Importance: Spanish-speaking populations represent a significant percentage of occupational therapy clientele globally. Culturally appropriate Spanish translations of assessments are therefore imperative. This study describes the process of a culturally adapted translation of a set of tests for use with Spanish-speaking pediatric populations. Objective: To produce a culturally adapted Spanish translation of the Evaluation in Ayres Sensory Integration^® (EASI) for international use. Method: We used cultural adaptation methodology that included direct and back translations of the EASI by bilingual translators and interviews with pediatric occupational therapists and children ages 3–6 yr from Spain. Linguistic experts helped revise the translations, and pediatric occupational therapy leaders in five Spanish-speaking North and South American countries reviewed the translations for comprehensibility and cultural appropriateness. Results: Back translations demonstrated equivalence with the original EASI tests except for a few test instructions and scoring criteria. Interviews with occupational therapists and children in Spain revealed some comprehension difficulties for several tests, which were revised in consultation with a linguistic expert. Additional adaptations were made on the basis of recommendations to address cultural differences by occupational therapy leaders from five North and South American countries. Most changes in wording were made in one EASI test (Praxis: Following Directions) that is heavily dependent on language comprehension. Conclusions and Relevance: We used currently recommended methodologies to develop and adapt a Spanish translation of the EASI for use across diverse cultures. What This Article Adds: A Spanish translation of the EASI has been developed for use in culturally diverse Spanish-speaking countries around the world.

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Equine-assisted OT, or hippotherapy, is considered a viable approach to treating children with autism spectrum disorder. The findings of a pilot study examining the effect of an 8-session intervention on sensory integration among five children resulted in overall improved sensory integration. Analysis of parent perspectives revealed improved adaptive responses among the children when applying higher level skills in occupational contexts outside of therapy. Primary Author and Speaker: Glen S. Cotton

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The Evaluation in Ayres Sensory Integration (EASI) is a new, comprehensive assessment of sensory, motor, and praxis functions. To enhance clinical utility in pediatric practices, concurrent and construct validity of the vestibular and proprioceptive tests were examined. Results showed that the EASI is a valid measure of vestibular and proprioceptive constructs. Primary Author and Speaker: Jenni Petersen Additional Authors and Speakers: Zoe Mailloux, Roseann C. Schaaf Contributing Authors: Marco Leao

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Trampoline exercise is a movement-based program that has been proposed as beneficial for children with autism or sensory integration and processing challenges. This session shares data from a pretest–posttest study documenting motor and psychosocial improvements in children who participated in a structured trampoline exercise group. Results suggest this is a potentially effective school-based or community-based method to address both the motor and the social needs of these children. Primary Author and Speaker: Sarah A. Schoen Additional Authors and Speakers: Vincentia Ferrari, Virginia Spielmann

Evidence Connection articles provide case examples of how practice decisions may be informed by findings of systematic reviews sponsored by the American Occupational Therapy Association (AOTA) Evidence-Based Practice (EBP) Project. This Evidence Connection article describes a case report of a child with a diagnosis of autism spectrum disorder who has difficulties in function and participation related to challenges in sensory integration. This article is the first in a two-part series, and it focuses on occupational therapy provided to the child by a clinic-based therapist in collaboration with the child’s school-based occupational therapist. Part 2 in this series will describe the same child’s intervention by the school-based therapist. Intervention decisions are informed by findings of systematic reviews of intervention effectiveness that were part of an AOTA EBP Project addressing occupational therapy interventions for children and youth with challenges in sensory integration and sensory processing.

This systematic review examines the literature published from January 2007 through May 2015 related to the effectiveness of occupational therapy interventions using parental or teacher education and coaching with children with challenges in sensory processing and sensory integration (SP–SI). Of more than 11,000 abstracts and 86 articles that were considered, only 4 met the criteria and were included in this review. Studies of parental training and coaching for children with challenges in SP–SI and comorbid autism spectrum disorder have suggested that educational or coaching programs could result in positive outcomes for both parents and children, often in a relatively short time period. Recommendations include a greater focus on providing educational interventions for parents and teachers and including specific assessment of SP–SI before implementing interventions meant to address those issues. Specific recommendations for future research are provided.

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.

Many children and youth with and without disabilities are affected by challenges in processing and integrating sensations. Occupational therapy practitioners serve a pivotal role in the evaluation and treatment of this population. This special section of the American Journal of Occupational Therapy includes articles that elucidate the relationship between sensory processing and participation in valued occupations as well as articles that guide best practice, including systematic reviews on common occupational therapy interventions for children and youth with challenges in processing and integrating sensation. This editorial elaborates on key issues for future research.

