Sensory Processing Disorder Treatment: What Helps and How to Get It

How is sensory processing disorder treated?

With occupational therapy. Occupational therapists are widely recognized as the lead profession in evaluating and treating sensory integration and processing challenges, and children are usually referred to them when those challenges get in the way of daily life.⁠³ Cleveland Clinic lists the aims as meeting developmental milestones, improving self-care, play and social skills, and improving self-regulation and behavior.⁠¹

The options fall into a few groups: direct therapy such as Ayres Sensory Integration, sensory techniques applied to the child, coaching for the adults around the child, and changes to the sensory environment.⁠^2,3 They differ a great deal in what the research supports.⁠³

A 2025 review found moderate evidence that targeting several sensory systems works better than targeting one, and that sensory strategies may work best as part of a larger plan rather than on their own.⁠³

What does a sensory processing treatment plan involve?

A plan starts from an assessment and sets goals with the family. AOTA’s Practice Smart recommendations tell occupational therapists not to begin intervention without an occupational profile and collaborative goals, and not to use sensory-based interventions without documented assessment results.⁠¹⁸ The plan then usually draws on four kinds of help:⁠³

• Direct therapy. Sessions with an occupational therapist; for many children this means Ayres Sensory Integration, delivered in a room with suspended equipment.⁠^2,15
• Home and school strategies. Routine sensory activities and tools fitted to the child, such as headphones for background noise, fidget toys, or a planned break for walking, spinning or swinging.⁠¹
• Coaching for parents and teachers. A 2025 review found strong evidence for training caregivers in sensory strategies and says caregiver training or coaching should be part of any sensory intervention.⁠³
• Changes to the environment. Adjusting a setting to the child; one study of a dental clinic adapted for autistic children found better participation.⁠^3,16

Coaching has some of the best evidence of any option. An earlier review of parent and teacher coaching found only four eligible studies, but they suggested positive results for both parents and children, often in a short time.⁠^3,19 If a plan is only clinic sessions, ask what you and the school should be doing between them.⁠³

What happens in a sensory integration session?

It looks like play, because it is built from play. In one randomized trial, sessions took place in a large gym with mats, suspended swings, large balls, a climbing wall and foam blocks; the child played actively while the therapist set activities at the just-right challenge for that child.⁠¹⁴ For ASI, the fidelity measure expects a therapist with postprofessional training in sensory integration and a room with space for both vigorous and quiet activity.⁠¹⁵

The therapy is individually tailored, child-directed and goal-based, which is what separates it from sensory techniques applied to a child.⁠^3,20 Its evidence is mixed: strong for individualized goals in autistic children, while one UK trial found no benefit over usual care.⁠^21,22

What you should get from the therapist: regular discussion of how therapy is going, goals set with you, and education for the family or teachers. All three are part of the fidelity measure for the therapy.⁠¹⁵

What is a sensory diet, and does it work?

Occupational therapists often recommend routine sensory activities and tools at home and school, alongside therapy and customized to the child, to help with focus and organization.⁠¹ A schedule of activities like this is what a sensory diet means; in one school study, sensory diets were built into the regular school day.⁠³

The research on sensory diets themselves is small. In the 2025 review, one single-subject study that built sensory diets into the regular school day found three of four children improved their behavior, and the review rated the evidence for multisensory routines like these as moderate.⁠³ An earlier review found the evidence for adding multisensory activities to preschool routines insufficient to draw conclusions.⁠¹⁶

Practical routines are in sensory diet strategies.

What does the evidence say about SPD treatments?

Two reviews from the same team, published in 2025 and 2026, cover the two halves of treatment: sensory-based interventions, and occupational therapy using Ayres Sensory Integration. Both looked at studies from 2015 to 2024.⁠^2,3

Which treatments have strong evidence?

• Ayres Sensory Integration, for individual goals. Strong evidence for goal attainment and occupational performance.⁠² A review limited to randomized trials found strong evidence that it helps autistic children meet their individualized goals.⁠²¹
• Caregiver training. Strong evidence for training caregivers in the use of sensory strategies.⁠³
• Deep pressure tactile input. Strong evidence from four studies, two of weighted items and two of massage. This is weighted products and massage, not every activity people call deep pressure.⁠³
• Qigong massage. Rated strong in a 2018 review of specific sensory techniques for children with autism or ADHD.⁠¹⁶

Which treatments have moderate evidence?

• Ayres Sensory Integration, for daily skills. Moderate evidence for daily living and self-care skills, and for social, communication and play skills.⁠²
• Targeting several senses. Moderate evidence that sensory input across several systems works better than input to one.⁠³
• Sensory changes to a dental clinic for autistic children, from a 2018 review.⁠¹⁶

Which options have thin or mixed evidence?

• Changing the sensory environment. Only one study met the 2025 review’s criteria, too few to rate. Even so, a 2026 review recommends modifying environments to support people with sensory difficulties.⁠^3,23
• Weighted blankets. In 67 autistic children with severe sleep problems, a weighted blanket did not improve sleep, though children and parents preferred it.⁠²⁴ A later trial in children with ADHD found improved sleep, and a 2026 crossover trial in 42 children with mild intellectual and developmental disabilities found lower anxiety during dental treatment.⁠^3,25 The sensory tools evidence page has more on sensory products.
• Single-sense techniques. Techniques aimed at only one sense have limited, mixed evidence.⁠³

Does massage help sensory processing difficulties?

