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Challenges with processing and integrating sensory information affect children's ability to successfully engage in their occupations at school and fully participate in the educational process. Occupational therapy using Ayres Sensory Integration® (ASI) is an evidence-based intervention for autistic children that has emerging evidence for children with idiopathic sensory integration differences. This article is a call to action for the occupational therapy profession to increase the use of ASI principles in school settings because it historically has been limited in its application. In this column, we respond to two main questions. First, is ASI necessary, essential, and inherently appropriate in school settings? Second, does ASI align with education laws and mandates? We present evidence showing that interventions to address sensory integration and processing function fall within the domain of school-based occupational therapy practitioners and provide examples for ways to use the principles of ASI across all the tiers of a multitiered system of supports. We also make recommendations for next steps that focus on best practices for implementing ASI in the academic setting and address concerns related to the feasibility of ASI in school-based practice within existing systemic and logistical constraints. As a result, occupational therapy practitioners will be empowered to advocate for use of ASI and its principles in the educational setting to proactively provide the support their students deserve., (Copyright © 2025 by the American Occupational Therapy Association, Inc.)

This pilot study sought to determine the feasibility of quantifying sensory processing, postural control, motor skill development and participation in daily life in children with idiopathic toe walking (ITW) compared to children without ITW. A nonrandomized, prospective case-control design was employed. Twenty participants were recruited. Computerized weight bearing and postural control data was successfully collected. Differences were found in forefoot/rearfoot weight bearing, balance, sensory-motor abilities and parent reported participation challenges. Sensory processing results were inconclusive. Findings can inform standardized assessment and treatment of ITW.

Importance: Adolescents and adults report that their sensory integration and processing differences affect their occupational performance and quality of life, thus requiring effective sensory-focused interventions. Researchers have yet to investigate this population's experience of occupational therapy interventions designed to remediate these challenges., Objective: To explore the perceived experience of adolescents and adults with respect to (1) response to intervention, (2) strategies offered to manage sensory differences, and (3) need for services on completion of an intervention., Design: Retrospective, qualitative study., Setting: Zoom or phone call., Participants: Eleven adolescents and adults with sensory integration and processing differences who had previously completed occupational therapy interventions., Intervention: Sensory-based intervention based on the principles of Ayres Sensory Integration® (ASI) and the Sensory Therapies and Research Frame of Reference., Outcomes and Measures: A semistructured interview to obtain data, followed by an in-depth analysis using an inductive coding process to group initial open codes into themes and common subthemes Results: Open codes were grouped into three core themes: (1) therapist-related factors (what the therapist did in treatment); (2) client-related factors (what the client experienced); and (3) follow-up (future needs of the clients). Four main subthemes of the client-therapist relationship emerged: (1) therapeutic alliance; (2) education and knowledge; (3) strategies, tools, and resources; and (4) future needs., Conclusions and Relevance: This study provides a perspective on the experience of adolescents and adults specific to the impact of a sensory-focused occupational therapy intervention on their daily lives. This will help occupational therapists when designing interventions for current and future clients. What This Article Adds: This study highlights the need for further research addressing effective sensory-based interventions for adolescents and adults. It also captures which components of intervention clients deemed helpful and identifies potential targets for future intervention., (Copyright © 2023 by the American Occupational Therapy Association, Inc.)

Importance: There is a paucity of research that explores the effectiveness of sensory integration interventions in the school setting., Objective: To test the effectiveness of a sensory integration intervention paired with teacher consultation, aligned with the principles of Ayres Sensory Integration® and the Sensory Therapies and Research Frame of Reference, to improve functional regulation and active participation in school for students with sensory integration and processing differences., Design: Concurrent, multiple-baseline, single-subject design., Setting: Public elementary school in the United States., Participants: Students (N = 3; ages 5-8 yr) whose sensory integration and processing differences were affecting their school occupational performance and were not remediated by integrated support., Intervention: For 15 wk, each student had one-to-one sensory integration intervention 2×/wk for 30 min and a consultation between the occupational therapist and teacher weekly for 10 min., Outcomes and Measures: The dependent variables, functional regulation and active participation, were measured weekly. The Short Child Occupational Profile and Behavior Assessment System for Children, Third Edition, were given before and after intervention. Goal Attainment Scaling and semistructured interviews with the teachers and participants were completed after intervention., Results: All 3 students showed meaningful improvement in functional regulation and active participation in the classroom during the intervention period as demonstrated by a 2-SD band method or celeration line analysis. All additional measures noted positive change., Conclusions and Relevance: Findings suggest that sensory integration intervention with consultation in the education setting can improve school performance and participation for children with sensory integration and processing challenges. What This Article Adds: This study offers an evidence-based model of service delivery for the school setting that is effective in improving the functional regulation and active participation of students whose sensory integration and processing challenges interfere with occupational engagement and are not mitigated by embedded supports., (Copyright © 2023 by the American Occupational Therapy Association, Inc.)

Background: A developing area for therapy is teaching children to ride a bicycle. Little has been written about the effectiveness of these programs. This study explored outcomes from participation in a novel bicycle riding program for children with a wide array of developmental challenges., Method: Two studies were conducted; a nonconcurrent, multiple baseline design with four participants and a pretest-posttest single group with 15 children., Results: Study 1 participants improved on broad jump. Balance positions showed variable responses. Study 2 participants showed significant improvement on broad jump, and a trend toward significance walking forwards and backwards. Parents reported improvement in following rules, participating in daily routines, interacting with peers, and feeling good about him/herself and a change in child's participation in community and extracurricular activities. All children improved in glide time or achieved independent riding., Conclusions: Preliminary evidence was found for the effectiveness of one approach for developing motor and social skills within the context of learning to ride a bicycle. Children over the age of 6 years were able to ride a two-wheeled bicycle at the end of the program. Participation suggested improvement in motor coordination and dynamic balance as well as changes in measures of social interaction and self-esteem.

Competing Interests: The authors declare the following Conflicts of Interest (Bottema-Beutel et al., 2021): SS was involved in the development of an intervention based on the principles of ASI. She is employed by a clinic that offers ASI as a direct service and which trains others to use the intervention. She does not receive royalties for the sale of materials or personal fees for paid workshops. RS received grant funding to support research on ASI. She trains individuals in ASI intervention and receives royalties for the sale of materials she created. She will seek funding from Thomas Jefferson University to support the publication of this manuscript. ZM receives monetary compensation from her teaching for both the Collaborative for Leadership in ASI and for Thomas Jefferson University both of which are entities, which provide training in ASI intervention. She also receives royalties for the sale of materials she created. AB attests that she receives monetary compensation from the sale of ASI materials she created. SL attests that she receives monetary compensation from the sale of ASI materials she created. She provides training on the Neuroscience Basis for ASI and receives honoraria. She will seek funding from an internal research fund at Colorado State University to pay for this article's publication fee. TM-B developed two interventions based on ASI, Safe Place- An ASI based trauma informed intervention and Sensory Bridges to Social Competency- an ASI based sensory motor social group intervention. The author owns and is employed by company TMB Education, LLC., that provides ASI. She also trains others to use the intervention and receives speaker fees for the delivery of this content. LP is a co-author of the Sensory Processing Measure (SPM and SPM-2) assessments published by Western Psychological Services. She receives monetary royalties for the sale of these products, and occasionally receives compensation for teaching workshops on how to use the SPM assessments. SR is affiliated with an OT clinic that provides ASI but is not employed by the entity. She receives compensation for training others to use the intervention as well as royalties from publications and speaker fees through CLASI.

Mentoring is essential at all stages of a professional career. However, little has been written about the effectiveness of programs for practicing clinicians. This study was designed to address the need for evidence about the effectiveness of formal mentorship programs by describing the impact of the STAR mentorship program on a group of clinicians specializing in sensory integration and processing challenges. This study utilized an exploratory, retrospective, survey research design. Course evaluations were examined from 240 subjects following participation in a one-week, small group mentorship training program. Qualitative methods were adapted for use in this study. Sixteen codes, with operational definitions, were developed to analyze the surveys. Ninety-six percent indicated that the program met or exceeded their expectations; only 12.5% had a negative comment. Impact on psychosocial function was reflected by 22% of the participants. Comments related to impact on career function were indicated by 45% of the participants. Ninety-four percent provided positive comments about the program structure , and 74% responded with positive comments regarding content of the program. Positive outcomes were associated with this one mentorship program, suggesting a need for more in-person, structured mentored learning experiences. Mentorship is recommended as a method to address the growing need within the profession to support career development, build knowledge, skill and attitudes, and aspirations/commitment as well as enhance professionalism/professional development., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Sarah A. Schoen et al.)

