A significant number of children supported at Sensational Kids present with developmental delays and sensory processing differences. Among the varied caseload that we support at Sensational Kids, many of our clients are neurodivergent.

At Sensational Kids we ensure best practice by following research and using evidence based practice models.

“There is ample evidence that Occupational Therapy using Ayres Sensory Integration results in measurable improvements in individualized goals for autistic children in randomized control trials. It is rated as an evidence-based intervention for autistic children ages 5-9 years of age by well-respected, evidence-based practice organizations (these are listed below). In addition, preliminary evidence of effectiveness in non-autistic children is emerging. There is one single-subject research design in a school-based study that focused on non-autistic children with sensory integrative challenges; and another multiple-baseline study design in a clinic setting. Both show promising results. As with most interventions, additional studies are needed to expand the evidence to wider age ranges, clinical settings, and diverse groups.”

Evidence for Occupational Therapy using Ayres Sensory Integration® Integration® Prepared by Roseann Schaaf, PhD, OTR/L, FAOTA & Kelly Auld-Wright, OTD, OTR/L, The Collaborative for Leadership in Ayres Sensory Integration® February 28, 2024 – see document attached.

Our commitment to best practice and evidence based practice, is supported by our use of Ayres Sensory Integration (ASI®) as the foundation framework within which therapists at Sensational Kids practice. We believe that a child needs to be well regulated and needs to be processing sensory information effectively in order to feel safe, engage successfully and develop the skills they need to participate in the occupations of childhood. To this end, our Clinical Manager and Clinical Team Lead are both qualified ASI practitioners and provide training, supervision and support to the rest of the clinical team. During the induction period, clinicians are provided with in-service training in the core principles of ASI and the ASI Fidelity Measure.

The Ayres Sensory Integration Fidelity Measure provides a valid measure of ASI intervention for use in effectiveness studies. Adherence to the Fidelity Measure’s structural and process elements will increase the likelihood that interventions called SI are faithful to ASI principles not only in research but also in education and practice.

According to the ASI fidelity measure, the physical environment in which therapy takes place needs to adhere to the following principles:

• Adequate space for flow of vigorous physical activity
• Flexible arrangement of equipment and materials for rapid change of the intervention environment.
• No less than 3 hooks for hanging suspended equipment, minimal distance between hooks 2.5 to 3 ft
• One or more rotational devices attached to ceiling support to allow 360 of rotation
• Quiet space (e.g., tent, adjacent room, or partially enclosed area)
• One or more sets of bungee cords for suspended equipment
• Mats, cushions, pillows (available to be used to pad floor underneath all suspended equipment during intervention)
• Equipment adjustable to child’s size
• Therapist monitors accessible equipment for safe use
• Unused equipment stored or placed so children cannot fall or trip 4.74
• Documentation of routine monitoring of equipment safety (e.g., ropes and bungee cords not frayed)
• Variety of equipment available (e.g., bouncing equipment such as trampoline; rubber strips or ropes for pulling; therapy balls; swings [platform swing, square platform, glider swing, frog swing, flexion disc, bolster swing, tire swing, net swing]; scooter and ramp; weighted objects such as balls or bean bags in a variety of sizes; inner tubes; spandex fabric; crash pillow; ball pit; vibrating toys, massagers, tactile material; visual targets; ramps; climbing equipment; barrel for rolling; props to support engagement in play, e.g., dress-up clothes, stuffed animals, and dolls; materials for practicing daily living skills, e.g., school supplies, clothing, and shoes with laces)

The therapy environment also needs to allow the clinician to provide support that meets the following criteria:

1. Ensures physical safety.
2. Presents sensory opportunities. The therapist must present the child with 2 of 3 types of sensory opportunities—tactile, vestibular, and proprioceptive—to support the development of self-regulation, sensory awareness, or movement in space.
3. Helps the child to attain and maintain appropriate levels of alertness. The therapist helps the child to attain and maintain appropriate levels of alertness and an affective state that supports engagement in activities.
4. Challenges postural, ocular, oral, or bilateral motor control, through postural challenges, resistive whole-body challenges, ocular–motor challenges, bilateral challenges, oral challenges, projected action sequences.
5. Challenges praxis and organization of behaviour providing opportunities for the child to conceptualize and plan novel motor tasks and to organize his or her own behaviour in time and space.
6. Collaborates in activity choice. The therapist must negotiate activity choices with the child, allowing the child to choose equipment, materials, or specific aspects of an activity.
7. Supports child’s intrinsic motivation to play. The therapist creates a setting that supports play as a way to fully engage the child in the intervention

Adherence to the Ayres Sensory Integration Fidelity Measure principles ensures that we strive to provide ASI intervention to the best of our abilities.

Our sensory motor gyms allow us to adhere to these principles and thus provide therapeutic support in line with international best practice guidelines.

Recommended Citation Parham, L Diane; Roley, Susanne Smith; May-Benson, Teresa A.; Koomar, Jane; Brett-Green, Barbara; Burke, Janice P; Cohn, Ellen S.; Mailloux, Zoe; Miller, Lucy J.; and Schaaf, Roseann C., “Development of a fidelity measure for research on the effectiveness of the Ayres Sensory Integration intervention.” (2011). Department of Occupational Therapy Faculty Papers. Paper 24. https://jdc.jefferson.edu/otfp/24

Over and above the value of ASI for autistic children, sensory motor gyms play a crucial role in general paediatric therapy as they provide a safe, controlled and engaging environment where children can develop and enhance essential motor skills and sensory processing abilities through play. We carefully and purposefully selected the equipment in our gyms to create an environment that enhances natural exploration and targets natural areas of gross motor, fine motor, and sensory development through movement. We use neutral colours on our walls to prevent sensory overload that may be caused by bright, bold wall decor. Our gyms are designed to offer multiple sensory opportunities, including touch, sight, balance, vestibular and proprioceptive input, through various activities and equipment such as specialized swings, balance beams, tunnels, climbing walls, ramps, balls and textured surfaces.

Our gyms offer the opportunity for children of all abilities to develop skills in the following areas:

Processing of sensory information, sensory regulation, gross motor skills, bilateral motor coordination, postural control, strength and endurance, balance and coordination, motor planning, fine motor skills, task organisation, perceptual motor skills, social skills, executive function skills, cognitive skills, visual perceptual skills, self confidence and self esteem (this list is not exhaustive).

Supporting these underlying / component skills allows children to understand their bodies, identify their strengths, building their sense of self and developing their maximum potential, allowing them to engage successfully in the occupations of childhood in their own unique ways. These skills will enable the development of more complex skills such as those required for playing, engaging with family members and peers, dressing, feeding, toileting, riding a bicycle, tying shoelaces, learning to draw, read and write etc…

In summary, our sensory motor gyms offer a multifaceted approach to therapy, addressing physical, sensory, social, and cognitive development in a holistic manner. They create a motivating, safe and playful environment for children to enhance cognitive and motor skills, regulate sensory input, and develop in a supportive, fun, and interactive environment.