Massage is one of the better-supported sensory techniques, though the studies are few. Two of the four deep pressure studies in the 2025 review used massage: one found better motor skills in young children who had massage alongside routine rehabilitation, and one found that massage with joint compressions before bed improved sleep and reduced daytime sleepiness.⁠³ A 2017 review in autism found massage improved symptom severity and sensory challenges, but rated that evidence low because the studies probably shared participants.⁠²⁶ Qigong massage was the one technique rated strong in a 2018 review.⁠¹⁶

Which sensory treatments are not supported?

• Alternative seating. Stability balls, cube chairs and T-stools did not improve attention, productivity or behavior in three studies.⁠³
• Weighted vests. A review of seven studies concluded they are ineffective and cannot be recommended; a later school study found no improvement in attention or learning.⁠^3,4
• Brushing protocols. The Wilbarger protocol has only four small, low-quality case series behind it, too few to support or refute it.⁠⁵
• Auditory integration and other sound therapies. A Cochrane review found no evidence that they are effective for autism, and the AAP’s parent site says the method has not proved scientifically valid.⁠^17,27
• Reflex integration programs without a clear link to daily-life outcomes, which AOTA tells therapists not to use; see retained primitive reflexes.⁠¹⁸

What “not supported” means. It means the studies did not find the benefit the product or routine is sold for. In the weighted blanket trial, the blankets were well tolerated and children and parents preferred them, so a child who likes one can keep it, as long as nobody expects it to fix sleep.⁠²⁴

What is the best treatment for sensory processing disorder?

Start from the child, not the product. A 2025 review concludes that sensory-based interventions should be matched to the individual’s sensory needs, which takes a clear assessment by a trained practitioner, and AOTA tells therapists not to use them without documented assessment results.⁠^3,18 From there, the research suggests a few working rules:⁠³

• Prefer options with evidence for the goal you care about. ASI for individual daily-life goals; caregiver coaching and deep pressure among sensory techniques.⁠^2,3
• Use several senses, not one gadget. Input across several sensory systems has moderate evidence over single-sense techniques.⁠³
• Build it into a larger plan. Sensory strategies may work better as part of a plan than on their own.⁠³
• Set a trial period. The AAP suggests trying therapy for a defined period and teaching families how to judge whether it is working.⁠⁶
• Skip what has been tested and failed. Weighted vests and alternative seating for attention, and sound therapies for autism.⁠^3,4,17

What does treatment look like at different ages?

What helps babies and toddlers with sensory difficulties?

Under age 3, the route is the state’s early intervention program, which a parent can contact directly.⁠¹⁰ Occupational therapy in early intervention addresses a young child’s adaptive development, behavior and play, and sensory, motor and postural development, and it includes adapting the child’s environment.⁠⁹ Services are aimed at the child’s function in home, school and community settings.⁠⁹

What helps school-age children with sensory difficulties?

At school, support often looks like small, practical changes: headphones to block background noise, fidget toys, and a planned break for a sensory activity such as walking, spinning or swinging.⁠¹ When a child’s difficulties call for special education, occupational therapy can be written into the IEP as a related service.⁠¹² Outside school, clinic-based therapy such as ASI is the option with the strongest trial evidence, mostly in autistic children aged 4 to 12.⁠^20,21

How is treatment different for autistic children?

Most of the evidence comes from autistic children. ASI is listed as an evidence-based practice for autism by the National Clearinghouse on Autism Evidence and Practice, and a 2019 review found it meets Council for Exceptional Children criteria for autistic children aged 4 to 12.⁠^20,28 Its best-supported use is individual goals; reviews find no benefit for behaviors of concern, and a UK trial found no effect on problem behaviors.⁠^21,22

Two cautions apply. The AAP says sensory-based therapy may be one component of a comprehensive treatment plan, not the whole of it.⁠⁶ And AOTA tells therapists not to try to reduce or eliminate an autistic person’s restricted and repetitive behaviors without first understanding what the behavior means to the person.⁠¹⁸

More background is in sensory processing and autism.

What about children with ADHD and sensory difficulties?

The evidence is thinner than for autism. The AAP lists ADHD among the conditions in which difficulty processing sensory information is common, which is one reason it calls for a thorough evaluation.⁠⁶ A few studies help: the 2018 review of specific sensory techniques included children with ADHD, a weighted blanket trial in children with ADHD found improved sleep, and a pilot trial of occupational therapy using sensory integration in children with sensory modulation disorder found gains in attention.⁠^3,16,29 A review of randomized trials of ASI says more research is needed for children other than autistic children.⁠²¹ Alternative seating, often suggested for attention, did not improve it.⁠³

Can sensory processing disorder be cured?

Cleveland Clinic states there is no cure for sensory processing disorder, but that occupational therapy can help manage the symptoms, especially where they affect daily life.⁠¹ The measurable gains in trials are practical ones: children reaching goals their families chose, needing less help with self-care, and doing better on socialization.⁠^14,30

A 2026 meta-analysis of 23 trials found sensory integration therapy improved motor skills, daily functioning and individualized goals, but not balance, visual construction or sensory processing itself.⁠³¹ Reviews find no benefit for behaviors of concern such as irritability.⁠²¹ So the aim is a child who manages more of daily life, not a child whose sensory differences are gone.⁠^1,31

When should a child be seen for sensory difficulties?

