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Introduction to Sensory Integration

Learning Module

Abstract

Course is designed to provide a introduction to sensory integration field; train learners on identifying students who may have sensory processing disorder, and administering sensory reactivity tools to assist in developing strategies to help students participate, engage and learn.

Keywords

sensory integration, sensory reactivity assessment

Learning Objectives

Your curruculum developer: Dr. Anna Y. Len, PT, CSCS, ASI cert

Dr. Len has been in the Physical Therapy field for over 15 years and 23 years in the field of Autism. She received her Doctor of Physical Therapy degree from New York University in 2003. She has advanced training in Sensory Integration Framework and is ASI certified since 2006. She has been an adjunct faculty at New York University – Doctor of Physical Therapy Program since 2005 and frequently speaks on the topics of ASD, Sensory Integration framework, and visual supports in physical therapy. She has also served as Master Clinician for NYU's Physical Therapy Department since 2006.

Dr. Len has been speaking nationally and internationally on the topic of Sensory Integration for the past 15 years and has achieve an Expert Level in the field. She has also presented her own research on "Sensory Processing Dysfunction in Children with Idiopathic Toe-walking" at APTA Section on Pediatric Annual Conference (SoPAC) 2012 and APTA Combined Section Meeting (CSM) 2013. Dr. Len is currently involved with ASI Vision 2020 efforts including serving as one of the lead investigators for standardizing new Evaluation in Ayres Sensory Integration tool and becoming an Instructor for the ASI Certification course.

 

For the Learner

This Learning module was created from Dr. Len's lectures and introduces the work of prominent SI researchers and clinicians. It is meant to be as an introductory course for those insterested in learning about the Sensory Integration field. Course content will enable learners to apply gained knowledge to the classroom, therapy sessions and own edcational experience.

Learning Objectives:
*By the end of the course the Learners will be able to:

1. understand the improtance of sensory integration and praxis for development and learning
2. gain skills to identlify studnets with possible SPD
3. administer assessement of sensory reactivity, score and interprate the results
4. participate in discussions during interdisciplinary meetings on how best to support students' with SPD
5. demonstrate understanding of how to adapt the teaching approach or learning environment based on students' needs

Learning Outcomes:
*This learning module is most appropriate for educators and therapists, but can be beneficial for any health care professional or administraotor involved in creating best working environments.

*Course duration is 10 weeks.

*Basic understanding of anatomy and at least 1 year experience in learning settings is needed.

*Successfull completion of the course includes review of all presented materials, peer engagement through submisson of comments and participation in collective intelligence work through Learners updates prompted by Administrators Updates.

For the Administrator

This Learning module was created from Dr. Len's lectures and introduces the work of prominent SI researchers and clinicians. It is meant to be a guide on how to introduce Sensory Integration field.

Learning Objectives:
*By the end of the course the Administrators will be able to:

  • guide the class through the learning process
  • create opprotunities for engagement while learning the concepts
  • assist and comment on collective intelligence opportunities

Learning Outcomes:
*This learning module is most appropriate for educators who would like to teach other therapists, teachers or parents on the Sensory Integration field.

*Course duration is 10 weeks.

*Administrator trainning level: ASI Level 3: advanced level outcomes

Update 1: Sensory Systems and Sensory Integration

Learning Objective:

  • Learners will be able to define what is sensory integration
  • Learners will understand the improtance of sensory processing for development and learning in the frist year of life

For the Learner

Every individual has seven sensory systems which help with own body awareness as well as to assess the envrinment we are in.

[The Seven Sensory Systems image], Retrieved from https://momentousinstitute.org/blog/making-sense-of-sensory-processing

The senses are interconnected with each other, connected with other systems in the brain
and allow us to experience, interpret, and respond to different stimuli in our environment
Sensory systems interconnections start forming before birth and continue to develop as the person matures and interacts with the environment.

Sensory processing involves perceiving, organizing and interpreting information received through sensory systems (e.g., taste, touch, smell, sight, auditory, vestibular) in order to produce an adaptive response.

