In our previous blog, we explored how sensory processing, particularly the vestibular, proprioceptive, and tactile systems, forms the critical foundation upon which oral motor skills are built. We looked at how these foundational sensory systems influence everything from postural control during feeding to force regulation during chewing, and why addressing sensory processing is essential before expecting complex oral motor skills to emerge.

A newly published paper takes this sensory-first thinking further, offering a rich framework that has direct relevance to how we, as occupational therapists, work with autistic children. Published in February 2026 in the journal Research in Neurodiversity, the paper “Sensory-processing informed autism practice for child-centred therapists” by Stuart Daniel, Kelly Mahler, and colleagues presents five areas of sensory-processing informed clinical technique designed to help child-centred therapists better support autistic children. The author team comprised OTs, SLPs, psychologists, play therapists, and developmental researchers, more than half of whom are autistic themselves and bring a powerful blend of lived experience and clinical expertise.

In this blog, we’ll review the key ideas from the paper and explore what they mean for your day-to-day OT practice, particularly when working with autistic children around sensory processing, regulation and communication.

Why This Matters: Sensory Processing and Dysregulation in Autism

As we discussed in our previous blog, the SenseUp Model places the nervous system safety and then sensory systems at the base of the developmental pyramid. Daniel et al. (2026) reinforce this foundational view, noting that over 90% of autistic children experience sensory processing differences across all eight senses.

What the paper highlights especially well is the concept of baseline chronic dysregulation. The authors explain that dysregulation isn’t simply something that happens to autistic children when they encounter a sensory stressor, it is often their baseline state, present at rest and in the presence of everyday demands. This chronic dysregulation comes at the cost of wellness, social ease, and the capacity for connection and learning.

This has significant implications for our practice. In our clinical practice, its important to know if a child’s nervous system is already in a state of hypervigilance or shut-down before they even arrive at a therapy session (or a mealtime, or a classroom), the sensory foundations we’re trying to build upon are already compromised. The paper underscores that sensory processing patterns in autistic children correlate moderately to strongly with difficulties at school and at home, with dysregulation level as the significant mediating factor.

The Role of Interoception

One of the most valuable contributions of this paper is its emphasis on interoception; the sense that monitors the internal condition of the body. Daniel et al. remind us that interoception is equally foundational, particularly for autistic children. When an autistic child has difficulty perceiving internal signals (such as hunger, thirst, the need to use the toilet, pain, or the early signs of overwhelm ) they struggle to monitor and act on their own basic needs.

The paper invites us to consider interoception as a crucial piece of the sensory puzzle.

Understanding Interactive Mismatch

Before the paper moves into its practical clinical techniques, it asks us to sit with an important idea: the Double Empathy Problem. This concept, grounded in research, holds that communication difficulties between autistic and non-autistic people are bidirectional ie. they go both ways. It’s not that the autistic child has a deficit in communication; rather, there is a mismatch between neurotypes that affects both parties. Autistic people may not understand non-autistics and non-autistics may not understand autistics either!

The paper identifies three implicit biases that most non-autistic therapists (including us as OTs) tend to bring to our interactions with autistic children. First, we tend to assume a neurotypical range of sensory experience when considering what is and isn’t a stable environment. Second, we assume that the children we work with understand the basic ways we communicate through voice and body language. Third, we assume a neurotypical level of coherence in internal experience as the child’s bodily sensations, regulatory states, and emotions are integrated in the way we might expect.

The Five Areas of Sensory-Informed Clinical Technique

The heart of the paper presents five areas of clinical technique. These were written specifically for child-centred therapists and are deeply relevant to all paediatric OT practice. Let’s explore each one and consider what it means for us.

1. Sensory Stability

This first area connects directly to what we know from the SenseUp Model about foundational sensory input. The paper argues that before any therapeutic work can happen, the sensory environment must be tailored to minimise potential stressors for each autistic child.

Daniel et al. provide a detailed table of environmental adaptations across sensory systems, including keeping ambient sound levels low, simplifying the visual environment, using warm low-level lighting, avoiding scented products, and having weighted items and varied seating options available. They note that bright lights, flickering LEDs, strip lighting, high-contrast visual patterns, background electronic hums, and strong smells can all threaten sensory stability for autistic children.

What this means for OT practice: Think about your therapy room, your clinic, or the classroom you consult in. Consider the sensory load before you even begin working with a child. Is the lighting fluorescent? Are there background hums from electronics? Is the space visually cluttered? The paper encourages us to start with a very-low-risk sensory baseline and then adapt as we get to know each child’s individual profile.

2. Tailored Interaction

The second area addresses how we use our bodies and voices to interact with autistic children. The paper suggests starting sessions minimal and slow, simply being in the space together without agenda or expectation. The authors note that even well-meaning intentions may be perceived as imposing on a child whose nervous system is already dysregulated.