When the sensory differences get in the way. Researchers distinguish sensory differences, which may or may not affect participation in daily activities, from sensory challenges, which do.⁠³ Cleveland Clinic notes that a pediatrician may refer a child whose sensory behavior is not typical to an occupational therapist, and that providers see the benefit of therapy especially when sensory difficulties affect day-to-day functioning.⁠¹

The AAP adds a caution: sensory difficulties are seen in many conditions, including autism, ADHD, developmental coordination disorder and childhood anxiety, and these must be considered in a thorough evaluation.⁠⁶

How do I get a sensory processing assessment?

Sensory processing disorder is not an official medical diagnosis, and the AAP advises that it generally should not be diagnosed, because there is no universally accepted framework.⁠^1,6 What a child can get is an occupational therapy assessment: the therapist watches the child respond to sensory experiences and asks about symptoms, behavior and medical history.⁠¹

A full assessment report, as the fidelity measure for Ayres Sensory Integration describes it, covers the child’s history and occupational profile, the reason for referral, sensory processing, praxis, motor skills and visual perception, and what the results mean for the child’s life.⁠¹⁵ Standardized tools include the Sensory Profile, the Sensory Integration and Praxis Tests and the Sensory Processing Measure, all used in the trials described above.⁠^14,22

Through school. A parent can request an initial evaluation to find out whether a child has a disability, and occupational therapy is one of the related services an IEP can include; see IEPs and 504 plans.⁠^10,11,12

See alsohow sensory processing difficulties are assesseddoes insurance cover therapy for kids

What happens after the assessment?

The results should be explained in terms of the child’s daily life and turned into an intervention plan with goals agreed with the family.⁠^15,18 Ongoing communication with parents and teachers, including education in the strategies, is part of good practice under the fidelity measure, and caregiver coaching has strong evidence in its own right.⁠^3,15 The AAP adds that other developmental and behavioral conditions must always be considered as part of a thorough evaluation.⁠⁶

How long does sensory processing therapy take?

• Sessions. Studies in a 2019 review ran from three sessions a week for 6 weeks to one a week for 36 to 40 weeks, and there are no definitive guidelines on how much is enough.⁠²⁰
• Functional goals. In a 2014 trial, evaluators set five goals with each family before therapy, and goal attainment was the main outcome.⁠¹⁴
• Uneven progress. Gains can show in some areas and not others; the 2026 meta-analysis found improvement in motor skills and daily functioning but not in balance or sensory processing scores.⁠³¹
• A review point. The AAP suggests a trial period of therapy and teaching families how to judge whether it is working.⁠⁶
• Change over time. As children grow, their surroundings and challenges change, so therapy may need to change too.⁠¹

How much does sensory processing therapy cost?

Costs depend on the route. Three routes reduce or remove the cost to the family:⁠^8,13

• Early intervention, under 3. Evaluation and assessment must be provided at no cost to parents; states may charge sliding fees for services, but a family that cannot pay receives all services free.⁠⁸ Occupational therapy in early intervention covers sensory, motor and postural development.⁠⁹
• School services, age 3 and older. Occupational therapy can be a related service in an IEP, and special education and related services are provided at public expense, without charge.⁠^10,12,13
• Insurance. Sensory integration is billed under CPT code 97533, and coverage varies by plan; Blue Cross Blue Shield of Michigan excluded it until March 1, 2026, when it began covering Ayres Sensory Integration for patients with an autism diagnosis.⁠³²

Cost-effectiveness has been tested once: in the UK SenITA trial, sensory integration therapy was not cost-effective compared with usual care.⁠²²

The cost of pediatric occupational therapy and the cost and insurance guides go further.

Is there sensory processing disorder treatment for adults?

Yes. Sensory processing disorder can affect adults, and occupational therapists offer strategies for coping with sensory challenges at all ages.⁠^1,7 The STAR Institute describes adults who may have difficulty with routines at work, in close relationships and in recreation.⁠³³

The research has not caught up. The reviews cover children and youth up to age 21, and the 2025 review calls for research across the lifespan.⁠^2,3 For adults, occupational therapists work with the person directly on individualized sensory strategies for home, school and community.⁠⁷

See Sensory tools for adults and sensory processing in adults.