Sensory integration is organization of sensation for use. (Jean Ayres, 1979)

The term “sensory integration” as used by Jean Ayres, pioneer of this field in therapy, refers to the ability to produce appropriate motor and behavioral responses to stimuli.

Media embedded October 12, 2019

(Pathways, 2013)

Components of Sensory Integration:

As stimuli is introduced, first step is to register it. We are able to observe an orientation to the stimuli in the individual, as they either inhibit or facilitate the input. If the individual is able to modulate or appropriately respond/react to the input, the next step would be to interprate what this stimuli means and put into the long term memory loop. This will allow for quick prediction of the response required when it is presented next time. When the input is interprated the response if formed and executed. 

(Len, n.d.)

Below are the videos of the Sensory Milestones acquired in the first year of life:

Media embedded October 12, 2019
Media embedded October 12, 2019
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Media embedded October 12, 2019

(Pathways, 2016)

 

Additional reference materials:

Sensory Processsing 

Sensory Processing Disorder 

 

Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.

Make an Update: Describe how early sensory milestones babies acquire maybe relevant later for learning in the classroom. Support your writing with at least one scholarly article. Include an annotated bibliography entry of your source.

For the Administrator

Discussion prompts during live sessions could include:

  • Name a sense and ask to post what this sense is used for.
  • Name a task and ask which sensations are sued in order to accomplish this task.

 

Update 2: Jean Ayres - The Pioneer

Learning Objective:

  • Learners will become familliar with the work of Jean Ayres
  • Learners will demonstrate ability to identify pertinent literature sources 
  • Learners begin to critically analyze and share current research in 'sensory integration'

For the Learner

 

Wikipedia contributors. (2019, September 3). Anna Jean Ayres. In Wikipedia, The Free Encyclopedia. Retrieved 23:28, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Anna_Jean_Ayres&oldid=913877311

In the video below, Lucy Jane Miller is speaking about Dr. A. Jean Ayres and her work.

Media embedded October 12, 2019

(SPD, 2010)

Addtional References:

Jean Ayres  - biography

2019 Article: Jean Ayres theories reviewed:

Kilroy, E., Aziz-Zadeh, L., & Cermak, S. (2019). Ayres theories of autism and sensory integration revisited: what contemporary neuroscience has to say. Brain Sciences, 9(3), 68. doi: 10.3390/brainsci9030068

Ayres_20Theories_20of_20Autism_20and_20SI_20revisted_202019.pdf

Make an Update: Idtenify and review one scholarly article on the topic of Sensory Integration which maybe relavant to your practice setting or educational environment. Include an annotated bibliography entry of your source.

For the Administrator

Ayres theories revisited (2019)

 

Jean Ayres Biography link

Jean Ayres Bibliography of Work

Wikipedia contributors. (2019, September 3). Anna Jean Ayres. In Wikipedia, The Free Encyclopedia. Retrieved 23:28, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Anna_Jean_Ayres&oldid=913877311

Update 3: Sensory Reactivity

Learning Objective:

  • Learners will be able to define what is sensory reactivity
  • Learners will be able to identify behaviors which are symptoms of sensory reactivity problems

For the Learner

(Len, n.d.)

Sensory Reactivity is the brain’s ability to automatically respond and adjust to the intensity of sensory stimuli as well as disregard some stimuli depending on situation.

  • Focus on what’s important (ie ball, directions)
  • Ability to grade responses (ie force)

 

(Iles, 2016)

Media embedded October 12, 2019

 

(Len, n.d.)

In order for an individual to effectively learn, work, play, they need to be able to attain the optimal zone of engagement.

(Len, n.d.)

Students who function in low arousal (sleepy state) or high arousal (anxious state) are not ready to learn.  Below is a video demonstrating a child who is overwhelmed by the environment. He is hyperresponsive or hyperreactive to the sensory stimuli around him and is in high arousal state. Attemping him to learn during this state will not be appropriate. 

 

Media embedded October 12, 2019

(Jiron, 2015)

Student who are functioing in the low arousal state (sleepy) maybe erradically moving (high activity mode) in an attempt to wake themselves up or just sitting disingaged (low activity mode). In either case, they are also not ready to participate. 

