top of page
Search

The Case for Ayres SI® and Sensory Integration in the Schools

Ayres SI in the Schools

 


Ayres SI® is an evidence-based intervention in which practitioners use individually tailored, purposeful, playful, sensory-rich activities with a “just right” challenge to promote adaptive responses and provide a foundation for growth and development.  Ayres SI® principles are aligned with Dr. Ayres’ sensory integration theory and constructs. (Parham et al., 2011; AOTA, 2023; Whiting  et al., 2025)




Ayres SI® principles:

  1. Sensory information provides an important foundation for learning and behavior.

  2. Sensory integration is a developmental process.

  3. Successful integration of sensory information improves with adaptive responses.

  4. The ‘‘just right challenge’’ provides the opportunity for sensory integration to occur.

  5. Children have an internal drive to seek meaningful experiences from the environment.

  6. Due to neuroplasticity, enriched experiences cause changes in the nervous system.

  7. Sensory integration is a foundation for physical and social engagement and participation in daily life activities and routines.

(SIPT course notes)

 

Many will allege that sensory integration is only provided in the medical model of occupational therapy services in outpatient clinics and not aligned with the educational model in school settings.    Within a medical model, occupational therapy services remediate developmental and functional challenges to improve function across all environments. In the school model, OT services address challenges that are related to the student’s ability to access and participate in their education.  The therapeutic approaches and interventions used to meet these outcomes may be similar.  (AOTA, 2023) Sensory integration intervention approaches are not specific to the setting but to support success with occupation-based goals.

 

Clarification of Sensory Interventions


Sensory Integration Interventions:

Play-based method that uses active engagement in “just right” challenges and sensory-rich activities to elicit the child’s adaptive responses and improve the child’s ability to be successful and meet environmental challenges. (Watling, 2015)


Ayres SI ®Sensory Integration Interventions:

In addition to the above, interventions follow a systematic approach and a set of fidelity principles to ensure evidence-based interventions align with Dr. Ayres's sensory integration theory and constructs.  (Parham et al., 2011)


Sensory-based Strategies:

Typically occurs in the child’s natural environment to produce a short-term effect on self-regulation, attention, or behavioral organization. (Watling, 2015)

Although they are based on sensory integration theory, they do not constitute sensory integration intervention.

 

Research to support sensory integration intervention in the school setting:

  • The number of children demonstrating challenges in sensory processing and sensory integration is increasing and affecting their successful participation in the school setting. (Whiting et al, 2025)

  • Sensory processing and integration challenges inherently affect a child's ability to access and participate in school occupations.  (Gonçalves et al., ,2025)

  •  65% of SBOTPs (School-Based Occupational Therapy Practitioners) report that sensory-related issues are frequently or always the reason for referrals for OT assessments. (Bolton et al., 2020)

  •  Sensory integration occupational therapy is used when sensory-related issues affect a child’s ability to access the general and special education curriculum, behave adaptively, and participate in activities at school. (Smith-Roley et al, 2009)

  •  Occupational therapy practitioners may use sensory-based interventions or ASI® interventions to support the child’s engagement and participation at home, in schools, and in the community. (American Occupational Therapy Association, 2023)

  •  Research has demonstrated emerging and promising evidence of ASI within the school setting. (Whiting et al, 2023)

 

Implementation of Sensory Integration and Ayres SI ® Interventions in the School Setting

1. Through the Multitiered System of Support (MTSS)

2. Direct Occupational Therapy Service

* Both include consultation between the occupational therapy practitioner and the educational team

 

Sensory Integration Through the Multitiered System of Support (MTSS)

Occupational Therapy can support students within the MTSS framework to increase access to their learning by addressing:

•       positive behavior

•       social participation

•       academic performance

•       environmental modifications

Sensory needs may impact the above areas and overall participation in learning.

