Document Type (Journals)

Original Research


Occupational therapy students must be prepared to use clinical reasoning to select appropriate interventions for children with sensory processing disorders (SPDs). Although these interventions are typically taught in entry-level occupational therapy programs, there is little information regarding the method by which occupational therapy students are taught a clinical reasoning process to determine which sensory processing intervention to use with pediatric clients. A problem-solving framework called A SECRET was used to teach students clinical reasoning for children with SPDs, via an online, module-based course. Following the module, the students were tested with an online assessment tool regarding their ability to discriminate between appropriate and inappropriate intervention strategies, and to articulate their rationale to demonstrate how they clinically reasoned through a complex client case. Eight students participated in a focus group to provide their perceptions of the online delivery of the content and the A SECRET reasoning process. Five descriptive representations emerged from the qualitative data analysis: the A SECRET Process, Self-Regulation, the Occupational Therapy Practice Framework, Participation, and Safety/Security. The findings suggest an inherent value for online learning to assist occupational therapy students in their program’s first year to learn the A SECRET process and then clinically reason through a simulated case study.


Bryan M. Gee, PhD, MEd, OTR/L, BCP has a Ph.D. in instructional design and a MEd in instructional technology from Idaho State University. He also has an OTD from the University of Saint Augustine and a combined BS/MS in Occupational Therapy from D’Youville College. He is the Director of the Occupational Therapy Program and Associate Professor at Idaho State University in Pocatello, Idaho. Kelly E. Thompson, EdD, OTR/L has an EdD in Educational Leadership from Idaho State University. She also has an MS in Occupational Therapy from Belmont University and a BS in Occupational Therapy from University of New Hampshire. She is a Clinical Associate Professor at Idaho State University. Jane Strickland, EdD earned her doctorate in instructional technology from Idaho State University and has a Master of Education and BS from Montana State University. She was an Associate Professor in the Department of Organizational Learning & Performance at Idaho State University and now holds the title of Professor Emeritus. Lucy Jane Miller, PhD, OTR/L has a PhD in Early Childhood Special Education from University of Denver. She also has an MS in Occupational Therapy from Boston University and a BS in Psychology from Lewis & Clark College. She is the Founder of the STAR Institute for Sensory Processing Disorder (SPD), a premier treatment, research and education center for children with SPD.

Declaration of Interest

The authors report no declarations of interest.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.