Relatedliving with SPDSPD in childrensensory diet strategies

Frequently Asked Questions

Sources

1. Cleveland Clinic. Sensory Processing Disorder (SPD). Health Library, last updated March 20, 2025. Checked October 11, 2026.
   Show the passageHide the passage

   “Healthcare providers and parents typically identify SPD in children. But it can also affect adults.” “Currently, SPD isn’t an official medical diagnosis.” “your child’s pediatrician may refer you to an occupational therapist. These professionals can assess your child for SPD by watching them interact with certain sensory experiences. They’ll also ask about your child’s symptoms, behavior and medical history to help in the diagnosis.” “There’s no cure for sensory processing disorder. But various types of occupational therapy can help manage the symptoms of SPD”. At school a child may need “Access to headphones to block out background noises while they work”, “Access to fidget toys” and “A designated break to do a sensory activity, like walking, spinning or swinging”; “Occupational therapists offer strategies for coping with sensory challenges for all ages.” “As children age, their environments and learning challenges change, so their therapy may need to change as well.” Questions to ask include “Can you help me find out if my insurance will cover SPD therapy?”
2. Piller A, Glennon TJ, Andelin L, Auld-Wright K, McHugh Conlin J, Teng K, Tarver T. Occupational therapy interventions using Ayres Sensory Integration® for children and youth (2015–2024): a systematic review. American Journal of Occupational Therapy. 2026;80(1):8001185030. PMID 41324442. Checked October 11, 2026.
   Show the passageHide the passage

   The abstract: inclusion covered “studies published in English between May 2015 and January 2024 with participants ages 0-21 yr with sensory processing challenges”; “Twelve studies (four randomized controlled trials, four nonrandomized group designs, and four single-subject designs) met the inclusion criteria. Strong strength of evidence supports ASI for individual goal attainment and occupational performance. Moderate strength of evidence supports ASI in improving daily living and self-care skills and social, communication, and play skills.”
3. Piller A, McHugh Conlin J, Glennon TJ, Andelin L, Auld-Wright K, Teng K, Tarver T. Systematic review of sensory-based interventions for children and youth (2015–2024). Frontiers in Pediatrics. 2025;13:1720179 (November 13, 2025). PMID 41321460. Checked October 11, 2026.
   Show the passageHide the passage

   The abstract: “Twenty-one studies were included. Strong strength of evidence supported use of deep pressure tactile input and caregiver training on the use of sensory strategies. Moderate strength of evidence supported that alternative seating did not improve attention. Additionally moderate strength of evidence supported targeting a variety of sensory systems is more effective than targeting only one system. There is a lack of evidence on the impact of sensory environmental modifications.” SBIs “tend to be practitioner or adult-led interventions, involving passive sensory input applied to the child, and can include sensory techniques, such as massage, wearing earmuffs, passive swinging, caregiver sensory training, and sensory environmental modifications”. Deep pressure: “Four studies supported the use of deep pressure tactile stimulation, two of which examined weighted items and two of which examined massage.” One “demonstrated statistically significant improvements in motor skills for young children who received massage in addition to routine rehabilitation”; another “utilized massage with joint compressions prior to bedtime. Participants had significant improvements in overall sleep and a decrease in daytime sleepiness.” “Weighted vest wearing did not significantly improve attention, body perception, coping skills or learning when worn in the school setting”; a weighted blanket study “yielded statistically significant results for improved sleep for children with ADHD”. Seating: stability balls at school “found no significant improvements in productivity or seatwork”; cube chairs or T-stools, no significant improvement in attention. “A third Level II (38) SSD study using sensory diets as part of the regular school day showed three of four participants improving behavior.” The environmental modification study “demonstrated significant improvements in participation within a dental environment”. Implications: “The evidence indicates that caregiver training or coaching should be considered as part of any sensory intervention.” “SBIs may be more effective when implemented as part of a larger intervention plan, rather than as a standalone intervention.” “a clear assessment of sensory processing as part of a comprehensive evaluation to identify the client’s needs should be performed by a trained practitioner”. Introduction: differences “are estimated to affect 5%–25% of children in the United States”; “Occupational therapists are widely recognized as leaders in the evaluation and treatment of SI/SP challenges”. “Research is needed across environments and the lifespan.”
4. Stephenson J, Carter M. The use of weighted vests with children with autism spectrum disorders and other disabilities. Journal of Autism and Developmental Disorders. 2009;39(1):105–114. PMID 18592366. Checked October 11, 2026.
   Show the passageHide the passage

   The abstract: vests are claimed to help with “inattentiveness, hyperactivity, stereotypic behaviors and clumsiness”; “Seven studies examining weighted vests are reviewed. While there is only a limited body of research and a number of methodological weaknesses, on balance, indications are that weighted vests are ineffective.” “weighted vests cannot be recommended for clinical application at this point”.
5. Weeks S, Boshoff K, Stewart H. Systematic review of the effectiveness of the Wilbarger protocol with children. Pediatric Health, Medicine and Therapeutics. 2012;3:79–89. doi:10.2147/PHMT.S37173. Checked October 11, 2026.
   Show the passageHide the passage

   The abstract: “The Wilbarger protocol is the most prescriptive program used to treat sensory overresponsivity in children aged 2–12 years.” “Four level IV intervention (case series with pretest/posttest) studies were included for indepth review. All four studies had very small sample sizes, exhibited low methodological quality, differed in outcome measures used, and lacked homogeneity of samples and treatment fidelity.” “A lack of high quality evidence currently exists to support or refute the use of the Wilbarger protocol with children.” The grade of recommendation “suggests that the Wilbarger protocol should be applied with caution”.
6. Section on Complementary and Integrative Medicine; Council on Children with Disabilities; American Academy of Pediatrics; Zimmer M, Desch L. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129(6):1186–1189. PMID 22641765. Checked October 11, 2026.
   Show the passageHide the passage

