Sensory Integration Therapy (Ayres SI) for Children

What is Sensory Integration?

Ayres Sensory Integration was developed by occupational therapist and psychologist A. Jean Ayres. It is based on the idea that some children have trouble taking in and organizing sensations such as touch, movement, body position, sound, and sight, and that this can affect behavior, motor skills, attention, and daily routines.

In a typical session, your child plays in a clinic room with suspended swings, mats, climbing equipment, and textured materials. The therapist follows your child's lead while shaping activities so they are just challenging enough. The goal is not the swing itself but better participation in real life, such as tolerating tooth brushing, getting dressed, joining playground games, or staying calm in a busy classroom.

"Sensory integration" is often used loosely. Ayres Sensory Integration refers to a specific, defined approach with fidelity standards. It is different from sensory diets, weighted vests, brushing protocols, or sensory breaks added to a school day. Those tools have their own, generally weaker, evidence.

Who is it for?

Who provides it?

A licensed occupational therapist (OT, often written OTR/L) or, under OT supervision, a licensed occupational therapy assistant. In Illinois, OTs are licensed by the Illinois Department of Financial and Professional Regulation (IDFPR) under the Illinois Occupational Therapy Practice Act, and you can check a license on the IDFPR License Look Up. For true ASI, ask whether the therapist has advanced training such as the CLASI Certificate in Ayres Sensory Integration (CASI) and uses a standardized assessment such as the EASI (Evaluation in Ayres Sensory Integration) or the older SIPT, plus a clinic with suspended equipment.

What do families and practitioners report?

Many families say sensory integration therapy helped their child tolerate everyday experiences that used to cause distress, like haircuts, noisy rooms, or new clothes. Parents often describe a calmer child, better body awareness, and more confidence on the playground. OTs who use ASI say its strength is that it targets goals the family chooses and builds on play the child enjoys.

Does it work? What the research says

The evidence depends on which "sensory" approach you mean. For ASI delivered as designed, a 2018 systematic review in the American Journal of Occupational Therapy (Schaaf and colleagues) found strong evidence that it helps autistic children make progress on individualized goals measured by Goal Attainment Scaling, and moderate evidence for some other outcomes. A 2019 review by ASI researchers (Schoen and colleagues, Autism Research) judged ASI evidence-based for autistic children ages 4 to 12, and the 2020 National Clearinghouse on Autism Evidence and Practice (NCAEP) report also listed ASI as an evidence-based practice, based on three studies. That same report noted that other sensory approaches, such as sensory diets, lack similar support.

Other findings urge caution. The American Academy of Pediatrics' 2012 policy statement said research on sensory integration therapy is limited and inconclusive, advised that sensory processing disorder generally should not be diagnosed as a stand-alone condition, and said OT with sensory-based therapies may be acceptable as one part of a broader plan. A 2022 UK randomized trial (SenITA, 138 autistic children) found no benefit over usual care on problem behaviors, adaptive behavior, or caregiver stress, though children did make progress on their individual goals. Several large insurers still classify sensory integration therapy as experimental.

Is it covered by insurance in Illinois?

OT evaluations and treatment are commonly covered by commercial insurance and Illinois Medicaid (including All Kids) when medically necessary, but some commercial plans specifically exclude "sensory integration therapy." For example, Aetna's clinical policy (reviewed 2026) lists it as experimental. For state-regulated Illinois plans, the autism coverage law (215 ILCS 5/356z.14) requires coverage for children under 21 with autism for occupational therapy that addresses areas including sensory processing and motor planning; self-funded employer plans may not have to follow it. Children under 3 can get OT through Illinois Early Intervention, and school-age children can receive OT as a related service on an IEP when it supports their education.

What to consider and ask

• Ask whether the therapist uses Ayres Sensory Integration as defined, or a looser mix of sensory activities.
• Agree on two or three concrete daily-life goals at the start and check progress every few months.
• Ask your pediatrician to consider other explanations too, such as anxiety, ADHD, sleep problems, or hearing issues.
• Plan a time-limited trial, for example 3 to 6 months, and decide ahead of time what 'working' would look like.
• Check how the therapist coaches you, so strategies carry over to home and school.
• Ask how sessions will be billed, since many insurers cover OT but not 'sensory integration' by name.