Sensory integration therapy

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Sensory integration therapy is an attempt to treat sensory processing disorder and related situations. It is generally based on A. Jean Ayres's sensory integration theory, which proposes that sensory processing is linked to emotional regulation, learning, behavior, and participation in daily life.

Theoretical concept[edit]

A. Jean Ayres' sensory integration theory[1] describes:

  • how the neurological process of processing and integrating sensory information from the body and the environment contribute to emotional regulation, learning, behavior, and participation in daily life,
  • empirically derived disorders of sensory integration,[2][3] and
  • an intervention approach.

"Sensory integration theory is used to explain why individuals behave in particular ways, plan intervention to ameliorate particular difficulties, and predict how behavior will change as a result of intervention."[4] Ayres wrote, "Sensory Integration is the organization of sensations for use. Our senses give us information about the physical conditions of our body and the environment around us...The brain must organize all of our sensations if a person is to move and learn and behave in a productive manner".[5]

The neurological process of sensory integration is a "particular way of viewing the neural organization of sensory information for functional behavior".[6] It is studied by different professions on diverse levels, such as by occupational therapists as a foundation for occupational performance and participation, by psychologists on a cellular level as multi-sensory integration.[7]

As a theory, sensory integration is "a dynamic and ecological theory that specifies the critical influence of sensory processing on human development and function".[8] "It contributes to the understanding of how sensation affects learning, social-emotional development, and neurophysiological processes, such as motor performance, attention, and arousal".[8]

As an intervention approach, it is used as "a clinical frame of reference for the assessment and treatment of people who have functional disorders in sensory processing".[6]


People with sensory integrative dysfunction experience problems with their basic senses of touch, smell, hearing, taste, sight, body coordination, and movement against gravity. Along with this might possibly be difficulties in movement, coordination and sensing where one's body is in a given space. According to proponents of sensory integration therapy, sensory integrative dysfunction is a common disorder for individuals with neurological learning disabilities such as an autism spectrum disorder,[9][10] attention deficit hyperactivity disorder,[11] and sensory modulation dysfunction.[12]

Evidence and effectiveness[edit]

While sensory based treatments have been highly advocated for, there is disagreement over their therapeutic worth, largely due to problems with methodology and confusion of terms and conflation with similar and related approaches.[13][14][15]

Ayres' theory of sensory integration is frequently critiqued. Emerging evidence with improved methodology, the development of a Fidelity Measure and increasing focus of resources on areas of practice that might not typically attract medical research funding, means that the much needed evidence for Ayres SI is now emerging.[16][17]

Hume and colleagues support the use of Ayres’ Sensory Integration, making the case for why review of science and evidence should be ongoing.[18]

“The current report updates and extends the work on evidence-based, focused intervention practices begun with an initial review of the literature from 1997 to 2007 (Odom et al. 2010a, b) and extended through a second report that covered the literature from 1990 to 2011 (Wong et al. 2015); extending this systematic review through 2017 added 567 articles to the review. As the intervention literature has provided more empirical information and as practices have evolved, some of the classifications required reconceptualization and revision of previous definitions. In an active research area, knowledge does not stand still, and in fact, identification of EBPs should be dynamic, reflecting the growth of knowledge across time (Biglan and Ogden 2019)."

In their article they clearly state the importance of clearly defining what sensory integration therapy is and is not; helping to clarify and delineate the clinical practice reported on in their article, from other related approaches based on Ayres theory.[18]

"It is important to note that Sensory Integration refers explicitly to the classical sensory integration model developed by Jean Ayres (2005) and not to a variety of interventions that address sensory issues but have been found to be unsupported (Case-Smith et al. 2015; Watling and Hauer 2015).”

The review explored therapy outcomes over time, reflecting an emphasis on meaningful participation in everyday life, something which is core to the underlying principles of Ayres’ Sensory Integration.


Sensory integration theory originated from the work of A. Jean Ayres, an occupational therapist and psychologist, in 2005.

Ayres' approach has proliferated among therapy and educational professionals over the past several decades. It has been met with some resistance within the occupational therapy profession and in other disciplines.[6]

See also[edit]


