In this blog, we are exploring sensory approaches and practical strategies for integrating sensory approaches into OT. Three main areas will be explored including, key sensory theories in neurological health and OT practice, some of the major assessment/screening tools used by OTs to identify sensory challenge areas and, sensory interventions once issues are identified.
Sensory Integration
Sensory integration is the bringing together of information received from our sensory systems that the brain interprets, selects, and organises to appropriately produce motor, behavioural, emotional and attentional responses (Camino-Alarcón et al., 2024).
Information detected by the senses includes (Cohen et al., 2020):
- Taste
- Visual
- Auditory
- Tactile
- Olfactory
- Proprioception.
What is Sensory Integrative dysfunction?
This involves, impairments with the sensory integration process where the brain is unable to efficiently process sensory information from the environment causing disorganisation (McCurdy et al., 2022; Cohen et al., 2020).
Why is this a Problem?
- Creates challenges learning, problem-solving and functioning in day-to-day activities
- The person may experience discomfort and stress
- Presents challenges managing everyday demands (McCurdy et al., 2022).
Sensory Integration Theory (SIT)
Anna Jean Ayres, Occupational Therapist and Psychologist (1970s) developed Sensory Integration Theory (McCurdy et al., 2022). The Sensory Integration Theory was developed to fill an identified gap in understanding and assessment (Schell & Gillen, 2019, p. 590).
At the time, theories based on ‘learning difficulties’ did not:
- Justify the range of challenges experienced by the children she worked with, or,
- Provide guidance on how to assist these children.
SIT framework explains HOW sensory processing impacts human behaviour and development. It focuses on integration of sensory information from the environment to create an adaptive response, essential for learning and daily functioning (Alotaibi et al., 2025).
What is Sensory Integration therapy?
A ‘clinic’ and ‘play-based’ intervention that uses sensory-enhanced practices to bring about adaptive responses in the child (Schell & Gillen, 2019, p.960).
More about Sensory integration:
- It is a restorative approach, which aims to change the central nervous system and improve a person’s skills
- It involves structured activities – sensory stimulation delivered using sensory input tailored to the individual (Schell & Gillen, 2019, p.960)
- Adaptive behavioural responses are thought to mirror organisation of neural activity that will generalise to everyday behaviours (Schell & Gillen, 2019, p.960)
- Gross motor activities start up somatosensory, vestibular, and proprioceptive systems and are thought to assist the child to bring together sensory information.
SIT is developed to assist children to self-regulate their emotions, and self-regulation involves emotional regulation and sensory modulation (Schell & Gillen, 2019, p.974).
Sensory modulation
Most authors define sensory modulation as BOTH a neurophysiological process and a behaviour (Brown et al. 2019)
The Neurophysiological Process
The ability of the central nervous system to regulate, process and respond to sensory stimuli. Neurological thresholds consist of sensory over-responsivity and under-responsivity.
The Behavioural Process
The individual’s visible responses to the sensory stimuli, such as sensory seeking and or avoiding tendencies.
What is it?
Sensory modulation is “the ability to self-organize and regulate reactions to sensory inputs in a graded and adaptive manner. The ability to self-organize inhibitory and excitatory sensory stimulation and adapt to environmental changes” (Champagne, 2011, p. 252).
Note: A literature review that investigated the historical idea of ‘sensory modulation’ revealed definition inconsistencies (Brown et al., 2019).
Sensory Framework
Sensory Processing Assessments
Below, are four examples of sensory processing assessments that demonstrate integrating sensory approaches into OT.
- Adolescent/Adult Sensory Profile (AASP)
Purpose
Identifies sensory processing patterns to understand the influence of different sensory processing patterns on functional performance (Cohen et al. 2020; Schell and Gillen, 2019, p. 952).
Age: 11 years and older (self-report form).
Population: Neurological + Mixed populations.
Area of assessment
- Hearing
- Infant & Child Development
- Olfaction
- Taste
- Touch
- Vestibular
- Vision and Perception.
