Notes on Sensory-Related Terminology Across Disciplines: Part One
Overview and Rationale
Sensory integration (SI) theory and its associated intervention techniques form a fundamental basis of pediatric occupational therapy (OT) practice, a domain that significantly draws from advanced concepts in neuroscience, behavioral neurology, neuropsychology, and the established framework of occupational therapy itself, as articulated by Ayres (1972, 1974, 2005).
The precise terminology employed across these distinct disciplines plays a crucial role in several aspects:
(a) Shaping the foundational understanding of SI theory within a broader scientific context.
(b) Guiding the strategic planning and selection of appropriate intervention methods.
(c) Facilitating effective and accurate daily communication with other healthcare professionals and researchers.
(d) Supporting evidence-based practice, as practitioners are required to integrate diverse literatures from OT, neuroscience, and behavioral science.
(e) Influencing perspectives on the underlying principles of occupation within the field of occupational science (Blanche, 2001; Parham, 2002).
Significant barriers to achieving cross-disciplinary terminological consistency exist, primarily due to inherent differences in terminology, intervention goals, core values, and therapeutic approaches. These disparities often lead to the creation of isolated 'silos' for both clinical practitioners and scientific researchers, impeding collaborative progress (Cascio et al., 2016; p. 920).
The effort to clarify sensory processing terminology has been a persistent and recurring theme throughout OT literature. Notably, a series of three articles published in the Sensory Integration Special Interest Section Quarterly in 2000 (Hanft et al., 2000; Lane et al., 2000; Miller & Lane, 2000) specifically addressed this issue, providing significant historical context for ongoing discussions.
This particular article aims to systematically compare and contrast the similarities and differences in definitions for key terms across occupational therapy, neuroscience, and behavioral science. The terms under scrutiny include: Sensory Integration (SI), Multisensory Integration (MSI), Sensory Processing (SP), Sensory Modulation, and Sensory Discrimination. Part Two of this work is slated to provide an in-depth exploration of terms specifically associated with sensory modulation.
Key Concepts and Definitions Across Disciplines
SI in OT (theory, model for practice, assessment procedures, intervention):
Ayres (1972, 1974, 2005) originally defined SI as the inherent ability of the central nervous system to effectively organize sensory information received from the body and the environment, facilitating its functional use. This process involves multiple complex neural mechanisms, including intersensory integration, which collectively transform raw sensory data into a cohesive and meaningful whole. It also encompasses the capacity to filter or enhance neuronal responses and modify perception and motor responses through active interaction with the environment.
SI theory specifically emphasizes the critical role of body-centered senses: touch (tactile), proprioception (body position and movement awareness), and vestibular inputs (head movement and gravity). The vestibular system, for example, is highlighted for its significant influence on ocular-motor control and balance (Ayres, 1972; 1974; 2005).
Neuroscience perspective on sensory processing:
Within neuroscience, the specific term “sensory integration” is rarely utilized in the same comprehensive manner as in OT. Instead, terms like unimodal or unisensory processing are typically used to describe the mechanisms by which a single sensory neuron (e.g., visual, tactile, proprioceptive) initially transforms an external or internal stimulus into a neuronal signal that is then transmitted to the central nervous system (CNS) (Kandel et al., 2013).
The intricate structure and precise function of individual sensory neurons, along with countless CNS connections, are extensively and well understood within neuroscience research.
Multisensory Integration (MSI) is a concept rigorously studied at the cellular and neural levels in neuroscience. This field primarily investigates how multiple sensory inputs are combined and processed, with a common emphasis on interactions between audiovisual, somatosensory, and vestibular modalities. However, MSI research within neuroscience is not commonly framed or referenced using the broader term “sensory integration” as it is in behavioral science or OT.
Behavioral science perspective on sensory processing:
There is a growing and significant interest within behavioral science in understanding how various forms of sensory information profoundly influence brain-behavior relationships, particularly in conditions like autism spectrum disorder (Wolfe et al., 2012).
The predominant term employed within behavioral science to describe these brain–behavior relationships related to sensation is “sensory processing.”
Behavioral science research offers numerous examples linking sensory processing directly to higher-order cognitive functions. For instance, the accurate perception and interpretation of visual information are critical foundational components that contribute significantly to the development of sophisticated visual perceptual skills, while effective sound perception is fundamental to the acquisition and development of speech and language.
