Evidence for Occupational Therapy using ASI (R)

asi autistic children ayres sensory integration occupational therapy ot Jun 06, 2024
SenseUp Blog

Evidence-Based Support for Ayres Sensory Integration® in Occupational Therapy for Autistic Children

Occupational Therapy using Ayres Sensory Integration® (ASI) has been confirmed as an evidence-based intervention for autistic children aged 5-9. This endorsement comes from three major evidence-based practice organisations, establishing ASI as a credible and effective approach for supporting autistic children.

Robust Research Backing

To date, there are eight published randomised controlled trials (RCTs) evaluating ASI, six of which specifically focus on its use in occupational therapy. These studies consistently demonstrate significant improvements in children’s individualised goals, using goal attainment scales to measure progress. Notably, the studies by Schaaf and Omari, known for their rigorous methodology, revealed significant advancements in daily living skills and socialisation, assessed via the Pediatric Evaluations of Disability Inventory.

Key Findings

  1. Significant Improvements:

    • Studies consistently show that children receiving ASI outperform those in control groups on individualised goals.

    • Improvements in daily living skills and socialisation have been statistically significant in high-rigor studies.

  2. Satisfaction and Positive Impact:

    • Despite a cost-effectiveness trial not favouring ASI over usual care, significant improvements in individualised goals were noted.

    • Parents, children, and teachers reported high satisfaction, observing positive changes in children’s daily lives.

  3. Global Evidence:

    • Two additional RCTs from Japan and Turkey support the effectiveness of ASI, demonstrating significant improvements in targeted developmental areas.

  4. Emerging Evidence:

    • Early research indicates ASI may also benefit non-autistic children, with studies showing improvements in motor skills, functional regulation, and active participation in school settings.

Best Practices for Evaluating Evidence

It is essential to focus on RCTs that adhere to the ASI Fidelity Measure to evaluate the evidence accurately. Systematic reviews often include studies that do not meet these fidelity criteria, leading to inconsistent conclusions. However, two systematic reviews by Schoen et al. (2018) and Schaaf et al. (2018) provide reliable evidence by including only studies that adhere to ASI principles.

Recognised Evidence-Based Practice

ASI has received evidence-based ratings from several reputable organisations:

  • The National Clearinghouse on Autism Evidence and Practice

  • The Council for Exceptional Children’s Standards for Evidence-Based Practices in Special Education

  • The U.S. Preventative Services Task Force Guidelines for Evidence Reviews

These endorsements highlight ASI as a validated and effective intervention, reinforcing its value in supporting autistic children through occupational therapy.


Occupational Therapy using Ayres Sensory Integration® is a well-supported, evidence-based intervention for autistic children. With numerous studies demonstrating its efficacy in improving individualised goals, daily living skills, and socialisation, ASI stands as a robust approach in the field of occupational therapy. The high satisfaction rates among parents, children, and educators further underscore its positive impact, making it a preferred choice for practitioners aiming to enhance the lives of autistic children.


Prepared by Roseann Schaaf and Kelly Auld-Wright for The Collaborative for Leadership in Ayres Sensory Integration(R) (CLASI).  This research brief was prepared on 28th February 2024 with the purpose of summarising current evidence.  

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