Layout
5-point Likert scale:
- This ranges from “almost always” to “almost never”
- Numerical values of 5 to 1 respectively or 0 for “does not apply”.
4 quadrants
These reflect sensory processing patterns:
- Sensation seeking
- Sensory sensitivity
- Sensation avoiding
- Low registration.
9 subscales
- Auditory
- Visual
- Touch
- Movement
- Body Position
- Oral Sensory
- Conduct
- Social Emotional.
Scoring
- The subscale raw scores are calculated, followed by quadrant raw scores.
- The raw scores are converted into percentile ranks.
Pros
- Top-down approach
- Standardised assessment
- Flexible administration – Self report, caregiver, educators
- Self-report administration stretches to as young as 11 years of age
- A norm-referenced assessment (ranks and compares an individual on a bell curve to others of the same population)
- 5-point Likert scale (Cohen et al. 2020)
- Able to identify and develop a client’s awareness and strategies to optimize the desired sensory environment (Pearson assessment, 2025)
- Non-intrusive, easy to administer and score (Pearson assessment, 2025)
- The Subscale Internal consistency reliability was 0.82 (low registration), 0.79 (sensation seeking), 0.81 (sensory sensitivity), and 0.66 (Sensation avoiding subscales (Skocic et al., 2024).
Cons
- Self-report administration to as young as 11 years of age (a possibility of inaccurate results) (Cohen et al. 2020)
- It is expensive to purchase the assessment
- Does not consider impact of cognitive factors (e.g. cognitive decline in older adults) on sensory processing (Passarello et al., 2022)
- No questions related to interoception/internal sensory processing that limits a holistic view of the client (DuBois et al. 2017).
- Sensory Processing Measure (SPM)
Purpose
The SPM assesses sensory issues, sensory processing, praxis, and social participation of primary school children at home, school and in the community (Sralab, 2017; Schell and Gillen, 2019, p. 952).
Age: 6 -12 years
Population: Paediatrics
Area of assessment
- Activities of Daily Living
- Balance – Non-vestibular
- Balance – Vestibular
- Behaviour
- Communication
- Coordination
- Eating
- Functional Mobility
- Hearing
- Occupational Performance
- Olfaction
- Seating
- Smell
- Social Relationships
- Social Support
- Stress & Coping
- Taste
- Touch
- Upper Extremity Function
- Vestibular
- Vision & Perception.
Pros
- Administration: Parent or teacher questionnaire
- A standardised assessment
- Paper and pencil administration
- Administration time is 15-20 mins (per form)
- No training is required (Sralab, 2017).
Cons
- Bottom-up approach
- Expensive to purchase
- MUST observe the child in the environment being rated for at least one month (Sralab, 2017).
- Three forms to be completed by different individuals:
- Home Form (completed by child’s care provider)
- Main Classroom Form (completed by child’s primary teacher)
- School Environments Form (completed by other school personnel who work with and observe the child) (Sralab, 2017).
- Child and Adolescent Scale of Participation (CASP)
Purpose
CASP measures a child/young adult’s participation in home, school and community activities in four sub-domains:
- Home (e.g. social play/leisure with friends/family, chores, self-care, moving about at/around home, communication with others)
- Community (e.g. social play/leisure with friends, structured events/activities, moving around the community, communicating with others)
- School (e.g. education, social play/recreation, moving around at school, using educational materials/equipment, communication with others)
- Home and community living (e.g. household activities, shopping and managing money, managing daily schedule, community access, work activities/responsibilities).
Age: 3-22yrs.
Population: Children/adults with chronic health conditions and/or disabilities (Sralab, 2020).
Area of assessment
- Activities of Daily Living
- Functional Mobility
- Life Participation
- Occupational Performance
- Social Relationships (Schell and Gillen, 2019, p. 952-953).
Layout
20 ordinal-scaled items across 4 subsections (Sralab, 2017).
This scale involves:
- Full participation
- Somewhat limited
- Very limited
- Unable
- Not applicable.