   The abstract: “Brushes, swings, balls, and other specially designed therapeutic or recreational equipment are used to provide these inputs. However, it is unclear whether children who present with sensory-based problems have an actual ‘disorder’ of the sensory pathways of the brain or whether these deficits are characteristics associated with other developmental and behavioral disorders. Because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed. Other developmental and behavioral disorders must always be considered, and a thorough evaluation should be completed. Difficulty tolerating or processing sensory information is a characteristic that may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders.” “Occupational therapy with the use of sensory-based therapies may be acceptable as one of the components of a comprehensive treatment plan. However, parents should be informed that the amount of research regarding the effectiveness of sensory integration therapy is limited and inconclusive. Important roles for pediatricians and other clinicians may include discussing these limitations with parents, talking with families about a trial period of sensory integration therapy, and teaching families how to evaluate the effectiveness of a therapy.”
7. American Occupational Therapy Association. Sensory Integration & Processing. Clinical topic page, undated. Checked October 11, 2026.
   Show the passageHide the passage

   “Occupational therapy practitioners play a central role in identifying and addressing sensory integration and processing challenges with clients across the lifespan. OTPs collaborate with clients, caregivers, educators, and other professionals to develop and implement individualized sensory interventions, supporting people’s participation in desired activities in home, school, and community settings.”
8. Electronic Code of Federal Regulations. 34 CFR 303.521 System of payments and fees. IDEA Part C regulations. Checked October 11, 2026.
   Show the passageHide the passage

   Required functions “must be carried out at public expense, and for which no fees may be charged to parents”, including “Evaluation and assessment”; a State may set a “schedule of sliding or cost participation fees that may be charged to the parent for early intervention services”, and a family that meets the State’s definition of inability to pay “must be provided all part C services at no cost”.
9. Electronic Code of Federal Regulations. 34 CFR 303.13 Early intervention services. IDEA Part C regulations. “Occupational therapy includes services to address the functional needs of an infant or toddler with a disability related to adaptive development, adaptive behavior, and play, and sensory, motor, and postural development.” It includes “Adaptation of the environment”. Checked October 11, 2026.
10. Centers for Disease Control and Prevention. Early Intervention. Learn the Signs. Act Early., undated. Checked October 11, 2026.
    Show the passageHide the passage

    “These publicly funded programs provide services for free or at reduced cost for any child who is eligible.” “Eligibility for early intervention services is based on an evaluation of your child’s skills and abilities.” “If your doctor is not able to connect you, you can reach out yourself. A doctor’s referral is not necessary.” “If your child is under age 3: Call your state or territory’s early intervention program”; “If your child is age 3 or older: call any local public elementary school (even if your child does not go to school there)” to ask for an evaluation “through the school system for preschool special education services”.
11. Electronic Code of Federal Regulations. 34 CFR 300.301 Initial evaluations. IDEA Part B regulations. Checked October 11, 2026.
    Show the passageHide the passage

    “either a parent of a child or a public agency may initiate a request for an initial evaluation to determine if the child is a child with a disability”; the evaluation “Must be conducted within 60 days of receiving parental consent for the evaluation” or within the State’s own timeframe.
12. Electronic Code of Federal Regulations. 34 CFR 300.34 Related services. IDEA Part B regulations. Checked October 11, 2026.
    Show the passageHide the passage

    Related services are “such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes ... physical and occupational therapy”; occupational therapy “Means services provided by a qualified occupational therapist”.
13. Electronic Code of Federal Regulations. 34 CFR 300.17 Free appropriate public education. IDEA Part B regulations. FAPE “means special education and related services that” “Are provided at public expense, under public supervision and direction, and without charge” and “Are provided in conformity with an individualized education program (IEP)”. Checked October 11, 2026.
14. Schaaf RC, Benevides T, Mailloux Z, Faller P, Hunt J, van Hooydonk E, Freeman R, Leiby B, Sendecki J, Kelly D. An intervention for sensory difficulties in children with autism: a randomized trial. Journal of Autism and Developmental Disorders. 2014;44(7):1493–1506 (online November 10, 2013). PMID 24214165. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: children “ages 4–8 years”; “the children in the treatment group (n = 17) who received 30 sessions of the occupational therapy intervention scored significantly higher (p = 0.003, d = 1.2) on Goal Attainment Scales (primary outcome), and also scored significantly better on measures of caregiver assistance in self-care (p = 0.008 d = 0.9) and socialization (p = 0.04, d = 0.7) than the Usual Care control group (n = 15).” The setting: “a large gym equipped with mats, a variety of suspended swings, large balls, a climbing wall, carpeted barrels, large inner tubes and foam blocks with opportunities for active, guided, sensory motor play”; “The treatment utilizes individually tailored sensory motor activities at the just right challenge with a playful approach”. Entry required difficulty “as measured by the Sensory Profile” or “the Sensory Integration and Praxis Test”; evaluators “met with the parents to identify five goals”. Sensory features (“hyper- or hypo reactivity to sensory input or unusual interest in the sensory aspects of the environment”) “are now included as one of four possible manifestations of ‘Restricted, Repetitive Patterns of Behavior, Interests, or Activities’ (American Psychiatric Association 2013)”.
15. May-Benson TA, Roley SS, Mailloux Z, Parham LD, Koomar J, Schaaf RC, Van Jaarsveld A, Cohn E. Interrater reliability and discriminative validity of the structural elements of the Ayres Sensory Integration® Fidelity Measure. American Journal of Occupational Therapy. 2014;68(5):506–513. PMID 25184462. Checked October 11, 2026.
    Show the passageHide the passage

