Across the lifespan · participation · adult practice
Sensory Integration with Adults
A practical hub for sensory integration assessment, intervention, co-produced tools, research, learning and participation beyond childhood.
Sensory integration is not only relevant in childhood. Adults rely on sensory information to organise movement, recognise body signals, plan actions, navigate environments, build relationships and participate in the occupations that give life meaning.
Adult sensory integration practice therefore needs to connect neuroscience and clinical reasoning with real life, personal priorities, health, identity, context and the person’s own account of their experience.
Explore the adult resource hub
Assessment, intervention, research, tools and learning
Move through the pages according to the question you are holding. Each page links professional reasoning with participation, lived experience and the Sensory Project’s developing practice history.
Sensory Integration Assessment Beyond Childhood
Person-led assessment, clinical observation, EASI, AASH, adult PRN and co-produced tools.
Explore assessment → InterventionSensory Integration Intervention Beyond Childhood
Assessment-led support, ASI fidelity, adult contexts, participation goals and ethical practice.
Explore intervention → Shared lensPEAR TREE™ Lens with Adults
Person, Environment, Activity and Relational response, with embodied evaluation and ethics.
Explore PEAR TREE™ → Research and historyResearch and Practice Beyond Childhood
Research, audit, conference work, publications, co-production and a rich adult practice history.
Explore research and practice → LearningCourses and Learning Beyond Childhood
Seeing Differently, webinars, workshops, ASI1–ASI3, MSc routes and communities.
Explore courses and learning → Searchable libraryASI Beyond Childhood Library
Search articles, publications, posters, presentations and practice-history resources.
Search the library →What sensory integration means in adult life
Sensory systems work together to support action and participation
Sensory integration describes how the nervous system receives, organises and uses sensory information from the body and the environment. In adult life this is visible through movement, balance, body awareness, attention, emotional regulation, planning, social participation and the ability to carry out everyday occupations.
Registration and modulation
Noticing sensory information and responding with an intensity that fits the situation, activity and person’s needs.
Discrimination
Understanding the qualities of sensory information, including where it is coming from, how strong it is and what it means.
Postural and ocular control
Using vestibular, proprioceptive and visual information to support balance, stability, gaze and coordinated movement.
Praxis
Imagining, planning, sequencing and adapting unfamiliar or complex actions in response to the demands of the environment.
Adult life and participation
Sensory integration is visible in ordinary occupations
Adult sensory patterns may become clearer through the things a person chooses, avoids, changes, repeats, finds effortful, adapts or uses to recover. They may also change with pain, fatigue, medication, pregnancy, menopause, ageing, neurological change, stress, relationships, housing or life transitions.
Work and study
Open-plan environments, commuting, online meetings, lighting, movement, concentration, deadlines, communication and recovery.
Home and self-care
Cooking, cleaning, washing, dressing, sleep, food, personal space, body signals and shared living.
Relationships
Touch, proximity, conversation, intimacy, trust, social expectations and the ways support is offered or received.
Parenting and caregiving
Interrupted sleep, noise, physical contact, emotional demand, changing routines and balancing another person’s needs with one’s own.
Health and rehabilitation
Pain, fatigue, neurological change, appointments, hospital environments, mobility, body awareness and confidence.
Community and leisure
Travel, shopping, exercise, hobbies, social events, faith, culture, belonging and access to valued places.
What sensory patterns may look like
Describe first, interpret second
A sensory interpretation should begin with what the person notices, what happens in everyday life and the contexts in which participation becomes easier or harder. One fact may connect with several sensory systems, and patterns may become clearer over time.
Movement at work
Rather than writing “sensory seeking”, record: “Walks around the room during meetings and says movement helps them listen.”
Touch preference
Rather than writing “tactile defensive”, record: “Says light unexpected touch feels uncomfortable and prefers firm touch when they initiate it.”
Visual complexity
A person dims lights at home, avoids visually crowded shops, prefers open running routes and keeps surfaces visually clear.
Recovery after participation
An adult appears to manage a busy event but needs the following day in bed or cannot prepare food afterwards.
Assessment and clinical reasoning
Adult assessment needs more than a checklist
Assessment should connect sensory integration functions with the person’s occupational history, health, roles, environments, relationships, priorities and participation. It may involve self-report, collaborative conversation, observation, functional assessment, standardised measures and specialist sensory integration assessment where indicated.
