Three Myths About Sensory Integration – A Look at the Facts

AUTOMATED TRANSLATION - NOT YET EDITED

Ayres Sensory Integration (ASI®) is an established therapeutic approach in occupational therapy that has been researched and developed for over 50 years. Nevertheless, certain misconceptions persist in professional circles and are still perpetuated in training and practice today. Three particularly common myths are:

Myth 1: Sensory integration is not activity-oriented.

Myth 2: Sensory integration is not client-centered.

Myth 3: Sensory integration is not evidence-based.

This article explains why these assumptions are incorrect and what scientific basis ASI® therapy actually has.

Myth 1: Sensory Integration is Not Occupation-Oriented

A frequent criticism of ASI® within the OT community is that this approach focuses primarily on sensory processing and not on occupations relevant to everyday life.

The fact is: The starting point and goal of occupational therapy based on the ASI® approach (OT-ASI) is in fact to improve the child's participation in everyday life. Therapy begins with a detailed assessment of the child's participation level, using standardized assessments (e.g., EASI – Evaluation in Ayres Sensory Integration) to analyze whether sensory integration disorders contribute to the everyday problems of the child . As we know, this is the case for 6-15% of children, and for the diagnosis of "developmental coordination disorder" alone, nearly 80% of the affected children have sensory issues.

Therapeutic goals are derived directly from the child's everyday problems and are aimed at improving occupational competence (Schaaf & Mailloux, 2015). Individual, everyday-related therapy goals are measured using instruments such as the Canadian Occupational Performance Measure (COPM) or Goal Attainment Scaling (GAS).

ASI Therapy is not based on skill training, but rather on eliciting adaptive responses through controlled sensory stimuli in a variety of situations. This improves brain function and skills, and makes the child's behavior more adaptable to a wide range of everyday challenges. This results in lasting changes in the child's ability to act—a central feature of occupation-oriented occupational therapy.

Children focusing on filling and transferring beans using different containers while their tactile system receives increased input

Myth 2: Sensory Integration is Not Client-Centered

Another misconception is that ASI® therapy (OT-ASI) is standardized and does not sufficiently address the individual needs of the clients.

The fact is: ASI® is a highly client-centered approach, both in goal setting and in the therapy itself. Therapy goals are developed jointly with parents and child and adapted to individual challenges and strengths. The therapy measures used are based on intrinsically motivating, playful activities that are precisely tailored to the child's sensory needs.

The ASI® Fidelity Measure ensures that therapy is individualized, relevant to everyday life, and oriented toward the child's personal interests (Parham et al., 2011). ASI® also includes ongoing parental counseling to support the transfer of therapy into everyday life (Schaaf & Mailloux, 2015).

Myth 3: Sensory Integration is Not Evidence-Based

Some professionals still view ASI® as “not scientifically based” or claim that there is “no research” on ASI®.

The fact is: The results of the many effectiveness studies on Sensory Integration before 2010, were mostly mixed. This was because the term "Sensory Integration" was used to lump together all sorts of interventions, from actual Sensory Integration therapy within OT to weighted vests or sitting balls used by educators in the classroom. A good example of such a misleading study is Lang et al. (2012).

Since the introduction of the ASI® Fidelity Measure (Parham et al. 2007, 2011) and the increasing number of methodologically high-quality studies, ASI® has met the criteria of renowned organizations for evidence-based practice for several years.

In a highly acclaimed systematic review by the National Clearinghouse on Autism Evidence and Practice (Steinbrenner et al., 2020), ASI® was recognized as an evidence-based intervention for children with autism. Important randomized controlled trials (RCTs) were conducted by Schaaf et al. (2018, 2025). They were able to demonstrate in a highly objective manner that ASI® produces significant improvements in sensory processing and participation in children with sensory integration difficulties.

The scientific data clearly shows that ASI® is a proven effective occupational therapy method.

Conclusion: Sensory Integration is a Modern Therapeutic Approach

These three myths persist in the professional world, even though current scientific evidence has long since refuted them. ASI® is occupation-oriented, client-centered, and evidence-based—and, with its consideration of the latest neurobiological findings, a highly contemporary approach in occupational therapy.

For German speakers among the readers, GSIÖ offers those who are interested in delving deeper into ASI® research and practice free learning opportunities in the SiNN-VOLL blog and the podcast and in monthly meetings, the ASI Study Club.

📌 More information: www.sensorische-integration.org