Importance: The Sensory Processing Three Dimensions (SP3D) Occupational Performance Scale (OPS) is a new parent-report measure developed for use as part of a comprehensive occupational therapy evaluation for children with sensory processing and integration challenges., Objective: To examine the internal consistency and discriminant validity of the SP3D OPS, examine relations between sensory processing subtypes and areas of occupational performance (OP), and determine the extent to which specific sensory processing challenges predict problems with OP., Design: Nonexperimental, descriptive design using correlations, group comparisons, and stepwise regression., Setting: Three outpatient clinic sites in the United States., Participants: Parents of 66 children (33 typically developing and 33 with clinical problems) ranging in age from 4 to 12 yr., Outcomes and Measures: The SP3D OPS and SP3D Inventory were completed by parents to address psychometrics of the SP3D OPS and determine the association between sensory processing and integration challenges with OP., Results: Internal consistency reliability and discriminant validity of the SP3D OPS were supported. Scores on the Dyspraxia and Sensory Overresponsivity subscales best predicted deficits in OP. Significant relations were found between sensory processing and integration and competency in multiple OP areas., Conclusions and Relevance: The SP3D OPS shows promise as a measure of OP. The OP deficits among children with sensory processing and integration challenges are in part due to subtype presentation. Further studies of the SP3D OPS's reliability and validity are needed., What This Article Adds: This new occupational performance measure shows associations between sensory processing and OP areas. It can provide information to support therapists in identifying family concerns relevant to goal setting and intervention., (Copyright © 2021 by the American Occupational Therapy Association, Inc.)

Purpose: One goal of occupational therapists working with children who have sensory processing challenges is the regulation of arousal. Regulation strategies have not been evaluated using an empirical measure of physiological arousal., Objective: To establish the feasibility of using an objective physiologic measure of sympathetic arousal in therapeutic settings and explore the relation between therapeutic activities and sympathetic arousal. To evaluate changes in electrodermal activity (EDA) during occupational therapy sessions., Methods: Twenty-two children identified with sensory modulation dysfunction (SMD) wore a wireless EDA sensor during 50 min occupational therapy sessions ( n = 77 sessions)., Results: All children were able to wear the sensor on the lower calf without being distracted by the device. The five insights below are based on a comparison of EDA recordings in relation to therapists' reflections describing how sympathetic arousal might correspond to therapeutic activities., Conclusion: Objective physiological assessment of a child's sympathetic arousal during therapy is possible using a wireless EDA measurement system. Changes in EDA may correspond directly with therapeutic activities. The article provides a foundation for designing future therapeutic studies that include continuous measures of EDA., (Copyright © 2020 Hedman, Schoen, Miller and Picard.)

Sensory integration is one of the most highly utilized interventions in autism, however, a lack of consensus exists regarding its evidence base. An increasing number of studies are investigating the effectiveness of this approach. This study used the Council for Exceptional Children (CEC) Standards for Evidence-based Practices in Special Education to evaluate the effectiveness research from 2006 to 2017 on Ayres Sensory Integration (ASI) intervention for children with autism. A systematic review was conducted in three stages. Stage 1 involved an extensive database search for relevant studies using search terms related to sensory integration and autism, interventions suggesting a sensory integration approach, and high-quality study designs. Searches yielded 19 studies that were evaluated in Stage 2. Six of these met inclusion criteria of being peer-reviewed, written in English, description of intervention this is consistent with ASI intervention, and comparison group design or single subject method employed. Prior to analysis using CEC standards, three articles were excluded because intervention details were not consistent with the core principles of ASI, or because of major methodological flaws. In Stage 3, the remaining three studies were rated using the CEC quality indicators and standards for an evidence-based practice. Two randomized controlled trials respectively met 100% and 85% of the CEC criteria items. One additional study met more than 50% of the criteria. Based on CEC criteria, ASI can be considered an evidence-based practice for children with autism ages 4-12 years old. Autism Research 2019, 12: 6-19. © 2018 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY: Ayres Sensory Integration intervention is one of the most frequently requested and highly utilized interventions in autism. This intervention has specific requirements for therapist qualifications and the process of therapy. This systematic review of studies providing Ayres Sensory Integration therapy to children with autism indicates that it is an evidence-based practice according to the criteria of the Council for Exceptional Children., (© 2018 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.)

