A History of Sensory Integration an Sensory Processing Disorder
Jean Ayres begins working on her theory of SI.
Jean Ayres publishes Sensory Integration and Learning Disorders. In this book she outlines her SI theory and discusses how children can be assessed for SI dysfunction. The book also includes recommendations on how to treat and support children who have sensory challenges.
Sensory Integration and the Child is published. Jean Ayres wrote this book for parents in order to break her SI theory into a more easily read format. Publishers released an updated 25th anniversary edition of this book in 2004. The newer edition includes comments from occupational therapists currently researching SI.
Some authors, especially in education, discredit the effectiveness of SI for children. All readers must, however, note that a huge flaw with many of studies at this time is that they do not quantify what classes as ‘sensory integration.’ Many studies call sensory strategies such as weighted blankets and ball chairs ‘SI treatment,’ even though they are not. This is like calling an Ace of Spades the King of Diamonds, although the two may be cards, they are not the same.
Winnie Dunn publishes the ‘Sensory Profile.’ This is the first standardised assessment to look at sensory modulation difficulties. You can read more about sensory modulation on our ‘What is SPD?‘ page. Dunn published an updated version of the tool in 2014 (SP2).
Above all there is a huge push for all research on SI theory and treatment to be of high quality. In order to do this, researchers must describe exactly what their treatment process involved.
Lucy Miller and colleagues formally publish the term Sensory Processing Disorder (SPD) in their books. Parnham and colleagues also publish a fidelity measure, this clearly describes the components of SI treatment. They, therefore, recommend this is used in all research on SI effectiveness.
The term Sensory Processing Disorder is used more widely in media and publications, especially books on the topic for parents and teachers. However, many books written for therapists typically continue to use the term SI. Schaff and Davies (2010) discuss the evolution of SI in an editorial for the American Journal of Occupational Therapists. Overall, they conclude there is no consensus on term use and advocate continued research.
Authors continue to use the terms SI and SPD interchangeably. A huge amount of research is currently being done to support the use of SI treatment, including using SI for children with autism. This also includes randomised control trials, the most rigorous type of evidence. For more information on publications, you can follow the links at the end of this timeline.
Therapists continue to train in Ayres® SI through organisations including the SI Education and CLASI. In addition, Lucy Miller offers training in her A SECRET model, this now includes university certification.
There is more research being published and conducted on SI. Some of the research (e.g. Schaaf, 2018) indicates that it is an effective treatment for children, including those with autism. Other reviews (e.g. Novak, 2019) come to the opposite conclusion. Unfortunately, a lot of research uses the term sensory integration therapy, however, they do not stick to the fidelity treatment measure. This means it is not always clear if Ayres® SI has been used (e.g. Karim, 2015). In some cases, the treatment has been described as SI, when it clearly is not. For example, this study which uses Brain Gym as their ‘sensory integration approach.’ It is important when you are reading research and information that you check what model the authors are using.
There is a large research study (Randell, 2019) underway at the University of Cardiff comparing sensory integration therapy with usual care for children with autism. The results of this study should be available in 2021. This study has the potential to provide more clarity on the effectiveness of Ayres® SI.
An updated version of Sensory Integration Theory and Practice was published in 2019. This outlines the latest research and models of sensory integration.
2020 and beyond
The Ayres 2020 vision team are working on a new assessment tool, the EASI, to help therapists assess for sensory integration dysfunction. They aim to publish this in 2022. Currently the assessment tool is being standardised. This means that it is being tested with typically developing children to identify age cut offs and scores.
The results from the Cardiff study will be published. In addition, the impact of SI is being researched by many individuals and teams. This research will be used to inform and shape the future of sensory integration theory and practice.
There is also a lot of ongoing research studying the impact of sensory processing in autism. It’s an exciting time to be working in the field.