Goal Attainment Scaling as a Measure of Meaningful Outcomes for Children With Sensory Integration Disorders

Abstract

Goal attainment scaling (GAS) is a methodology that shows promise for application to intervention effectiveness research and program evaluation in occupational therapy (Dreiling & Bundy, 2003; King et al., 1999; Lannin, 2003; Mitchell & Cusick, 1998). This article identifies the recent and current applications of GAS to occupational therapy for children with sensory integration dysfunction, as well as the process, usefulness, and problems of application of the GAS methodology to this population. The advantages and disadvantages of using GAS in single-site and multisite research with this population is explored, as well as the potential solutions and future programs that will strengthen the use of GAS as a measure of treatment effectiveness, both in current clinical practice and in much-needed larger, multisite research studies.

An Intervention for Sensory Difficulties in Children with Autism: A Randomized Trial

“…It provides a systematic process for identification of goals that are specifically relevant to individuals and their families and has been shown to be a promising outcome measure in ASD (Ruble et al 2012). GAS has been used extensively for outcome measurement (Ruble et al 2010; Pfeiffer et al 2011; Miller et al 2007; Mailloux et al 2007) and is shown to be a valid and reliable method for measurement of progress on individualized goals for children with ASD (Ruble et al 2012; Palisano et al 1992). For example, Ruble et al (2012) report good reliability when objectives are clearly measurable finding average intra class correlation between 2 study samples of 0.98 (CI 0.74–0.99) for measurability, 0.96 (CI 0.74–0.99) for equi-distance, and 0.77 (CI 0.65–0.99) for difficulty.…”

“…GAS is used to measure functional and meaningful aspects of an individual’s progress (Mailloux et al 2007; Kiresuk et al 1994). In autism, inherent heterogeneity often confounds findings, and thus, it is important to utilize outcome measures that are sensitive to individual outcomes.…”

A randomized, single-blind cross-over design evaluating the effectiveness of an individually defined, targeted physical therapy approach in treatment of children with cerebral palsy

“…26,27 Before the start of the programs, individual goals based on specific goal items of the Gross Motor Function Measure-88, were formulated according to the specific, measurable, achievable, realistic/ relevant and timed (SMART)-principle. 28 A score between -2 and 2 was given depending on the goal achievement.…”

A multi-site study of the feasibility and clinical utility of Goal Attainment Scaling in geriatric day hospitals

“…Given the heterogeneity of GDH patients, and the diversity in approaches and models of care used by GDHs, Forster et al [12,13] strongly recommend that future studies of GDHs should be multi-centre trials. Mailloux et al [19] reviewed GAS in both single and multi-site applications. They concluded that additional research on the psychometric properties of GAS across sites was necessary for multi-site applications [19].…”

“…Mailloux et al [19] reviewed GAS in both single and multi-site applications. They concluded that additional research on the psychometric properties of GAS across sites was necessary for multi-site applications [19].…”