Although the DSM-5 added sensory symptoms as a criterion for ASC, there is a group of children who display sensory symptoms but do not have ASC; children with sensory processing disorder (SPD). To be able to differentiate these two disorders, our aim was to evaluate whether children with ASC show more sensory symptomatology and/or different cognitive styles in empathy and systemizing compared to children with SPD and typically developing (TD) children. The study included 210 participants: 68 children with ASC, 79 with SPD and 63 TD children. The Sensory Processing Scale Inventory was used to measure sensory symptoms, the Autism Spectrum Quotient (AQ) to measure autistic traits, and the Empathy Quotient (EQ) and Systemizing Quotient (SQ) to measure cognitive styles. Across groups, a greater sensory symptomatology was associated with lower empathy. Further, both the ASC and SPD groups showed more sensory symptoms than TD children. Children with ASC and SPD only differed on sensory under-reactivity. The ASD group did, however, show lower empathy and higher systemizing scores than the SPD group. Together, this suggest that sensory symptoms alone may not be adequate to differentiate children with ASC and SPD but that cognitive style measures could be used for differential diagnosis., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Rationale: This study explored subtypes of sensory processing disorder (SPD) by examining the clinical presentations of cluster groups that emerged from scores of children with SPD on the Sensory Processing 3-Dimension (SP-3D) Inventory., Method: A nonexperimental design was used involving data extraction from the records of 252 children with SPD. Exploratory cluster analyses were conducted with scores from the SP-3D Inventory which measures sensory overresponsivity (SOR), sensory underresponsivity (SUR), sensory craving (SC), postural disorder, dyspraxia, and sensory discrimination. Scores related to adaptive behavior, social-emotional functioning, and attention among children with different sensory modulation patterns were then examined and compared., Results: Three distinct cluster groups emerged from the data: High SOR only, High SUR with SOR, and High SC with SOR. All groups showed low performance within multiple domains of adaptive behavior. Atypical behaviors associated with social-emotional functioning and attention varied among the groups., Implications: The SP-3D Inventory shows promise as a tool for assisting in identifying patterns of sensory dysfunction and for guiding intervention. Better characterization can guide intervention precision and facilitate homogenous samples for research.

This article builds on the work of Case-Smith and colleagues and proposes a roadmap to guide future research in occupational therapy. To foster best practice in the application of principles and practices of sensory integration (SI), the pillars of practice, advocacy, and education are identified as elements that provide the foundation for research. Each pillar ensures that SI research is conducted in a rigorous and relevant manner. To this end, achievements to date are discussed, with proposed goals presented for each pillar. Finally, the roadmap builds on the pillars and outlines implications for occupational therapy with the overarching theme that a wide array of scientists, educators, therapists, and service recipients will be needed to ensure that those who may benefit most have access to intervention that is evidence based, theory driven, and provided within the highest standards of service delivery., (Copyright © 2015 by the American Occupational Therapy Association, Inc.)

This article presents the current state of measurement in the area of sensory integration within the field of occupational therapy in three areas: (1) phenotypic characterization, (2) intervention adherence and dosage, and (3) outcome measurement. The need for additional measurement tools in all three areas is addressed. In regard to outcome measurement of occupational therapy using sensory integration, the use of both qualitative and quantitative methods to obtain outcome data is recommended. Further, a strategy is recommended for obtaining outcome data from direct report from the child or other stakeholder., (Copyright © 2014 by the American Occupational Therapy Association, Inc.)