The paper draws on research around vitality, which includes the energy, style, and feel of our movements and voice. Autistic children often have difficulty reading neurotypical vitality forms, meaning the subtle ways we communicate intention through how we move and speak may be unclear or confusing. Daniel et al. suggest several strategies: isolating body language (pausing, then communicating, then pausing again), exaggerating or theatrically diminishing movements for clarity, adding non-verbal sound effects, and using a melodic “story-teller” voice with short utterances, regularity, and rhythmic intonation.

Interestingly, the paper references neuroimaging research showing that the speech-processing systems of many autistic children are more effectively engaged by song than by speech. The quality of rhythmicity in our communication helps autistic children predict what is coming next in interactions.

What this means for OT practice: Whether you’re working on feeding, self-care skills, handwriting, or play, the way you present yourself using your voice, your body, your pace matters profoundly. Slowing down, simplifying your communication, and being conscious of the “vitality” of your movements can make the difference between a child who shuts down and one who begins to engage.

3. Tailored Empathy

This is perhaps the most thought-provoking section of the paper. The authors argue that the standard practice of labelling emotions for autistic children, “You look sad,” “Are you frustrated?” can be not only inaccurate but actively harmful. For many autistic children, their internal experiences don’t align with neurotypical frameworks of emotion. Non-autistic adults are known to have considerable difficulty reading the expressions and intentions of autistic children, and inaccurate emotion labelling over time can lead to self-doubt, disconnection, and masking.

The paper gives a striking example: a therapist might interpret a stomach ache as anxiety (“butterflies”), when the child might actually be feeling excitement, or might have a genuine gastrointestinal symptom. Over time, the child learns to attribute physical symptoms to anxiety, potentially masking real health concerns.

Instead of emotion labelling, the paper recommends behavioural empathy where you reflect what you observe rather than interpret what you think the child feels. For example, “You’re walking with slow, heavy feet… shoulders and head hanging down” instead of “You look sad.” The authors also suggest reflecting broad valence states like a sense of “too much”-ness, “not enough”-ness, “stuck”-ness, or “just-not-right”-ness, which are considered more universal and accessible than specific emotion labels.

What this means for OT practice: This has real implications for how we interact during therapy sessions. When a child pushes food away, gags, or refuses to engage, our instinct might be to label: “I can see you’re worried about trying that.” The paper invites us instead to describe what we see: “Your hands pushed the plate away, your body moved back in the chair.” This keeps us accurate, respects the child’s experience, and avoids the risk of layering our own neurotypical interpretations onto their behaviour.

4. Playful Mindfulness

The fourth area introduces playful mindfulness, an approach adapted from Kelly Mahler’s Interoception Curriculum. The goal is to help autistic children move safely from hypervigilant external orientation towards embodiment and a gentle interoceptive focus on “how I feel in my body.”

The approach works within child-led play, using gentle, curious questions to draw a child’s attention to sensations in their body. The template starts with external body parts (hands, feet, mouth) and gradually moves towards internal experiences (heart, lungs, stomach) as the child becomes more comfortable. The emphasis is on curiosity rather than correct answers. “I wonder how your hands feel in the sand?” rather than “Tell me what you’re feeling.”

Over time, the approach supports children in connecting sensations with valence states (comfortable vs uncomfortable, nice vs not-nice) and then, gradually, with regulatory states recognising that certain body feelings mean they need to eat, rest, use the toilet, or move to a safe space.

What this means for OT practice: This is a natural fit for OT. We already use play-based, sensory-rich environments. The playful mindfulness approach gives us a structured yet flexible way to build interoceptive awareness within activities we’re already doing during sensory play, messy play, movement activities, and occupation based exploration. The key shift is towards facilitating the child’s own noticing, rather than interpreting for them. This could mean gently drawing attention to how the hand feels when touching a new texture, rather than asking “Do you like it?”

5. Tailored Vocabularies of Feelings

The final area builds on everything that comes before. Rather than insisting on standard emotion labels, the paper suggests helping each autistic child develop their own personally meaningful vocabulary for their internal experiences. A child might call the overwhelming sensation caused by loud noises “big red zaps” rather than “anxiety.” The important thing isn’t the label but that the child can recognise the experience and connect it to a helpful regulatory action (such as putting on noise-reduction headphones and going to a safe space).

The paper envisions vocabularies made up of sounds, movements, gestures, drawn images, colours, objects, or words and individualising whatever is most meaningful for each child. These personalised signifiers can then be shared with the significant adults in the child’s life, creating a bridge for communication and support.

What this means for OT practice: This connects beautifully to our work on self-regulation strategies and sensory diets. Rather than teaching a child to say “I’m overwhelmed” (which may not match their experience), we can support them in developing their own way of signalling what’s happening inside and what they need. This could be a picture card, a hand signal, a particular object, or a unique word.

Hearing from Autistic Voices: The Sense Portraits

One of the most powerful elements of the paper is the inclusion of three sense portraits which are first-person descriptions of sensory processing from three of the autistic authors. These accounts bring the research to life in deeply personal ways and are well worth reading in full.

