A systematic review of the literature related to performance difficulties for children and adolescents with difficulty processing and integrating sensory information was completed as part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association. The review focused on functional performance difficulties that these children may exhibit in areas of occupation including play and leisure, social participation, activities of daily living, instrumental activities of daily living, rest and sleep, education, and work. The results suggest that children and adolescents with difficulty processing and integrating sensory information do exhibit functional performance difficulties in key areas of occupation. However, further descriptive studies are needed to tie these difficulties to their specific sensory and motor issues. Researchers are encouraged to include functional performance measures and measures of social participation in their studies to further elucidate these relationships.