Resources & FAQs

The World Federation of Occupational Therapy (WFOT) defines occupational therapy as: "A healthcare profession based on the knowledge that purposeful activity can promote health and well-being in all aspects of daily life. The aims are to promote, develop, restore, and maintain abilities needed to cope with daily activities to prevent dysfunction"

Occupational therapists view the child, the child's environment, and the interaction between the child and the environment in a holistic way. The dynamic nature of this interaction is created by the child's continual development, maturation and learning. The environment is also continually evolving and changing.

The occupational therapist is concerned with analysing the child's ability to perform in everyday contexts. Occupational therapists hold two broad goals for the children they serve. These goals are to improve the child's functional performance and to enhance the child's ability to interact within his or her physical and social environments.

The underlying skills that an occupational therapist is concerned with are: · Sensorimotor components include sensory and perceptual processing, neuromuscular abilities, and motor skills. · Motor components refer to gross, fine and oral motor skills. · Cognitive components underlie the child's ability to perceive, attend, and learn from the environment. · Psychosocial skills refer to the child's underlying abilities to interact with others, to cope with new or difficult situations, and to manage his or her behaviours in socially appropriate ways.

The performance areas that the occupational therapist is concerned with are: · Self-care: refers to physical daily living skills. These include feeding and eating, grooming and hygiene, dressing, and functional mobility. · Play and leisure: refer to skills and performance of intrinsically motivating activities, spontaneous enjoyment, and self-expression. · School: skills in this area refer to reading, writing, math, and higher-level problem solving and cognitive skills.

In 1989 sensory integration was defined as "the neurobiological process that organises sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment. The spatial and temporal aspects of inputs from different sensory modalities are interpreted, associated, and unified. Sensory integration is information processing" (Ayers, 1989; p.9).

Modulation of sensory input is critical to our ability to engage in daily life activities. Filtering of sensations and attending to those that are relevant and attending attention to task requires a good level of sensory modulation (Lane, 2002). When modulation is inadequate, the child's attention may be continually diverted to ongoing changes in the environment and this may interfere with learning and play. Current research is examining the Sensory Modulation Disorder (SMD) as a valid clinical syndrome (Miller et al. 2007)

Under the light of sensory integration theory, praxis is viewed as a uniquely human skill that enables the brain to conceptualise, organise, and direct purposeful interactions with the world (Ayres, 1985). Praxis includes knowing what to do as well as how to do it and is fundamental for skills such as getting dressed, learning to write, or playing. The ability for praxis includes 3 components (Ayres, 1989) · Ideation - knowing what to do · Motor planning - directing and organising the movement · Execution - carrying out the motor plan

For most children, sensory integration develops in the course of ordinary childhood activities. But for some children, sensory integration does not develop as efficiently as it should. When the process of sensory integration is disordered, a number of problems in learning, development, and/ or behaviour may become evident (Sensory Integration International, 1991). Sensory Processing Disorder (SPD) manifests itself in two major ways: poor praxis and poor modulation (Bundy & Murray, 2002).

● Hyperactivity and distractibility ● Delays in speech and language ● Low muscle tone and coordination problems ● Slow development of motor skills ● Poor organisation of behaviour ● Learning difficulties at school ● Sensitivity to movement, touch, sights, sounds, and smells ● Poor organisation skills in adolescence

· Clumsiness · Difficulty planning and organising the sequences of movements in activities such as cutting with scissors or riding a bicycle · Difficulty with daily activities such as getting dressed, using knife and fork · Tendency to bump into and/ or trip over things · Taking longer to learn skills such as tying shoelaces, writing letters or numbers, catching a ball · Poor gross motor control when running, climbing, jumping, and going up and down stairs · Doing things in inefficient ways · Low self-esteem · Difficulty when transitioning from one activity to another

