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Challenges with processing and integrating sensory information affect children's ability to successfully engage in their occupations at school and fully participate in the educational process. Occupational therapy using Ayres Sensory Integration® (ASI) is an evidence-based intervention for autistic children that has emerging evidence for children with idiopathic sensory integration differences. This article is a call to action for the occupational therapy profession to increase the use of ASI principles in school settings because it historically has been limited in its application. In this column, we respond to two main questions. First, is ASI necessary, essential, and inherently appropriate in school settings? Second, does ASI align with education laws and mandates? We present evidence showing that interventions to address sensory integration and processing function fall within the domain of school-based occupational therapy practitioners and provide examples for ways to use the principles of ASI across all the tiers of a multitiered system of supports. We also make recommendations for next steps that focus on best practices for implementing ASI in the academic setting and address concerns related to the feasibility of ASI in school-based practice within existing systemic and logistical constraints. As a result, occupational therapy practitioners will be empowered to advocate for use of ASI and its principles in the educational setting to proactively provide the support their students deserve. This article is a call to action for the occupational therapy profession to increase the use of Ayres Sensory Integration® in school settings. [ABSTRACT FROM AUTHOR]

Sensory features are part of the diagnostic criteria for autism and include sensory hypo/hyper reactivity and unusual sensory interest; however, additional sensory differences, namely differences in sensory integration, have not been routinely explored. This study characterized sensory integration differences in a cohort of children (n = 93) with a confirmed diagnosis of autism (5–9 years) using a standardized, norm-referenced battery. Mean z scores, autism diagnostic scores, and IQ are reported. Participants showed substantial deficits in tactile perception, praxis, balance, visual perception, and visual-motor skills. Relationship with autism diagnostic test scores were weak or absent. Findings suggest additional sensory difficulties that are not typically assessed or considered when characterizing sensory features in autism. These data have implications for a greater understanding of the sensory features in the autism phenotype and the development of personalized treatments. [ABSTRACT FROM AUTHOR]

Importance: Occupational therapy using Ayres Sensory Integration® (ASI) is an evidence-based intervention that includes parent education and participation to support outcomes. However, guidelines for this parent component have not been published. Objective: To obtain input from stakeholders on a revised guidebook for parent education during ASI intervention. Design: Cross-sectional survey design. Setting: Online surveys. Participants: Experts in ASI, occupational therapy practitioners who use this approach, and parents of children with autism who received occupational therapy using this intervention. Outcomes and Measures: Surveys designed and vetted to obtain input on content and usability. Results: Experts rated the guidebook as consistent with ASI principles, practitioners rated it as clinically useful, and parents rated it as useful and clear. Conclusions and Relevance: The parent guidebook for ASI is ready for further testing and use. What This Article Adds: This report adds knowledge translation and best practice strategies in parent education to the parent guidebook for ASI and provides evidence that it is acceptable by experts, parents, and clinicians. This report adds knowledge translation and best practice strategies in parent education to the parent guidebook for using Ayres Sensory Integration® (ASI) and provides evidence that the guidebook is acceptable by experts, parents, and clinicians. [ABSTRACT FROM AUTHOR]

Importance: Children with autism spectrum disorder (ASD) often experience feeding challenges related to difficulties with sensory integration. Objective: To evaluate the content, acceptability, and usefulness of MealSense©, an online parent education program for children with ASD who have feeding challenges related to poor sensory integration. Design: A descriptive study in which experts reviewed and rated MealSense content for consistency with Ayres Sensory Integration® (ASI) principles and evidence-based practices in feeding. Participants: A convenience sample of expert reviewers (n = 5) and parents of children with ASD and feeding challenges (n = 5). Results: Expert ratings (n = 5) met criteria showing that MealSense is consistent with ASI and evidence-based practices in feeding. Parent ratings (n = 5) met criteria showing that MealSense is acceptable and useful. Conclusions and Relevance: MealSense is acceptable and useful to parents of children with ASD and is consistent with ASI and evidence-based practices in feeding. What This Article Adds: This study provides preliminary support for MealSense as an evidence-based tool to supplement direct intervention for children with ASD and feeding difficulties. Further research is needed to determine its efficacy in improving the transfer of feeding skills into the home environment. This study provides preliminary support for MealSense, a web-based program designed to help parents of children with autism spectrum disorder address feeding difficulties related to sensory integration challenges. [ABSTRACT FROM AUTHOR]

Importance: Vestibular and proprioceptive functions play a critical role in occupational performance and participation. Assessment of these functions in a reliable and valid manner is part of a comprehensive assessment in the Ayres Sensory Integration® frame of reference, commonly applied in pediatric occupational therapy. Objective: To report on reliability and validity of six tests of vestibular and proprioceptive functions of the Evaluation in Ayres Sensory Integration (EASI). Design: We used Rasch analyses to examine and modify the number of items and scoring categories on the six tests and known-groups analysis to examine group differences. We evaluated internal consistency using Cronbach's α and Rasch person reliability. Participants: The sample contained typically developing children (n = 150) and children with sensory integration concerns (n = 84); all participated voluntarily. Outcomes and Measures: The EASI is used to measure sensory and motor functions in children ages 3 to 12 yr. The six tests of vestibular and proprioceptive functions were analyzed in this study. Results: Data from >96% of items conformed to the expectations of the model. We found statistically significant group differences (ps <.001–.128; ds = 0.20–1.31), with the typically developing children group scoring significantly higher on all but one test, and moderate to strong evidence of internal consistency (Rasch person-reliability indices ≥ 0.80; strata > 3) for five of six tests. Conclusions and Relevance: The EASI vestibular and proprioceptive tests have strong construct validity and internal reliability, indicating that they are psychometrically sound clinical measures. What This Article Adds: The development of occupational therapy assessments with strong psychometric properties, such as the EASI tests of vestibular and proprioceptive functions, enhances clinical practice and research by elucidating the factors affecting participation in accurate and dependable ways so that occupational therapy interventions can be focused and effective. The researchers report on the reliability and validity of six tests of vestibular and proprioceptive functions of the Evaluation in Ayres Sensory Integration® (EASI). [ABSTRACT FROM AUTHOR]

Date Presented 03/22/24 Findings from a National Institutes of Health–funded comparative effectiveness trial comparing Ayres Sensory Integration (ASI) and applied behavioral analysis (ABA) for children with autism are presented, and their implications for OT practice are discussed. Primary Author and Speaker: Roseann C. Schaaf Additional Authors and Speakers: Zoe Mailloux, Elizabeth Ridgway Contributing Authors: Sophie C. Molholm, Emily Joneshuwer, Joanne Hunt, Rachel L. Dumont, Benjamin C. Leiby, Misung C. Li, Catherine C. Sancimino [ABSTRACT FROM AUTHOR]

This systematic review addresses the question "What is the efficacy of occupational therapy using Ayres Sensory Integration® (ASI) to support functioning and participation as defined by the International Classification of Functioning, Disability and Health for persons with challenges in processing and integrating sensory information that interfere with everyday life participation?" Three randomized controlled trials, 1 retroactive analysis, and 1 single-subject ABA design published from 2007 to 2015, all of which happened to study children with autism, met inclusion criteria. The evidence is strong that ASI intervention demonstrates positive outcomes for improving individually generated goals of functioning and participation as measured by Goal Attainment Scaling for children with autism. Moderate evidence supported improvements in impairment-level outcomes of improvement in autistic behaviors and skills-based outcomes of reduction in caregiver assistance with self-care activities. Child outcomes in play, sensory--motor, and language skills and reduced caregiver assistance with social skills had emerging but insufficient evidence. [ABSTRACT FROM AUTHOR]

This article builds on the work of Case-Smith and colleagues and proposes a roadmap to guide future research in occupational therapy. To foster best practice in the application of principles and practices of sensory integration (SI), the pillars of practice, advocacy, and education are identified as elements that provide the foundation for research. Each pillar ensures that SI research is conducted in a rigorous and relevant manner. To this end, achievements to date are discussed, with proposed goals presented for each pillar. Finally, the roadmap builds on the pillars and outlines implications for occupational therapy with the overarching theme that a wide array of scientists, educators, therapists, and service recipients will be needed to ensure that those who may benefit most have access to intervention that is evidence based, theory driven, and provided within the highest standards of service delivery. [ABSTRACT FROM AUTHOR]