OBJECTIVE. Sensory modulation issues have a significant impact on participation in daily life. Moreover, understanding phenotypic variation in sensory modulation dysfunction is crucial for research related to defining homogeneous groups and for clinical work in guiding treatment planning. We thus evaluated the new Sensory Processing Scale (SPS) Assessment. METHOD. Research included item development, behavioral scoring system development, test administration, and item analyses to evaluate reliability and validity across sensory domains. RESULTS. Items with adequate reliability (internal reliability >.4) and discriminant validity (p < .01) were retained. Feedback from the expert panel also contributed to decisions about retaining items in the scale. CONCLUSION. The SPS Assessment appears to be a reliable and valid measure of sensory modulation (scale reliability >.90; discrimination between group effect sizes >1.00). This scale has the potential to aid in differential diagnosis of sensory modulation issues., (Copyright © 2014 by the American Occupational Therapy Association, Inc.)

Migraine headaches are associated with sensory hyperreactivity and anxiety in the general population, but it is unknown whether this is also the case in autism spectrum disorders. This pilot study asked parents of 81 children (aged 7-17 years) with autism spectrum disorders to report their child's migraine occurrence, sensory hyperreactivity (Sensory Over-Responsivity Inventory), and anxiety symptoms (Spence Child Anxiety Scale). Children with autism spectrum disorders who experienced migraine headaches showed greater sensory hyperreactivity and anxiety symptomatology (p < 0.01; medium effect size for both) than those without migraines. Sensory hyperreactivity and anxiety symptomatology were additionally correlated (ρ = 0.31, p = 0.005). This study provides preliminary evidence for a link between migraine headaches, sensory hyperreactivity, and anxiety symptomatology in autism spectrum disorders, which may suggest strategies for subtyping and exploring a common pathogenesis., (© The Author(s) 2013.)

Anecdotal reports and empirical evidence suggest that sensory processing issues are a key feature of autism spectrum conditions. This study set out to investigate whether adults with autism spectrum conditions report more sensory over-responsivity than adults without autism spectrum conditions. Another goal of the study was to identify whether autistic traits in adults with and without autism spectrum conditions were associated with sensory over-responsivity. Adults with (n = 221) and without (n = 181) autism spectrum conditions participated in an online survey. The Autism Spectrum Quotient, the Raven Matrices and the Sensory Processing Scale were used to characterize the sample. Adults with autism spectrum conditions reported more sensory over-responsivity than control participants across various sensory domains (visual, auditory, tactile, olfactory, gustatory and proprioceptive). Sensory over-responsivity correlated positively with autistic traits (Autism Spectrum Quotient) at a significant level across groups and within groups. Adults with autism spectrum conditions experience sensory over-responsivity to daily sensory stimuli to a high degree. A positive relationship exists between sensory over-responsivity and autistic traits. Understanding sensory over-responsivity and ways of measuring it in adults with autism spectrum conditions has implications for research and clinical settings.

Sensory modulation disorder (SMD) is a severe inability to regulate responses to everyday sensory stimulation to which most people easily adapt. It is estimated to affect 5% to 16% of the general population of children. Although heterogeneity is seen in the presentation clinically, previous research has not empirically investigated whether the clinical heterogeneity of SMD can be classified into subtypes. This study explores a cohort of 98 children identified with SMD at the Department of Pediatric Rehabilitation by a member of the occupational therapy team at The Children's Hospital of Denver. Two subtypes of SMD were identified through cluster analysis based on data from 4 parent-report instruments. The first subtype is characterized by sensory seeking/craving, hyperactive, impulsive, externalizing (eg, delinquent, aggressive), unsocial, inadaptive, and impaired cognitive/social behavior. The second subtype is characterized by movement sensitivity, emotionally withdrawal, and low energy/weak behavior. Findings from this study present a step toward understanding and classifying the complexities of children with SMDs., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Children who are over-responsive to sensation have defensive and "fight or flight" reactions to ordinary levels of sensory stimulation in the environment. Based on clinical observations, sensory over-responsivity is hypothesized to reflect atypical neural integration of sensory input. To examine a possible underlying neural mechanism of the disorder, integration of simultaneous multisensory auditory and somatosensory stimulation was studied in twenty children with sensory over-responsivity (SOR) using event-related potentials (ERPs). Three types of sensory stimuli were presented and ERPs were recorded from thirty-two scalp electrodes while participants watched a silent cartoon: bilateral auditory clicks, right somatosensory median nerve electrical pulses, or both simultaneously. The paradigm was passive; no behavioral responses were required. To examine integration, responses to simultaneous multisensory auditory-somatosensory stimulation were compared to the sum of unisensory auditory plus unisensory somatosensory responses in four time-windows: (60-80 ms, 80-110 ms, 110-150 ms, and 180-220 ms). Specific midline and lateral electrode sites were examined over scalp regions where auditory-somatosensory integration was expected based on previous studies. Midline electrode sites (Fz, Cz, and Pz) showed significant integration during two time-windows: 60-80 ms and 180-220 ms. Significant integration was also found at contralateral electrode site (C3) for the time-window between 180 and 220 ms. At ipsilateral electrode sites (C4 and CP6), no significant integration was found during any of the time-windows (i.e. the multisensory ERP was not significantly different from the summed unisensory ERP). These results demonstrate that MSI can be reliably measured in children with SOR and provide evidence that multisensory auditory-somatosensory input is integrated during both early and later stages of sensory information processing, mainly over fronto-central scalp regions., (2010 Elsevier B.V. All rights reserved.)

