A new 2026 systematic review and meta-analysis matters right now because it helps bring some much-needed clarity to an increasingly confused conversation.
Across 23 randomised controlled trials, sensory integration therapy was associated with significant improvements in motor skills, daily functioning, and individualised goals in children. The strongest effects were seen for individualised goals, especially in studies aligned with Ayres’ principles.
That matters for several reasons.
First, it reinforces that fidelity is not a trivial issue. Ayres’ legacy was never just about offering sensory experiences in a loose or generic way. It was about a distinct therapeutic approach grounded in theory, relationship, careful observation, clinical reasoning, and the “just-right challenge”. When practice is aligned with those principles, outcomes appear more meaningful.
Second, this paper also helps us avoid a false split.
Protecting fidelity does matter. It protects children, families, practitioners, and the integrity of the evidence. But fidelity should not be used to shrink Ayres’ legacy into a narrow corner of practice, as though the theory matters only in a clinic or only when every feature of full Ayres Sensory Integration can be delivered.
Ayres gave us more than an intervention protocol.
She gave us a way of understanding development, participation, and the relationship between sensation, action, and everyday life.
That wider knowledge matters across practice.
It helps us notice patterns in how a person manages their body, attention, emotion, coordination, relationships, and occupations.
It helps us shape environments more thoughtfully.
It helps us make better decisions about when universal support is enough, when targeted adaptation is needed, and when fidelity-grounded intervention is indicated.
It helps teams and services think more clearly.
So yes, this review supports the importance of studies aligned with Ayres’ principles.
But it also reminds us why the wider theory still matters so deeply.
Words matter.
Fidelity matters.
And so does the wise, ethical, evidence-informed application of sensory integration knowledge beyond the therapy session.
For practitioners, service leaders, and commissioners, this is an important moment to resist collapsing everything into one vague category of “sensory approaches”. We need clearer language, better distinctions, and practice that honours both the integrity of Ayres Sensory Integration and the broader value of sensory integration knowledge in real world services.
Reference:
Park, S. H., & Kim, E. Y. (2026). Effects of sensory integration therapy in children: A systematic review and meta analysis of randomized controlled trials. Research in Developmental Disabilities, 172, 105269.
https://doi.org/10.1016/j.ridd.2026.105269
