How Does Sensory Integration Therapy Work?

Sensory integration therapy, also referred to as Ayres Sensory Integration (ASI), is a therapeutic approach that’s used to improve symptoms of sensory integration dysfunction. Developed in the 1970s by Dr. A. Jean Ayres, ASI is the theory of sensory integration itself and a combination of two types of tools:

• assessment tools used to measure someone’s sensory integration
• therapeutic tools used to improve symptoms of sensory dysfunction

So, what happens during sensory integration therapy? With ASI, trained occupational therapists aim to help people improve their sensory symptoms by using various therapeutic tools in a clinical setting, with the goal of:

• stimulating the senses through sensory input
• challenging fine and gross motor planning
• encouraging movement of the body
• developing new adaptive behaviors and responses

For example, therapeutic tools can be physical in nature, such as trampolines or climbing walls, or mental in nature, such as participation or skill challenges.

Occupational therapists are healthcare professionals who use a variety of therapeutic approaches to help people perform their daily tasks, both inside and outside of the home.

Occupational therapists play a huge role in helping people — especially those with autism spectrum disorder (ASD) — manage sensory symptoms. According to the American Occupational Therapy Association (AOTA), some of the people who can benefit the most from occupational therapy include:

• Infants and toddlers: For infants and toddlers, occupational therapy can improve the different aspects of early life, such as playtime, sleep, meals, and socialization.
• School-age children: For school-age children, occupational therapy can help improve things, such as routines, self-care, academics, socialization, and focus.
• Adolescents: For adolescents, occupational therapy can also help improve additional skills that are important to young adults, such as driving, independence, and even relationships.
• Adults of any age: For adults of any age, especially those with late diagnoses, occupational therapy can improve school, work, leisure, and relationship skills.

Sensory integration therapy is performed by specially trained occupational therapists to not only help improve immediate sensory symptoms, but also help manage long-term symptoms.

Most of the available research on sensory integration therapy focuses on autistic children, so there’s limited research on the benefits of sensory integration therapy outside of this population.

A 2020 report from The National Clearinghouse on Autism Evidence and Practice found that ASI is primarily used in autistic children ages 3 to 11.

In younger autistic children, ASI focuses specifically on helping to improve communication, cognition, and self-development, according to the report. It may also be used to help autistic adolescents improve their social, behavioral, and motor skills.

Sensory integration — or sensory processing — is the way in which we gather and process information about the world around us through our senses. Sensory integration isn’t just our sense of sight, smell, taste, touch, or sound, but also how our body is oriented and moves in space.

Sensory integration is comprised of eight total systems, but there are three sensory systems that are the most negatively affected when someone has challenges with sensory processing:

• The tactile system: This system is responsible for recognizing touch sensations, like pressure or temperature, through the skin.
• The proprioceptive system: This system is responsible for informing us of where we are in space through our muscles and joints.
• The vestibular system: This system is composed of a complex organ in the ear, responsible for determining our movement and balance.

Sensory integration dysfunction can look different for everyone.

For example, people who have sensory modulation challenges may experience an underreaction or overreaction to sensory input, while people with sensory discrimination challenges may have trouble distinguishing between senses. And in people with sensory-based motor challenges, it can be difficult to move or stabilize the body.

Research suggests that anywhere between 90% and 95% of autistic children experience difficulties with sensory integration. Because of this, sensory integration therapy, specifically ASI, is one of the approaches that may be considered for helping manage sensory symptoms in children with ASD.

However, while research on sensory integration therapy for ASD does exist, it’s still quite limited.

For example, one 2015 study on a sensory integration program for young children with ASD found that there was a significant improvement in motor skills according to the Peabody Developmental Motor Scale (PDMS-2) after treatment. But while the results showed promise, this study was small and limited only to motor challenges.

More recently, a systematic review from 2019 analyzing the available research on ASI found only three major studies from 2006 to 2017 that met the criteria for being evidence-based research.

Even though these three studies did show potential improvements in sensory, motor, verbal, and social symptoms in children with ASD, they were also limited — with a total of only 69 participants between them.

Ultimately, while ASI specifically may be a helpful option for certain people with ASD, more research is needed.

Although ASI has been used for over 50 years as a treatment for sensory integration challenges, the research remains limited and the results mixed.

A recent review of the available literature found that current studies on sensory integration therapy are limited.

In the review, the researchers mention that not only do most smaller scale studies show mixed results, but also many of the systematic reviews also lack conclusive evidence on the effectiveness of sensory integration therapy.

Ultimately, while some research shows that there may be a benefit to using sensory integration therapy for people with sensory challenges, we just don’t know enough about its long-term effectiveness.

Despite the popularity of sensory integration therapy as a treatment option for sensory processing challenges, the research is still limited, with only a small number of studies showing that it can be an effective treatment.

However, that doesn’t mean that sensory integration therapy can’t be effective at helping some people manage their sensory symptoms.

If you’re considering sensory integration therapy for yourself or a loved one, the AAP recommends making sure that you have a way to track whether it’s effective. So, this means creating specific treatment goals with a trained occupational therapist and checking in to see if the therapy is helping to meet those goals.

And if you’re interested in learning more about other treatment options for sensory integration challenges outside of sensory integration therapy, consider reaching out to your pediatrician or occupational therapist to learn more.