Summary on terminology across disciplines:
The establishment of shared and consistent terminology is recognized as essential for facilitating more effective cross-disciplinary reading, comprehensive understanding, and practical application of complex concepts among researchers and practitioners.
The authors explicitly state that they do not endorse one specific term as definitively correct over others. Their primary objective is, instead, to present the diverse disciplinary perspectives to empower OT practitioners with an expanded knowledge base and enable them to integrate a broader range of research findings into their clinical practice.
Core Terms and Cross-Disciplinary Perspectives
Sensory Integration (SI) – OT perspective:
This term encompasses a holistic theory of brain–behavior relationships, provides a robust model for clinical practice, includes specific assessment procedures, and guides occupational therapy interventions (Ayres, 1972, 1974, 2005).
The Sensory Integration & Processing Special Interest Section (SIPSIS) describes SI as focusing intently on the neurobiological, sensory, and praxis foundations that underpin human occupation.
Multisensory Integration (MSI) – cross-disciplinary perspective:
While OT historically used the term “intersensory integration,” Multisensory Integration (MSI) now refers specifically to the dynamic combination of information received from different sensory modalities. This integration typically results in greater neuronal responses than would be achieved by merely summing the responses from individual sensory inputs (Bremner et al., 2012; Stein, 2012).
In neuroscience, MSI is meticulously studied at the cellular level of neural circuitry and individual neurons. Behavioral science, however, uses MSI less frequently, often placing greater emphasis on the broader concept of sensory processing instead.
Neuroscience research highlights a wide array of intermodal interactions, including but not limited to audiovisual, olfactory/flavor, somatosensory (touch, pressure, temperature, pain), and vestibular interactions (Bremner et al., 2012; Stein, 2012).
Sensory Processing (SP) – cross-disciplinary construct:
Across the fields of OT, neuroscience, and behavioral science, Sensory Processing (SP) serves as a broad, overarching construct. It describes the complex interactions between the brain and sensory signals originating from the environment and the body, along with the subsequent behavioral and physiological responses (Ayres, 2005; Baranek et al., 2006; Dunn, 2001; Miller et al., 2009; Parham et al., 2007; Schauder & Bennetto, 2016).
While the construct is widely accepted, individual disciplines may emphasize different specific facets or aspects of SP, acknowledging its broad and integrative nature rather than defining it as a singular, narrowly delineated process.
Sensory Modulation – cross-disciplinary concept (to be elaborated in Part Two):
The term “sensory modulation” originated within occupational therapy to describe the brain’s intrinsic capacity to effectively facilitate and inhibit neural messages, ensuring they are relevant and appropriately tuned for optimal function (Ayres, 2005).
Over subsequent years, the scope and interpretation of the term “modulation” have broadened considerably within OT practice and literature, though it remains less commonly used or is understood differently in other disciplines.
Sensory Discrimination / Perception – nuanced meanings across disciplines:
OT perspective: Sensory discrimination specifically refers to the brain’s sophisticated ability to accurately differentiate and interpret distinct sensory information (e.g., distinguishing between different textures or pressures of touch). This capacity is crucial as it directly contributes to refined sensorimotor control, often referred to as praxis, and is fundamental to the comprehensive development of various motor skills. Vestibular discrimination, for example, is intrinsically linked to balance and precise ocular-motor control, while effective proprioceptive integration is essential for the generation of appropriately graded muscle force for movement.
Neuroscience perspective: Within neuroscience, sensory discrimination is primarily understood in relation to the specific neural response properties and coding mechanisms of neurons within the central nervous system (CNS) (Kandel et al., 2013).
Behavioral science perspective: From a behavioral science standpoint, when the brain accurately perceives and interprets sensory information, this foundational ability directly supports a wide array of cognitive functions. Sensory perception is explicitly linked to cognitive processes such as visual perceptual skills and the development of robust speech and language abilities (Wolfe et al., 2012).
An illustrative example includes research on the temporal binding window in cross-modal perception, specifically visual–auditory binding, as investigated by Powers et al. (2009).
