Exploring the alignment between occupational therapy using Ayres Sensory Integration® with children and occupation-centred practice: An observational study.
Carolina Acuña, Sebastian Gallegos-Berrios, Jacqui Barfoot and 2 others
None of the eight ASI-trained therapists demonstrated all 22 occupation-centred practice components.
The most commonly missed were collaboration with families, client-chosen goals, and occupational outcome measures. ASI fidelity was met by all, but fidelity does not guarantee an occupational focus.
Key findings
1No participant demonstrated all 22 OCP components, with the range of components achieved spanning from 3 to 17 out of 22.
2Six therapists showed no evidence of developing a collaborative partnership with caregivers or establishing client-chosen goals, and seven did not establish outcome measures based on occupational performance and satisfaction.
3All participants met ASI fidelity criteria, but the authors state that meeting fidelity does not necessarily imply an occupational lens.
Still to come
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Only eight therapists, seven in Australia and one in New Zealand, all in private practice. The authors note there are roughly 80 ASI-certified therapists in Australia and three in New Zealand, so this is a small slice of the eligible pool. One session per therapist was observed. The authors acknowledge that a therapist might practise differently with other clients or at other stages of an intervention. The first author, who is ASI-certified, conducted most interviews. Participants knew this, which the authors flag as a social desirability risk: therapists may have emphasised aspects of their practice that align with ASI principles. A single static camera was used to record sessions in often large, dynamic therapy spaces, so some movement and interaction may have been missed. The OCP checklist was developed and operationalised within this study. It has not been validated as a standalone instrument and is proposed only as a reflective tool, not a scored standard. The authors did not directly ask participants about their training in frameworks such as DDDM, so it is unclear whether lack of familiarity or lack of use drove the gaps observed.
Declared interests
The authors declare no conflicts of interest. The study was funded by the University of Queensland. The first author is ASI-certified and clinically experienced in ASI, which the authors disclose in their positionality statement.
The easy way to misread this
Do not read this as evidence that ASI is ineffective or that it cannot be delivered in an occupation-centred way. The study observed how eight therapists in one region delivered ASI and whether their practice matched a 22-component OCP checklist. It did not measure whether children improved, and the sample is too small to represent all ASI practitioners. The authors themselves frame this as preliminary and exploratory.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →