Current Research on OT

At Oak Bloom OT, we take pride in the fact that we are constantly researching and reviewing current evidence-based interventions and OT literature and implementing them into our very own practice. On this page, you will find research articles outlining the evidence and effectiveness behind the interventions that we create for your child. 

Fine Motor Research

Case-Smith, J. (2000). Effects of occupational therapy services on fine motor and functional performance in preschool children. The American Journal of Occupational Therapy, 54(4), 372–380. 

  • The present study examined 44 preschool-aged children with fine motor delays who received occupational therapy services 

  • Intervention included

    • A preparatory activity to improve a child's arousal, attention, postural tone, and readiness for action

      • Therapists provided vestibular and proprioceptive input to promote postural stability and behavioral organization

    • Fine motor activities included visual perception, visual-motor integration, in-hand manipulation, bilateral manipulation, play, and peer interaction

  • Findings showed a significant improvement in all 8 fine motor assessments for each student

  • Fine motor outcomes were most influenced by therapists' emphasis on play and peer interaction

  • Functional outcomes were influenced by a number of sessions

Chang, S.-H., & Yu, N.-Y. (2017). Visual and haptic perception training to improve handwriting skills in children with dysgraphia. The American Journal of Occupational Therapy, 71(2). 

  • Prior research found that children with slow handwriting speed relied more on visually directed processes, like sequence memory and visual-motor integration

  • Additional research found that haptic perception significantly improved legibility and speed of handwriting

  • In the current study, 28 first and second-grade children with handwriting difficulties were recruited. Half were put in the control group and received conventional handwriting training, while the intervention group had 12 sessions that included visual and haptic perception training.

  • Findings indicated an improvement in visual perceptual skills, far point copy speed, and handwriting accuracy for the individuals who underwent the 12 sessions of visual and haptic perception training. 

Piller, A., & Torrez, E. (2019). Defining occupational therapy interventions for children with fine motor and handwriting difficulties. Journal of Occupational Therapy, Schools, & Early Intervention, 12(2), 210–224.


  • Handwriting is a foundation skill for school subjects, like math, science, and reading

  • Handwriting involves various skills like motor planning, visual perception, visual-motor coordination, sensory processing, and cognition

  • Poor handwriting has been shown to negatively affect a student's academic performance in areas including time management, work completion, and legibility

  • Current OT approaches used to improve handwriting include

    • Cognitive-based approach - using verbal mnemonics, verbal rote scripts, feeling the movement

    • Multi-sensory approach - utilizing all sensory systems to assist with learning through sensory activities

    • Motor approach - improving motor components, like grip strength and pencil control

  •  Results indicated that most OTs employ multi-sensory and motor approaches

    • Multi-sensory treatment showed improvement in skills that ​affect handwriting, like sensorimotor function and visual perception (p < 0.05)

    • Motor approaches improved grasping skills, core strength, and postural control, which all affect handwriting (p <0.05)

Roberts, G. I., Derkach-Ferguson, A. F., Siever, J. E., & Rose, M. S. (2014). An examination of the effectiveness of handwriting without Tears® instruction. Canadian Journal of Occupational Therapy, 81(2), 102–113. 

  • Handwriting Without Tears (HWT) is a multi-sensory program that incorporates a variety of sensory strategies to ensure memory is stored in multiple sensory areas 

  • HWT also incorporates a cognitive and motor approach

  • The present study examined the effectiveness of the HWT curriculum

  • Findings revealed that individuals who received HWT curriculum achieved significantly higher improvements compared to students with teacher-designed instruction in the domains of letter spacing, sizing, form, and alignment 

Tseng, M. H., & Chow, S. M. (2000). Perceptual-motor function of school-age children with slow handwriting speed. The American Journal of Occupational Therapy, 54(1), 83–88. 

  • The present study examined differences in perceptual-motor measures between children with slow and normal handwriting speed

  • 34 slow hand writers and 35 normal speed writers between the ages of 7 to 11 attending elementary school were given 3 perceptual-motor tests

  • Predictors of handwriting speed for slow writers were age, visual sequential memory, and visual-motor integration

    • Slow hand writers rely more heavily on visually directed processes​

  • Predictors of handwriting speed for normal speed writers were age, upper limb speed, and dexterity

  • The findings of this research indicate the importance of improving visual motor function for slower writers


Gross Motor Research

Bellows, L. L., Davies, P. L., Anderson, J., & Kennedy, C. (2013). Effectiveness of a physical activity intervention for a head start preschoolers: A randomized intervention study. The American Journal of Occupational Therapy, 67(1), 28–36. 


