Assessment · adolescents · adults · older adults
Sensory Integration Assessment Beyond Childhood
Person-led, data-informed assessment that connects sensory integration functions with lived experience, occupation and participation.
Assessment beyond childhood needs more than a checklist. It requires a careful occupational question, age-appropriate methods, explicit clinical reasoning and a clear account of what the person themselves experiences.
The strongest pathway combines professional data with PEAR TREE™, Sensory Ladders®, Sensory Spiders™ and Sensory Grids™ so that scores, observations and everyday life can be understood together.
Start with participation
Assessment is a process, not a single score
Sensory integration assessment beyond childhood begins with the person’s everyday life. The purpose is not to prove that somebody is different. It is to understand how sensory integration functions, health, context and relationships may be influencing participation, effort, recovery and wellbeing.
A strong assessment combines lived experience, occupational history, observation, appropriate measures and clinical reasoning. It keeps hypotheses open and makes clear what is known, what is inferred and what still needs to be explored.
What matters to the person?
Begin with roles, routines, identity, strengths, interests and the occupations the person wants or needs to access.
Where does participation change?
Compare environments, activities, people, timing, predictability, health and recovery rather than locating everything inside the person.
What information is needed?
Select direct and indirect methods that answer the occupational question and fit the person’s age, communication and circumstances.
What does the pattern mean?
Synthesise scores, observations and lived experience into testable hypotheses, not fixed labels or assumptions.
A layered assessment process
Gather widely, then interpret carefully
Everyday life and history
Explore routines, interests, work, study, home life, relationships, health, development, trauma, movement, sleep, eating, recovery and previous support.
The person’s own account
Use the person’s words, AAC, images, objects, movement or another preferred form. Include strengths, helpful choices and what already works.
Function in context
Observe posture, ocular control, bilateral integration, praxis, sensory reactivity and participation in meaningful tasks, not decontextualised performance alone.
Direct and indirect tools
Use measures whose constructs, age range, psychometrics and intended purpose fit the assessment question. Avoid extending norms beyond their validated use without clear caution.
Patterns and alternative explanations
Consider sensory discrimination, reactivity, postural control, praxis, interoception, health, pain, fatigue, anxiety, trauma, medication and environmental mismatch together.
Participation and next steps
Connect findings with proximal sensory motor goals and distal outcomes that matter in real life, including access, agency, effort, confidence and belonging.
Co-produced tools
Hold professional data and lived experience together
These Sensory Project tools support shared noticing, communication and formulation. They complement assessment. They are not diagnostic tests or substitutes for specialist professional reasoning.
PEAR TREE™ Lens
Keep Person, Environment, Activity and Relational response visible, then use Triage, Relationship, Embodied evaluation and Ethics to guide proportionate next steps.
Explore the adult PEAR TREE™ page →Sensory Ladders®
Explore changing body states, early cues, communication, regulation, recovery and what supports participation across the day.
Explore Sensory Ladders® →Sensory Spiders™
Map possible sensory patterns visually, notice interactions between systems and keep priorities transparent without rushing to one explanation.
Explore Sensory Spiders™ →Sensory Grids™
Gather facts from everyday occupations, organise working hypotheses and track what changes when supports are tested in real contexts.
Explore Sensory Grids™ →Measures and observations
Choose methods that fit the person and the question
Depending on professional scope and training, an assessment plan may draw on several complementary sources.
EASI and SIPT
Direct assessment of sensory integration constructs, administered and interpreted by appropriately educated therapists within each tool’s intended age range and guidance.
SPM-2 and sensory histories
Indirect information about sensory processing and participation across settings, including the Adolescent Adult Sensory History where appropriate.
Clinical observations
Structured observation of postural, ocular, bilateral, sensory motor and praxis functions, interpreted developmentally and in relation to occupation.
Adult vestibular measures
Age-appropriate interpretation of postrotary nystagmus and other vestibular information, including protocol confidence and the person’s own movement experience.
Functional and occupational assessment
Observation and analysis of real activities, environmental demands, routines and the person’s own priorities.
Health and differential review
Medical, neurological, psychological and environmental factors are considered so sensory language does not obscure pain, illness or another unmet need.
Neuroaffirming assessment means holding both
Services may still require standardised scores, percentiles and thresholds. A neuroaffirming pathway also values strengths, identity, context, relationships, self-knowledge and participation. Neither source should erase the other.
A rich practice history
Assessment beyond childhood has developed through practice, publication and co-production
Early adult tools
Sensory Levels, Sensory Ladders® and the Be SMART Profile supported shared noticing and adult mental health practice.
Adult service data and publication
Assessment, service development, conference presentation and peer-reviewed adult mental health work made practice beyond childhood more visible.
Adult PRN and Rio
Historical adult vestibular research and contemporary adult mental health audit were brought together as a visible evidence trail.
Porto measurement with meaning
Adult PRN, data-driven co-production and assessment datasets connected scores with lived experience, shared priorities and participation.
Learning and resources
Build assessment competence at the right level
ASI2 Comprehensive Assessment
Hands-on learning in direct and indirect assessment, scoring, interpretation and clinical reasoning across the lifespan.
Explore ASI2 → Specialist workshopClinical Observations Across the Lifespan
Develop precision in conducting and interpreting clinical observations while linking sensory motor functions with participation.
Explore the workshop → Practice resourceAssessment Interpretation Tool Beyond Childhood
A structured aid for organising assessment information and supporting data-driven reasoning with adults.
View the tool → Position and practiceNeuroaffirming Assessment
Explore how normative measures can be balanced with Ladders, Spiders, Grids, Tracks and person-led plans.
Read the assessment page → Porto pilotAdult PRN Metrics
Age-banded preliminary data, symmetry and a co-produced vestibular self-reflection checklist.
Open the poster → Evidence and historyResearch and Practice Beyond Childhood
Follow the research, conference and practice history that underpins this developing field.
Explore the research page →Clear boundaries
Assessment tools do not create competence on their own
- Reflective tools do not diagnose sensory integration dysfunction or replace comprehensive occupational therapy assessment.
- Standardised tools should be used within their manuals, training requirements, age ranges and psychometric limits.
- Medical or neurological review may be required where pain, illness, medication, sensory loss or functional change may be contributing.
- Reports should distinguish observation, self-report, test result, clinical interpretation and hypothesis.
- Professional roles and postgraduate education should be described accurately and transparently.
Frequently asked questions