Pros
- Top-down approach – This looks at the roles and occupations of the person first, followed by the person’s factors and environment factors that contribute to occupational performance
- Standardised assessment
- Flexible Administration – self-administered, caregiver, parent or guardian in person/via mail survey, or via telephone
- Administration time: 10 minutes
- Training not required
- Can be accessed for free
- Flexible scoring (e.g. use of sub-section total scores) (Sralab, 2017)
- Asks for descriptions of supports/barriers to participation in areas, modifications, assistive devices (Sralab, 2017).
Cons
- Many items may not be applicable to children under 6 years old and recommend focus on item-level responses (Sralab, 2017).
Other Sensory-based Assessments
- Sensory Profile – 2
- The Sensory Perception Quotient
- The Sensory processing scales
- Sensory over-responsivity scales
- Activity card sort (Schell and Gillen, 2019, p. 952-953)
- Non standardised observational assessments.
Sensory therapy approaches in the OT space
- Sensory tool integration
Definition: Helps individuals regulate their level of alertness and emotional state through tailored sensory input.
NDIS Community Examples:
- An OT develops a daily sensory routine for a young adult with autism, using noise-cancelling headphones, and a visual schedule to manage transitions
- School staff to offer sensory breaks (e.g., movement activities, deep pressure input) to reduce meltdowns in the school environment
- A client with ADHD uses a portable sensory toolkit (fidget tools, chewable tools, busy books) to increase focus during community outings.
- Sensory-based environmental adaptations
Definition: Modifying environments to reduce sensory overload or increase sensory input.
NDIS Community Examples:
- An OT recommends dim lighting and low-arousal colors in a participant’s bedroom to support sleep for someone with sensory sensitivity
- A shared day program space is zoned with quiet corners and active zones, guided by OT to meet varying sensory needs
- Installation of acoustic panels or rugs to reduce auditory overstimulation in supported accommodation.
- Sensory diet programs
Definition: A customised set of sensory activities scheduled throughout the day to support regulation and functional participation.
NDIS Community Examples:
- An OT creates a “movement circuit” with trampoline, scooter board, and animal walks for a child with sensory seeking behaviours at home
- A young adult with sensory sensitivities accesses a quiet space with dim lighting, calming music, and tactile fidget items before attending therapy sessions, helping to reduce anxiety and improve engagement
- An OT partners with a school program to embed structured calming routines such as yoga stretches, deep breathing, and slow rhythmic movements into the daily schedule.
- Functional sensory integration in daily tasks
Definition: Embedding sensory strategies into meaningful occupations to build tolerance and skill.
NDIS Community Examples:
- An OT supports a young adult with tactile defensiveness to engage in meal preparation using gloves, gradually increasing tolerance to different food textures
- A client with vestibular sensitivities is introduced to community transport training with graded exposure and support from OT
- A participant with sensory avoidance is supported to attend community events by using pre-event visual stories, calming tools, and a pre-planned quiet retreat option.
All four of these approaches are great examples of integrating sensory approaches into OT.
Disclaimer
Trauma cautions
When integrating sensory approaches into OT, consider that sensations can trigger re-experiencing of past trauma, high distress, and other emotional responses.
Case Study
Josephine is a 13-year-old female that has started high school earlier this year. Josephine has challenges becoming overstimulated within busy environments, particularly relating to auditory stimuli (i.e. loud spaces).
This is having a direct impact on their ability to process information during class time (and therefore falling behind on class work), and also regulating themselves whilst in the school yard/interacting with others.
Josephine does not currently have any strategies to manage their sensory overstimulation, and this is causing her a lot of distress whilst at school, but also significant levels of fatigue once back at home. This then is causing decreased regulation capability at home and an increase in tension/family relationship breakdown.
Questions to consider
- What are factors we need to consider for Josephine (from an OT framework lens)?
- What would you do from a sensory screening/assessment perspective?
- What do you think would assist with sensory management strategies?