· Aversion or struggle when picked up, hugged, or cuddled · Aversion to certain daily life activities, including baths or showers, cutting of fingernails, haircuts, face washing and dental work · Responding with aggression to light or unexpected touch to arms, face, legs · Avoidance of certain styles or textures of clothing (e.g. scratchy) · Avoidance of play activities that involve body contact · Dislike getting hands in sand, finger-paint, paste · Exaggerated fear of falling or heights · Become anxious when feet leave the ground · Seem particularly slow at movements · Avoid jumping down from higher surfaces · Avoid climbing, escalators, or elevators · Seem to misunderstand what is said · Have difficulty looking and listening at the same time · Seem distracted if there is a lot of noise around · Hold hands over ears · Gag easily with food in mouth · Picky eater · Mouth objects · Express discomfort with light · Rock unconsciously · Become overly excitable during movement activities · Be "on the go" · Be slower than others to respond to sensation

Sensory Processing Disorder (SPD) may exist on its own, or it may coexist with: · Attention Deficit and Hyperactivity Disorder (ADHD) · Asperger's Syndrome · Fragile X Syndrome · Autistic Spectrum Disorder (ASD) · Pervasive Developmental Disorder (PDD) · Cerebral Palsy (CP) · Spina Bifida · Nonverbal Learning Disorder (NLD)

"Therapy involving therapeutic sensory experiences...can be more effective than drugs, psychological analysis, or rewards and punishment in helping the brain and body to develop optimally" During Sensory Integration Therapy, the child is guided through activities that challenge his or her ability to respond appropriately to sensory input by making a successful organised response (SII, 1991). Therapy takes place in a safe and interesting environment and through the use of specialised suspended equipment the child is afforded the opportunity to integrate sensations arising from the vestibular, proprioceptive, tactile, visual, and auditory systems. Treatment is developed in collaboration with the child and aims at meeting the child's specific needs for development. The activities are also designed to elicit autonomic responses and are graded to lead to higher levels of organisation that will promote the child's interaction with the environment. Specific skills training is not part of sensory integration treatment, rather activities are used to help the child develop the underlying abilities that are necessary for learning and mastering of skills.

"Occupation is as necessary to life as food and drink" (Dunton, 1919) In April 1979 the Representative Assembly in Detroit, USA, adopted the "Philosophical Base of Occupational Therapy" and provided a foundation of the theory and practice of Occupational Therapy by stating that: "Man is an active being whose development is influenced by the use of purposeful activity. Using their capacity for intrinsic motivation, human beings are able to influence their physical and mental health. Occupational Therapy is based on the belief that purposeful activity may be used to prevent and mediate dysfunction and to elicit maximum adaptation. Activity as used by the occupational therapist includes both an intrinsic and a therapeutic purpose" (Resolution 532-79, 1979) The World Federation of Occupational Therapy (WFOT) defines occupational therapy as: "A healthcare profession based on the knowledge that purposeful activity can promote health and well-being in all aspects of daily life. The aims are to promote, develop, restore, and maintain abilities needed to cope with daily activities to prevent dysfunction"

Occupational therapists view the child, the child's environment, and the interaction between the child and the environment in a holistic way. The dynamic nature of this interaction is created by the child's continual development, maturation and learning. The environment is also continually evolving and changing. The spirit, the playfulness, and the joy of childhood create the context for occupational therapy with children.

The occupational therapist is concerned with analysing the child's ability to perform in everyday contexts. Occupational therapists hold two broad goals for the children they serve. These goals are to improve the child's functional performance and to enhance the child's ability to interact within his or her physical and social environments. The first goal, that of improving the child's functional performance, is approached with a unique perspective in which performance is analysed into components of the underlying ability and skill. The second goal of occupational therapy is to improve the reciprocal relationships between the child and the environment. Based on the premise that the child and the environment are dynamic, the occupational therapist may emphasise development of underlying skills, facilitation of functional performance in everyday activities, or adaptation of the environment to enable the child to achieve desired and expected social roles.

