Defining the key elements of the Affolter Model® in a multiprofessional Delphi study: a first step toward evidence-based Tactual Interaction Therapy.

The expert panel was restricted to certified or licensed Affolter Model practitioners with at least five years of practical application, so the result reflects one association, not all users of the model. The survey was available only in German and French, and most participants were from Switzerland and Germany, so other countries and languages may not be represented. The sample was small for profession-specific analysis, with 15 occupational therapists, 6 speech therapists, 5 physical therapists and 5 curative educators among 40 participants. The initial statements were written by the project group before the panel voted, and the project group also revised wording, so consensus may have been shaped by that group. The study used mean values from an ordinal Likert scale, which the authors note is controversial, and individual feedback may have anchored later responses. No patients were treated or assessed, so the study cannot show that Tactual Interaction Therapy improves function, participation, language, movement or daily activities.

Do not read the agreed statements as proof that Tactual Interaction Therapy improves patient outcomes. The study asked experts to define the Affolter Model, and it did not recruit patients or measure treatment effects.