Practical note on terminology usage:
This article explicitly does not advocate for the adoption of a single, universally preferred term. Instead, its core message emphasizes the crucial importance of understanding the diverse perspectives and nuanced meanings of these terms across disciplines. This understanding is vital for broadening the scope of OT practice and enhancing the effective translation of research into clinical application.
Table of Key Terms Across Disciplines (Paraphrased for Clarity)
Sensory Integration (OT): Defined as the self-organizing process of the brain to array sensory information for purposeful use; involves multiple neural processes, crucially including intersensory integration; its function is to transform raw sensory data into a coherent and functional whole, thereby affecting neural responses through filtration or enhancement, and altering perception and motor output via environmental interaction. Related references include foundational works by Ayres (1972; 1974; 2005).
Multisensory Integration (MSI): Characterized by the phenomenon where unisensory inputs from different modalities combine to generate neural responses that are quantitatively greater than simply the sum of their individual parts; historically referred to as intersensory integration within OT literature; neuroscience research rigorously emphasizes the underlying neural mechanisms specific to the integration across a broad spectrum of modalities, such as audiovisual, somatosensory, and vestibular systems. Key references include Bremner et al., 2012; Stein, 2012.
Sensory Processing (SP): An overarching and comprehensive construct that encapsulates the intricate brain–body interactions with sensory input from both the internal and external environment, along with the diverse resulting responses (behavioral, physiological, and cognitive); the specific emphases and interpretations of this construct may vary significantly across different scientific and professional disciplines. References: Ayres, 2005; Baranek et al., 2006; Dunn, 2001; Miller et al., 2009; Parham et al., 2007; Schauder & Bennetto, 2016.
Sensory Modulation: Refers to the brain’s dynamic and adaptive capability to both facilitate and inhibit neural messages in a way that is precise, timely, and relevant for optimal function and engagement; a concept primarily developed and focused within OT; profoundly linked to the sophisticated structures and functions of the central nervous system; further detailed exploration of this concept is reserved for Part Two of this series. Reference: Ayres, 2005.
Sensory Discrimination / Perception: The OT perspective highlights the brain’s ability to finely discriminate sensory information (e.g., tactile input) which is foundational for shaping refined motor skills and praxis; neuroscience views it largely through the lens of neural response properties and coding within the CNS; behavioral science emphasizes the direct link between accurate sensory perception and its support for complex cognitive functions and the development of perception-driven skills (e.g., visual perceptual skills, speech/language). References: Kandel et al., 2013; Powers et al., 2009; Wolfe et al., 2012.
Interdisciplinary Significance and Practical Implications
The establishment of shared and unambiguous terminology is critically important, as it directly enables researchers and clinicians across occupational therapy, neuroscience, and behavioral science to read, accurately interpret, and consistently apply complex concepts within their respective areas of work, fostering a more unified scientific dialogue.
This article strongly advocates for a profound awareness of the existing terminological differences across disciplines. Such awareness is instrumental in supporting robust evidence-based practice, fostering effective cross-disciplinary collaboration, and ultimately facilitating the efficient translation of cutting-edge research findings into practical clinical settings.
The practical implications of adopting a more unified and understood terminology are far-reaching. They include demonstrably improved communication among diverse professionals, better alignment and integration of fundamental research findings with daily clinical practice, and the development of a richer, more scientifically grounded foundation for evolving occupation-based interventions across the entire human lifespan.
SIPSIS and Professional Context
The Sensory Integration & Processing Special Interest Section (SIPSIS) is a dedicated professional body focused explicitly on advancing OT research and further developing SI theory, assessment methodologies, and intervention strategies as they are directly applied in occupational therapy practice. This section was formerly known as SIS and is now referred to as SIPSIS.
SIPSIS provides valuable resources for its members and the broader OT community, including:
Opportunities to meet directly with the committee members, accessible via www.aota.org/SIPSIS
A dedicated online forum for discussion and collaboration, available at www.aota.org/SIPSIS-forum
Note on Sleep Interventions and NTPE (Night Time Positioning Equipment)
Sleep is recognized as a complex, absolutely essential occupation, profoundly connected to the overall physical, emotional, and cognitive well-being of individuals. Both rest and sleep are explicitly recognized as fundamental occupations within the Occupational Therapy Practice Framework (AOTA, 2014; with updates through 2017).
