Effectiveness of Ayres Sensory Integration® in autism spectrum disorder: randomized controlled trial

A single-blind randomized controlled trial in Turkey tested occupational therapy using Ayres Sensory Integration® (ASI) added to usual IEP-based education in preschool children with ASD (48–59 months). Sixty-three children were randomized (32 ASI, 31 usual care), and 60 completed the study and were included in the final analysis (30 per group). The ASI group received about 36 h of ASI across 12 weeks, on top of the standard program. Post-intervention outcomes showed the clearest functional gain in VABS-II Daily Living Skills (p = .042), while other VABS-II domains did not reach significance (Total p = .055). Goal Attainment Scaling (GAS) also separated the groups, with higher post scores in the ASI group (1.65 vs. 0.69; p < .001), and a large between-group effect for GAS (r = .48). Sensory Profile analyses identified between-group differences in several areas, including Vestibular Processing (p = .004), Auditory Processing (p = .021), and Visual Processing (p = .031), along with multiple factor scores. Fidelity checks using the ASIFM indicated that sessions met recommended criteria (mean ≈ 92.9). These findings suggest that ASI added to usual care may support individualized goal attainment and daily living skills, with additional between-group differences observed in several sensory processing domains. Trial registration ClinicalTrials.gov, NCT07507630. Registered on 27 March 2026, retrospectively registered.