Importance: Occupational therapy using an Ayres Sensory Integration^® (ASI) approach is a common intervention that has not been extensively studied in children with idiopathic sensory processing and integration challenges (e.g., without a diagnosis of autism). Objective: To test the effectiveness of ASI using measures related to motor coordination and functional performance in children with a sensory-based motor disorder (SBMD). Design: Nonconcurrent, multiple baseline, single subject. Setting: Outpatient clinic that was part of a children’s hospital in an urban setting. Participants: Three boys (ages 5–8 yr) with an SBMD. Intervention: Each participant received ASI 3 times per week for 10 wk. Outcomes and Measures: Three motor probes were measured weekly. Pre- and posttest assessments included goal attainment scaling (GAS) and the Bruininks–Oseretsky Test of Motor Proficiency–Second Edition (BOT–2). Results: All 3 participants showed improvements in motor probes during the intervention period on the basis of a 2 SD band method of analysis. Statistically significant improvements were noted across GAS goals, and positive changes were found on the BOT–2, with large effect sizes. Conclusions and Relevance: Findings suggest improved motor performance and high goal achievement using ASI for children with idiopathic sensory processing and integration challenges. What This Article Adds: This study adds to a body of literature suggesting that ASI is effective in increasing functional performance in children with sensory processing and integration challenges. Future studies using multiple baseline designs are feasible in the clinic setting and can help build the evidence base for ASI.

This literature review was completed as part of the Evidence-Based Literature Review Project of the American Occupational Therapy Association to explore the effectiveness of occupational therapy interventions with children and adolescents experiencing difficulty processing and integrating sensory information. This part of the review focused on interventions other than the sensory integration approach. Twenty articles (reporting on 21 studies) met the inclusion criteria. This systematic review found that children with difficulty processing and integrating sensory information and difficulties with the performance of daily occupations can benefit from intervention. However, the great variability that characterizes this literature in terms of populations, interventions, and study quality precludes the formation of any firm conclusions regarding specific approaches. There is an urgent need for well-controlled studies examining the effectiveness of frequently used pediatric occupational therapy interventions with well-defined, homogeneous populations on outcomes that target participation in everyday life.

OBJECTIVE. The study examined behavioral treatment effects of classical sensory integration therapy. METHOD. This study used a prospective longitudinal, single-subject ABAB design. The participant was a boy, age 3 years and 5 months, with average nonverbal intellectual skills, delayed communication skills, and sensory modulation disorder. Difficulties with modulating sensory input and delayed communication skills affected his occupational performance in preschool. Behavioral data were collected in the preschool by teachers who were blind to the type and timing of sensory integration therapy. RESULTS. Improvement in behavior regulation was observed, including increased engagement and decreased aggression, less need for intense teacher direction, and decreased mouthing of objects. CONCLUSION. Classical sensory integration therapy may be associated with improved self-regulatory behaviors.

This study compared the effects of occupational therapy, using a sensory integration (SI) approach and a control intervention of tabletop activities, on the frequency of self-stimulating behaviors in seven children 8–19 years of age with pervasive developmental delay and mental retardation. Daily 15-min videotape segments of the subjects were recorded before, immediately after, and 1 hour after either SI or control interventions performed during alternating weeks for 4 weeks. Each 15-min video segment was evaluated by investigators to determine the frequency of self-stimulating behaviors. The results indicate that self-stimulating behaviors were significantly reduced by 11% one hour after SI intervention in comparison with the tabletop activity intervention (p = 0.02). There was no change immediately following SI or tabletop interventions. Daily ratings of self-stimulating behavior frequency by classroom teachers using a 5-point scale correlated significantly with the frequency counts taken by the investigators (r = 0.32, p < 0.001). These results suggest that the sensory integration approach is effective in reducing self-stimulating behaviors, which interfere with the ability to participate in more functional activities.

Objective. The purpose of this study was to gain an understanding of parents’ perceptions of outcomes of occupational therapy intervention using a sensory integration approach. Method. Interviews with parents regarding their children’s participation in occupational therapy were analyzed using grounded theory. Results. The parents’ experiences of sitting in the waiting room while their children received occupational therapy emerged as a powerful outcome theme. Through their interactions with other parents, this particular group of parents gave and received naturally occurring support for parenting children with sensory integrative dysfunction. Additionally, by virtue of repeated experiences of waiting, parents moved to positions of liminality, shared weekly rituals, engaged in downward social comparison, and reframed their views of their children. Conclusion. Implications are proposed for expanding the definition of family-centered intervention; attending to the meaning of the cultural world of practice; and directing future research related to how a physical setting, such as a waiting room, might shape naturally occurring support and social interaction.

The results of studies examining the effectiveness of sensory integration therapy were reviewed, using recently developed quantitative methods that treat the literature review process as a unique type of research. Forty-nine studies were located initially. Eight of these studies met the following criteria: (a) they investigated the effect of sensory integration therapy; (b) they included dependent measures of academic achievement, motor or reflex performance, and / or language function; (c) they included a comparison between at least two groups; and (d) they reported quantitative results of the effect of sensory integration therapy. The 8 studies contained a total of 47 statistical hypothesis tests that evaluated the effectiveness of sensory integration therapy. An analysis of these tests, using quantitative reviewing methods, revealed that subjects participating in sensory integration therapy performed significantly better than members in the control groups who did not receive sensory integration therapy. The application of sensory integration therapy to various client populations is discussed in relation to the existing empirical support revealed in the studies reviewed. The advantages of quantitative reviewing procedures are discussed, and use of the procedures with the developing occupational therapy research literature is recommended.

Twelve college-age students who had either a low grade point average or visual perceptual problems were provided a program of sensory integration activities to determine whether sensory integration therapy would affect their academic performance. Selected reading tests were administered to establish a pre-test baseline. The students were then given a sequenced program of sensory integration activities designed to stimulate the vestibular system. After a 14-week period, reading tests were again administered. Test results indicate a statistically significant improvement in reading skills and support the use of sensory integration therapy for individuals with difficulty learning at the college level.