This Letter to the Editor is a response to Whiting et al.’s (2025) article “Occupational Therapy Using Ayres Sensory Integration® in School-Based Practice: A Call to Action.” We want to address issues that arise from this call to action.
The primary purpose of school-based occupational therapy is to facilitate children’s access to and participation in their educational program. Occupational therapy ethics and competency documents provide guidance on what comprises best and competent practice, with occupation-based interventions central to both (American Occupational Therapy Association, 2017). Occupation-based interventions are top-down approaches that leverage the dynamic interaction among person, occupation, and environment to support daily occupations.
The Ayres Sensory Integration® (ASI) framework is a top-to-bottom-up approach (see Dancza & Rodger, 2018) that requires its practitioners to ask about occupational goals; however, ASI uses impairment-based intervention theory (Novak & Honan, 2019). To be specific, the main focus...