Comprehensive, reliable, and valid assessment is essential for individually tailored, appropriate, and effective intervention planning and implementation. Research, education, and practice using an Ayres Sensory Integration^® (ASI) approach have a long history of prioritizing comprehensive assessment. To meet the need for a set of tests that will fully evaluate the constructs of ASI with psychometrically strong, internationally appropriate, and easily accessible measurement tools, the development of the Evaluation in Ayres Sensory Integration^® (EASI) has been initiated. This article introduces the EASI, describes the overarching plan for its development, and reports the results of promising preliminary analyses of discriminative validity data.

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.

Despite the availability of innovative health care research, a gap exists between research-generated knowledge and the utilization of that knowledge in real-world practice settings. This article examines the transition from research to implementation in the context of the dissemination of A. Jean Ayres’ sensory integration procedures and of the challenges currently facing the University of Southern California Well Elderly Studies research team. Drawing from the emerging field of implementation science, this article discusses how researchers can develop an implementation plan to more easily translate evidence into practice. Such plans should address the intervention’s reach (i.e., its capacity to penetrate into the intended target population), the settings for which it is applicable, the leaders who will encourage practitioner uptake, stakeholder groups, and challenges to dissemination. By taking action to ensure the more effective dissemination of research-generated knowledge, researchers can increase the likelihood that their interventions will lead to improvements in practice and more effective care for consumers.

OBJECTIVE. This quasi-experimental study compared the effect of sensory integrative (SI) therapy, neurodevelopmental treatment (NDT), and perceptual–motor (PM) approach on children with mild mental retardation. METHOD. Children (N = 120) were randomly assigned to intervention with SI, NDT, or PM; another 40 children served as control participants. All children were assessed with measures of sensorimotor function. RESULTS. After intervention, the treatment groups significantly outperformed the control group on almost all measures. The SI group demonstrated a greater pretest–posttest change on fine motor, upper-limb coordination, and SI functioning. The PM group showed significant gains in gross motor skills, whereas the NDT group had the smallest change in most measures. CONCLUSION. SI, NDT, and PM improved sensorimotor function among children with mild mental retardation. The choice of sensorimotor approaches should be determined on the basis of the child's particular needs because each approach may have an advantage in certain aspects of sensorimotor function.

OBJECTIVE. This study examined interrater reliability of score interpretation on the Sensory Integration and Praxis Tests (SIPT). METHOD. Using SIPT scores of two complex cases, 20 trained participants independently rated each case for presence of sensory integrative dysfunction and for relevance of specific patterns of dysfunction. They also provided comments to justify their ratings. RESULTS. Agreement on the presence of sensory integrative dysfunction was 70% for Case A and 100% for Case B. Reliability was more variable for dysfunctional pattern ratings, ranging from 50% to 100% agreement for Cases A and B, respectively. Participants consistently appeared to use configural decision-making strategies to guide their ratings. CONCLUSION. Interrater reliability was moderate to high for interpretation of the presence of sensory integrative dysfunction using SIPT scores. Less agreement was apparent regarding specific patterns of dysfunction. Results suggest that additional clinical information, such as clinical observations and case history, may be needed to make reliable distinctions among dysfunctional patterns.

OBJECTIVE. This study examined the effects of Ayres’s sensory integration intervention on the behavior and task engagement of young children with autism spectrum disorders (ASD). Clinical observations and caregiver reports of behavior and engagement also were explored to help guide future investigations. METHOD. This single-subject study used an ABAB design to compare the immediate effect of Ayres’s sensory integration and a play scenario on the undesired behavior and task engagement of 4 children with ASD. RESULTS. No clear patterns of change in undesired behavior or task management emerged through objective measurement. Subjective data suggested that each child exhibited positive changes during and after intervention. CONCLUSION. When effects are measured immediately after intervention, short-term Ayres’s sensory integration does not have a substantially different effect than a play scenario on undesired behavior or engagement of young children with ASD. However, subjective data suggest that Ayres’s sensory integration may produce an effect that is evident during treatment sessions and in home environments.

OBJECTIVE. We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles). METHOD. We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements. RESULTS. Most studies described structural elements related to therapeutic equipment and interveners’ profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than half of the process elements. Intervention descriptions in 35% of the studies were inconsistent with one process element, therapist–child collaboration. CONCLUSION. Validity of sensory integration outcomes studies is threatened by weak fidelity in regard to therapeutic process. Inferences regarding sensory integration effectiveness cannot be drawn with confidence until fidelity is adequately addressed in outcomes research.