    The structural elements cover “(1) therapist qualifications, including postprofessional training in sensory integration and clinical experience or supervision in OT–SI; (2) components of the occupational therapy assessment report, including history, occupational profile, and evaluation of sensory integration functions; (3) physical environment and equipment, including space for vigorous as well as quiet activity; (4) provisions for safety of therapeutic equipment; and (5) communication with parents and teachers, including collaborative goal setting and family or teacher education.” Assessment reports contain “Interpretation of results in relation to child’s life” and, “As appropriate, intervention plan and collaborative goals related to participation.” Sample items: “Ceiling hooks, rotational devices, and bungee cords for suspended equipment”; “Therapists routinely meet with parents and teachers regarding course of intervention as related to child’s occupational performance.” “The process elements address the dynamics of therapist–child interaction during occupational therapy sessions.” Ratings “by 259 occupational therapists from 185 different facilities” showed the structural section “significantly differentiates between settings in which therapists reportedly do and do not practice OT–SI”.
16. Bodison SC, Parham LD. Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: a systematic review. American Journal of Occupational Therapy. 2018;72(1):7201190040p1–7201190040p11. PMID 29280714. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Eight studies met inclusion criteria. Seven studies evaluated effects of specific sensory techniques for children with autism spectrum disorder (ASD) or attention deficit hyperactivity disorder: Qigong massage, weighted vests, slow swinging, and incorporation of multisensory activities into preschool routines. One study of sensory environmental modifications examined adaptations to a dental clinic for children with ASD. Strong evidence supported Qigong massage, moderate evidence supported sensory modifications to the dental care environment, and limited evidence supported weighted vests. The evidence is insufficient to draw conclusions regarding slow linear swinging and incorporation of multisensory activities into preschool settings.”
17. Sinha Y, Silove N, Hayen A, Williams K. Auditory integration training and other sound therapies for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews. 2011;(12):CD003681. PMID 22161380. Checked October 11, 2026.
    Show the passageHide the passage

    Authors’ conclusions: “There is no evidence that auditory integration therapy or other sound therapies are effective as treatments for autism spectrum disorders.” “of the seven studies including 182 participants that have been reported to date, only two (with an author in common), involving a total of 35 participants, report statistically significant improvements in the auditory intergration therapy group and for only two outcome measures”. Other sound therapies “include the Tomatis Method and Samonas Sound Therapy”.
18. American Occupational Therapy Association. Practice Smart! Recommendations carried over from AOTA’s Choosing Wisely list (2018 to 2021), undated page. Checked October 11, 2026.
    Show the passageHide the passage

