Disclaimer: In this blogpost we have utilised identify-first language in line with current preferences in the Autistic community. However, we acknowledge that everyone is on their own journey, and they have the right to choose if they prefer person-first language.
Ayres Sensory Integration (ASI) is an established therapeutic approach pioneered by Jean Ayres, initially designed to support children facing learning and behavioural challenges. Currently, ASI stands as an evidence-based approach for autistic children. However, in the realm of sensory-based therapies, it's important to distinguish ASI from other approaches to support informed decision and clarification amongst the different approaches.
The ASI Approach
- Multi-Sensory Engagement: ASI hinges on the incorporation of multiple sensory experiences, with a particular focus on proprioceptive, vestibular, and tactile inputs.
- Active Participation: A defining feature of ASI is the child's active involvement during sessions. This participation entails decision-making, interaction with the environment, and the display of adaptive responses aligned with the activity's demands.
- Meaningful and Playful Activities: ASI prioritises activities that hold significance for the child and are executed in a playful manner.
The theoretical underpinning of ASI posits that our bodies have the ability to receive, sort, and process sensory input from both our bodies and the environment through our senses (touch, gravity, body position and movement, sight, smell, hearing, and taste). The responsibility of organising this sensory information and planning an appropriate, adaptive response lies with the brain.
Assessment and Intervention in ASI
For Occupational Therapists using ASI, standardized assessments and clinical observations serve as essential tools to guide clinical reasoning, especially when sensory integration issues are thought to affect a child's performance. The intervention typically unfolds within a clinical setting, featuring a specialised therapy room equipped with sensory equipment that provides tactile, visual, proprioceptive, and vestibular stimuli. While children are actively engaged in the decision-making process, therapists provide guidance and adapt the sensory environment to suit each child's unique needs.
The aim of the ASI approach is to build the foundational skills important for the clients to perform their everyday activities. Therefore, therapists using ASI are trained to link functional goals with the activities performed in the sensory room.
Sensory-based approaches that are not considered ASI:
There are some other approaches and activities that might address sensory systems; however, they are not considered an Ayres Sensory Integration approach. These sensory-based approaches may encompass:
- Single Stimulus Focus: Addressing only one sensory stimulus, such as swinging the child.
- Passive Application: Administering sensory input to the child in a passive manner, with the child passively receiving the input that the therapist or primary carer provide.
- Pre-determined Sensory Opportunities: Supplying sensory experiences decided by someone other than the child, such as sensory diets.
- Environmental Modifications: Suggesting changes to the child's surroundings at home or school, such as the use of wobble chairs.
These sensory approaches are often employed to support the client's regulation or engagement but may not necessarily be tied to specific functional goals and the child’s performance.
The importance of defining ASI
- Informed Practice: Occupational Therapists can better define their instruments and practices, ensuring alignment with evidence-based strategies.
- Empowered Clients and Families: Clear definitions empower clients, families, and caregivers, enabling them to enhance their understanding of the scope of Occupational Therapy and advocate for their needs effectively.
- Research Collaboration: Precise terminology enables professionals to identify essential tools for their practice and facilitates collaboration with researchers, ultimately advancing the field.
In conclusion, the distinction between ASI and other sensory approaches is pivotal for practitioners, clients, and the progression of Occupational Therapy as a whole. It ensures that therapeutic strategies are chosen and employed with precision, promoting the best possible outcomes for those we support.