What is Sensory Integration Therapy (OT-SI) and Will it Help My Child?

I’ll never forget the first time my husband came with me to one of our son, H’s sensory integration therapy sessions.

A few minutes into the session, as he watched H fly down a zip line, crash into ball pit, then search for toys hidden among the balls, he turned to me with a puzzled/slightly annoyed look on his face and said, “So we’re paying for him to come play for an hour? Can’t we just take him to open gym at the Y for about a tenth of the cost?”

In his defense, he’s not the only parent who’s had this reaction.

A typical OT-SI session takes place in a large play gym that looks like a Gymboree. To an uninformed onlooker (such as my newbie husband!) it really does appear as if the child is merely playing.

But, there’s more going on than meets the eye...

What is OT-SI?

Conceptualized by psychologist, occupational therapist and neuroscientist, Dr. Jean Ayres, Sensory Integration Therapy (OT-SI) is a form of occupational therapy that uses fun, play-based sensory activities (rotary swinging, climbing a rock wall, finding toys hidden in a ball pit, jumping on a trampoline while trying to catch a ball etc.) to help a child’s brain respond to sensations and movement in a more “organized” way.

Over time, with repetitive exposure to sensory activities that become increasingly more challenging, the child’s brain will start to “integrate” sensory input more efficiently. He’ll have better self-regulation (fewer meltdowns), more focus, less anxiety and will feel more comfortable and confident in his own skin.

The primary goal of OT-SI is to restore your child’s ability to participate in and truly enjoy the activities of daily life- engaging with family, playing with friends, getting dressed, participating in extracurricular activities and sports, going to school, eating and sleeping.

What does a typical OT-SI session look like?

A typical OT-SI session entails specifically chosen sensory-based play activities that engage two or more of the sensory systems, e.g., vestibular, proprioceptive, and tactile.

H’s sensory processing challenges are rooted in poor vestibular processing. He struggles with body awareness (knowing where his body is located in space), motor planning (the ability to conceive, plan and carry out a sequence of actions like getting dressed or doing an obstacle course), hand-eye coordination and balance.

As an infant and toddler, he was over-responsive to certain textures and sounds, struggled with fine motor skills (holding crayons, buttoning and zipping clothes) and preferred to play by himself.

His OT-SI sessions begin with an activity of his choice that helps “organize” and “wake-up” his nervous system. For him, it’s usually jumping on the trampoline, which provides vestibular and proprioceptive input in a way that’s not overstimulating.

Next, his OT introduces him to a predetermined activity like flying down a zipline, crashing into a ball pit then searching among the balls for hidden tactile toys.

Again, to the unsuspecting eye it looks like a fun game, but it’s actually engaging his vestibular, proprioceptive, tactile and visual systems all at once: The motion on the zipline activates the vestibular system; Hanging on to the zipline equipment and crashing into the ball pit activates the proprioceptive system; Moving through the ball pit to find the hidden toys stimulates his tactile and visual systems and requires motor planning.

His sessions end with an activity of his choice that’s calming and regulating like the Superman swing.

Your child’s unique sensory profile will determine the type of multi-sensory activity the OT chooses. The goal is to choose an activity that’s both “fun” and has the “just right challenge” for the child; it has to be engaging and challenging, but not too challenging.

A skilled SI-certified therapist will:

  • Choose activities that engage two or more of the sensory systems
  • Ensure the environment is safe for the child
  • Monitor the child’s arousal level and adjust the activity if it’s too challenging i.e., the child becomes distressed or checked out
  • Establish an emotional connection with the child
  • Choose activities that the child is internally motivated to complete
  • Have consistent communication with the parent about the focus of treatment and the child’s progress

What is the outcome of OT-SI?

When H began receiving OT-SI at 11 months old, he wouldn’t go anywhere near a ball pit, cried hysterically if we put him on a rotary swing and had an extremely hard time self-regulating. His OT had her work cut out for her in terms of finding activities with the “just right challenge.”

Now, he basically navigates his way through the sensory gym as if he owns the damn thing. Zip line, ball pit, rotary swing, obstacle course, bring it on!

His gross and fine motor skills have improved dramatically as has his ability to self-regulate. He still has sensory processing challenges, but they’re no longer impacting his ability to take part in and enjoy daily activities.

When he was a toddler, I worried that he wouldn’t be able to attend a “regular” school. He’s in Kindergarten now at our local public school and he’s thriving.

But, the improvements didn’t happen overnight. It took commitment, consistency and weekly collaboration with his OT to discuss ways to support his therapy at home to see the results.

If you suspect or know your child has sensory processing issues (click here for a list of 15 sensory red flags), OT-SI is one of the best interventions you can invest in.

Children who struggle with things like ASD, ADHD, Anxiety and OCD often have underlying sensory processing issues and until the sensory piece is addressed, they will continue to struggle. Click here to find a SI certified occupational therapist in your area.

Important note- Unfortunately, public schools do not provide OT-SI. School-based OT primarily addresses fine motor skills. To receive OT-SI, you have to go through a private clinic.

If you think your child has sensory issues but aren’t sure or you know your child does, and need help finding an SI certified OT, click here to schedule a FREE 30-minute strategy session so I can guide you towards the right resources.

If you have any questions, leave them in the comments below. If your child has received OT-SI, what has his experience been like? The Sensory Mom community and I would love to hear from you.


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Hi! I'm Cameron, mom of two incredible, "differently-wired" boys who have sensory processing challenges, wife of a nerdy surfer, mindfulness practitioner and Parenting Coach with master's degrees in education and psychology.