Sensory Integrative Therapy and Autism Ranking:

Key Features

Sensory integrative therapy (also known as sensory integration training, SI, SIT, Ayres Sensory Integration or ASI) is an intervention designed to help people children with poor sensory integration.

According to Pollock (2009), 

“This treatment approach aims to provide the child with various sensory experiences. These experiences are matched during therapy with a “just right” challenge, an activity that requires the child to give an adaptive response. SIT is an active therapy. The child must be motivated and engaged in the choice of activities; hence, play is the medium of choice. Activities usually involve large pieces of equipment such as big rolls and balls, trampolines, and suspended equipment that provide intense proprioceptive, vestibular, and tactile experiences.”

Essential elements

According to Case-Smith et al (2015), sensory integrative therapy has 10 essential elements.

 “The 10 essential elements are as follows: (a) ensuring safety, (b) presenting a range of sensory opportunities (specifically tactile, proprioceptive, and vestibular), (c) using activity and arranging the environment to help the child maintain self-regulation and alertness, (d) challenging postural, ocular, oral, or bilateral motor control, (e) is challenging praxis and organization of behavior, (f) collaborating with the child on activity choices, (g) tailoring activities to present the “just-right challenge,” (h) ensuring that activities are successful, (i) supporting the child’s intrinsic motivation to play, and (j) establishing a therapeutic alliance with the child.”

Evaluation

According to the American Occupational Therapy Association (2008), it is important to carry out an evaluation of the specific needs of each child before beginning a sensory integrative therapy programme.

“When a child is referred for an occupational therapy evaluation, the occupational therapist will rely on a variety of strategies to assess the issues underlying the expressed concerns. If sensory processing problems are suspected, the therapist may use specific ASI evaluation methods including observation of the child in the natural setting, caregiver and teacher interviews, standardized testing, and structured clinical observations to determine the specific ways in which disordered use of sensation is interfering with the child’s functional performance.” 

Personalised treatment plan

A key element of sensory integrative therapy is the use of a personalised treatment plan based on the evaluation. For example, according to Schaaf et al (2014), 

“…. if assessment data [show] that the goal of ‘participate in a play activity with a peer for 10 min’ may be related to poor tactile processing and praxis (hypothesis), individually-tailored sensory motor activities [are] designed to address tactile discrimination and improve praxis. Individually-tailored treatment activities might include activities such as using a carpeted scooter board while in the prone position to pull oneself up a ramp, then working to turn the scooter board around to ride down the ramp and land in a cushioned area of mats and pillows that are covered with various textures. In this activity, the child is experiencing total body tactile and proprioceptive sensations (from scooter board texture, actively moving muscles against resistance, and landing in textured mats and pillows) to increase body awareness and using this enhanced sensory input to plan body movements during the scooter board activity. Of note, the intervention is contextualized in play with active involvement of the child and conducted in a large gym equipped with mats, a variety of suspended swings, large balls, a climbing wall, carpeted barrels, large inner tubes and foam blocks with opportunities for active, guided, sensory motor play. The therapist facilitates the child’s ability to participate in the sensory-motor experiences in adaptive ways (e.g.: use a trapeze swing to experience proprioceptive and vestibular sensations to increase body awareness and then organize the body to hold onto the swing and jump into a large ball pit).”

Other interventions

According to Pollock (2009), there are a number of interventions (such as sensory diets) which are based on the Ayres theory of sensory integration but which differ from “classical” sensory integrative therapy.

“Occupational therapists use other forms of intervention which are based on sensory integration theory, but which differ from classical SIT. These approaches use a sensory integration framework to help understand and explain children’s behaviour, but rather than trying to remediate an underlying impairment, these methods are embedded in the child’s daily routines and focus on working with the children, parents, and educators to adapt the child’s environment in ways that will facilitate the child’s ability to participate. This approach may include such things as modifications to the child’s clothing, altering room configurations, noise or light levels, experimenting with food textures, adapting tools and materials, changing program demands, and so on. These approaches are designed to help children function to the best of their ability given their sensory processing capabilities as opposed to trying to change their underlying neurological functioning. In this way, they are distinct from classical SIT.”

In practice, sensory integrative therapy is sometimes carried out alongside other sensory-based interventions (such as sensory diets), as well as alongside other types of intervention (such as behavioural programmes). 

Notes 

Bilateral (two sides of the body); ocular (relating to the eyes); oral (relating to the ears); postural (relating to body position); praxis (the ability by which we work out how to use our hands and body in skilled tasks like playing with toys); proprioceptive (sense related to position and movement of the body); tactile (relating to touch); vestibular (sense related to balance and spatial orientation).

Updated

16 Jun 2022

Last Review

01 Apr 2018

Next Review

01 May 2024