Students with sensory reactivity probelms will present with various maladaptive behaviors which should should be seen as a symptom of stuggle not defiance. 

(Len, n.d.)

  • Sensory-Registration Problems - refers to difficulties of the person who frequently is underresponsive and fails to attend to or register relevant stimuli
  • Sensation-Seeking Behavior - refers to difficulties of the person who frequently seek out, engage in intense stimulation
  • Sensory-Defensive Behavior - refers to difficulties of the person who are overresponsive to ordinary sensory input and react defensively to one or all stimuli with strong negative emotions

Addtional References:

Please see a list of literature used during the appliation process to include sensory reactivity in DSM-5.

Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007, March). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61(2), 135–142.

Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.

Make an Update: Pick one sensory system, based on your experience as a learner or an educator discuss what kind of maladaptive behaviors maybe observed if they were 1. overresponsive to the input 2, underresponive to the input. How did this impact your learning or did it impact your students' learning experience. 

For the Administrator

Application to include SPD into DSM-5

Somatosensory Modulation Problems - Problems with balance, movements and body position

Vestibular Sensitivity (Gravitational Insecurity) - irrational fear of head moving through space

Difficulty negotiating stairs, fear of heights, fear of dynamic equipment, sensitive to motion in the car/train, tying shoes, moving objects from floor to shelf, negotiating changing in height surfaces

Proprioceptive Sensitivity = too linked to tactile but can present as:

Avoidance of gross motor activity
Arching away from cuddling

Tactile Defensiveness - Hypersensitivity to tactile sensations and involves tendency to overreact to ordinary touch sensations Ayres (1964, 1972b, 1979)

Example: Light touch sensations are aversive

Implications:

  • self-care activities
  • classroom participation in arts & crafts activities
  • social situations with close proximity to others

Other systems:

Visual Defensiveness - Hypersensitivity to light or avoidance of gaze

Example: Catching a ball, poor eye contact

Implications:

  • Avoidance of visually stimulating environments

Auditory Defensiveness - Hypersensitivity sounds

Example: clapping their hands over their ears, produces excessive amount of repetitive noises with hands and mouth; fears and negative responses to vacuum cleaners, lawn mowers, hair dryers, leaf blowers, sirens, toilet flushing

Implications:

  • Overreacts to loud sounds, and hears noises that others do not hear
  • Covers ears during instruction, walks away from group activities

Olfactory Defensiveness - Hypersensitivity to odors

  • May gag or be distressed with certain smells, picky eaters
  • Avoids cafeteria or eating in groups


 

Update 4: Sensory Perception

Learning Objective:

  • Learners will be able to define what is sensory discrimination or perception
  • Learners will be able to dicuss how sensory perception impacts postural control, self consept and learning

For the Learner

(Len, n.d.)

Sensory Perception is one’s ability to distinguish one sensory experience from another and allows us to judge if a stimuli is a threat or not.

  • Type and Location of stimuli (ie touch)

Postural control  is a great example of sensory perception. It relies on the individuals ability to interprate the information from multiple sensory systems before movement can take place or static control can be effectively executed. 

 

(Len, n.d.)

Below is a chart demonstrating how sensory input is processed to allow for attention, organization and engagement in the classroom.

(Len, n.d.)

Difficulty processing or integrative sensory input will lead to problems with conceptration, organization, self esteem, self control, academic learning difficulties, coordianiton and stuggle with abstract thinking and reasoning. If the indvidual is unable to interpret sensory input they will not be able to organize and executre a response, which leads to praxis difficulters (next update).
 

Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.

Make an Update: Pick one sensory system, based on your personal expereince, discuss what kind of difficulties you had or your students displayed with the difficulty processing input or interpreting information from that system.

