Girl eating from a bowl with a spoon

Sensory Integration Therapy

​Sensory Integration Therapies are therapeutic interventions that treat patients exhibiting difficulties in processing information through the senses. Sensory integration therapies target the processing of the five “common” senses of sight, sound, touch, smell, and taste, and they also address the functioning of the complex senses of balance (also called vestibular sense), proprioception (the sense of one’s body in space), interoception (sensing one’s body internally), and thermoception, or one’s sense of temperature.

Sensory Integration Therapies are built on the theories and research of occupational therapist Anna Jean Ayres, PhD. In 1972, Dr. Ayres published her definition of sensory integration as “the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment.”

 Each child’s sensory integration challenges are unique and may require multiple assessments and customized treatment plans. Special needs resources company Harkla describes the complex sensory integration that occurs when we perform basic tasks:

“...a student may have a panic type response when another child simply brushes against him in line. Another example is when a student feels pain when wearing clothing with tags or seams. What’s interesting about sensory processing, is that most activities require us to combine information we obtain from different senses at the same time. When you close your eyes to wash your hair, you know exactly where to place your shampoo-filled hands. Even though you’re not looking, you use your fingers to rub in the shampoo and feel when your hair is soapy. This activity uses tactile (touch), proprioception (position in space), and vestibular (balance so you don’t fall over with your eyes closed).”

Possible Uses

​Sensory Integration Therapies are commonly prescribed for children and teens with sensory processing disorder (SPD) and autism spectrum disorder (ASD). They can be effective for children who are both under- or over-sensitive to sensory stimuli; who exhibit extreme activity levels and/or problems with balance and coordination; and who have difficulties with language, motor skills, and speech.

How It Works

Modalities of Sensory Integration Therapy include DIR/Floortime, the Sensory Diet, the Wilbarger Protocol, and Astronaut Training and are typically administered by occupational therapists. Activities may include games, puzzles, and personal care or household tasks that help the child regulate their state of sensory arousal and build neuronal pathways for more effective integration of sensory input from multiple sources. The following are brief overviews of established Sensory Integration Therapies. Your occupational therapist will be able to prescribe the ones best suited for your child’s sensory integration.

D.I.R/Floortime - D.I.R. is a framework for understanding human social and emotional development. It was created by Dr. Stanley Greenspan and emphasizes the importance of social connections to meet emotional and cognitive developmental milestones. D.I.R.stands for “Developmental, Individual-differences, Relationship-based model.” In DIR/Floortime, parents and therapists follow the child’s emotional lead to create playtime activities that enhance their emotional bond. As the child demonstrates progress, the caregiver helps him move up the developmental ladder with further activities involving problem-solving and perceptual challenges, all the while maintaining a nurturing bond led by the child’s emotional experience.

The Sensory Diet - The Sensory Diet concept is a widely-practiced intervention developed by occupational therapist Patricia Wilbarger. It is a collection of daily activities sequenced by the child’s therapist to prevent both hyper- and hypo-arousal in the child’s daily life. Activities may include sequences of jumping, spinning, and lifting as well as touching fabrics or tasting foods with complex textures. The activities are designed with the child’s preferences and the parents’ resources in mind. According to Kid Sense, a therapy clinic in Unley, Australia, “a sensory diet is used both as a treatment strategy when attention or behaviour is problematic as well as a preventative tool in advance of known behaviour challenges (exposure to known triggers, certain times of day or specific environments).”

The Wilbarger Protocol - Also developed by Patricia Wilbarger, this protocol is designed to help children who are oversensitive to touch. The protocol is customized for each child; an occupational therapist can teach caregivers the techniques to use for their child. The foundation of the protocol is the use of small surgical or “sensory” brush along the limbs and back of the child, several times a day. The protocol can also include a series of joint compression exercises. The Wilbarger Protocol is often a component of a child’s Sensory Diet plan.

Astronaut Training - Occupational therapists Mary J. Kawar and Sheila Frick developed the Astronaut Training protocol to help children and teens improve the integration of their vestibular senses. Astronaut Training helps patients improve balance and coordination; Kawar and Frick gave the intervention its name since children struggling with vestibular sensation can appear “lost in space.” The program uses movement exercises to help patients activate the muscular support in their core. It also employs visual and auditory stimuli to help coordinate appropriate responses and move the body out of the “fight or flight” trauma response.

Things to Consider

 While few large randomized studies have been conducted on the effectiveness of Sensory Integration Therapies, occupational therapists and caregivers have recorded anecdotal evidence of their effectiveness for decades. Autism Speaks, however, funded a research study in 2013 that showed autistic children who received the therapies showed clear improvements in social connection and needed less assistance from parents are caregivers.

Sensory Integration Therapies require consistent application at home as well as in the therapeutic setting. It’s important that parents and caregivers let the therapist know their goals for treatment and make sure they understand how to implement the techniques at home.