By providing sensory interventions that address barriers at a population (Tier 1) and group level (Tier 2), school-based occupational therapy practitioners may be able to improve:

•       physical well-being

•       mental well-being

•       support participation and success

(Piller, et al, 2023)

 

Sensory Integration within Direct Occupational Therapy Service in the School Setting


Ayres SI® Sensory Elements within direct occupational therapy services


1. Ensures physical safety of the child through manipulation of protective and therapeutic equipment and/or the therapist’s physical proximity and action.

 

2. The therapist presents the child with at least two of the following three types of sensory opportunities: Tactile, vestibular, and proprioception to support the development of self-regulation, sensory awareness, or movement in space.

 

3. The therapist supports sensory modulation for attaining and maintaining a regulated state by modifying sensory conditions and challenges to help the child to attain and maintain appropriate levels of arousal and alertness, as well as an affective state and activity level that support engagement in activities.


4. The therapist supports and challenges the development of postural, ocular, oral motor, or bilateral motor control.


5. The therapist supports and presents challenges to the child’s ability to conceptualize and plan novel motor tasks and to organize his or her own behavior in time and space.

 

6. The therapist negotiates activity choices with the child, allowing the child to choose equipment, materials, or specific aspects of an activity. Activity choices and sequences are not determined solely by the therapist.


7. The therapist presents or facilitates challenges to the child’s postural/ocular/oral control, sensory modulation and discrimination, or praxis that are not too difficult or too easy for the child to achieve. (the just-right challenge)

 

8. The therapist supports the child’s ability to respond successfully. (the adaptive response)

 

9. The therapist supports the child’s intrinsic motivation to play by creating a setting that supports play as a way to fully engage the child.

 

10. The therapist promotes and establishes a connection with the child that conveys a sense of working together towards one or more goals in a mutually enjoyable partnership.

 (Parham, et al, 2011)


Sensory integration is one of several theories and approaches used by occupational therapists and occupational therapy assistants working with children and youth, and can be used effectively to support occupation-based outcomes in the school setting (AOTA, 2023)

 

Learn more:


References:

American Occupational Therapy Association. (2023). Position Statement: Sensory integration approaches for children and youth within occupational therapy practice. American Journal of Occupational Therapy


Bolton, T., & Plattner, L. (2020). Occupational therapy role in school-based practice: Perspectives from teachers and OTs. Journal of Occupational Therapy, Schools, and Early Intervention, 13, 136–146.


Gonçalves, M., & Abreu, A. M. (2023). Sensory processing and occupational participation.

Journal of Occupational Therapy, Schools, and Early Intervention, 16, 480–495.


Parham, L. D., Roley, S. S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J. P., et al. (2011). Development of a fidelity measure for research on the effectiveness of the Ayres Sensory Integration Intervention. American Journal of Occupational Therapy, 65, 133–142. http://doi: 10.5014/ajot.2011.000745


Smith-Roley, S., Bissell, J., Clark, G. F. (2009). Providing occupational therapy using sensory integration theory and methods in school-based practice. The American Journal of Occupational Therapy: 63(6), 823–842. https://doi.org/10.5014/ajot.63.6.823


Smith-Roley, S., Bissell, J., Clark, G. F. (2009). Providing occupational therapy using sensory integration theory and methods in school-based practice. The American Journal of Occupational Therapy: 63(6), 823–842. https://doi.org/10.5014/ajot.63.6.823


Watling, R., & Hauer, S. (2015). Effectiveness of Ayres Sensory Integration® and sensory-based interventions for people with autism spectrum disorder: A systematic review. American Journal of Occupational Therapy, 69, 6905180030. http://dx.doi.org/10.5014/ajot.2015.018051


Whiting, C. C., Schoen, S. A., Bundy, A., Lane, S. J., Mailloux, Z., Roley, S. S., . . . Schaaf, R. C. (2025). The Issue Is—Occupational therapy using Ayres Sensory Integration® in school-based practice: A call to action. American Journal of Occupational Therapy, 79, 7901347020. https://doi.org/ 10.5014/ajot.2025.050971

 
 
 

Recent Posts

See All

Comments

bottom of page