 

For the Administrator

Processing Difficulties will lead to:

Auditory

  • Difficulty interpreting what they hear
  • Unable to consistently respond to verbal requests or directions
  • Child relies on other system mainly visual to assist them in interpreting directions (ie always the follower never the leader)

Visual

  • Get confused during handwriting activities
  • Difficulty learning how to read


Vestibular-Proprioceptive

  • Difficulties with balance, movement and body position
  • Appear clumsy, accident prone and careless
  • Fall out of their chair for no apparent reason
  • Loose balance and walk into walls
  • Trip on their own feet or run into others when waking in a straight line


Tactile

  • Struggle to make sense of their own touch and the touch of others; difficulty with localizing touch
  • Avoidance of fine-motor tasks
  • Aggressive or startle when touched from behind
  • Need to look at objects in order to identify or manipulate them


Gustatory/ Olfactory

  • Picky eaters
  • Language delays
     

Update 5: Praxis

Learning Objective:

  • Learners will be able to define what is praxis and what it is responsible for
     

For the Learner

Praxis is an intellegence of doing (Jean Ayres, 1985)

(Len, n.d.)

Praxis is one's ability to conceive, plan, and execute a novel action.

  • Enables adaptive behavior
  • Assessed by looking at skills (GM and FM abilities)
  • Ability to use motor skills flexibly, freely, without effort
  • Involves feedback for adjustment of performance and feedforward ability for organizing novel actions
  • Based on somatosensory (senses of the body) perception

 

There are three components to praxis:

Ideation

  • Figuring out WHAT to do
  • The ability to conceptualize a novel action
  • Using what you learned but on new tasks

Motor planning

  • Figuring out HOW to do it
  • Based on body scheme (memory)
  • The ability to organize a novel action (Sequencing, Imitation and copying, Initiation)

Execution

  • Actually DOING the action

Below is an ideation praxis challenge. A child is asked to figure out what he can to do with a chair. The number of ideas he came up with in 60 seconds is recorded.

(Len, n.d.)

Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.

Project: Create a video of adult or child engaging in ideation activity which may involve an object or just own body (directions below).

  • Demonstration: Hop like bunny and say "I can use my body to hop like a bunny". Stand on one leg and say "or I can stand like this".
  • Directions:: "Please, show me how many things you can do with your body in one minute". 

Link your obeservations to the expereince of learning. How would observed success or difficulties impact this student's learning, studying habbits, engagement with peers. 

For the Administrator

Update 5: Sensory Integrative Dysfunction

Learning Objective:

  • Learners will be able to define what is sensory integrative dyfunction
  • Learners will be able to identify symptoms of sensory integrative dysfunction in a academic environment

For the Learner

Sensory Integrative Dysfunction

1 in 6 children experiences sensory challenges sufficient to disrupt their academic, social, and/or emotional development (Ben-Sasson, Carter, Briggs-Gowen, 2009).

Editorial 2018 on State of Science in SI
Media embedded October 13, 2019

(WSJ, 2016)

​Dr. Schaaf is describing the Sensory Integration dysfunction in the video below and speaks about the research in the field of SI.

Media embedded October 12, 2019

(Schaff, 2008)

Below is a webinar: Sensory Issues in ChildrenL Developing your child's senses which will provide additional understanding on the topic. 

Media embedded October 12, 2019

(Pathways, 2014)

Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.

For the Administrator

Update 6: Dyspraxia and Developmental Coordination Disorder

Learning Objective:

  • Learners will be able to define what is dyspraxia
  • Learners will be able to identify symptoms of dyspraxia in a academic environment

For the Learner

Developmental Dyspraxia is associated with difficulties in skill acquisition. Children usually present with:

  • Poor antigravity muscle tone
  • Poor movement quality, grading
  • Delayed postural responses
  • Behavioral characteristics, such as poor self concept, easily frustrated, distractible, controlling or manipulative, emotionally labile, disorganized 
  • Other related problems, such as deficits in body scheme, possible vestibular processing deficits, possible tactile defensiveness, possible poor articulation 

Below is a video offering a inside look at the life with Dyspraxia.

Media embedded October 12, 2019

(Fixers, 2013)

Below is a look at Developmental Coordination Disorder (DCD) which is often used interchangibly with Dyspraxia. DCD is a medical disagnsis which can be found in DSM - 5.