Begin with the person’s account
Ask what they notice, what matters, what already works, what feels effortful and how they prefer to communicate.
Gather across contexts
Compare home, work, travel, relationships, health settings and valued occupations rather than relying on one environment.
Look for patterns and interactions
Consider how sensory systems work together and how context, activity, health, emotion and relationship shape the response.
Use age-appropriate interpretation
Adult assessment requires adult norms, adult occupations and an understanding of developmental and health-related change.
Keep hypotheses open
Sensory information can guide the next question without being treated as a fixed explanation for behaviour or distress.
Link findings with participation
Ask whether assessment findings help explain access, effort, agency, recovery, safety, belonging or meaningful occupation.
PEAR TREE™ Lens
Keep the person, context and relationship together
PEAR TREE™ is one way to organise reflection around adult participation. It does not replace occupational therapy assessment or specialist sensory integration reasoning.
Person
What matters to the person? What strengths, preferences, body signals, health factors, identity and previous experiences shape this situation?
Environment
What changes across places? Consider sound, light, movement, temperature, smell, visual complexity, crowding, access and opportunities to pause or leave.
Activity
What is the person trying to do, and what sensory, motor, cognitive, emotional and social demands are hidden inside that activity?
Relational response
How do pace, proximity, tone, expectations, trust, consent and willingness to adjust affect the sensory experience?
Triage
What needs attention first, including pain, illness, fatigue, medication, distress, access or immediate environmental mismatch?
Relationship
How will support be offered collaboratively, predictably and with genuine choice and the ability to stop?
Embodied evaluation
Did the change improve comfort, effort, recovery, agency, belonging or meaningful participation?
Ethics
Whose goals are being pursued, and does the support protect dignity, identity, autonomy and the person’s right to decline?
Support and intervention
Intervention should support occupation, not impose a sensory recipe
Support may include environmental adaptation, activity modification, collaborative routines, sensory and motor experiences, coaching, education, relationship-based support or specialist Ayres’ Sensory Integration® intervention where this is indicated and within scope.
Start with what already helps
Protect effective routines, environments, movement, recovery, tools and relationships before adding something new.
Make support chosen and contextual
Consider timing, intensity, predictability, meaning, consent and whether the support helps in the activity that matters.
Review the outcome that matters
Evaluate participation, agency, comfort, effort and recovery, not only whether somebody became quieter or appeared compliant.
Clear boundaries
Sensory language should not replace careful assessment
- Sensory integration differences cannot be diagnosed from a checklist, preference or isolated observation.
- Medical review may be needed where pain, illness, neurological change, medication effects or another health concern may contribute.
- Reflective tools do not replace occupational therapy assessment, functional assessment, standardised measures or specialist sensory integration assessment where indicated.
- Touch, pressure, movement or restrictive equipment require meaningful consent, risk consideration and a genuine ability to stop.
- Professional roles, education and scope should be described accurately and transparently.
Courses, webinars and postgraduate modules
Learning for different roles and levels of practice
Choose learning that matches your role, intended contribution and current scope. Focused webinars and Seeing Differently support sensory-informed practice. ASI1–ASI3 provide the specialist education route into Ayres’ Sensory Integration® theory, comprehensive assessment and evidence-based intervention across the life span.
Seeing Differently
A staged learning journey through sensory integration, participation and wellbeing, combining flexible online learning, practical tools, lived experience, case application and tutor conversation.
Sensory “Espresso” Shots
Short bursts of focused CPD for busy therapists and managers, with practical learning around assessment, neuroscience, trauma-informed practice and everyday participation.
Interoception, Body Awareness and Self-Regulation
Focused learning about tactile, proprioceptive and interoceptive systems and their contribution to regulation, cognition, communication and participation.
ASI and Learning Disabilities Across the Lifespan
Research, evidence, neurodiversity and practical skill development with perspectives from families and therapists supporting children and adults.
ASI and Trauma Across the Lifespan
Neuroscience, trauma-informed care, sensory-rich environments and case-based thinking for adults and others whose participation has been shaped by trauma.
Ayres’ Sensory Integration for Older Adults
Learning beyond childhood that connects neuroscience, trauma-informed care, environments, ageing and participation.
ASI Wise Certificate modules
ASI1–ASI3 across the life span
The certificate route builds specialist competence step by step, from theory and neuroscience through comprehensive assessment and evidence-based ASI intervention.