  • Prior research indicates that children with poorer motor skill performance were less active than children with better-developed motor skill

  • Children who do not have developed motor skills may experience decreased self-esteem and avoidance of movement 

  • The present study employed a randomized controlled trial that included 3-5-year-olds. The intervention group participated in the “Mighty Moves” intervention, which included skills from three gross motor categories: stability, locomotor, and manipulation

  • The instruments used to assess motor skills were the Peabody Developmental Motor Scales (PDMS-2) 

  • The pre-test and post-test results from the PDMS-2 revealed that children receiving physical activity intervention demonstrated significant changes in gross motor skills compared to the control group


Logan, S. W., Robinson, L. E., Wilson, A. E., & Lucas, W. A. (2011). Getting the fundamentals of movement: A meta-analysis of the effectiveness of motor skill interventions in children. Child: Care, Health and Development, 38(3), 305–315. 


  • The development of fundamental movement skills (FMS) is associated with positive health outcomes and does not develop naturally through maturational processes

  • FMS includes locomotor skills and object control skills, which need to be learned through practice and reinforcement

  • The meta-analysis examined journals and articles that (1) implemented any type of motor skill intervention (2) had pre-post test qualitative assessment of FMS and (3) availability of means and standard deviations of motor performance

  • The meta-analysis revealed that motor skill interventions resulted in significant improvements in FMS in both areas of locomotor and object control, indicating that motor skill interventions are effective in improving FMS in children  


Morgan, R., & Long, T. (2012). The effectiveness of occupational therapy for children with developmental coordination disorder: A review of the qualitative literature. British Journal of Occupational Therapy, 75(1), 10–18. 


  • Current research indicates that motor deficits derived from developmental coordination disorder can lead to social and emotional problems

  • The present review aimed to provide evidence-based practice by identifying and describing interventions that were perceived to be effective by children with developmental coordination disorder (DCD) and their parents

    • The research question was: “In children diagnosed with DCD, what is the most effective occupational therapy for decreasing core symptoms of the condition and improving occupational outcomes?”

  • The study predominantly examined the intervention experiences of children with DCD and their parents

  • Parents noted that effective interventions were focused not on the remediation of motor impairments, but however the broader issue of developing their child’s self-worth and social participation

    • However, parents also reported that achieving motor competency through mastering skills for their children improved their self-confidence. Improved motor skills led to their children developing friendships, taking pride in achievements, and increasing motivation to build on their successes 

    • Parent’s also stressed the provision of parent-focused training, which included training in helping them readjust expectations of their child, parent role, and intervention

  • Children reported that DCD negatively impacted their ability to engage in self-care and play activities, and considered these areas to be important to address in therapy

  • The present study reveals the importance of addressing the goals that parents and children with DCD have into therapy in order to improve the effectiveness of therapy


Smits-Engelsman, B. C., Blank, R., Van Der Kaay, A.-C., Mosterd-Van Der Meijs, R., Vlugt-Van Den Brand, E., Polatajko, H. J., & Wilson, P. H. (2012). Efficacy of interventions to improve motor performance in children with developmental coordination disorder: A combined systematic review and meta-analysis. Developmental Medicine & Child Neurology, 55(3), 229–237. 


  • The aim of this study was to examine the evidence about the efficacy of motor interventions for children with Developmental Coordination Disorder (DCD) 

  • The study examined 26 articles that were published between 1995 to 2011 and categorized articles between (1) task-oriented approach (2) motor training based on physical and occupational therapy and (3) process-oriented approach

  • The study indicates that in general, task-oriented and motor training-based interventions like physical and occupational therapy show strong treatment effects, whereas process-oriented therapy is weak

  • The study thus indicates that treatment activities should be task-oriented, functional, relevant to daily living, and child centered in order to promote the transfer of skills


Sensory Integration Research

May-Benson, T. A., & Koomar, J. A. (2010). A systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children. The American Journal of Occupational Therapy, 64(3), 403–414. 


