Our Standards &
Evidence Policy
Families make decisions about their child based on what a clinic tells them. This page sets out the rules we hold ourselves to when we tell you anything, so that you can hold us to them too.
Pediatric therapy is a field where some promising tools are moving faster than the research behind them. That creates a real risk: a clinic can describe an early-stage therapy in language that sounds settled, and a parent has no practical way to tell the difference. We think the burden of making that difference visible belongs to us, not to you.
So we have written down what we will and will not say. If you find something on this website that falls short of what follows, we want to hear about it, and we will fix it.
Seven rules we hold ourselves to
We describe evidence by its actual strength
When we cite research, we state the study design, how many people were in it, and what it does not establish. A randomized controlled trial and an uncontrolled pilot study are not the same kind of evidence, and we do not present them as though they are. Where the evidence for something we offer is preliminary, we use the word preliminary.
We disclose off-label and investigational use before you decide
Photobiomodulation applied to the head, and non-invasive vagus nerve stimulation at the ear, are not FDA cleared for the pediatric uses described on this site. We tell you this in conversation and in writing, before you consent and before you pay. You may decline either one and still receive the rest of the program.
We do not guarantee outcomes
We will not predict how your child will respond, quote a success rate, or suggest that a result another family experienced is a result you should expect. Outcomes in occupational therapy vary widely and depend on factors no clinician controls.
We stay inside our scope of practice
We are occupational therapists. Arizona law is explicit that an occupational therapy evaluation does not include making a medical diagnosis, and ours does not. We do not prescribe or adjust medication, provide psychotherapy, interpret medical imaging, or advise you to change any treatment your physician has recommended. When a child needs something outside occupational therapy, our responsibility is to refer, and we do.
We will not recommend more therapy than your child needs
Arizona treats promoting a treatment or device beyond the point of reasonable benefit as unprofessional conduct, and we agree with the principle regardless of the rule. We will not add sessions, add technology, or extend a program because it is available to sell. If your child has reached a plateau or is finished, we will say so.
We do not use fear to sell therapy
We will not tell you that a window is closing, that your child will fall permanently behind without us, or that other providers have failed you. Urgency is a sales technique, and it has no place in a conversation about a child.
We correct ourselves in public
If something on this site is inaccurate or has been overtaken by newer research, we change it and note the date. This page carries a review date for that reason.
Our four evidence levels
Every therapy described on this website is assigned one of the four levels below, and every study on our Research page is labelled with its design and sample size. The level reflects the strength of the evidence, not our enthusiasm for the therapy. A therapy at an earlier level is not a therapy we think is unlikely to help. It is one where the research is still catching up to what we see in practice, and we would rather say so.
Multiple randomized controlled trials, or systematic reviews and meta-analyses of them, in a population similar to the children we see.
Example: Ayres Sensory Integration for individualized goals in autistic children roughly aged 4 to 12.
At least one well-conducted randomized controlled trial, with limited replication, or consistent findings across several smaller controlled studies.
Example: Primitive reflex integration for reading difficulty, which rests on a single randomized trial published in 2000.
Small trials, pilot studies, uncontrolled or open-label studies, or retrospective reviews. Encouraging signals that have not been independently confirmed at scale.
Example: Photobiomodulation and non-invasive vagus nerve stimulation in children.
Laboratory work, animal studies, or research in adults that explains how something could plausibly work, without showing that it does work in children.
Example: Much of the widely cited photobiomodulation literature falls here.
Why we can use these tools at all
Arizona does not maintain an approved list of modalities that occupational therapists may or may not use. The Board places the responsibility on each individual therapist to obtain the necessary training, supervision and demonstrated competency for every modality they select, and to keep that competency current as the evidence develops.
We take that as a responsibility rather than a loophole. Every modality we use is tied to a functional goal written into your child's plan, because a modality that is not connected to your child's daily life is not occupational therapy. If you want to know what training stands behind any technique we use with your child, ask us and we will tell you.
Ask us the hard questions
Questions about the research are always welcome. We love walking families through the evidence so you feel confident in every step of your child's care.
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