and Framing Reports Around Strengths and Difficulties Impacting Participation.
Words matter; ‘sensory integration and processing’ are crucial concepts that need careful consideration.
Sensory integration is a foundational concept in occupational therapy. It was originally developed by Dr. A. Jean Ayres to describe how the brain organises and interprets sensory information to support adaptive responses and meaningful engagement in daily life.
Over time, ‘sensory processing’ has gained traction in broader discussions about sensory differences.
However, the American Occupational Therapy Association (AOTA) advocates for the use of the term ‘sensory integration and processing’ in clinical practice, research, and professional documentation, as it better reflects the dynamic nature of how sensory input is received, interpreted, and utilised to support participation in daily occupations.
While the Royal College of Occupational Therapists (RCOT) recognises Ayres Sensory Integration® (ASI) and sensory-based interventions (SBIs), their focus is on ensuring that occupational therapists maintain an occupational perspective, considering sensory issues within the context of participation and engagement.
Why ‘Sensory Integration and Processing’ Matters
The term ‘sensory integration’ refers to the neurological processes that enable an individual to make sense of sensory input and generate adaptive responses. In contrast, ‘sensory processing’ describes how sensory information is managed but does not fully capture how this input is utilised for motor planning, emotional regulation, social interaction, and engagement in daily activities.
By using ‘sensory integration and processing’, we acknowledge that:
Sensory integration is an active process, not merely passive processing of inputs:
How an individual registers, perceives, integrates, and organises sensory input directly influences their ability to plan, coordinate, and execute purposeful actions.
Integration supports participation
Effective sensory integration underpins the capacity to engage meaningfully in everyday occupations, including social interactions, learning, self-care, and leisure activities.
The research foundation is robust
Ayres’ work identified the foundational role of sensory integration in supporting praxis (ideation, planning, and execution). Contemporary research continues to evidence the links between sensory integration challenges and difficulties with participation across the lifespan, particularly in neurodiverse populations.
Processing alone does not explain participation difficulties
An individual may register sensory input. Still, if they struggle to integrate it effectively, they may experience challenges in motor coordination, social engagement, emotional regulation, or adaptive problem-solving in response to environmental demands.
Framing Reports Around Strengths and Difficulties in Participation
Both AOTA and RCOT encourage therapists to move away from a deficit-based model and instead frame reports in a manner that recognises both the strengths and challenges that influence an individual’s participation. By doing this, occupational therapists and other allied healthcare professionals provide individuals, families, and others with a more precise, functional, and clearly targeted understanding of how sensory integration and processing differences affect engagement in meaningful occupations.
Key Recommendations for Report Writing:
Describe Sensory Integration and Processing Differences in Context
- Reports should articulate how sensory integration and processing differences impact participation rather than simply stating that individuals have ‘sensory processing difficulties’.
- Example:
- Instead of: “David has sensory processing difficulties.”
- Reframe as: “David experiences differences in sensory integration and processing, particularly in how he perceives and responds to vestibular and proprioceptive input. These differences affect his ability to plan movements confidently, leading to challenges when navigating new environments and unstable surfaces.”
Frame Reports Around Strengths and Participation
- Identifying an individual’s sensory strengths alongside their challenges promotes a balanced, person-centred perspective that leads to a hypothesis or plan for intervention or sensory strategies that can be directly linked to assessment data about sensory integration and processing
- Example:
- Instead of: “Emily has significant sensory processing difficulties.”
- Reframe as: “Emily demonstrates strengths in using deep pressure input to support regulation. However, she experiences challenges with auditory filtering, which can make group settings overwhelming. She benefits from opportunities to prepare for changes in noise levels and structured sensory input to support her engagement.”
Connect Sensory Integration and Processing to Real-Life Participation
- The key to making reports meaningful is linking sensory integration differences to real-world engagement in daily occupations.
- Example:
- Instead of: “James has difficulties with sensory processing and struggles with attention.”
- Reframe as: “Differences in sensory integration and processing impact James’ ability to sustain attention in classroom activities where background noise is present. He benefits from structured sensory input to support focus, and access to movement breaks helps maintain his engagement in learning.”
Avoid Overpathologising Sensory Differences
Sensory integration and processing differences are most accurately described and presented as if on a continuum. They will include strengths and challenges and should not automatically be framed as a disorder. Instead, describing how these differences influence participation and support for unmet needs is essential.
Example:
Instead of: “Mary’s sensory processing disorder causes distress.”
Reframe as: “Mary experiences sensory integration and processing differences that make certain environments more challenging. She has developed strategies that support regulation, such as using deep pressure and movement input.”
The Bigger Picture – Supporting Participation Through Sensory Integration and Processing
Using the term ’sensory integration and processing’ rather than just ‘sensory processing’ reflects a deeper and more precise understanding of how sensory differences shape lived experiences. Occupational therapy aims to support participation, and by framing reports with a focus on strengths and adaptive responses, we empower individuals, families, and other professionals to implement strategies that enhance engagement in daily life.
AOTA explicitly promotes the use of ‘sensory integration and processing’ in their literature online and even the name of their special interest group as a preferred term, aligning with the theoretical foundations of Ayres Sensory Integration®. The RCOT, while not explicitly advocating for this terminology, highlights the importance of an occupational focus when considering sensory integration and processing in practice. Their 2021 publication, Sensory Integration and Sensory-Based Interventions, guides occupational therapists’ use of sensory approaches within an occupation-centred framework. The term “sensory integration” also leads to the finding of texts aligned with Ayres’ Sensory Integration rather than the term “sensory processing”.
ASI Wise and the Sensory Project use the term ‘sensory integration and processing’ with and without Ayres’s, depending on the context of the writing, and would strongly encourage our students and membership to do this also.
For further reading, visit:
- AOTA’s Sensory Integration & Processing Special Interest Section: www.aota.org
- RCOT’s guidance on sensory approaches: www.rcot.co.uk
By adopting a participation-focused, strengths-based approach to sensory integration and processing, occupational therapists can continue to provide evidence-informed, person-centred interventions that support meaningful engagement in everyday life.