Reference List
Alotaibi, H. M., Alduais, A., Qasem, F., & Alasmari, M. (2025). Sensory Processing Measure and Sensory Integration Theory: A scientometric and narrative synthesis. Behavioral Sciences, 15(3), 395-. https://doi.org/10.3390/bs15030395
Bundy, A. C., Lane, S., Murray, E. A., & Fisher, A. G. (2020). Sensory integration: Theory and practice (3rd ed.). Philadelphia: F.A. Davis.
Brown, A., Tse, T., & Fortune, T. (2019). Defining sensory modulation: A review of the concept and a contemporary definition for application by occupational therapists. Scandinavian Journal of Occupational Therapy, 26(7), 515–523. https://doi.org/10.1080/11038128.2018.1509370
Champagne, T. (2011). Sensory modulation & environment : Essential elements of occupation : handbook & reference (3rd ed.). Pearson Australia Group.
Camino-Alarcón, J., Robles-Bello, M. A., Valencia-Naranjo, N., & Sarhani-Robles, A. (2024). A Systematic Review of treatment for children with Autism Spectrum Disorder: The sensory processing and sensory integration approach. Children, 11(10), 1222-. https://doi.org/10.3390/children11101222
Cohen, B., Donaldson, A., Park-Chan, J., & Valenzuela, J. (2020). Physiological responses & coping strategies of sensory defensive adults. https://doi.org/10.33015/dominican.edu/2020.OT.09
DuBois, D., Lymer, E., Gibson, B., Desarkar, P., & Nalder, E. (2017). Assessing Sensory Processing Dysfunction in adults and adolescents with Autism Spectrum Disorder: A scoping review. Brain Sciences, 7(8), 108. https://doi.org/10.3390/brainsci7080108
McCurdy, C., Patiño, S., McMahon, J., & Hagen, S. (2022). Adults with sensory defensiveness and their use of coping strategies. https://doi.org/10.33015/dominican.edu/2022.OT.08
Parham, L.D., & Ecker, C. (2007). Sensory Processing Measure (SPM): Home Form. Western Psychological Services: Los Angeles.
Parham, L.D., Ecker, C., Miller Kuhaneck, H., Henry, D.A., & Glennon, T.J. (2007). Sensory Processing Measure (SPM): Manual. Western Psychological Services: Los Angeles.
Passarello, N., Tarantino, V., Chirico, A., Menghini, D., Costanzo, F., Sorrentino, P., Fucà, E., Gigliotta, O., Alivernini, F., Oliveri, M., Lucidi, F., Vicari, S., Mandolesi, L., & Turriziani, P. (2022). Sensory Processing Disorders in children and adolescents: Taking stock of assessment and novel therapeutic tools. Brain Sciences, 12(11), 1478. https://doi.org/10.3390/brainsci12111478
Pearson.(2025). Adolescent/Adult Sensory Profile. https://www.pearsonassessments.com/en-us/Store/Professional-Assessments/Motor-Sensory/Adolescent-Adult-Sensory-Profile/p/100000434?srsltid=AfmBOoo_AKPIwBjHd4P-ZmNo3YsdOre1PRfLCZhauw3LTHB9W8I98Ms2&tab=product-details
Schell, B. A., & Gillen (Ed.).(2019). Willard and Spackman’s Occupational Therapy (13th ed.). Wolters Kluwer.
Shirley Ryan Ability Lab. (2020). Child and Adolescent Scale of Participation.nhttps://www.sralab.org/rehabilitation-measures/child-and-adolescent-scale-participation
Shirley Ryan Ability Lab. (2017). Sensory Processing Measure.https://www.sralab.org/rehabilitation-measures/sensory-processing-measure
Skocic, D., Brown, T., Yu, M., & Reed, K. (2024). Convergent validity of two adult self‐report sensory scales: Comparing the Adolescent/Adult Sensory Profile and the Sensory Processing Measure 2–Adult Form. Australian Occupational Therapy Journal, 71(6), 897–909. https://doi.org/10.1111/1440-1630.12963
At Ability Partners, we believe integrating sensory approaches into OT services are a great way to promote engagement in meaningful activities that support participants. We have an excellent team of OTs experienced at utilising sensory approaches and working alongside clients to achieve goals that really matter.
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