DSM-V (2013) Developmental Coordination Disorder (DCD) 315.4

  • Marked impairment in the development of motor coordination
  • Must interfere with academics or ADL
  • Not due to medical condition
     
Media embedded October 12, 2019

(Oxford Brooks University, 2015)

Addtional Resources:

Developmental Coordination Disorder

Wikipedia contributors. (2019, October 8). Developmental coordination disorder. In Wikipedia, The Free Encyclopedia. Retrieved 23:43, October 13, 2019, from https://en.wikipedia.org/w/index.php?title=Developmental_coordination_disorder&oldid=920259466

Make an Update: Idtenify and review one scholarly article on the topic of Dyspraxia or Developmental Coordination Disorder which maybe relavant to your practice setting or educational environment. Include an annotated bibliography entry of your source. Discuss could you support the students' with praxis difficulties in class. Discuss activities that can be used to challedge and develop students' praxis abilities in class. 

For the Administrator

Update 7: Assessment tools of Sensory Integration Dysfunction

Learning Objective:

  • Learners will become familiar with standardized questionnaires used to assess sensory reactivity
  • Learners will be able to score and discuss result of the senosry profile or sensory processing measure
  • Learners will become familiar with standardized tools used to assess sensory processing and praxis
     

For the Learner

Assessment of sensory functions is outmost importance to ensure apprpriate intervention plan.

Below is an interview Dr. Zoe Malloiux  gave in Turkey on SI, SI assessment and treatment. 

Media embedded October 12, 2019

(Arti TV, 2019)

Two of most popular standardized parent questionares used to assess sensory modulation ability and determine if the individual has sensory reactivity problems in comparison to age matched peers are: Sensory Profile authored by Winnie Dunn and Sensory Processing Measure authored by Dianne Parham. 

Sensory Profile

 

Media embedded October 12, 2019

(SP Image, Pearson); Video (Pearson, 2018)

Sensory Processing Measure

Media embedded October 12, 2019

 (SPM Image, WSP) ; Video (LSU, 2014)

Gold standard for assessing Sensory Processing and Praxis abilities is Sensory Intergration and Praxis Test (SIPT) authored by Jean Ayres.

SIPT

(SIPT Image, WSP)

Gold standard for assessing Developemtal Coordination Disorder is Movement ABC.

Movement ABC

Media embedded October 12, 2019

(ABC-2 Image, Pearson); Video (Vanderpool, 2012)

Addtional Reference Materials:

Purchasing materials: Pearson (SP-2, Movement ABC-2) and WPS (SPM, SIPT) 

Zoe Mailloux

Project DUE week 10 of the course: Pick one tool which assesses Sensory Reactivity to administer and score.  Share your results via snapshot of the scoring sheet and written explantion of the findings or video of the administration with written explanation of your findings. Discuss how you can you adapt the environment or change your teaching approach to help the individual so then can participate and learn based on the assessment. Include at lease 2 scholarly references. Review work of 2 peers using provided rubric.

Rubric for Project assessment of peers and self assessment

 

For the Administrator

Purchase materials: Pearson (SP-2, Movement ABC-2) and WPS (SPM, SIPT).

Learners will pick one of the tools below to administer to a child or adult and score, sharing their results with snapshot of the scoring sheet or a video of the administration.

Learners will discuss their findings and share ideas on strategies to incorporate to promote learning in this individual which can include adaptation of the environment, changing pedagogical approach or other tools supported by the published literature. Sources have to be included in a PDF.

Create a presentation on completed project and share during lightining talk. 

 

TOOLS:

Sensory Processing Measure:

  • Age group: Preschool, School aged

  • Environment: School vs Home

(SPM Image, WSP)

Sensory Profile:

  • Age group: 0-6 months, 7-36 months, school age, adult

  • Enviroment: School vs Home

 

(SPM Image, WSP)

SIPT 

SIPT overview by Mailloux, 1990

 

Update 8: Treatment of Sensory Integrative Dysfunction

Learning Objective:

  • Learners will become familiar with ASI Fidelity Measure
  • Learners will be able to identify Ayres Sensory Integration Treatment approach from Sensory Based Approach

For the Learner

(Len, n.d.)

