Pediatric Occupational Therapy has a specific purpose and system for treating children experiencing Sensory Integration dysfunction. Over the years since A. Jean Ayres advanced the field of Occupational Therapy with her theory of Sensory Integration, there have been gradual deviations from her original work to the extent that it has become necessary to clearly define and crystallize research practices and therapeutic protocols that can be endorsed by the American Occupational Therapy Association and the Sensory Integration Global Network. Fidelity to these practices and protocols lends legitimacy to research and treatment practitioners and excludes pretenders and hangers-on who do not adhere to the Ayres Model of Sensory Integration. Fidelity in research provides a baseline for scientific progress and research breakthroughs. Fidelity in therapy (read ‘Sensory Integration Intervention Process’) provides reliability of outcomes based on research, Evidence Based Practice.
The therapeutic approach of sensory integration was originally developed by A. Jean Ayres, PhD, OTR, and is formally known as Ayres Sensory Integration® (ASI; Ayres, 1989). ASI® includes:
- the theory of sensory integration,
- assessment methods to measure sensory integration,
- and a core set of essential intervention constructs that can be utilized to intervene with clients who have difficulty processing sensory information.Frequently Asked Questions About Ayres Sensory Integration-American Occupational Therapy Association
|Table 1. Core Elements of Sensory Integration Intervention Process|
|Core Process Elements||Description of Therapist’s Behavior and Attitude|
|Provide sensory opportunities||Presents the child with opportunities for various sensory experiences, which include tactile, vestibular, and/or proprioceptive experiences; intervention involves more than one sensory modality.|
|Provide just-right challenges||Tailors activities so as to present challenges to the child that are neither too difficult nor too easy, to evoke the child’s adaptive responses to sensory and praxis challenges.|
|Collaborate on activity choice||Treats the child as an active collaborator in the therapy process, allowing the child to actively exert some control over activity choice; does not predetermine a schedule of activities independently of the child.|
|Guide self-organization||Supports and guides the child’s self-organization of behavior to make choices and plan own behavior to the extent the child is capable; encourages the child to initiate and develop ideas and plans for activities.|
|Support optimal arousal||Ensures that the therapy situation is conducive to attaining or sustaining the child’s optimal level of arousal by making changes to environment or activity to support the child’s attention, engagement, and comfort.|
|Create play context||Creates a context of play by building on the child’s intrinsic motivation and enjoyment of activities; facilitates or expands on social, motor, imaginative, or object play.|
|Maximize child’s success||Presents or modifies activities so that the child can experience success in doing part or all of an activity that involves a response to a challenge.|
|Ensure physical safety||Ensures that the child is physically safe either through placement of protective and therapeutic equipment or through the therapist’s physical proximity and actions.|
|Arrange room to engage child||Arranges the room and equipment in the room to motivate the child to choose and engage in an activity.|
|Foster therapeutic alliance||Respects the child’s emotions, conveys positive regard toward the child, seems to connect with the child, and creates a climate of trust and emotional safety|
|March/April 2007, Volume 61, Number 2 Fidelity in Sensory Integration Intervention Research|
What does fidelity mean for you?
As a parent, fidelity means you can understand and confirm that the therapeutic treatment your child is getting is backed by research and meets official standards and will produce the results based on that research. As an OT, fidelity means you can rely on its protocols and practices and that certification confirms your knowledge of fidelity. As a researcher, fidelity means your work will further the knowledge and understanding of Sensory Integration Theory and your results build on A. Jean Ayres model.
- Ayres Sensory Integration Intervention– Sensory Integration Network
- Understanding Ayres Sensory Integration-AOTA Continuing Education Article