    “2. Don’t provide sensory-based interventions to individual children or youth without documented assessment results of difficulties processing or integrating sensory information.” “6. Don’t initiate occupational therapy interventions without completion of the client’s occupational profile and setting collaborative goals.” “7. Don’t provide interventions for autistic persons to reduce or eliminate “restricted and repetitive patterns of behavior, activities, or interests” without evaluating and understanding the meaning of the behavior to the person, as well as personal and environmental factors.” “8. Don’t use reflex integration programs for individuals with delayed primary motor reflexes without clear links to occupational outcomes.”
19. Miller-Kuhaneck H, Watling R. Parental or teacher education and coaching to support function and participation of children and youth with sensory processing and sensory integration challenges: a systematic review. American Journal of Occupational Therapy. 2018;72(1):7201190030p1–7201190030p11. PMID 29280713. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Of more than 11,000 abstracts and 86 articles that were considered, only 4 met the criteria and were included in this review. Studies of parental training and coaching for children with challenges in SP-SI and comorbid autism spectrum disorder have suggested that educational or coaching programs could result in positive outcomes for both parents and children, often in a relatively short time period.” Recommendations include “including specific assessment of SP-SI before implementing interventions meant to address those issues”.
20. Schoen SA, Lane SJ, Mailloux Z, May-Benson T, Parham LD, Smith Roley S, Schaaf RC. A systematic review of Ayres Sensory Integration intervention for children with autism. Autism Research. 2019;12(1):6–19 (online December 12, 2018). PMID 30548827. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: the review used “the Council for Exceptional Children (CEC) Standards for Evidence-based Practices in Special Education to evaluate the effectiveness research from 2006 to 2017 on Ayres Sensory Integration (ASI) intervention for children with autism”; “Two randomized controlled trials respectively met 100% and 85% of the CEC criteria items”; “Based on CEC criteria, ASI can be considered an evidence-based practice for children with autism ages 4–12 years old.” Lay summary: “This intervention has specific requirements for therapist qualifications and the process of therapy.” Sensory-based interventions “are largely characterized as protocols that are passively applied to the child and have been found to have few positive effects” and “lack many of the key ingredients of the ASI such as individual-tailoring, active engagement of the child, the establishment of a therapeutic alliance between the child and therapist, targeting the just right challenge and provided within the context of play”; the principles are those “described by Ayres [Ayres, 1972, 1979, 1989; Ayres & Robbins, 2005] and operationalized in the Ayres Sensory Integration Fidelity Measure”. Discussion: the results “apply only to children with ASD who have IQs above 65”; “This range, from 18 to 40 sessions, is not uncommon in pediatric occupational therapy practice as there are no definitive guidelines to guide dosage.”
21. Acuna C, Gallegos-Berrios S, Barfoot J, Meredith P, Hill J. Ayres Sensory Integration® with children ages 0 to 12: a systematic review of randomized controlled trials. American Journal of Occupational Therapy. 2025;79(3):7903205180. PMID 40193295. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Nine RCTs (N = 344 participants), six with autistic children and three with other child populations, were included.” “Strong evidence from five RCTs (four Level 1b) indicates that ASI supports autistic children in meeting their individualized goals. Moderate evidence from three RCTs (two Level 1b) indicates no benefits of ASI for behaviors of concern, such as noncompliance or irritability. Bias concerns persist among included studies.” “It is not recommended to address behaviors of concern, such as resistance to change or irritability. More research is needed to determine ASI’s benefits for other child populations.” The trials “compared implementation of ASI with its Fidelity Measure with children ages 0 to 12 yr”.
22. Randell E, Wright M, Milosevic S, Gillespie D, Brookes-Howell L, Busse-Morris M, Hastings R, Maboshe W, Williams-Thomas R, Mills L, Romeo R, Yaziji N, McKigney AM, Ahuja A, Warren G, Glarou E, Delport S, McNamara R. Sensory integration therapy for children with autism and sensory processing difficulties: the SenITA RCT. Health Technology Assessment. 2022;26(29):1–140. PMID 35766242. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “The intervention was manualised sensory integration therapy delivered over 26 weeks and the comparator was usual care.” “A total of 138 participants were randomised (n = 69 per group).” The therapy “was delivered with good fidelity and adherence and minimal contamination, and was associated with no adverse effects”; “There were no significant main effects of the intervention at 6 or 12 months.” “Health economic evaluation suggests that sensory integration therapy is not cost-effective compared with usual care alone.” “The intervention did not demonstrate clinical benefit above standard care. Subgroup effects are hypothesis-generating only. The intervention is likely to be effective for individualised performance goals, although it is unclear whether effects were in addition to standard care or were maintained.” “Carers and therapists reported improvement in daily functioning.” “Carer-rated goal performance and satisfaction increased across sessions”; limitations included “no measurement of comparator arm goal performance”. Plain language summary: “The sensory integration therapy involved 24 face-to-face sessions in an occupational therapy clinic, followed by two telephone calls with the carer.” The primary outcome was problem behaviors on the Aberrant Behavior Checklist; sensory processing was measured with “the Sensory Processing Measure at screening”.
23. Kishida Y, Stephenson J, Kemp C, Salisbury C. Efficacy of interventions adhering to the revised Ayres Sensory Integration® Fidelity Measure: a systematic review. Journal of Autism and Developmental Disorders. 2026;Online March 28, 2026, ahead of print. PMID 41903087. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Ten studies that involved children younger than 10 years were identified. Positive outcomes were reported in higher risk of bias studies and case studies. Only four studies were rated as having a low risk of bias. No study directly measured both proximal and distal outcomes, used blind assessors, and reported intervention fidelity data. Mixed results were reported in low risk of bias studies. The quality of the GAS used was poor in studies where positive outcomes were identified.” “There is limited current evidence to support the positive effect of interventions adhering to the ASI fidelity measure.” Recommendations include “modifying environments to support individuals who present with sensory difficulties”.
24. Gringras P, Green D, Wright B, Rush C, Sparrowhawk M, Pratt K, Allgar V, Hooke N, Moore D, Zaiwalla Z, Wiggs L. Weighted blankets and sleep in autistic children: a randomized controlled trial. Pediatrics. 2014;134(2):298–306. PMID 25022743. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Seventy-three children were randomized and analysis conducted on 67 children who completed the study.” “The use of a weighted blanket did not help children with ASD sleep for a longer period of time, fall asleep significantly faster, or wake less often. However, the weighted blanket was favored by children and parents, and blankets were well tolerated over this period.”
25. Ajgaonkar S, Shetty AA, Rai K. Weighted blankets for special children: a randomized crossover trial investigating effects on dental anxiety and physiological responses. International Journal of Paediatric Dentistry. 2026;36(4):595–604 (online May 1, 2026). PMID 42067993. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “A randomized crossover trial was conducted on 42 children (aged 6-14 years) with mild IDD. Custom-made weighted blankets (10% of body weight, filled with kitchen grains) were used.” “Use of weighted blankets significantly reduced anxiety and physiological markers across both groups.” Measured “during Atraumatic Restorative Treatment (ART)”.
26. Weitlauf AS, Sathe N, McPheeters ML, Warren ZE. Interventions targeting sensory challenges in autism spectrum disorder: a systematic review. Pediatrics. 2017;139(6):e20170347. PMID 28562287. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Twenty-four studies, including 20 randomized controlled trials (RCTs), were included. Only 3 studies had low risk of bias.” “sensory integration-based approaches improved sensory and motor skills-related measures (low SOE)”; “Studies of auditory integration-based approaches did not improve language (low SOE). Massage improved symptom severity and sensory challenges in studies with likely overlapping participants (low SOE).” “Some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear.”
27. American Academy of Pediatrics, HealthyChildren.org. Sensory Integration Therapy. Last updated October 7, 2019; from Autism Spectrum Disorders: What Every Parent Needs to Know (2012). Checked October 11, 2026.
    Show the passageHide the passage