The underlying skills that an occupational therapist is concerned with are: ● Sensorimotor components include sensory and perceptual processing, neuromuscular abilities, and motor skills ● Motor components refer to gross, fine and oral motor skills ● Cognitive components underlie the child's ability to perceive, attend, and learn from the environment ● Psychosocial skills refer to the child's underlying abilities to interact with others, to cope with new or difficult situations, and to manage his or her behaviours in socially appropriate ways.

The performance areas that the occupational therapist is concerned with are: ● Self-care: refers to physical daily living skills. These include feeding and eating, grooming and hygiene, dressing, and functional mobility ● Play and leisure: refer to skills and performance of intrinsically motivating activities, spontaneous enjoyment, and self-expression ● School: skills in this area refer to reading, writing, math, and higher-level problem solving and cognitive skills. Sources: Case-Smith 1996; Hopkins & Smith, 1993; & Christiansen, 1991

Dr. A. Jean Ayres, an occupational therapist with advanced training in neurosciences and educational psychology, developed the theory of sensory integration to explain the relationship between deficits in interpreting sensory information from the body and the environment and difficulties with academic and motor learning (Bundy & Murray, 2002). Ayres' primary objective when developing the theory of sensory integration was to explain the underlying cause of sensorimotor and learning problems in children in order to determine the optimal mode of intervention (Ayres, 1972; 1979). In the first publication of the theory in 1972 Dr. Ayres postulated that learning is a function of the brain and that disordered sensory integration accounts for some aspects of learning disorders and that enhancing sensory integration will make academic learning easier (Sensory Integration and Learning Disorders, 1972). In 1989 sensory integration was defined as "the neurobiological process that organises sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment. The spatial and temporal aspects of inputs from different sensory modalities are interpreted, associated, and unified. Sensory integration is information processing" (Ayers, 1989; p.9). Since then a great body of research has been published on sensory integration and its potential application to diverse populations. In fact the theory of sensory integration has sparked more research and controversy than any other theory developed by an occupational therapist.

The Sense of Touch (the tactile system) The tactile system is the largest sensory system and plays a major part in determining human physical, mental, and emotional behaviour. Touch sensations flow into the brain to tell us that something is touching us and play an important role in body awareness and movement. The tactile system is important for: ● Recognising shape and texture of objects ● Identifying whether a stimulus is painful or dangerous ● Planning movements ● Development of fine more skills & manipulation of objects ● Emotional security ● Social skills The Sense of Body Position and Movement (the proprioceptive system) The word proprioception refers to the sensory information that we receive from our joints and muscles. This information is telling us about the position, movement, force, and direction needed for activities such as buttoning clothes, writing, screwing a lid on a jar or playing with a toy without breaking it. The proprioceptive system is important for: ● Development of an internal map of our body (body scheme) ● Body awareness ● Motor control and motor planning ● Emotional security Gravity, Balance, and Movement (the vestibular system) The vestibular system is locate in our inner ear and is giving us information about where we stand in the world. It tells us where we are in relation to gravity; whether we are moving or standing still, and how fast or slow we are going. The vestibular system is important for: ● Balance ● Physical activities such as running, climbing, dancing ● Coordination of the two sides of the body ● Knowing where we are going ● Seeing clearly while moving The Sense of Sight (the visual system) The visual system helps us to navigate in the world and judge the speed and distance of objects and people. The visual system is important for: ● Following a moving object with our eyes ● Writing letters and numbers ● Fitting pieces into jigsaw puzzles and cutting along lines ● Copying from the blackboard or from books The Sense of Sound (the auditory system) The auditory system is located in our ear and relates to the ability to receive sounds. The auditory system is important for: ● Locating sounds in the environment ● Discriminating between sounds and words such as "ba" and "ma" ● Attending to, understanding, or remembering what is read or heard ● Making up rhymes and singing ● Speaking and articulation The Sense of Smell (the olfactory system) Smell plays an important role in establishing and receiving memories and associations that influence some of our choices and preferences, such as a specific type of perfume or a certain type of soap. A baby can recognise his mother just through smell and our food choices are greatly dependent upon the sense of smell. The sense of taste (the gustatory system) Taste helps us to survive and provides us with essential information about bitter, salty, sweet, and sour flavours. These tastes are important in our selection of food or to inform us whether certain tastes might be harmful for our body.