  1. ^ Smith Roley, Susanne; Mailloux, Zoe; Miller Kuhaneck, Heather (September 2007). "Understanding Ayres' Sensory Integration". OT Practice. 12 (17): CE1-8.
  2. ^ Mulligan, Shelly (1998). "Patterns of sensory integration dysfunction: A confirmatory factor analysis". American Journal of Occupational Therapy. 52 (10): 819–828. doi:10.5014/ajot.52.10.819.
  3. ^ Mailloux, Zoe; Mulligan, Shelly; Roley, Susanne S.; Blanche, Erna I.; Cermak, Sharon (2011). "Verification and clarification of patterns of sensory integrative dysfunction". American Journal of Occupational Therapy. 65 (2): 143–151. doi:10.5014/ajot.2011.000752. PMID 21476361.
  4. ^ Murray, Anita C.; Lane, Shelly J.; Murray, Elizabeth A. (2001). Sensory integration (2 ed.). Philadelphia: F.A. Davis. p. 5. ISBN 0-8036-0545-5.
  5. ^ Ayres, A. Jean (2005). Sensory integration and the child : understanding hidden sensory challenges (25th anniversary ed., rev. and updated ed.). Los Angeles, CA: WPS. p. 5. ISBN 978-087424-437-3.
  6. ^ a b c Parham, D. & Mailloux, Z. (2010). Sensory Integration. In Case-Smith, J. & O’Brien, J. (Eds.), Occupational Therapy For Children (6th ed.). (pp 325-372). Maryland Heights, Missouri: Mosby Elsevier.
  7. ^ Wallace, Mark T.; Stein, Berry E. (1997). "Development of multisensory neurons and multisensory integration in cat superior colliculus". Journal of Neuroscience. 17 (7): 2429–2444. doi:10.1523/JNEUROSCI.17-07-02429.1997. PMC 6573512. PMID 9065504.
  8. ^ a b Smith Roley, S. & Jacobs, E. S. (2009). Sensory Integration. In Crepeau, E. B., Cohn, E. & Boyt Schell, B. (Eds.), Willard & Spackman’s Occupational Therapy (11th ed.). (pp. 792-817). Baltimore, MD: Lippincott Williams & Wilkins.
  9. ^ Marco EJ; Hinkley LB; Hill SS; Nagarajan SS (May 2011). "Sensory processing in autism: a review of neurophysiologic findings". Pediatr. Res. 69 (5 Pt 2): 48R–54R. doi:10.1203/PDR.0b013e3182130c54. PMC 3086654. PMID 21289533.
  10. ^ Dawson, G.; Watling, R. (October 2000). "Interventions to facilitate auditory, visual, and motor integration in autism: a review of the evidence". J Autism Dev Disord. 30 (5): 415–21. doi:10.1023/A:1005547422749. PMID 11098877. S2CID 9012157.
  11. ^ Ghanizadeh A (June 2011). "Sensory processing problems in children with ADHD, a systematic review". Psychiatry Investig. 8 (2): 89–94. doi:10.4306/pi.2011.8.2.89. PMC 3149116. PMID 21852983.
  12. ^ Miller, L. J.; Reisman, J. E.; McIntosh, D. N.; Simon, J. (January 2001). S. S. Roley; E. I. Blanche; R. C. Schaaf (eds.). An ecological model of sensory modulation: Performance of children with fragile X syndrome, autistic disorder, attention-deficit/hyperactivity disorder, and sensory modulation dysfunction (PDF). Understanding the nature of sensory integration with diverse populations. Tucson, AZ: Therapy Skill Builders. pp. 75–88. ISBN 9780761615156. OCLC 46678625. Archived from the original (PDF) on 2012-10-25. Retrieved 2013-07-26.
  13. ^ Barton EE, Reichow B, Schnitz A, Smith IC, Sherlock D (2015). "A systematic review of sensory-based treatments for children with disabilities". Res Dev Disabil. 37: 64–80. doi:10.1016/j.ridd.2014.11.006. PMID 25460221.
  14. ^ Case-Smith J, Weaver LL, Fristad MA (2015). "A systematic review of sensory processing interventions for children with autism spectrum disorders". Autism. 19 (2): 133–48. doi:10.1177/1362361313517762. PMID 24477447. S2CID 44303535.
  15. ^ Schaaf, Roseann C.; Dumont, Rachel L.; Arbesman, Marian; May-Benson, Teresa A. (2018-01-01). "Efficacy of Occupational Therapy Using Ayres Sensory Integration®: A Systematic Review". American Journal of Occupational Therapy. 72 (1): 7201190010p1–7201190010p10. doi:10.5014/ajot.2018.028431. ISSN 0272-9490. PMID 29280711. S2CID 4018104.
  16. ^ Watling, Renee; Hauer, Sarah (September 2015). "Effectiveness of Ayres Sensory Integration® and Sensory-Based Interventions for People With Autism Spectrum Disorder: A Systematic Review". The American Journal of Occupational Therapy. 69 (5): 6905180030p1–12. doi:10.5014/ajot.2015.018051. ISSN 0272-9490. PMID 26356655.
  17. ^ Lane, Shelly J.; Mailloux, Zoe; Schoen, Sarah; Bundy, Anita; May-Benson, Teresa A.; Parham, L. Diane; Smith Roley, Susanne; Schaaf, Roseann C. (2019-06-28). "Neural Foundations of Ayres Sensory Integration®". Brain Sciences. 9 (7): 153. doi:10.3390/brainsci9070153. ISSN 2076-3425. PMC 6680650. PMID 31261689.
  18. ^ a b Hume, Kara; Steinbrenner, Jessica R.; Odom, Samuel L.; Morin, Kristi L.; Nowell, Sallie W.; Tomaszewski, Brianne; Szendrey, Susan; McIntyre, Nancy S.; Yücesoy-Özkan, Serife; Savage, Melissa N. (2021-01-15). "Evidence-Based Practices for Children, Youth, and Young Adults with Autism: Third Generation Review". Journal of Autism and Developmental Disorders. 51 (11): 4013–4032. doi:10.1007/s10803-020-04844-2. ISSN 1573-3432. PMC 8510990. PMID 33449225.