ISIC2025/2026
A case study illustrating its use for those who struggle to participate
Authors: Maggie Morton, Kathryn Smith, Katie Crowfoot and Dr Gretchen Dahl-Reeves
A case study illustrating its use for those who struggle to participate
A case study illustrating its use for those who struggle to participate
This poster presents a clinical case study illustrating the use of Ayres Sensory Integration® (ASI) to support participation for a 3-year-old autistic child with learning difficulties who communicated non-verbally and experienced significant challenges engaging in activities of daily living. Referral to occupational therapy was made as the child was struggling to participate in activities of daily living, often expressing this difficulty through self-injurious behaviour.
The child was unable to engage in standardised assessment; a sensory integration-informed assessment approach was used, including the Sensory Processing Measure (SPM) (home and nursery forms), the Paediatric Evaluation of Disability Index (PEDI), and collaborative information-gathering with parents and early years professionals. Occupational therapy intervention was delivered in keeping with fidelity to Ayres Sensory Integration®, alongside psychoeducation and co-production with the child’s mother, enabling ongoing assessment and the development of individualised, sensory-rich activities.
Outcomes included improvements in:
- postural control
- somatopraxis
- shared attention
- engagement
This led to meaningful participation gains, such as attending nursery, walking outdoors with a caregiver, and participating in community play activities, experiences previously inaccessible to the child and transformative for the family.
Novak’s systematic review (2019), and a theme of RCOT’s Children, Young People and Families conference (Birmingham UK, 2024) advocated for top-down OT approaches only for children with disabilities. However, these approaches are inaccessible for children, as represented by this boy’s case study. This case study highlights the importance of developmentally appropriate, bottom-up occupational therapy approaches for children who cannot access purely top-down interventions.
It reinforces the need for timely, strengths-based assessment and model-matched intervention, demonstrating how Ayres Sensory Integration® can enable understanding, participation, and thriving for children with complex developmental needs.