The overall goal of this study was to determine if parasympathetic nervous system (PsNS) activity is a significant biomarker of sensory processing difficulties in children. Several studies have demonstrated that PsNS activity is an important regulator of reactivity in children, and thus, it is of interest to study whether PsNS activity is related to sensory reactivity in children who have a type of condition associated with sensory processing disorders termed sensory modulation dysfunction (SMD). If so, this will have important implications for understanding the mechanisms underlying sensory processing problems of children and for developing intervention strategies to address them. The primary aims of this project were: (1) to evaluate PsNS activity in children with SMD compared to typically developing (TYP) children, and (2) to determine if PsNS activity is a significant predictor of sensory behaviors and adaptive functions among children with SMD. We examine PsNS activity during the Sensory Challenge Protocol; which includes baseline, the administration of eight sequential stimuli in five sensory domains, recovery, and also evaluate response to a prolonged auditory stimulus. As a secondary aim we examined whether subgroups of children with specific physiological and behavioral sensory reactivity profiles can be identified. Results indicate that as a total group the children with severe SMD demonstrated a trend for low baseline PsNS activity, compared to TYP children, suggesting this may be a biomarker for SMD. In addition, children with SMD as a total group demonstrated significantly poorer adaptive behavior in the communication and daily living subdomains and in the overall Adaptive Behavior Composite of the Vineland than TYP children. Using latent class analysis, the subjects were grouped by severity and the severe SMD group had significantly lower PsNS activity at baseline, tones and prolonged auditory. These results provide preliminary evidence that children who demonstrate severe SMD may have physiological activity that is different from children without SMD, and that these physiological and behavioral manifestations of SMD may affect a child's ability to engage in everyday social, communication, and daily living skills.

A high incidence of sensory processing difficulties exists in children with Autism Spectrum Disorder (ASD) and children with Sensory Modulation Disorder (SMD). This is the first study to directly compare and contrast these clinical disorders. Sympathetic nervous system markers of arousal and reactivity were utilized in a laboratory paradigm that administered a series of sensory challenges across five sensory domains. The Short Sensory Profile, a standardized parent-report measure, provided a measure of sensory-related behaviors. Physiological arousal and sensory reactivity were lower in children with ASD whereas reactivity after each sensory stimulus was higher in SMD, particularly to the first stimulus in each sensory domain. Both clinical groups had significantly more sensory-related behaviors than typically developing children, with contrasting profiles. The ASD group had more taste/smell sensitivity and sensory under-responsivity while the SMD group had more atypical sensory seeking behavior. This study provides preliminary evidence distinguishing sympathetic nervous system functions and sensory-related behaviors in Autism Spectrum Disorder and Sensory Modulation Disorder. Differentiating the physiology and sensory symptoms in clinical groups is essential to the provision of appropriate interventions.