Ayres_2C_20A._20J._20(1972)._20Improving_20Academic_20Scoresthrough_20Sensory_20Integration._20.pdf

Ayres, A. J. (1972). Improving Academic Scoresthrough Sensory Integration. Journal of Learning Disabilities, 5(6), 338–343. https://doi.org/10.1177/002221947200500605

When considering SI treatment it is improtant to note a few concepts:

  • Sensory Integration required active selection of sensations that are most useful at the time; organization of them in a fashion that facilitates accomplishing goals.
  • Essential ingredient for positive brain changes is that the organism actively interacts with a challenging environment (Bennett, Diamond, Krech & Rosenzweg, 1964)
  • Passive exposure to sensory stimulation does not produce these same positive changes (Dru, Walker, & Walker, 1975)
  • Motivation that comes from within the child to explore = inner drive is a necessary ingredient for effective treatment (generated by Limbic system) (Ayres ,1979)

Below is a video discussing the treatment available for SI dysfunction.

Media embedded October 12, 2019

(Pathways, 2013)

Not all Sensory Integration treatment is the same.

Ayres Sensory Integration® (ASI) = sensory integration intervention (Ayres, 1972) is a play based method that uses active engagement in sensory-rich activities to elicit the child’s adaptive responses and improve the child ability to successfully perform in meeting environmental challenges ( Ayres, 1972; Koomar & Bundy, 2002). It akes place in the clinic, using gross motor tasks that activate the vestibular and somatosensory systems aim to target specific objectives keeping in mind 10 essential elements described by (Ayres, 1972, Parham, et al, 2007, 2011; and in the Guide (Schaaf, Maillox, 2014)

Sensory-based interventions (SBIs) - consist of applying adult-directed sensory modalities to the child with the aim of producing a short-term effect of self-regulation, attention and behavioral organization (Watling, Koenig, Davies and Schaaf, 2011). It may include modalities such as Weighted vests, bouncing on a ball, adapted seating devices and provided in systematic manner as part of sensory diet.

Case Study: Ryder

Media embedded October 12, 2019

(Pathways, 2012)

To ensure fidleity in sensory integration research, Fidelity measure was developed.

A. Len lecture

(Len, n.d.)

Treatment approach which does not demonstrate requried fidelity score is not considered Ayres Sensory Integration and should not be grouped with the ASI but instead place into SBT group when assessing treatment effectiveness. 

A. Len Lecture

(Len, n.d.)

Additional Resources:

(Len, n.d.)

Comment: Mention a stand-out idea, or new thought prompted by this material. Use @Name to speak with others about their thoughts.

Update: Identify research which demonstrates the use of ASI treatment or SBT in various populations. Duscuss the results. Include an annotated bibliography entry of your source.

For the Administrator

See research on the following Diagnses where SPD has been found to  frequently co-occur:

  • Autistic Spectrum Disorder (Autism, PDD)
  • Developemntal Coordiantion Disorder / Dyspraxia
  • Downs Syndrome
  • Prematurity
  • Cerebral Palsy
  • ADHD
  • OCD
  • Fetal Alchohol Syndrome

 

Share the following document with the Learners to assist with their Project

Activities for Classroom to help with Organization

 

Rubrick for assessing the Project and student engagement

Rubric_20for_20Project_20on_20Sensory_20Reactivity.docx

 

Update 9: Training in Ayres Sensory Integration

Learning Objective:

  • Learners will become familiar with exepritse levels in Sensory Integration traning

For the Learner

 

Media embedded October 12, 2019
Building Competences in ASI article

(Video, CL-ASI)

Below is the chart demonstrating the level of trainings agreed upon by international SI network (ICEASI) requried to move through the SI expertise levels.

(Expertise in ASI, Image, ICEASI)

Please fill out the course survery

Snapshot of Survey available via Survey Monkey

 

For the Administrator

Ask Learners to fill out course survey.

