Download the full position statement as a pdf or see below.
What is Ayres Sensory Integration Therapy?
Ayres Sensory Integration (ASI) Therapy® is a specific sensory technique aimed at remediation of dysfunction and underlying nervous system issues. This is an intervention approach based on the Ayres SI (sensory integration) theory and delivered directly 1:1 by a qualified sensory integration practitioner (an SI qualified Occupational, Physiotherapist or Speech and Language Therapist) in a clinic or community setting which meets certain criteria such as an appropriate environment and access to specific resources.
Why is Ayres Sensory Integration Therapy not provided in BLMK?
The Royal College of Occupational Therapy (RCOT) review of the evidence related to ASI® Therapy has identified that it is limited and inconclusive and as such, sensory issues must be considered in the context of the person’s engagement and performance in activities within relevant environments (RCOT Informed View, 2021).
Independent reviews of the use of Sensory Integration Therapy have identified that the evidence base of outcomes suggest that this is an ineffective treatment for children with sensory processing disorders such as Autistic Spectrum Disorder. This is outlined within the Novak review of Effectiveness of paediatric occupational therapy for children with disabilities (2019): A systematic review.
This is further explained by ‘Sensory Differences and Approaches to intervention’, Council for Disabled Children, published 2 Oct 2024, which states: “Research into the effectiveness of ASI® suggests that it is ineffective. Whilst some studies do show a positive effect, limitations in methodology means that it is difficult to generalise from these findings with confidence (Case-Smith et al 2015). A systematic review of the effectiveness of paediatric occupational therapy (Novak and Honan 2019) concluded that ASI® was ineffective in addressing behavioural, function or cognitive outcomes.”
Practitioners providing ASI® require specialist training, environments and equipment to deliver ASI® safely, and will use these concepts within their practice. Our community Occupational Therapy team do not have practitioners trained in ASI® or the specific environment and equipment to carry this out within the community.
Bedfordshire, Luton and Milton Keynes (BLMK) Integrated Care System completed an evidence review for sensory processing to understand effectiveness and impact of interventions to support children with sensory processing needs. The recommendations concluded that we will not currently offer sensory integration therapy or ASI® in BLMK as it is not an approach that is recommended by the Royal College of Occupational Therapy(RCOT), or by The National Institute for Health and Care Excellence (health and social care evidence-based guidance).
Other recent research, including a randomised controlled trial (Rendell et al., 2022), found no significant difference in outcomes between children who received ASI® Therapy and those who received usual occupational therapy care. Additionally, the study concluded that ASI® is unlikely to be a cost-effective use of resources, especially compared to more inclusive, everyday-context interventions.
Professional guidance from RCOT, the Council for Disabled Children (CDC), and other national frameworks consistently highlights that sensory differences are most effectively addressed through everyday participation in meaningful activities, rather than isolated, intensive therapy in specialist clinical environments.
What support is available in BLMK for children with Sensory Processing Differences?
Our evidence-based approach in BLMK is centered around changing the environment and adapting the child’s activities, taking into account their individual needs and personal factors. This is best achieved by the people who know the child well and spend the most time with them. As such this approach is focused on providing resources for the child, parent/carer, professionals and education staff to develop their knowledge and understanding through online tools, education, information and training programmes.
There are a wide range of resources, information and training available to families and professionals supporting children and young people with sensory differences which can be found within the local offer at Milton Keynes City Council.
In addition, parent and professional training has been developed through the RISE partnership to further support parents/carers and professionals to develop a deeper understanding of sensory differences and create person centered strategies to support children and young people. Read more here.
When does a child or young person need to be seen for specialist Occupational Therapy by the community team?
The Occupational Therapy team within the community will assess and treat children who have difficulties with functional skills that are not in line with their overall developmental abilities (this includes academic attainment levels). Functional skills are the everyday activities a child performs such as washing, dressing, use of cutlery and play.
The team do not accept referrals for children where the reason for the referral is solely for sensory differences and the child’s functional skills are in line with what is developmentally expected.
Referrals should be made if the referrer feels this is the appropriate occupational therapy service to meet the child’s needs, after review of the service criteria and applying the ‘Universal Offer’
Any professional who knows the child well, for example paediatrician, SENCo, teacher, GP, health visitor, physiotherapist, social worker, speech and language therapist can also refer.