THIS ARTICLE EXPLORES THE CONVERGENCE OF TWO FIELDS, WHICH HAVE SIMILAR THEORETICAL ORIGINS: a clinical field originally known as sensory integration and a branch of neuroscience that conducts research in an area also called sensory integration. Clinically, the term was used to identify a pattern of dysfunction in children and adults, as well as a related theory, assessment, and treatment method for children who have atypical responses to ordinary sensory stimulation. Currently the term for the disorder is sensory processing disorder (SPD). In neuroscience, the term sensory integration refers to converging information in the brain from one or more sensory domains. A recent subspecialty in neuroscience labeled multisensory integration (MSI) refers to the neural process that occurs when sensory input from two or more different sensory modalities converge. Understanding the specific meanings of the term sensory integration intended by the clinical and neuroscience fields and the term MSI in neuroscience is critical. A translational research approach would improve exploration of crucial research questions in both the basic science and clinical science. Refinement of the conceptual model of the disorder and the related treatment approach would help prioritize which specific hypotheses should be studied in both the clinical and neuroscience fields. The issue is how we can facilitate a translational approach between researchers in the two fields. Multidisciplinary, collaborative studies would increase knowledge of brain function and could make a significant contribution to alleviating the impairments of individuals with SPD and their families.

This article describes 3 stages of construction of the Sensory Over-Responsivity (SensOR) Scales: instrument development, reliability and validity analyses, and cross-validation on a new sample. The SensOR Scales include the SensOR Assessment, an examiner-administered performance evaluation, and the SensOR Inventory, a caregiver self-rating scale. Both scales measure sensory overresponsivity in 7 sensory domains. Data were collected from 2 samples consisting of participants who were typically developing (ns = 60 and 44, respectively) and participants with sensory overresponsivity (ns = 65 and 48, respectively), ages 3 to 55. In developing the research edition, items on the pilot version were reviewed for their internal consistency reliability, discriminant validity, and construct validity. Data from both samples on the research edition revealed high internal consistency reliability for domains and the total test and significant discrimination between the overresponsive and the typically responsive groups (p < .05). The preliminary psychometric integrity of the scales, along with continued research efforts, is an important contribution to evidence-based practice.

Goal attainment scaling (GAS) is a methodology that shows promise for application to intervention effectiveness research and program evaluation in occupational therapy (Dreiling & Bundy, 2003; King et al., 1999; Lannin, 2003; Mitchell & Cusick, 1998). This article identifies the recent and current applications of GAS to occupational therapy for children with sensory integration dysfunction, as well as the process, usefulness, and problems of application of the GAS methodology to this population. The advantages and disadvantages of using GAS in single-site and multisite research with this population is explored, as well as the potential solutions and future programs that will strengthen the use of GAS as a measure of treatment effectiveness, both in current clinical practice and in much-needed larger, multisite research studies.

Objective: The purpose of this pilot study was to prepare for a randomized controlled study of the effectiveness of occupational therapy using a sensory integration approach (OT-SI) with children who have sensory processing disorders (SPD)., Method: A one-group pretest, posttest design with 30 children was completed with a subset of children with SPD, those with sensory modulation disorder., Results: Lessons learned relate to (a) identifying a homogeneous sample with quantifiable inclusion criteria, (b) developing an intervention manual for study replication and a fidelity to treatment measure, (c) determining which outcomes are sensitive to change and relate to parents' priorities, and (d) clarifying rigorous methodologies (e.g., blinded examiners, randomization, power)., Conclusion: A comprehensive program of research is needed, including multiple pilot studies to develop enough knowledge that high-quality effectiveness research in occupational therapy can be completed. Previous effectiveness studies in OT-SI have been single projects not based on a unified long-term program of research.

Objective: We sought to assess validity of sensory integration outcomes research in relation to fidelity (faithfulness of intervention to underlying therapeutic principles)., Method: We identified core sensory integration intervention elements through expert review and nominal group process. Elements were classified into structural (e.g., equipment used, therapist training) and therapeutic process categories. We analyzed 34 sensory integration intervention studies for consistency of intervention descriptions with these elements., Results: Most studies described structural elements related to therapeutic equipment and interveners' profession. Of the 10 process elements, only 1 (presentation of sensory opportunities) was addressed in all studies. Most studies described fewer than half of the process elements. Intervention descriptions in 35% of the studies were inconsistent with one process element, therapist-child collaboration., Conclusion: Validity of sensory integration outcomes studies is threatened by weak fidelity in regard to therapeutic process. Inferences regarding sensory integration effectiveness cannot be drawn with confidence until fidelity is adequately addressed in outcomes research.