    “Sensory integration therapy, which was developed in the 1970s by an OT, A. Jean Ayres, is designed to help children with sensory-processing problems (including possibly those with ASDs) cope with the difficulties they have processing sensory input. Therapy sessions are play-oriented and may include using equipment such as swings, trampolines, and slides.” “the effectiveness of sensory integration therapy as a therapy for ASDs is limited and inconclusive. While this does not mean that the therapy might not be helpful in some children, effectiveness so far is mainly based on personal experiences.” On auditory integration training and behavioral optometry: “neither method has proved to be scientifically valid”.
28. National Clearinghouse on Autism Evidence and Practice. Evidence-Based Practices for Children, Youth, and Young Adults with Autism. Checked October 11, 2026.
    Show the passageHide the passage

    Steinbrenner JR, Hume K, Odom SL, Morin KL, Nowell SW, Tomaszewski B, Szendrey S, McIntyre NS, Yucesoy-Ozkan S, Savage MN. University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, 2020 (PDF). Ayres Sensory Integration is defined as “Interventions that target a person’s ability to integrate sensory information (visual, auditory, tactile, proprioceptive, and vestibular) from their body and environment in order to respond using organized and adaptive behavior”, supported by 1 article from 1990 to 2011 and 2 from 2012 to 2017. It is one of four practices that “were previously identified as ‘interventions with some evidence,’ and now meet the evidence-based criteria”; “Ayres Sensory Integration® refers explicitly to the model developed by Jean Ayers (2005) and not to a variety of unsupported interventions that address sensory issues”.
29. Miller LJ, Coll JR, Schoen SA. A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. American Journal of Occupational Therapy. 2007;61(2):228–238. PMID 17436845. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Twenty-four children with SMD were randomly assigned to one of three treatment conditions; OT-SI, Activity Protocol, and No Treatment.” “The OT-SI group, compared to the other two groups, made significant gains on goal attainment scaling and on the Attention subtest and the Cognitive/Social composite of the Leiter International Performance Scale-Revised.” “Findings suggest that OT-SI may be effective in ameliorating difficulties of children with SMD.”
30. Omairi C, Mailloux Z, Antoniuk SA, Schaaf R. Occupational therapy using Ayres Sensory Integration®: a randomized controlled trial in Brazil. American Journal of Occupational Therapy. 2022;76(4):7604205160. PMID 35849051. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Seventeen children with ASD ages 5-8 yr (n = 9 in the intervention group, n = 8 in the usual-care control group)”; “Participants in the intervention group scored significantly higher on outcome measures of self-care (p = .046, rb = .57), social function (p = .036, rb = .61), and parent-identified goal attainment (p < .001, rb = .94) compared with the control group.”
31. Park SH, Kim EY. Effects of sensory integration therapy in children: a systematic review and meta-analysis of randomized controlled trials. Research in Developmental Disabilities. 2026;172:105269. PMID 41935430. Checked October 11, 2026.
    Show the passageHide the passage

    The abstract: “Twenty-three RCTs out of 1406 articles were included.” “SIT produced significant improvements in motor skills (standardized mean difference [SMD] = 0.46, 95% CI = 0.03-0.89). Furthermore, SIT enhanced daily functioning (SMD = 0.62, 95% CI = 0.16-1.08) and individualized goals (SMD = 1.71, 95% CI = 0.80-2.62). Balance, visual construction, and sensory processing did not demonstrate statistically significant effects.”
32. American Occupational Therapy Association. AOTA advocacy leads to BCBS Michigan coverage of Ayres Sensory Integration® for autism. Lenhardt J. Advocacy news, February 26, 2026. Checked October 11, 2026.
    Show the passageHide the passage

    “Blue Cross Blue Shield of Michigan (BCBSM) will begin covering Ayres Sensory Integration® (ASI) for individuals with an autism diagnosis, effective March 1, 2026.” “In 2025, AOTA received concerns from members in Michigan regarding BCBSM’s policy language, which excluded coverage of sensory integration interventions under CPT® code 97533.”
33. STAR Institute for Sensory Processing. About SPD. Sensoryhealth.org, undated. Checked October 11, 2026.
    Show the passageHide the passage

    “When differences in sensory integration and processing are this extreme this is often referred to as sensory processing disorder (SPD) or ‘sensory integration dysfunction’.” “Pioneering occupational therapist, educational psychologist, and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological ‘traffic jam’”. “Sensory integration and processing refers to the way the nervous system receives messages from the senses and turns them into appropriate motor and behavioral responses.” “people who reach adulthood without treatment also may experience significant symptoms”; “These ‘sensational adults’ may have difficulty performing routines and activities involved in work, close relationships, and recreation.” “We also have a vision of a world where SPD is an accepted diagnosis, is included in diagnostic manuals such as the DSM and ICD, and where treatment is covered by insurance.”

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. It does not discourage seeking occupational therapy support. Always consult a qualified healthcare provider about your child.