Review Reports

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I want to begin by saying how genuinely grateful I am for the opportunity to read and provide feedback on your manuscript—it truly feels like a privilege. Your research topic is not just important; it’s also incredibly timely, dovetailing neatly with today’s academic discussions. I hope the observations I’ve included here will help refine your key arguments and amplify the paper’s overall impact.

ABSTRACT

Though your abstract lays out your project, a bit more detail about the narrative review process could really illuminate your work. Perhaps explain the criteria that guided which studies were included (and which were excluded), where you searched for them (databases, search terms), and the types of studies you ultimately reviewed. Including a few pointed examples or noteworthy findings from the literature would help readers understand how these discoveries shaped the guide you’ve developed. And since you mention future research directions, considering a brief roadmap of exactly which aspects of the guide need further testing—or a few tweaks based on early feedback—would give the abstract more substance.

INTRODUCTION

You note that you’ve created a novel tool for clinical decision-making, but you might try briefly clarifying why it’s so innovative compared to what’s already out there. Adding just a sentence or two about the broader implications of better detection and intervention—especially for families and educational systems—would also validate why your work matters. Finally, consider strengthening the introduction further by mentioning any existing gaps in research or practice that your study aims to bridge. Questions like “What pressing issue in the field does this tool address?” can help readers see where your work fits.

METHODS

Right now, the methods section references a narrative review, which is helpful for summarizing existing knowledge. However, narrative reviews can sometimes lack the rigor of systematic reviews or empirical studies—so you might think about whether a systematic review or some empirical data collection could boost the reliability of your findings. Additionally, you could give readers more specifics on how your literature review was conducted. For instance, what criteria steered your decisions on which articles to include? Which databases did you search, and which terms did you use? Over what time frame? Readers will likely also appreciate a clearer explanation of how you extracted and synthesized data from the studies themselves. 

You mention a proposed way of thinking about child behaviors, yet it’s not entirely clear whether this is a theoretical framework, a model, or a set of guidelines. A short, direct description would really help. Because your title focuses on supporting children and their families, you might include details on how the guide was tested or verified—did you seek expert input, conduct a pilot study, or incorporate any real-world scenarios? If the tool is meant to be used in practice, readers will want examples of how it was tried out, even if just in a small pilot. And given how sensory integration challenges often span multiple fields (like occupational therapy, psychology, and education), integrating a bit about how these disciplines feed into your guide could be quite illuminating.

RESULTS

Detailed case studies or illustrations would bring your results to life. They’d show readers exactly how different interventions fare and what effect they have in real-world settings. Plus, a more robust comparison of screening tools—what each tool does well, where they might fall short—could help primary care providers make solid, informed choices. You also mention potential challenges in putting the Sensory Integration Decision Guide into practice, and I applaud that honesty. Perhaps you could delve deeper into those obstacles, so PCPs are better prepared to address them. And while you do outline future research directions, offering more explicit suggestions—such as which key variables should be investigated next—would give a clearer sense of where we can build on your work.

Overall, I hope these thoughts spark some ideas for fine-tuning your manuscript and clarifying its contributions. Your research is poised to have a real impact, and with a few extra details in the abstract, a little more conceptual framing in the introduction, and stronger methodological descriptions, I suspect your paper will truly stand out.

Author Response

Please see attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for the opportunity to review your article. Below, I provide constructive feedback intended to enhance its clarity, depth, and scholarly impact. I hope these suggestions assist you in refining your work and strengthening its contributions.

Title
Supporting Children with Sensory Integration Challenges and Their Families: A Sensory Integration Decision Guide

Abstract
– Line 26: Limited methodological detail. “We conducted a narrative review” is too vague and should specify how the literature was selected, its scope, timeframe, etc.
– Line 37: “Future studies will need to determine the benefit of this tool” could specify what types of studies or measures are anticipated.
– The abstract shows partial misalignment with the title. It focuses on PCPs, not families or children directly, which may mislead readers expecting intervention or family-centered support.