 

 

References

Ayres, A. J. (1979). Sensory Integration and the Child: Understanding Hidden Sensory Challenges. Western Psychological Services (p. 211). Western Psychological Services. Retrieved from https://books.google.co.za/books/about/Sensory_integration_and_the_child.html?id=5GMQAQAAMAAJ&redir_esc=y

Ayres, A. J. (1972). Improving Academic Scoresthrough Sensory Integration. Journal of Learning Disabilities, 5(6), 338–343. https://doi.org/10.1177/002221947200500605

Ayres, A. J., Robbins, J., & McAtee, S. (2016). Sensory integration and the child: understanding hidden sensory challenges. Los Angeles, CA: WPS.

Kilroy, E., Aziz-Zadeh, L., & Cermak, S. (2019). Ayres theories of autism and sensory integration revisited: what contemporary neuroscience has to say. Brain Sciences, 9(3), 68. doi: 10.3390/brainsci9030068

Ermer, J., & Dunn, W. (1998). The sensory profile: a discriminant analysis of children with and without disabilities. American Journal of Occupational Therapy, 52(4), 283–290. doi: 10.5014/ajot.52.4.283

Ben-Sasson, A., Carter, A. S., & Briggs-Gowan, M. J. (2009). Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology, 37(5), 705–716. https://doi.org/10.1007/s10802-008-9295-8

Lane, S. J., & Schaaf, R. C. (2010). Examining the neuroscience evidence for sensory driven neuroplasticity: Implications for sensory-based occupational therapy for children and adolescents. American Journal of Occupational Therapy, 64(3), 375–390. https://doi.org/10.5014/ajot.2010.09069

Len, A.Y. (2003-2019) Sensory Integration, Autism, Lecture Series, [Power Point presentation]

May-Benson, T. A., & Koomar, J. A. (2010, May). Systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children. American Journal of Occupational Therapy. https://doi.org/10.5014/ajot.2010.09071

Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007, March). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61(2), 135–142.

Mailloux, Z. (1990). An overview of Sensory Integration and Praxis Tests. The American Journal of Occupational Therapy. : Official Publication of the American Occupational Therapy Association, 44(7), 589–594. https://doi.org/10.5014/ajot.44.7.589

Mailloux, Z., Parham, L. D., Roley, S. S., Ruzzano, L., & Schaaf, R. C. (2018). Introduction to the evaluation in ayres sensory integration® (EASI). American Journal of Occupational Therapy, 72(1). https://doi.org/10.5014/ajot.2018.028241

Parham, L. D., Cohn, E. S., Spitzer, S., Koomar, J. A., Miller, L. J., Burke, J. P., … Summers, C. A. (2007). Fidelity in sensory integration intervention research. American Journal of Occupational Therapy, 61(2), 216–227.

Parham, L. D., Roley, S. S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J. P., … Schaaf, R. C. (2011). Development of a fidelity measure for research on the effectiveness of the ayres sensory integration® intervention. American Journal of Occupational Therapy, 65(2), 133–142. https://doi.org/10.5014/ajot.2011.000745

Parham, L. D., Roley, S. S., May-Benson, T. A., Koomar, J., Brett-Green, B., Burke, J. P., … Schaaf, R. C. (2011). Development of a fidelity measure for research on the effectiveness of the ayres sensory integration® intervention. American Journal of Occupational Therapy, 65(2), 133–142. https://doi.org/10.5014/ajot.2011.000745

Schaaf, R. C., & Miller, L. J. (2005). Occupational therapy using a sensory integrative approach for children with developmental disabilities. Mental Retardation and Developmental Disabilities Research Reviews. https://doi.org/10.1002/mrdd.2006

Schaaf, R. C., Benevides, T. W., Kelly, D., & Mailloux-Maggio, Z. (2012). Occupational therapy and sensory integration for children with autism: A feasibility, safety, acceptability and fidelity study. Autism, 16(3), 321–327. https://doi.org/10.1177/1362361311435157

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