Objective: A pilot randomized controlled trial (RCT) of the effectiveness of occupational therapy using a sensory integration approach (OT-SI) was conducted with children who had sensory modulation disorders (SMDs). This study evaluated the effectiveness of three treatment groups. In addition, sample size estimates for a large scale, multisite RCT were calculated., Method: Twenty-four children with SMD were randomly assigned to one of three treatment conditions; OT-SI, Activity Protocol, and No Treatment. Pretest and posttest measures of behavior, sensory and adaptive functioning, and physiology were administered., Results: The OT-SI group, compared to the other two groups, made significant gains on goal attainment scaling and on the Attention subtest and the Cognitive/Social composite of the Leiter International Performance Scale-Revised. Compared to the control groups, OT-SI improvement trends on the Short Sensory Profile, Child Behavior Checklist, and electrodermal reactivity were in the hypothesized direction., Conclusion: Findings suggest that OT-SI may be effective in ameliorating difficulties of children with SMD.

The contributions of 12 food groups to the estimated dietary intakes of 11 nutritional elements in the diets of eight age-sex groups was determined from analyses of 234 core foods in the U.S. food supply and consumption data from national food consumption surveys. The major contributors of each element were grain products for sodium, iron, manganese, and iodine; vegetables for potassium; milk and cheese for calcium; milk and cheese and animal flesh for phosphorus; vegetables and grain products for magnesium; and animal flesh for zinc, copper, and selenium. For the infant diet, the milk and cheese group (which includes infant formula) was the major contributor to the estimated intakes of sodium, potassium, calcium, phosphorus, magnesium, zinc, copper, and iodine. Grain products were the primary sources for iron, manganese, and selenium in the infant diet. The diet of 2-year-olds, which includes a considerable amount of milk, contains larger percentages of sodium, potassium, calcium, phosphorus, magnesium, zinc, and iodine from milk and cheese than do the diets of older age-sex groups. For teenagers, milk and cheese make a greater contribution to potassium, calcium, phosphorus, magnesium, zinc, manganese, and iodine intakes than they do for the adult age-sex groups.

Dietary intakes of 11 nutritional elements for eight age-sex groups were estimated for the time period 1982 to 1991 on the basis of results from laboratory analyses of 234 core foods of the U.S. food supply and food consumption data from two national food consumption surveys conducted in the late 1970s. Estimated intakes based on the mean and median (50th percentile) levels of the elements in the foods were similar, except for iodine for which intake estimates based on mean values exceeded those based on median values. The high concentration of iodine in some foods resulted in higher mean (than median) values. Estimated intakes of sodium, potassium, phosphorus, selenium, and iodine met or nearly met dietary intake standards set by the National Academy of Sciences (NAS). Estimated intakes of copper were below NAS standards for all eight age-sex groups. Estimated intakes were below NAS standards for magnesium for six age-sex groups, calcium and zinc for five age-sex groups, iron for three age-sex groups, and manganese for one age-sex group. The diets of teenage girls had seven elements below NAS standards, the diets of adult women had five elements below NAS standards, and the diets of 2-year-olds and older men and women had four elements each below NAS standards. The estimated intake of sodium for 6-11-month-old infants showed a decreasing trend from 729 mg/day in 1982/83 to 632 mg/day in 1990/91. There were no other significant trends or changes in estimated element intakes over the 9-year period.

Daily intakes of aluminium were estimated for 14 age-sex groups based on the Food and Drug Administration's (FDA) Total Diet Study dietary exposure model. The aluminium content of the core foods of the FDA Total Diet Study were determined by analyses, recipe calculation, or literature values and coupled with information on food consumption from the 1987-88 US Department of Agriculture Nationwide Food Consumption Survey. Estimates of aluminium intakes ranged from 0.7 mg/day for 6-11-month-old infants to 11.5 mg/day for 14-16-year-old males. Average intakes for adult men and women were 8-9 and 7 mg/day, respectively. The major contributors to daily intake of aluminium were foods with aluminium-containing food additives, e.g. grain products and processed cheese.

The tumescent technique of local anesthetic administration was originally spawned by the desire to facilitate full-body, large volume liposuction in a safe and efficient outpatient manner. The numerous advantages of this technique are readily applied to cervicofacial rhytidectomy. The method described creates an essentially bloodless field via hydrodissection with overall decreased surgical morbidity secondary to the decreased necessity of sharp surgical dissection.