“I need YOU to know sensory challenges are more than a difference or dislike. They are more than a nuisance and something I can get used to. They are often disorienting and often make daily life a real struggle.”

— Kim Clairy, Sense Portrait

“It’s hard to trust others when I cannot even trust my own body.”

— Kim Clairy, Sense Portrait

The sense portraits describe experiences ranging from the disorienting impact of noisy environments on vision, to the intense need for proprioceptive and vestibular input, to the internal experience of shutdown and meltdown. One author describes how food textures can change just by moving to a different room, because visual processing affects how textures are perceived. Another explains that scrolling on a screen during conversation may actually represent deeper attention, not disengagement. These accounts remind us that the internal experience of the autistic children we work with may be profoundly different from what we observe on the outside.

Connecting the Dots: From Sensory Foundations to Sensory-Informed Practice

In our previous blog on the sensory foundations of oral motor development, we emphasised that addressing sensory processing is crucial before expecting complex oral motor skills to emerge. Daniel et al. (2026) reinforce and extend this principle. Their message is clear: before we can expect therapeutic engagement, regulation, or skill development, we need to attend to the sensory foundations.

• Postural foundations first: Daniel et al. include proprioceptive and vestibular support in their sensory stability recommendations, noting that seating options, weighted items, and body-awareness tools should be part of every therapy space.
• Tactile processing matters: The paper extends this by asking us to consider how tactile sensitivity interacts with the broader sensory environment and how it connects to interoceptive awareness.
• Context-specific, functional intervention: Daniel et al.’s emphasis on child-led, play-based, functional approaches aligns perfectly with this principle.
• The whole child: Both perspectives share a commitment to addressing the whole child rather than isolated skills. The evidence consistently points toward comprehensive, sensory-informed approaches.

Practical Takeaways for Your OT Practice

Drawing together the insights from Daniel et al. (2026) with the sensory foundations we’ve explored previously, here are some practical considerations for your work with autistic children:

Audit Your Sensory Environment

Before your next session with an autistic child, take a moment to experience your therapy space through a sensory lens. Notice the lighting, ambient sounds, smells, visual complexity, and tactile options available. Consider what you might simplify, soften, or adjust. Remember that what feels neutral to your nervous system may be overwhelming to theirs.

Slow Down and Simplify Your Interaction Style

Start sessions with minimal expectation. Be conscious of your vocal volume, pace, and tone. Use short, clear utterances. Give generous processing time. Think about whether your body language is adding clarity or adding to the sensory load.

Shift from Emotion Labelling to Behavioural Observation

Practice describing what you see rather than interpreting what you think a child feels. This takes practice, but it’s a more accurate and respectful way of connecting with autistic children’s experiences.

Build Interoceptive Awareness Through Play

Use sensory-rich activities as opportunities to gently draw children’s attention to their body sensations. Start with external body parts and concrete sensations before moving towards internal experiences. Keep it curious, keep it light, and follow the child’s lead.

Support Personalised Regulatory Strategies

Help each child develop their own vocabulary and signals for their internal experiences, and connect these with meaningful regulatory actions. Share these with families and school teams to create consistency across environments.

Remember the Foundations

As the SenseUp Model frames for us, and as Daniel et al. (2026) reinforce, sensory processing is foundational. When we address the sensory environment, interaction style, and interoceptive awareness, we’re not adding extras onto our OT practice but we’re attending to the very foundations upon which all other skills are built.

Conclusion

Daniel et al.’s (2026) paper offers a thoughtful, evidence-based, and neurodiversity-affirming framework that has clear relevance for occupational therapy practice with autistic children. By attending to sensory stability, adapting our interaction styles, rethinking how we empathise, supporting interoceptive awareness, and embracing personalised vocabularies of feelings, we can create therapeutic spaces where autistic children feel safer, more regulated, and more able to engage.

As occupational therapists, we’re uniquely positioned to integrate these insights into our practice. The sensory foundations are our territory. This paper helps us see how to build on those foundations with greater sensitivity, accuracy, and respect for the autistic children and families we serve.

We encourage you to read the full paper. It’s open access and well worth your time:

https://www.sciencedirect.com/science/article/pii/S305057982600001X?dgcid=coauthor&fbclid=IwY2xjawQPPndleHRuA2FlbQIxMABicmlkETFTNG9hTDVCRFl3V2ttUmpvc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHhk_2DPPrBD6UPm0sySvKdsPZeOv2frmjh_KIywwUk9ev1esWkRbNt7kme_I_aem_yZuKoEfjkUN5M2hTCLAvHg

Reference

Daniel, S., Mahler, K., Ray, D. C., Sharp, K., Clairy, K., Inderbitzen, S. M., Laurent, A. C., Fede, J. H., & Delafield-Butt, J. T. (2026). Sensory-processing informed autism practice for child-centred therapists. Research in Neurodiversity, 2, 100015. https://doi.org/10.1016/j.rin.2026.100015