A. Jean Ayres (1972) defined praxis as the learned ability to plan and direct a temporal series of coordinated movements toward achieving a result - usually a skilled and non-habitual act. Under the light of sensory integration theory, praxis is viewed as a uniquely human skill that enables the brain to conceptualise, organise, and direct purposeful interactions with the world (Ayres, 1985). Praxis includes knowing what to do as well as how to do it and is fundamental for skills such as getting dressed, learning to write, or playing. Occupational therapists who view praxis from a sensory integrative perspective are concerned with the individual’s sensory processing and conceptual abilities (Ayres, 1985; Ayres et al., 1987). Praxis includes 3 components (Ayres, 1989) ● Ideation - knowing what to do ● Motor planning - directing and organising the movement ● Execution - carrying out the motor plan Disorders of Praxis Praxis and dyspraxia are complex concepts, and the terminology associated with them can be confusing. In a simple manner: ● Dyspraxia is a generic term that refers to developmentally based disorders of praxis with a variety of etiologies ● Sensory integrative- based dyspraxia refers to the praxis problems that have their bases in poor sensory processing (Reevs & Cermark, 2002) If praxis does not emerge, the result is Sensory-based Motor Disorder - dyspraxia, a developmental motor planning disorder. Sensory-based Dyspraxia is one of the most common manifestations of Sensory Processing Disorder in children with learning disorders or other developmental delays. Sensory-based Motor Disorder - dyspraxia is a brain dysfunction that hinders the organisation of sensory information and interferes with the ability to motor plan. The nature of the disorder indicates that the problem begins early in the child's life and affects his development as he grows (Ayres, 2005). In accordance with Sensory Integration theory, two levels of dysfunction in praxis have been identified: Bilateral Integration and Sequencing Deficit: is a mild form of Sensory-based Motor Disorder that involves: ● Difficulty using the two sides of the body in a co-ordinated manner & sequencing motor tasks ● Poor vestibular & proprioceptive processing Somatodyspraxia: is a more severe form of Sensory-based Motor Disorder that involves: ● Difficulty in formulating action plans; a problem with the motor-planning of new, rather than habitual, movements ● Poor tactile, vestibular & proprioceptive processing A Checklist for Problems in Praxis Some characteristics of poor motor planning are listed below. The following characteristics include some of the symptoms of a problem in praxis. ● Clumsiness ● Difficulty planning and organising the sequences of movements in activities such as cutting with scissors or riding a bicycle ● Difficulty with daily activities such as getting dressed, using knife and fork ● Tendency to bump into and/ or trip over things ● Taking longer to learn skills such as tying shoelaces, writing letters or numbers, catching a ball ● Poor gross motor control when running, climbing, jumping, and going up and down stairs ● Doing things in inefficient ways ● Low self-esteem ● Difficulty when transitioning from one activity to another (Source: Ayres, 2005; Kranowitz, 2003)

Modulation of sensory input is critical to our ability to engage in daily life activities. Filtering of sensations and attending to those that are relevant and attending attention to task requires a good level of sensory modulation (Lane, 2002). When modulation is inadequate, the child's attention may be continually diverted to ongoing changes in the environment and this may interfere with learning and play. Current research is examining Sensory Modulation Disorder (SMD) as a valid clinical syndrome (Miller et al. 2007) A Checklist for Problems in Sensory Modulation Some characteristics of poor sensory modulation are listed below. The following characteristics include some of the symptoms of a problem in sensory modulation. ● Aversion or struggle when picked up, hugged, or cuddled ● Aversion to certain daily life activities, including baths or showers, cutting of fingernails, haircuts, face washing and dental work ● Responding with aggression to light or unexpected touch to arms, face, legs ● Avoidance of certain styles or textures of clothing (e.g. scratchy) ● Avoidance of play activities that involve body contact ● Dislike getting hands in sand, finger-paint, paste ● Exaggerated fear of falling or heights ● Become anxious when feet leave the ground ● Seem particularly slow at movements ● Avoid jumping down from higher surfaces ● Avoid climbing, escalators, or elevators ● Seem to misunderstand what is said ● Have difficulty looking and listening at the same time ● Seem distracted if there is a lot of noise around ● Hold hands over ears ● Gag easily with food in mouth ● Picky eater ● Mouth objects ● Express discomfort with light ● Rock unconsciously ● Become overly excitable during movement activities ● Be "on the go" ● Be slower than others to respond to sensation (Ayres, 2005; Lane, 2002; Dunn, 1999)

"A sensory integrative problem may interfere directly with the learning process in the brain, or it may cause poor behaviour that interferes with schoolwork" (Ayres, 2005) For most children, sensory integration develops in the course of ordinary childhood activities. But for some children, sensory integration does not develop as efficiently as it should. When the process of sensory integration is disordered, a number of problems in learning, development, and/ or behaviour may become evident (Sensory Integration International, 1991). Sensory Processing Disorder (SPD) manifests itself in two major ways: poor praxis and poor modulation (Bundy & Murray, 2002). Sensory Processing Disorder (SPD) may exist on its own, or it may coexist with: ● Attention Deficit and Hyperactivity Disorder (ADHD) ● Asperger's Syndrome ● Fragile X Syndrome ● Autistic Spectrum Disorder (ASD) ● Pervasive Developmental Disorder (PDD) ● Cerebral Palsy (CP) ● Spina Bifida ● Nonverbal Learning Disorder (NLD) Some Common Signs and Symptoms of Sensory Processing Disorder "A child with sensory processing disorder often develops in an uneven way" ● Hyperactivity and distractibility ● Delays in speech and language ● Low muscle tone and coordination problems ● Slow development of motor skills ● Poor organisation of behaviour ● Learning difficulties at school ● Sensitivity to movement, touch, sights, sounds, and smells ● Poor organisation skills in adolescence (Ayres, 2005; Sensory Integration International, 1991)

"The belief that a child will outgrow his problem...may prevent him from getting professional help at the age that it will do the most good" How therapy works "Therapy involving therapeutic sensory experiences...can be more effective than drugs, psychological analysis, or rewards and punishment in helping the brain and body to develop optimally" During Sensory Integration Therapy, the child is guided through activities that challenge his or her ability to respond appropriately to sensory input by making a successful organised response (SII, 1991). Therapy takes place in a safe and interesting environment and through the use of specialised suspended equipment the child is afforded the opportunity to integrate sensations arising from the vestibular, proprioceptive, tactile, visual, and auditory systems. Treatment is developed in collaboration with the child and aims at meeting the child's specific needs for development. The activities are also designed to elicit autonomic responses and are graded to lead to higher levels of organisation that will promote the child's interaction with the environment. Specific skills training is not part of sensory integration treatment, rather activities are used to help the child develop the underlying abilities that are necessary for learning and mastering of skills.

Therapy using sensory integration as a frame of reference is dynamic and fun for the child. The clinical setting is safe and provides the child with the opportunity to explore appealing pieces of equipment: platforms to swing on, barrels to climb through, trapezes to swing from, and big blocks to climb over. The therapist and the child engage in a play situation where the child is motivated to seek new experiences and under the guidance of the trained professional to achieve success that probably would not occur in unguided play. The playful atmosphere incorporates opportunities for the child to take in enhanced sensation and promotes adaptive interactions with the environment.

Every day we receive a great deal of information from our senses. Our senses provide us with the information about our body and the environment around us. When this information flows in a well-organised manner, it enables the brain to form perception, behaviours, and learning. A child needs an enriched physical environment, a responsive social environment, and opportunities to successfully respond to and interact with the world. Sensory processing in the early years lays the foundation for establishing: ● Sleeping patterns ● Eating patterns ● Arousal ● Attention ● Motor skills ● Social interaction ● Play skills

The Screening Assessment is designed to identify children that may have mild to severe learning related problems. The purpose of the service is to reliably and quickly screen for the presence of developmental delays in each of the following areas: ● Sensory-Motor ● Language & ● Literacy The screening will show if the child is functioning within the typical range or whether there is need for further diagnostic evaluation. This joint diagnostic initiative is a positive way forward for children who manifest the following: ● Delayed language ● Speech & articulation difficulties ● Sensory processing difficulties ● Auditory processing difficulties ● Co-ordination difficulties ● Immature phonological awareness ● Handwriting difficulties ● Rationale for Screening in Early Years Developmental Screening is an important function of health care professionals. Early identification of developmental disorders and children “at risk” for school related problems can result in effective intervention at an early age. Researchers over the years have provided strong evidence of the effectiveness of early childhood intervention compared to no intervention. The aim of the screening assessment is to help identify these children early and before they experience failure at school. For this reason an assessment module for the initial screening of children preparing to enter reception has been developed. Diagnostic information will enable parents and educators to plan for future management of those “at risk” thus enabling them to access the curriculum more effectively. The screening assessment will be administered jointly by an Occupational and a Speech and Language Therapist and detailed feedback will be provided to parents and educators. The screening will cover the following areas: ● Developmental History ● Sensory Processing ● Gross & Fine motor skills ● Speech & Language ● Literacy Skills ● Numeracy skills

child resists being cuddled child avoids touch child has difficulty breastfeeding child has difficulty with sucking, chewing, or swallowing child doesn't tolerate new foods child avoids putting toys in mouth child avoids exploring toys with mouth child gags or vomits when objects are placed in mouth child becomes distressed when changing diapers child becomes distressed when having a bath child seems unaware of dirty diapers child is unaware of people around him child cannot tolerate change to routines/ schedules child has difficulty getting to sleep child is easily agitated and irritable compared to same age children child seems unaware of noise child takes long to respond to familiar voices child startles easily at familiar sounds child seems not to be paying attention child avoids eye contact child avoids looking at toys child is overly bothered when exposed to light child requires more support for sitting child becomes upset when placed on back child becomes upset when lifted child dislikes head tipped back child cries when moved

1. Red flags for Tactile Dysfunction 2. Red flags for Vestibular Dysfunction 3. Red flags for Proprioceptive Dysfunction 4. Red flags for Visual Processing Dysfunction 5. Red flags for Auditory Processing Dysfunction 6. Red flags for Olfactory (Sense of Smell) Dysfunction 7. Red flags for Gustatory (Sense of Taste) Dysfunction 8. Social and Emotional responses

"In many instances the theory falls short of its goals, but a useful purpose will have been served if a new focus stimulates further search for an even more effective and comprehensive theory... Truth like infinity, is to be forever approached but never reached " (p.4) Ayres, 1972 Sensory integration has been the subject of more research than any other approach within the field of occupational therapy (Parham & Mailloux, 2001). For many years, it has been one of the most frequently applied frames of reference used by paediatric occupational therapists (Mulligan, 2002). Hopscotch is dedicated to integrating cutting-edge research with clinical practice. In 2004 Dimitrios completed a major ethnographic study on the clinical reasoning processes of paediatric occupational therapists. His work has been presented in several workshops and most recently in the European Conference of Qualitative Research in Bournemouth (August, 2006). Dimitrios has also completed postgraduate studies in the field of Childhood Anthropology at Brunel University. This section aims at promoting public awareness of the research conducted in the field of sensory integration. The main objective is to familiarise visitors with published scientific research and trigger further reflection among parents, educators, students, researchers, and other professionals. Please click on one of the titles to expand its contents

