Soft Systems Methodology in Standardizing the Method for Applying Dolphin-Assisted Therapies in Neurodivergent Patients: Case Study of Delfiniti Mexico
, Brenda Lorena Flores Hidalgo 2, Oswaldo Morales Matamoros 3, Jesús Jaime Moreno Escobar 3,* and Hugo Quintana Espinosa 2
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
The article focuses on the application of Soft Systems Methodology (SSM) to standardize the method for implementing dolphin-assisted therapies for neurodivergent patients. The reviewer’s comments are presented below:
All descriptions in Figure 4 should be in English. Acronyms should be explained in a legend or caption below the figure.
Figure 5 is unclear. Before presenting the figure, the authors should explain the meaning of each infographic. Additionally, the reason for classifying some relationships as conflicting is not provided.
Figure 6 is also unclear. For example, in Figure 4, the family is connected by red arrows (both two-way and one-way) to objects DIF and ZIHUA. However, in Figure 5, the area they belong to is connected to the family with a green two-way arrow.
The structure of the article complicates its analysis. For instance, in Figure 11, the authors refer to tasks that are explained only on the following page.
Have the authors considered implementing newer approaches? For analyzing process completion time, using system dynamics models or business process modeling with BPMN notation and simulation could be helpful. The use of BPMN notation not only facilitates process simulation but also aids in standardizing them.
Author Response
See the attached pdf file.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for Authors
Standardization of activities, processes etc. is sine qua non demand in any system and discipline, in healthcare too. Standardization facilitates the evaluation of the efficacy of the intervention, could improve the data collection for research, and enable comparisons of result of different studies. Therefore the topic of the paper (standardization of specific therapy like DAT) can give an added value to making decision in choosing the specific therapy for specific population (children with disabilities).
The research is based on real data, and the research has been approved by the ethics committee.
The SSM is an appropriate approach in resolving complex real word situations. The results of each individual stage of SSM methodology are visualized and readable in that way. Although the aim of the study was only the first step in the standardization of DAT, the work is extremely valuable and can be a guide in the application to other therapeutic procedures.
There are some open questions:
1. Should DAT be considered as alternative or complementary treatment? It should be explained in the paper.
2. Fig. 4 – what are the supporting organizations? E.g. what is CRIT , IPn etc.? Clarification (description) is needed.
3. Table 1. – ununderstandable – does it mean that there were 6 patients, 2 of them with Down syndrome, 2 with Autism etc, OR ? What information this table should offer?
Author Response
See the attached pdf file.
Author Response File: Author Response.pdf