Theory and Neuroscience
Foundations of sensory integration, nervous system function, registration, perception, reactivity, praxis and participation across the life span.
Comprehensive Assessment
Direct and indirect assessment, EASI, sensory discrimination, reactivity, postural and ocular control, praxis, interpretation and clinical reasoning across the life span.
Evidence-Based ASI Intervention
Dynamic assessment, intervention planning, ASI fidelity, therapeutic activity, proximal goals and participation-related outcomes across ages and clinical settings.
Conference handouts, presentations and posters
Adult sensory integration shared through practice and research
These resources include pilot work, audit, dataset analysis, practice frameworks, fidelity adaptation and case-based learning. They can support reflection and service development, but they do not all answer the same questions or carry the same evidential weight.
Data-Driven Co-Production in Adult Sensory Integration
EASI and AASH findings are brought into conversation with Sensory Ladders®, Spiders™ and Grids™ to create client-owned, actionable plans in adult mental health practice.
Adult PRN Percentiles, Protocols and Practice
Preliminary age-banded postrotary nystagmus metrics, symmetry data and a co-produced vestibular self-reflection checklist link measurement with participation.
Sensory Needs and Hospital Discharge
An Essex audit considers environmental mismatch, delayed discharge and access to sensory-informed occupational therapy for autistic adults and adults with learning disabilities.
Bridging Sensory-Motor Processing and Human Occupation
Sensory Ladders® connect sensory-motor foundations with co-produced language, priorities and practical support for meaningful occupation.
ASI Fidelity in High-Security Mental Health
This poster makes safety-led adaptations visible while examining fidelity, agency, therapeutic alliance and trauma-informed ASI in restricted adult settings.
Occupational Therapy and Sensory Integration in Adult Mental Health
Historical data and contemporary practice are connected through ASI, data-driven decision making, recovery and occupational participation.
Earlier publications and practice history
A connected adult practice history
Adult sensory integration work within the Sensory Project and ASI Wise history includes NHS practice tools, conference handouts, service development, poster presentation and peer-reviewed publication.
Sensory Levels in Learning Disability
Smith, K. Training pack, Cornwall Partnership NHS Trust.
Sensory Ladders®
Early co-produced work supporting adults to recognise and communicate changing sensory and body states.
Be SMART Profile
Smith, K. and A, H. Cornwall Partnership NHS Trust. Published as a handout and learning tool for national and international teaching.
Sensory Processing Disorder in Mental Health
Brown, S., Shankar, R., Smith, K., Turner, A. and Wyndham-Smith, T. Occupational Therapy News, 14(5), 28–29.
Personalising Sensory Integration Approaches with Adults
Urwin, R. and Smith, K. Poster and presentation bringing together adult mental health and learning disability evidence and practice development.
Borderline Personality Disorder and Sensory Processing Impairment
Brown, S., Shankar, R. and Smith, K. Progress in Neurology and Psychiatry, 13(4), 10–16. DOI 10.1002/pnp.127
Sensory Processing in People with Asperger Syndrome
Shankar, R., Smith, K. and Jalihal, V. Learning Disability Practice, 16(2), with discussion of adult sensory experience and practice.
Older Adults and Sensory Integration
Research update connecting altered sensory processing, executive function and daily activity performance in older adults.
Sensory Ladders® in Adult Mental Health Quality Improvement
A Cygnet quality improvement study highlighted use of Sensory Ladders® within an acute mental health service.
Search the adult evidence and practice history
ASI Beyond Childhood Library
Search articles, peer-reviewed publications, conference posters, presentations and milestones relating to sensory integration in adolescence, adulthood and later life.
Learning and practical resources
Continue through the Sensory Project shop
PEAR TREE™ Model
A person-first, contextual and relational framework for participation, belonging and support.
PEAR TREE™ About Me
Adult and Older Adult versions for person-centred information sharing across settings.
Sensory Choices Checklist
Explore sensory choices, preferences and experiences across everyday adult life.
Sensory Grids™ Workbook
Gather everyday information before interpreting, then explore patterns across sensory systems and occupations.
Sensory Ladders®
Shared language around changing body states, early cues, support, recovery and participation.
A participation-focused next step
Understand the sensory experience within the person’s real life
Begin with the adult’s own priorities. Gather information across occupations and contexts. Keep hypotheses open, recognise what already works and use assessment findings to support agency, wellbeing and meaningful participation.