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Research Update: Sensory Integration and Functional Reaching in Children With Rett Syndrome/Rett-Related Disorders

In this preliminary study Drobnyk et al (2019) suggest that Ayres’ Sensory Integration may be a playful and fun way to help improve hand coordination in children with Rett Syndrome. Difficulty with hand movements — specifically from thinking about what to do and then doing it, is a difficulty often seen in children with Rett Syndrome. The authors considered it important to find and research possible therapeutic interventions to address this difficulty.

“The loss of functional hand skills is a primary characteristic of Rett syndrome. Stereotypies, dyspraxia, and other sensory processing issues severely limit the individual’s ability to reach toward and sustain grasp on objects. This loss of functional reach and grasp severely limits their ability to participate in self-help, play, and school-related activities.” 

The authors wondered if Ayres’ Sensory Integration Therapy might be such a therapy.  

“There are no studies that specifically examine the effects of ASI therapy on motor planning/praxis, functional reaching, or hand use of individuals with RTT. There is preliminary evidence that this type of therapy may benefit children with sensory processing issues who have other diagnoses…

…We proposed that Ayres Sensory Integration (ASI) treatment would improve sensory processing and motor planning, which would lay the sensory-motor groundwork for improving grasp of objects, an important first step in developing functional hand use.””

The research study findings were small, 

“This study provides preliminary data suggesting that ASI may have small positive effects on the rate of grasping in children with RTT and warrants further study before recommending it in routine practice,” the researchers stated.

However, interestingly they also found the following, and hope to publish these findings also.

“All our study participants exhibited neurological signs involving altered muscle tone, weakness, and balance that contributed to deficits in postural control, mobility, and hand function. Although we observed steady improvements in postural stability/control, balance, and mobility in all participants from the beginning of the intervention period to the end of the post-intervention period, tracking these outcomes was not an aim of this study. We did, however, document these promising observations and we will examine them in a future qualitative study.”

Read more here:

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ICEASI Education Standards Approved.

We are answering more and more questions online, via text and What’s App – all asking the same questions about our Certification in Ayres’ SI, and why our experienced Directors and Lecturers have chosen to be affiliated with the CL-ASI Programme.


We suggest that this recently published document developed after much consultation and with consensus from many organisations teaching ASI around the globe, is helpful (see below). Read more here about ICEASI, it’s history and development of these standards, which were published in an AOTA publication here. 

ASI Wise is part of ICEASI, so we use these standards to guide our programme and provide advice about knowledge and skills required for practice.Consultant OT, Director and CLASI Lecturer Kath Smith, pictured above, represents ASI Wise at ICEASI meetings.


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Coming soon the ICEASI website

Read more here:

More about ICEASI


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Best Practice Guidelines? Analysing Novak and Honan (2019)

Novak and Honan (2019) published a paper in the Australian Occupational Therapy Journal which has caused controversy, which was discussed in an earlier Sensory Project blog post:

Particularly upsetting was a traffic light system which indicated that sensory integration therapy is a red light (or do not do) intervention but that ABA (short for applied behaviour analysis) could be viewed as a green light (or can definitely use) intervention.

This is especially concerning as ABA has been linked to PTSD. Testimonials from those who have had ABS therapy have told us about the negative affect they have found this therapy has had on their lives.

Recently, the US Government has issued a report worth sharing that adds further information about ABA and it’s usefulness, which is in contrast to Novak’s article. The report, about comprehensive autism care, found that at best ABA does not change symptoms and at worst, ABA worsens them:

We are keen to hear your thoughts about the Novak’s article and the traffic light system. Follow the link below and join the discussion:

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Sensory Integration Matters: Coping with Christmas with children and adults with sensory integration challenges

Christmas can be a wonderful time of year but also a stressful confusing time of year for our children. For children who are more comfortable with routine, everything is changing. Consider the following if Christmas feels stressful:

  • Stay at home – prepare relatives for different expectations
  • Spread visits over a longer time
  • Allow your child to leave the room
  • Make time to go outside
  • Minimise the build up to Christmas
  • Maintain routine
  • Only put up decorations just before Christmas
  • Avoid flashing lights
  • Don’t wrap presents individually
  • Don’t wrap presents at all
  • Put batteries in in advance
  • Share out presents over a few days
  • Give permission to open presents elsewhere – e.g. away from the giver – thank you cards can be sent afterwards
  • Choose food so it’s easy to prepare and comfortable for everyone to eat


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Research Update: Examining overlap and homogeneity in ASD, ADHD, and OCD: a data-driven, diagnosis-agnostic approach

“Our results motivate a paradigm shift to challenge how ASD, ADHD, and OCD are currently defined, diagnosed, and treated. In particular, this paper adds to the evidence that these diagnoses may not exist as uniquely-defined diagnostic constructs, and highlights the need to discover other groupings that may be more closely aligned with biology and/or response to treatment.”

So, this study by Kushki et al 2019 is by no means simple. However, the results support our clinical experience of the overlap and common features seen in practice. We see similar overlap is the assessment data we gather, particularly when we SIPT our clients with these diagnoses. The study uses state of the art technology and research methodologies, statistical calculations, and techniques I had never heard of. I had to look them up. However, the research appears to support what we see in clinical practice. I look forward to reading more by these researchers in Canada.

“…we used a data-driven, diagnosis-agnostic approach to examine overlap across three neurodevelopmental disorders (ASD, ADHD, and OCD)…we observed that differences in the domains primarily affected in these disorders may exist along a continuum that includes typical development.”

“The majority of the data-driven clusters contained participants from multiple diagnostic categories, highlighting shared phenotypes and neurobiologies among the diagnostic groups.”

“Social difficulties and inattention are commonly reported as shared features of ASD, ADHD, and OCD….our results support the emerging recognition that the existing behaviorally-defined diagnostic labels may not capture etiologically, biologically, and phenomenologically homogeneous groups.

“…our results are consistent with the notion that that the ASD-like features, and to some extent inattention traits, exist across a continuum that includes typical development”

Read more here: