Sensory Integration Therapy: How It Helps Autistic Children

What Is Sensory Integration Therapy?

Sensory Integration (SI) therapy is an occupational therapy-based approach developed by A. Jean Ayres, an OT and neuroscientist, in the 1960s and 1970s. Ayres proposed that many children with learning and developmental challenges — including autism — had underlying difficulties in how their brains organized and interpreted sensory information. Her Sensory Integration and the Child (1979) remains foundational to the field.

ASI therapy uses child-directed, play-based activities involving specific sensory equipment to challenge and support the nervous system’s ability to process and integrate sensory input. Unlike passive sensory exposure, ASI follows the child’s lead and uses the “just right challenge” principle — providing sensory experiences that are slightly beyond the child’s current comfort zone, in a safe and supportive environment, to promote neurological adaptation.

How SI Sessions Work

A fidelity-based ASI session requires a purpose-built sensory gym equipped with:

• Suspended equipment — platform swings, net swings, bolster swings — for vestibular and proprioceptive input
• Crash pads and foam pits for deep pressure and proprioceptive input
• Tactile bins, textured surfaces, and materials for tactile exploration
• Climbing walls, scooter boards, and obstacle courses for motor planning
• Lycra tunnels, weighted tools, and resistance equipment

The OT carefully observes the child’s responses to sensory input and adjusts the activity in real time. Sessions last approximately 45–60 minutes. The therapist follows the child’s intrinsic motivation — supporting engagement in activities the child finds naturally appealing.

In addition to direct therapy, OTs trained in ASI provide home programs — sensory diets — to extend the benefits of sessions into the child’s daily environment. A sensory diet is a schedule of targeted sensory activities throughout the day (e.g., 10 minutes of heavy work before homework) to regulate arousal and reduce sensory-related distress.

Evidence and Effectiveness

The evidence base for ASI therapy has grown substantially over the past two decades, particularly since the development of the ASI Fidelity Measure (ASI-FM) by Parham and colleagues, which allows researchers to ensure treatment integrity in studies. Key findings include:

• A 2019 randomized controlled trial (Schaaf et al.) found significant improvements in goal attainment and daily living skills for autistic children receiving fidelity-based ASI compared to usual care
• Systematic reviews show moderate evidence for sensory and motor outcomes; evidence for social and behavioral outcomes is more limited and mixed
• ASI is included on the list of evidence-based practices for autism by several international guidelines, though strength of evidence ratings vary by outcomes

It is important to distinguish fidelity-based Ayres Sensory Integration (ASI) from general “sensory activities” that may use similar equipment without adhering to the ASI framework. The evidence applies primarily to structured ASI with trained therapists — not all sensory-based activities.

Finding a Trained SI Therapist

Not all OTs are trained in Ayres Sensory Integration. To find a qualified ASI therapist in Ontario:

• Confirm the OT holds training from a recognized ASI program — such as the USC Chan Division (the Ayres Clinic) or the CLASI certificate program
• Ask whether the therapist uses the ASI Fidelity Measure to guide their practice
• Children’s Treatment Centres (CTCs) in Ontario often have OTs trained in ASI
• Privately, autism-specialized OT clinics in urban centres frequently offer ASI — some fundable through OAP Childhood Budget

Learn more about occupational therapy for autism or understand sensory processing disorder.

Frequently Asked Questions