News: Critiquing the Evidence – Addressing the Novak and Honan ‘Traffic Light’ Systematic Review

We have started the meeting to address concerns raised by therapists across the UK and Ireland about this paper, and its impacts on people with sensory integration and processing difficulties.

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Novak’s paper “Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review”  suggests Ayres’ Sensory Integration is a red light intervention.

Ref: Iona Novak PhD, MSc (Hons), BAppSc Ingrid Honan PhD, BPysch(Hons) First published: 10 April 2019.

This paper is increasingly being used by local authorities to justify why Ayres’ Sensory Integration Therapy lacks evidence and therefore should not be funded.

As an organisation promoting the application of Ayres’ Sensory Integration as part of clinical practice, ASI Wise would support recent studies and literature that recognises Ayres’ Sensory Integration as evidence-based and relevant in many areas of clinical practice; ”Active, individually-tailored, sensory-motor activities contextualised in play at the just-right challenge that target adaptive responses for participation in activities and tasks.” Schaaf, ISIC 2018

There are many arguments that can be made as a rebuttal to this paper. We are establishing a working group to respond and reply to this paper, providing therapists in the UK and Ireland with a formal response to share with parents, educators and local authorities.

Here are our slides to guide tonight’s discussion, for those who have not been able to join tonight’s discussion and debate.

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We love this quote from Dr Susanne Smith Roley

“In their recent publication, AOTA (2018) recommends that practitioners using an SIT approach use clinical reasoning, existing evidence, and outcomes to create a comprehensive, individualized approach for each client, rather than using isolated, specific sensory strategies”.

Quote taken from lecture and cited in M6 CLASI CASI Leanring materials, 2019.

This quote from Schaaf is in support of Ayres’ Sensory Integration and in stark contrast to the recommendations in Novak’s paper.  

“Active, individually-tailored, sensory-motor activities contextualized in play at the just right challenge that target adaptive responses for participation in activities and tasks.”

Schaaf, ISIC 2018


A Systematic Review of Ayres’ Sensory Integration Intervention for Children with Autism. Schoen SA, et al. Autism Res. 2019.

Ayres Theories of Autism and Sensory Integration Revisited: What Contemporary Neuroscience Has to Say Kilroy et al, Brain Sci. 20199(3), 68;

Neural Foundations of Ayres Sensory Integration®, Lane et al, Brain Sci. 2019, 9(7), 153;

Examining the Neuroscience Evidence for Sensory-Driven Neuroplasticity: Implications for Sensory-Based Occupational Therapy for Children and AdolescentsShelly J. LaneRoseann C. Schaaf, American Journal of Occupational Therapy, May/June 2010, Vol. 64, 375-390. 

Please note: Recent advances in neuroscience support the application of the theory of Ayres’ Sensory Integration (ASI) as a treatment approach for children, adolescents, adults and with older adults.