [AOTA], 1996; Mulligan, 2002). Therapists use OT/SI to frame their clinical reasoning when working with people whose participation restrictions appear related to difficulty processing and integrating sensory information. The charge to conduct an evidence-based review of the literature on this topic came from the AOTA Representative Assembly (RA) in 2004 by Carolyn Baum, then president of AOTA. With this initiative, Baum and the RA recognized the valuable contribution that the sensory integration frame of reference provides for occupational therapists and the urgent need to generate and document evidence.
In light of the impact of the sensory integration frame of reference on occupational therapy, the task of conducting an evidence-basedreview of the literature takes on an important significance. Consumers are more savvy in their choices for interventions, and insurance company, school, and treatment facility administrators are demanding that interventions be evidence based. Concurrently, interest in applying sensory integration principles in interventions for children with autism and other clinical diagnoses has grown. With the increased public demand, a surge in theoretical and research articles, both inside and outside the profession of occupational therapy, has occurred. With it has come myriad information-some of it conflicting and confusing-regarding terminology and defining the intervention approach, including who should provide it and what outcomes should be expected. Hence, a "perfect storm" has arrived, and we must seize this opportunity to emerge as the leaders in the evolution of the theory of sensory integration and the treatment of people who experience participation limitations related to problems in processing and integrating sensory information. Our terminology must be clear, our...