Research Update: What is Ayres’ Sensory Integration Therapy(ASI) and what is not? Do not believe everything you read – ASI shows promise as an intervention for those with Autism.

It is so disappointing to once again read research about Ayres’ Sensory Integration purporting to examine ASI versus other therapies, reporting ASI does not have an effect. This is especially important when there is an evidence for ABA, the behavioural intervention in these studies possibly resulting in trauma.

2011 – Comparison of Behavioral Intervention and Sensory-Integration Therapy in the Treatment of Challenging Behavior

2017 – Comparison of behavioral intervention and sensory integration therapy on challenging behavior of children with autism

2018 – Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis

There is a growing evidence base, not just for the existence of sensory integration difficulties and sensory processing difference across the lifespan and across a range of different clinical presentations, but also for the therapy as developed by Jean A Ayres.

Research by Smith Roley el al 2015, Lloyd, MacDonald and Lord 2013 and Flanagan et al 2012 supports earlier evidence by others including Adamson, O’Hare and Graham 2006, and Siaperas et al 2011 that Sensory Integration difficulties are common in Autism.

Intervention studies that provide evidence sensory integration may be effective include Pfeiffer et al 2011 and most recently a systematic review by Schaaf et al 2018 also examines growing evidence in support of ASI.

“evidence is strong that ASI intervention demonstrates positive outcomes for improving individually generated goals of functioning and participation as measured by Goal Attainment Scaling for children with autism. Moderate evidence supported improvements in impairment-level outcomes of improvement in autistic behaviors and skills-based outcomes of reduction in caregiver assistance with self-care activities”  Schaaf et al 2018

Recently there has been a spate of research comparing ASI to other behavioural approaches. Sadly, what is described as ASI is most definitely not. Spinning someone 10 times one way and then the next, with a few pushups thrown in, is not Ayres’ Sensory Integration!

If you read or report studies that say that ASI doesn’t work compared to other therapies for Autism, please do so very very carefully. Those of us properly trained in ASI, to postgraduate level, as per the International Council for Education in Ayres Sensory (ICEASI) guidelines read the descriptions of what is delivered, we do not recognise it as being ASI therapy. This therapy was carefully researched and developed by Jean Ayres, and overtime has been researched and further developed including the development of the ASI FIdelity Tool (Parham et al 2011).

A parent who works in advertising and marketing pointed out to me that if what is written in these studies was on a website advertising these behavioural services instead of ASI, their description of ASI and their claims may be grounds for an argument for false advertising!

Ayres’ Sensory Integration is a very specific therapy, carried out in a very specialist way, but very experienced clinicians who plan and deliver intervention only after person specific assessment. The individualised intervention is determined and driven by the clinical data that is collected and analysed as part of the assessment, and ongoing observations and reflection are essential to the intervention.

Ayres’ Sensory Integration is about specific, personalised and targeted assessment and therapy; it includes the setting of goals and the measurement of outcomes. The therapist needs to have specialist, typically postgraduate, education in Ayres’ Sensory Integration, in line with internationally agreed standards as agreed by ICEASI.


Watch more about what Ayres’ Sensory Integration is here.

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