Introduction
– The objective is consistently stated across the abstract and introduction; however, it diverges from the title’s framing, which emphasizes support for families as well as children. The focus in the text is solely on primary care providers.
– Knowledge gap: While the introduction implies a need for improved PCP decision-making (lines 65–67), it does not clearly identify what is missing in existing literature or tools.
– Although the concept of sensory integration is defined, the theoretical framework (e.g., Ayres Sensory Integration Theory) could be more explicitly connected to the study’s rationale.

Methodology
– The Methods section (lines 79–84) is minimal and lacks the transparency typically expected in a narrative review. While the authors identify the design as a narrative review, they provide no details about databases searched, selection criteria, or analytical approach.
– The statement that they “propose a way of thinking” introduces conceptual discussion rather than methodology.
– Ethical considerations are reported later in the paper but not mentioned in this section.
– Overall, the section should be expanded to clarify how the literature review was conducted, which sources were considered, and how the Decision Guide was developed from the findings.

Results
– The Results section is a narrative explanation rather than a presentation of findings from a review. There are no data summaries, themes, tables, or structured synthesis.
– No mention is made of the number of studies, years covered, inclusion criteria, or methodological quality.
– The guide is introduced but not explained (no figure details, examples, or validation).
– Sections 3.3–3.4 mix results with discussion and recommendations, which reduces clarity about what the literature actually found versus what the authors propose.
– There are two sections labeled “3.3”; subsections should be correctly numbered for clarity.
– Although family aspects are mentioned, the section does not elaborate on how families are supported, which weakens alignment with the title.
– The Results cite many studies but do not differentiate between levels of evidence or methodological quality.

Discussion
– The manuscript does not include a dedicated Discussion section. As a result, the paper lacks interpretation of findings, integration with prior research, and acknowledgment of methodological limitations.
– The “Conclusions and Future Directions” section offers a brief summary but does not critically analyze the implications of the review or the practical value of the Decision Guide.
– A separate, well-developed Discussion section is needed to strengthen the paper’s academic contribution and coherence.

Conclusion
– The conclusion is concise but largely descriptive and repetitive. It restates the prevalence of sensory integration challenges and the importance of referral to occupational therapy without synthesizing the main contributions or implications of the review.
– The Sensory Integration Decision Guide—the manuscript’s central innovation—is barely mentioned, and its value for families or primary care providers is not analyzed.
– Furthermore, limitations of the review and concrete future research directions are missing.
– Expanding the conclusion to summarize key findings, articulate the guide’s relevance, and specify future validation steps would strengthen the paper’s scholarly and practical impact.

Author Response

Please see attachment

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The manuscript makes a relevant and potentially impactful contribution through the proposed Sensory Integration Decision Guide. The manuscript generally flows well, while sections 4 and 5 require further depth and clarity to demonstrate originality and applied value.

Sections 4 and 5 are central to demonstrating the manuscript’s originality, yet both are currently too brief and descriptive. The section on the Sensory Integration Decision Guide should be expanded to explain how findings from the literature and clinical expertise were synthesised into decision steps. Describe the logic of the guide and interpret Figure 1 rather than merely referencing it. This section should also explain what each pathway represents and how a primary care provider would use it in practice. Adding a short illustrative example or case scenario would make the guide’s application clearer and more clinically useful. It would also help to specify the intended users and settings in which the guide can be applied and to clarify whether it is conceptual, print-based, or digital. A brief acknowledgement that the guide has not yet been empirically validated, together with an indication of how it might be piloted or tested, would also add transparency and rigour.

The conclusion section should move beyond repeating background information and instead highlight the manuscript’s unique contribution, i.e., the introduction of a structured clinical decision-support guide bridging primary care and occupational therapy. This is where the authors have the opportunity to emphasise the potential benefits for early identification and timely referral, and outline concrete next steps for research or implementation, such as piloting the guide or gathering user feedback. Finally, it's also important to note the limitations of the current work and link the implications to broader interdisciplinary or public health contexts to strengthen the manuscript’s relevance and forward direction.

Author Response

Please see attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Many thanks for addressing all my comments.

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for your revised manuscript and for addressing the comments and suggestions provided. I have reviewed your responses and the changes made to the manuscript, and I confirm that the issues raised have been adequately addressed.

The revisions enhance the clarity and quality of the work, and I am satisfied with the responses provided.

 

Best regards