Expert Witness Journal Issue 63 October 2025 - Flipbook - Page 88
a selection of the evidence. They have explored a
number of di昀昀erent issues, including the e昀昀ects on
learning, how children with speci昀椀c needs compare
to typically developing children, and the impact of
sensory integration therapy.
They highlighted the factors a昀昀ecting systematic
reviews, i.e. sensory approaches di昀昀er in how they
are implemented, the terms used to label sensory
processing di昀케culties have been interchangeable
over the years.
Sanz-Carvera et al (2017) compared children
with di昀昀erent neurodevelopmental disorders and
typically developing children. They indicated that
children with conditions such as Autism (ASD) and
attention de昀椀cit hyperactivity disorder (ADHD)
process sensory information di昀昀erently. Their study
demonstrated how di昀昀erent contexts and demands
a昀昀ect children. Those with neurodevelopmental
disorders had higher levels of dysfunction compared
to typically developing children, both at home and
school. At home, the most a昀昀ected group included
those with ASD and ADHD. They had high levels of
sensory processing dysfunction. At school, children
with autism had a higher percentage of dysfunction,
particularly in relation to sound, touch and social
relationships.
Di昀케culties with proprioception
were more characteristic of ADHD. The study
explored the valuable role of occupational therapy.
It recommended early intervention to identify
di昀케culties, support for parents and teachers to
understand a child’s di昀케culties, and intervention
programmes, i.e. sensory activities and sensory
integration therapy.
A later systematic review (Schaaf et al 2018) identi昀椀ed
positive outcomes for function, participation, and
the level of assistance needed for self-care activities.
The study noted the increase in evidence regarding
play, sensory-motor skills, and language skills is
emerging.
A recent review of evidence (Acuña et al 2025)
applied 昀椀delity criteria for ASI, which measures
adherence to the structure and processes used
during therapy. It concluded that ASI signi昀椀cantly
improved autistic children’s individualized goals
linked to occupational performance, function, and
participation, i.e. sensory processing and regulation,
sitting, daily routines, meal preparation, community
participation,
communication,
behaviours,
emotional regulation, gross motor skills, 昀椀ne motor
skills, safety, sleep, self-care skills (dressing, bathing,
feeding), school participation, communication and
interaction, and play.
Ongoing research is needed to provide further
evidence on how sensory processing di昀케culties
impact on the education and function of children.
Studies that focus on individual targets and single
cases have demonstrated evidence that supports
intervention to increase regulation to sensory input.
Every child and young person is an individual and the
factors that a昀昀ect their development are di昀昀erent.
They change with age, in di昀昀erent situations, and
during every stage of their education. It is imperative
that assessments and intervention are individual.
Jones et al (2020) explored the e昀昀ects of sensory
processing on learning and school for autistic
pupils. The study concluded that negative sensory
experiences a昀昀ected learning. Di昀케culties included
distraction, anxiety and limited participation. The
study highlighted the importance of addressing
sensory needs, access to resources, and sta昀昀
knowledge to minimize the impact of sensory
processing di昀케culties.
Occupational therapy has a key role in an
Education, Health and Care plan
Watling and Hauer (2015) carried out a systematic
review of the e昀昀ectiveness of Ayres Sensory
Integration® (ASI) and sensory-based interventions
(SBIs) for children with ASD. SBIs are approaches
and strategies that address sensory issues. The
authors found moderate evidence for ASI and mixed
results for SBIs. Some studies noted signi昀椀cant
improvement from ASI for individualized goals and
sleep, but there was no clear evidence from others
in terms of task engagement or behaviours. SBI in
the home and clinic settings led to improvements
in behaviours and cognitive function. Clinic based
SBI that included vestibular, proprioceptive, and
tactile input was associated with improved motor
pro昀椀ciency and sensory functioning. The authors
noted caution as the evidence was varied and limited.
EXPERT WITNESS JOURNAL
An occupational therapy assessment provides
valuable information on a child or young person’s
special educational needs and how they a昀昀ect
their function. An accurate description of needs
will inform the content of sections B, E and F.
An occupational therapist is often instructed to
comment on the provision, speci昀椀cally occupational
therapy provision, and to comment on the education
placement.
What are the challenges as an expert?
It is necessary to build a rapport with a child/young
person within a very short period time to complete
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