Parents often focus on independence in activities of daily living and social participation when setting goals for their children with autism spectrum disorders. Occupational therapy practitioners use clinical reasoning to translate these goals to define occupation-based outcomes. This article describes an exploratory analysis of 160 parent-identified goals for children with autism. We identified sensory integrative factors hypothesized to influence each goal and then categorized the goals using the Occupational Therapy Practice Framework: Domain and Process and the International Classification of Functioning, Disability and Health (ICF). Most goals were at the ICF participation and activity levels. Activities of daily living were the most common area of occupation identified, followed by social participation and play. Sensory reactivity and somatopraxis were the most frequently occurring sensory integrative factors. The value of addressing parent goals using a systematic reasoning process to identify factors affecting participation and the importance of measuring participation outcomes are discussed. [ABSTRACT FROM AUTHOR]

To realize the American Occupational Therapy Association’s Centennial Vision, occupational therapy practitioners must embrace practices that are not only evidence based but also systematic, theoretically grounded, and driven by data related to outcomes. This article presents a framework, the Data-Driven Decision Making (DDDM) process, to guide clinicians’ occupational therapy practice using systematic clinical reasoning with a focus on data. Examples are provided of DDDM in pediatrics and adult rehabilitation to guide practitioners in using data-driven practices to create evidence for occupational therapy. [ABSTRACT FROM AUTHOR]

OBJECTIVE. We sought to characterize sensory integration (SI) and praxis patterns of children with autism spectrum disorder (ASD) and discern whether these patterns relate to social participation. METHOD. We extracted Sensory Integration and Praxis Tests (SIPT) and Sensory Processing Measure (SPM) scores from clinical records of children with ASD ages 4–11 yr (N = 89) and used SIPT and SPM standard scores to describe SI and praxis patterns. Correlation coefficients were generated to discern relationships among SI and praxis scores and these scores’ associations with SPM Social Participation scores. RESULTS. Children with ASD showed relative strengths in visual praxis. Marked difficulties were evident in imitation praxis, vestibular bilateral integration, somatosensory perception, and sensory reactivity. SPM Social Participation scores were inversely associated with areas of deficit on SIPT measures. CONCLUSION. Children with ASD characteristically display strengths in visuopraxis and difficulties with somatopraxis and vestibular functions, which appear to greatly affect participation. [ABSTRACT FROM AUTHOR]

This article presents the current state of measurement in the area of sensory integration within the field of occupational therapy in three areas: (1) phenotypic characterization, (2) intervention adherence and dosage, and (3) outcome measurement. The need for additional measurement tools in all three areas is addressed. In regard to outcome measurement of occupational therapy using sensory integration, the use of both qualitative and quantitative methods to obtain outcome data is recommended. Further, a strategy is recommended for obtaining outcome data from direct report from the child or other stakeholder. [ABSTRACT FROM AUTHOR]

OBJECTIVE. We present the case report of a 3-yr-old boy with retentive fecal incontinence and sensory overresponsivity. Sensory integration theory was used to address the overresponsivity affecting the child's ability to acquire age-appropriate toileting habits. We describe the 7 mo of treatment and 3 mo of follow-up in occupational therapy. METHOD. We analyzed a retrospective chart review of daily defecation log outcome data and parent interview. RESULTS. Notable improvements in acquiring age-appropriate toileting habits were documented and measured using daily defecation logs. Improvements in sensory processing were documented using the Sensory Profile and corroborated improvements in the child's ability to participate in toileting routines and parent report of improved quality of life. CONCLUSION. Occupational therapy using Ayres Sensory Integration® was a useful framework for addressing this child's toileting habits. This case explicates occupational therapy using data-driven intervention principles to address the relationship among sensory processing, behavior, and occupational performance. [ABSTRACT FROM AUTHOR]

In this case report, we describe the changes in adaptive behaviors and participation of 1 child with autism during a 10-wk program of intensive occupational therapy using a sensory integrative approach (OT-SI) following a manualized protocol. This case is part of a larger study examining the efficacy of the OT-SI approach. We found improvement in sensory processing, as measured by the Sensory Integration and Praxis Tests, as well as enhanced participation in home, school, and family activities, as indicated on parent-rated goal attainment scales. [ABSTRACT FROM AUTHOR]

Objective: To examine the feasibility, safety, and acceptability of a manualized protocol of occupational therapy using sensory integration principles for children with autism.Methods: Ten children diagnosed with autism spectrum disorder ages 4-8 years received intensive occupational therapy intervention using sensory integration principles following a manualized protocol. Measures of feasibility, acceptability and safety were collected from parents and interveners, and fidelity was measured using a valid and reliable fidelity instrument.Results: The intervention is safe and feasible to implement, acceptable to parents and therapist, and therapists were able to implement protocol with adequate fidelity. These data provide support for implementation of a randomized control trial of this intervention and identify specific procedural enhancements to improve study implementation. [ABSTRACT FROM AUTHOR]

When Ayres first presented the theory of sensory integration (SI), she grounded it in the neuroscience literature. Neuroplasticity was then, and is today, considered to be at the heart of this theory. This evidencebased review sought to critically examine the basic science literature to specifically identify evidence for the assumptions and tenets of Ayres' theory of SI. We reviewed literature between 1964 and 2005, within psychological, physiological, and biomedical areas, addressing neuroplasticity. The review focused on sensorimotor-based neuroplasticity; explored the data that addressed the links among sensory input, brain function, and behavior; and evaluated its relevance in terms of supporting or refuting the theoretical premise of occupational therapy using an SI framework (OT/SI) to treatment. Although direct application from basic science to OT/SI is not feasible, we concluded that there was a basis for the assumptions of Ayes' SI theory. [ABSTRACT FROM AUTHOR]

The article focuses on sensorimotor integration as intervention for sensory disorders. It states that sensory integration (SI) has furthered in intervening children with autism and developmental disabilities. It mentions several medical write ups that elaborate and support the effectiveness of SI in treating problems on processing and integrating sensory information.

This article provides an introduction and overview of sensory integration theory as it is used in occupational therapy practice for children with developmental disabilities. This review of the theoretical tenets of the theory, its historical foundations, and early research provides the reader with a basis for exploring current uses and applications. The key principles of the sensory integrative approach, including concepts such as “the just right challenge” and “the adaptive response” as conceptualized by A. Jean Ayres, the theory's founder, are presented to familiarize the reader with the approach. The state of research in this area is presented, including studies underway to further delineate the subtypes of sensory integrative dysfunction, the neurobiological mechanisms of poor sensory processing, advances in theory development, and the development of a fidelity measure for use in intervention studies. Finally, this article reviews the current state of the evidence to support this approach and suggests that consensual knowledge and empirical research are needed to further elucidate the theory and its utility for a variety of children with developmental disabilities. This is especially critical given the public pressure by parents of children with autism and other developmental disabilities to obtain services and who have anecdotally noted the utility of sensory integration therapy for helping their children function more independently. Key limiting factors to research include lack of funding, paucity of doctorate trained clinicians and researchers in occupational therapy, and the inherent heterogeneity of the population of children affected by sensory integrative dysfunction. A call to action for occupational therapy researchers, funding agencies, and other professions is made to support ongoing efforts and to develop initiatives that will lead to better diagnoses and effective intervention for sensory integrative dysfunction, which will improve the lives of children and their families. © 2005 Wiley-Liss, Inc. MRDD Research Reviews 2005;11:143–148. [ABSTRACT FROM AUTHOR]

Sensory integration, now trademarked as Ayres Sensory Integration® or ASI, is based on principles of neuroscience and provides a framework for understanding the contributions of the sensory and motor foundations of human behavior. The theory and practice of ASI continues to evolve as greater understanding of the neurobiology of human behavior emerges. In this paper we examine core constructs of ASI identified in the seminal work of Dr. Jean Ayres, and present current neuroscience research that underlies the main patterns of sensory integration function and dysfunction. We consider how current research verifies and clarifies Ayres' propositions by describing functions of the vestibular, proprioceptive, and tactile sensory systems, and exploring their relationships to ocular, postural, bilateral integration, praxis, and sensory modulation. We close by proposing neuroplasticity as the mechanisms underlying change as a result of ASI intervention. [ABSTRACT FROM AUTHOR]