Ayres, A. J. (1961) Development of the body scheme in children. American Journal of Occupational Therapy, 15, 99-104. Ayres, A. J. (1963) The Eleanor Clarke Slagle Lecture: The development of perceptual-motor abilities: a theoretical basis for treatment of dysfunction. American Journal of Occupational Therapy, 17, 221-226. Ayres, A. J. (1964) Tactile functions: their relations to hyperactive and perceptual-motor behaviour. American Journal of Occupational Therapy, 18, 6-11. Ayres, A. J. (1965) Patterns of perceptual-motor dysfunction in children: A factor analytic study. Perceptual and Motor Skills, 20, 335-368. Ayres, A. J. (1966a) Interrelations among perceptual-motor abilities in a group of normal children. American Journal of Occupational Therapy, 20, 288-292. Ayres, A. J. (1966b) Interrelations among perceptual-motor functions in children. American Journal of Occupational Therapy, 20, 68-71. Ayres, A. J., & Reid, W. (1966) The self-drawing as an expression of perceptual-motor dysfunction. Cortex, 2, 254-265. Ayres, A. J. (1969a) Deficits in sensory integration in educationally handicapped children. Journal of Learning Disabilities, 2, 160-168. Ayres, A. J. (1969b) Relation between Gessell developmental quotients and later perceptual-motor performance. American Journal of Occupational Therapy, 23, 11-17. Ayres, A. J. (1971) Characteristics of types of sensory integrative dysfunction. American Journal of Occupational Therapy, 25, 329-334. Ayres, A. J. (1972a) Sensory Integration and Learning Disorders. Los Angeles: Western Psychological Services. Ayres, A. J. (1972b) Types of sensory integrative dysfunction among disabled learners. American Journal of Occupational Therapy, 26, 13-18. Ayres, A. J. (1972c) Improving academic scores through sensory integration. Journal of Learning Disabilities, 5, 338-343. Ayres, A. J. (1975) Southern California Postrotary Nystagmus Test Manual. Los Angeles: Western Psychological Services. Ayres, A. J. (1976) The Effect of Sensory Integrative Therapy on Learning Disabled Children: The Final Report of a Research Project. Los Angeles: University of Southern California. Ayres, A. J. (1977) Cluster analyses of measures of sensory integration. American Journal of Occupational Therapy, 31, 362-366. Ayres, A. J. (1978) Learning disorders and the vestibular system. Journal of Learning Disabilities, 11, 18-29. Ayres, A. J. (1979) Sensory Integration and the Child. Los Angeles: Western Psychological Services. Ayres, A. J., & Tickle, L. (1980) Hyper-responsivity to touch and vestibular stimulation as a predictor of responsivity to sensory integrative procedures in autistic children. American Journal of Occupational Therapy, 34, 375-381. Ayres, A. J. (1985) Developmental Dyspraxia and Adult-Onset Apraxia. Torrance, CA: Sensory Integration International. Ayres, A. J., Mailloux, Z. K., & Wendler, C. L. W. (1987) Developmental Dyspraxia: Is it a Unitary Function? Occupational Therapy Journal of Research, 7, 93-110. Ayres, A. J. (1989) Sensory Integration and Praxis Tests Manual. Los Angeles: Western Psychological Services.

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1. Red flags for Tactile Dysfunction 2. Red flags for Vestibular Dysfunction 3. Red flags for Proprioceptive Dysfunction 4. Red flags for Visual Processing Dysfunction 5. Red flags for Auditory Processing Dysfunction 6. Red flags for Olfactory (Sense of Smell) Dysfunction 7. Red flags for Gustatory (Sense of Taste) Dysfunction 8. Social and Emotional responses