  • Approximately 90% of American occupational therapists who work in school settings use sensory integration in their practice

  • The present systematic review sought to examine the effectiveness of sensory integration for children with difficulty processing and integrating sensory information

  • Twenty-seven articles were collected in this systematic review and multiple skills were examined

    • Motor performance: 10 out of the 14 articles found positive gains from sensory integration intervention, suggesting that SI is better than no treatment 

    • Sensory processing: 7 out of 13 studies indicated positive improvements from sensory integration intervention, including changes in the duration of nystagmus, improvement with tactile function, and a decrease in sensory defensiveness

    • Behavioral outcomes: studies indicate that occupational therapists using sensory integration found improved outcomes in the areas of attention, cognition, and social skills in children with sensory processing issues compared to children who received no treatment

    • Academic and psychoeducational outcomes: 6 out of 12 studies found improved reading skills through the SI approach, however, it is unclear if these effects are significant

    • Occupational performance outcomes: 3 out of 3 studies regarding individualized goals demonstrated that sensory integration led to significant gains in self-identified tasks and activities, as well as positive changes in both performance and satisfaction of tasks

  • Overall, this systematic review validates the use of sensory integration in improving outcomes across multiple domains and skills


Miller, L. J., Coll, J. R., & Schoen, S. A. (2007). A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. The American Journal of Occupational Therapy, 61(2), 228–238. 


  • Sensory processing disorders are impairments in detecting, modulating, interpreting, or responding to sensory stimuli

  • The present study employed a randomized controlled trial to examine the effectiveness of occupational therapy using sensory integration for children with sensory modulation disorders (SMD)

  • Twenty-four children with SMD were randomly assigned to one of three treatment conditions: (1) OT-Sensory Integration (OT-SI), (2) Activity Protocol, and (3) No treatment

    • In the OT-SI group, the therapist and child interact in a large OT room equipped with sensory toys and activities. The child’s imagination creates a pretend situation, and the child interacts with sensory materials in an active, meaningful, and fun manner. 

  • The findings of this study indicate that the OT-SI group made significant gains compared to the other two groups in the goal attainment scale, and attention subtest and cognitive/social composite of the Leiter International Performance Scale-Revised. Additionally, the OT-SI demonstrated improvements in the Short Sensory Profile, and Child Behavior Checklist


Schaaf, R. C., Dumont, R. L., Arbesman, M., & May-Benson, T. A. (2017). Efficacy of occupational therapy using Ayres Sensory Integration®: A systematic review. The American Journal of Occupational Therapy, 72(1). 


  • In the US, 5%-16% of children report having difficulties in processing and integrating sensory experiences that affect their participation in activities of daily living, including sleeping, dressing, eating, playing, and school

  • The incident rate for sensory processing difficulties for children with autism is 56%-70%

  • Prior research indicates that sensory integration interventions contribute to improvement in individualized goals, school-related skills, sensory-motor skills, motor planning, and socialization

  • The present systematic review conducted examined current research to derive the efficacy of sensory integration interventions in occupational therapy

  • 5 studies were examined with all participants being children with autism

  • The findings of this study revealed that sensory integration intervention was effective in:

    • Improving outcomes of individually generated goals of function and participation

    • Improving impairment-level outcomes of improvement in autistic behaviors and skills-based outcomes of reduction in caregiver assistance with self-care activities

  • Implications of this review in OT practice support the use of sensory integration in therapy and highlight the importance of examining outcomes that focus on areas of function and participation that are meaningful to the child and family


Schoen, S. A., Miller, L. J., & Flanagan, J. (2018). A retrospective pre-post treatment study of occupational therapy intervention for children with sensory processing challenges. The Open Journal of Occupational Therapy, 6(1). 


  • The present study investigated the impact of an intensive, short-term program named the STAR program that incorporated principles of sensory integration, relationship-based therapies, and parent collaboration

    • The sensory component: prior systematic reviews have provided preliminary evidence for using sensory integration techniques with improvements in individualized goals

    • The relationship component: OTs use relationship-based interventions to improve social engagement, communication, and emotional development. These techniques promote problem-solving through communication and have shown increased social participation, competence, and engagement.

    • The parent component: current research indicates that parent involvement is integral, as parents are the primary supports to their child’s growth and development

  • A retrospective chart review of 179 children identified with sensory processing challenges without comorbid autism was done, evaluating changes in adaptive behavior, emotional functioning, sensory-related behaviors, and motor functioning

  • The intervention was an intensive, short-term relationship-based program where individuals received 50 min of OT three to five times a week. Individualized treatment focused on regulation strategies to address arousal, relationship-based strategies to enhance interpersonal connection, and sensory integration activities to address sensory and motor deficits. 

  • The findings of the study revealed that the intervention was effective in improving adaptive behavior, emotional functioning, and sensory processing as reported by parents as well as assessments

  • Additionally, the findings revealed gains in daily life functioning, such as communication, self-care, and social skills 

  • Implications of this research indicate the importance of providing sensory integration with a relationship-based approach and parent involvement