Therapy Guide
$100–$170/hour (OT-delivered); equipment/sensory tools: $50–$500
Typical Cost
1–2 sessions per week, typically 45–60 minutes each
Frequency
2–18 years (most commonly 3–12 years)
Age Range
3
Provider Types
Occupational therapy including sensory integration approaches is covered under OAP core clinical services when delivered by a College of Occupational Therapists of Ontario (COTO) registered occupational therapist. OAP childhood budgets fund OT services.
Sensory processing differences are extremely common in autism — the DSM-5 includes hyper- or hypo-reactivity to sensory input as a diagnostic criterion. These differences can manifest as distress from certain sounds, textures, or lights (hypersensitivity), limited response to pain or temperature (hyposensitivity), or an intense drive to seek specific sensory experiences like spinning, jumping, or deep pressure.
These sensory differences can significantly impact daily functioning, learning, and participation. A child who is overwhelmed by classroom noise may struggle to attend to instruction. A child who craves proprioceptive input may be in constant motion. Sensory integration therapy aims to help the nervous system process sensory information more effectively, reducing distress and improving participation in daily activities.
Ayres Sensory Integration (ASI) therapy takes place in a specially equipped clinic with suspension equipment (swings, bolsters), climbing structures, tactile materials, and weighted items. The occupational therapist creates a "just right challenge" — activities that are challenging enough to promote neural adaptation but achievable enough to maintain engagement and build confidence.
Key principles include child-directed activity choice within a structured therapeutic environment, active sensory engagement rather than passive exposure, and targeting the integration of vestibular, proprioceptive, and tactile processing. A fidelity measure developed by Parham et al. (2011) ensures therapy sessions adhere to ASI principles. In Ontario, many pediatric OT clinics offer ASI in purpose-built sensory gyms, while others provide modified sensory strategies within standard clinic spaces.
The evidence base for sensory integration therapy is mixed. A 2019 systematic review by Schoen et al. in the Journal of Autism and Developmental Disorders found that ASI therapy delivered with fidelity showed improvements in individualized goal attainment and sensory processing, but results were inconsistent across studies for broader outcomes. The 2012 Schaaf et al. pilot RCT showed positive results for individualized goals.
Professional organizations vary in their stance. The American Occupational Therapy Association supports ASI as an evidence-based intervention within OT scope of practice. Families should distinguish between formal Ayres Sensory Integration therapy delivered by trained OTs and "sensory diets" or sensory activities, which serve different purposes. ASI therapy targets the underlying processing mechanisms, while sensory strategies address day-to-day regulation.
Schoen et al. (2019)
A systematic review of Ayres Sensory Integration intervention for children with autism. Journal of Autism and Developmental Disorders, 49(1), 286-304.
Schaaf et al. (2014)
An intervention for sensory difficulties in children with autism: A randomized trial. Journal of Autism and Developmental Disorders, 44(7), 1493-1506.
Commitment to Accuracy: Our data is verified against official government reports (FAO, MCCSS), peer-reviewed scientific literature, and accessible public records. Last updated: March 24, 2026.
Verified Facts
Early Start Denver Model (ESDM) delivered to children aged 18–30 months produced significant gains in IQ, adaptive behaviour, and autism severity — some children no longer met diagnostic criteria at follow-up
Cochrane systematic review finds evidence that early intensive behavioural intervention (EIBI) may produce positive effects on adaptive behaviour and communication for young children with ASD (low certainty of evidence)
WHO recommends accessible, community-based early interventions for children with autism — timely evidence-based psychosocial interventions improve communication and social engagement
88,175, children are registered in the Ontario Autism Program
23.4%, Only 20,666 children have active funding agreements () — less than one in four