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Snoezelen on a variety of behaviors, such as
changes in affect, challenging behavior, relaxation,
behavior states and interactions (for
example, Ashby, Lindsay, Pitcaithly, Broxholme
& Geelen, 1995; Lindsay et al., 2001;
Mount & Cavet, 1995; Vlaskamp et al., 2003).
Some studies show positive outcomes, especially
with regard to relaxation, but several
show negative results, and <strong>the</strong>re is little evidence
on which to base any generalizations
(Hogg et al., 2001).
Aroma<strong>the</strong>rapy has also been subjected to
research, but to far less an extent than
Snoezelen. Lindsay et al. (2001) showed that
aroma<strong>the</strong>rapy has a limited effect on <strong>the</strong> communication
levels of those with PIMD. While
<strong>the</strong>re is a growing body of research on <strong>the</strong>
practice of aroma<strong>the</strong>rapy, <strong>the</strong>re are only a few
empirical studies on <strong>the</strong> effects of it (Maddock-Jennings
& Wilkinson, 2004), and none
with specific regard to people with PIMD.
We did find two studies that have been conducted
on <strong>the</strong> effectiveness of Sensory Integrative
Therapy (SIT) for people with PIMD.
One study by Brody, Thomas, Brody and
Kucherawy (1977) used a well-established research
design (for example, random assignment,
use of intervention manual and validated
outcome measures) and found no
significant difference between <strong>the</strong> SIT group
and <strong>the</strong> control group. In <strong>the</strong> o<strong>the</strong>r study by
Close, Carpenter and Cibiri (1986), no random
assignment, no intervention manual and
no validated outcome measures were used.
They showed that <strong>the</strong> SIT group improved
more than <strong>the</strong> control group. Smith et al.
(2005), in an overview of research (or <strong>the</strong> lack
of it) on SIT, stress <strong>the</strong> need for research
support in <strong>the</strong> future.
The influence of Equine Therapy on <strong>the</strong>
motor and social-emotional behavior of children
with disabilities has been examined in
several studies, but none of <strong>the</strong>se studies is
related to <strong>the</strong> population of children with
PIMD. In <strong>the</strong>ir literature review, Rolandelli
and Dunst (2003) stated that most of <strong>the</strong>se
studies report benefits, but methodological
and procedural problems raise questions
about <strong>the</strong> efficacy of <strong>the</strong> practice.
Finally, Basic Stimulation has not been subjected
to research, although some of <strong>the</strong> underlying
principles have been examined. This
is viewed by its creator as an indirect argument
in support of <strong>the</strong> intervention (Bienstein &
Fröhlich, 2003). Apparently, <strong>the</strong> scientific underpinning
proving <strong>the</strong> effectiveness of <strong>the</strong>se
frequently used <strong>the</strong>rapeutic interventions
does not have priority. It also seems that if
results and outcomes of research do not conform
to prevailing beliefs, such results and
outcomes are easily overlooked.
The use of ineffective <strong>the</strong>rapeutic interventions
is costly, not only in terms of raising false
hopes or running <strong>the</strong> risk of injuring <strong>the</strong> person
with PIMD, but also in monetary terms.
Quite a number of <strong>the</strong>rapeutic interventions,
especially some of those based on refuted
models of human behavior such as Therapeutic
Touch, start with training sessions or workshops
for those who will apply <strong>the</strong> intervention.
These training sessions or workshops are
not cheap. Fur<strong>the</strong>rmore, some of <strong>the</strong>se <strong>the</strong>rapeutic
interventions use expensive equipment,
while o<strong>the</strong>rs are not costly in terms of
material but are costly in terms of time. As a
result of <strong>the</strong> lack of research, <strong>the</strong> expenditure
by services on such <strong>the</strong>rapies may not be based
on rational decisions, and could actually conflict
with and undermine <strong>the</strong> effectiveness of
support. The lack of ‘evidence-based’ <strong>the</strong>rapeutic
interventions for people with PIMD
makes services vulnerable: if services are unable
to demonstrate <strong>the</strong> effectiveness of <strong>the</strong>ir
care, <strong>the</strong> willingness of those who are responsible
for <strong>the</strong> actual costs (such as health insurers,
or local systems providing financial assistance)
will decrease or decline.
Studying <strong>the</strong> effectiveness of <strong>the</strong>rapeutic interventions
for individuals with PIMD is timeconsuming
and methodologically complicated.
Therefore we need an efficient
research strategy to separate <strong>the</strong> <strong>the</strong>rapeutic
interventions that are actually beneficial to
people with PIMD from those that are that are
damaging, or have no effect at all but do
consume time and money. A logical starting
point would be an investigation of <strong>the</strong>rapeutic
interventions that are used most frequently.
Ano<strong>the</strong>r approach could be to examine <strong>the</strong>
type of claim that is made. It can be argued
that a claim that feelings of wellbeing or relaxation
improvement is of little concern relative
to a claim for restored functions or for
<strong>the</strong> stimulation of cognitive or motor development.
The stronger <strong>the</strong> claim, <strong>the</strong> more reason
<strong>the</strong>re is to determine whe<strong>the</strong>r or not this
Therapeutic Interventions / 339