In individuals diagnosed with intellectual and developmental disabilities (IDD), sleep disturbances are unfortunately common and directly correlate with significantly lower sleep quality and shorter sleep duration. This issue is particularly pronounced when mobility limitations necessitate frequent repositioning during the night (Sandella et al., 2011).
Night Time Positioning Equipment (NTPE): This approach involves the use of individualized bed modification strategies specifically designed to address underlying sensorimotor and musculoskeletal factors. It achieves this by carefully positioning the body symmetrically and in proper alignment, with the ultimate goal of positively influencing sleep participation. Reported benefits from limited evidence include improvements in spasms, enhanced pressure relief, and increased overall comfort for the individual. While current evidence is still limited, NTPE shows considerable promise as a supportive intervention for promoting healthy sleep occupations in IDD populations.
NTPE components and rationale:
NTPE specifically targets sensorimotor and musculoskeletal factors with the aim of promoting optimal body symmetry and alignment. This strategic positioning is believed to directly improve sleep participation, especially for individuals with significant mobility limitations who struggle to maintain comfortable and therapeutic positions independently.
Beyond direct positioning benefits, NTPE may influence broader sleep-related outcomes by fostering improved rest and recovery during the night, which in turn significantly supports enhanced daytime functioning and engagement in other occupations.
Practical considerations and framework:
A comprehensive conceptual OT framework for sleep management has been proposed. This framework is designed to guide clinical practice by integrating person, environment, and occupation to holistically support sleep. It advocates for a multi-faceted approach involving environmental adjustments, the appropriate use of assistive equipment, activity-based strategies, cognitive-behavioral approaches, and broader lifestyle interventions to optimize sleep (Reference: Ho & Siu, 2018).
Evidence and professional practice:
A survey involving approximately 250 occupational therapists across the United States revealed significant concerns regarding the insufficient coverage and integration of sleep-related issues within the traditional occupational profile and evaluation processes. This finding underscores a growing professional drive and imperative to incorporate more focused sleep-assessment and intervention strategies into routine OT practice.
Example article (case- or intervention-focused): The article by Casey, Hoffman, Hutson, and Kittelson-Aldred, titled “Supporting the Occupation of Sleep Through Night Time Positioning Equipment,” serves as a practical example of an OT intervention focused on NTPE to address sleep challenges.
Context and implications:
Sleep interventions, including the application of NTPE, powerfully illustrate the comprehensive capacity of occupational therapy to address complex, multi-factorial occupational challenges. By judiciously combining the assessment of client factors, strategic environmental design, and tailored occupational strategies, OTs can significantly improve participation in sleep and other related daytime occupations.
Connections to Foundational Principles and Real-World Relevance
This discussion meticulously reinforces several foundational principles of occupational therapy: centrally, the concept of occupation as the core of human existence; the critical importance of the person–environment–occupation (PEO) fit; and the pervasive role of sensory processing in facilitating successful engagement in all daily activities.
It actively encourages OT practitioners to rigorously bridge theoretical constructs from OT with empirical evidence derived from neuroscience and behavioral science. This integrative approach is crucial for expanding the scope of effective assessment strategies and enhancing the sophistication of intervention planning.
The real-world relevance of these discussions is extensive, encompassing critical areas such as fostering cross-disciplinary collaboration for advanced research on sensory function in complex populations like those with autism spectrum disorder, and the practical development of innovative OT programs in areas such as comprehensive sleep management for individuals with intellectual and developmental disabilities (IDD).
Key References (selected notable sources cited in the transcript)
Ayres, A. J. (1972). Sensory integration and learning disorders. Los Angeles: Western Psychological Services.
Ayres, A. J. (1974). The development of sensory integrative theory and practice. Dubuque, IA: Kendall/Hunt.
Ayres, A. J. (2005). Sensory integration and the child: 25th anniversary edition. Los Angeles: Western Psychological Services.
Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006). Sensory Experiences Questionnaire: Discriminating sensory features in young children with autism, developmental delays, and typical development. J Child Psychol Psychiatry, 47, 591–601.
Blanche, E. I. (2001). Transformative occupations and long-range adaptive responses. In S. Smith Roley, E. Blanche, & R. Schaaf (Eds.), Understanding the nature of sensory integration with diverse populations (pp. 421–433). San Antonio: Therapy Skill Builders.
Bremner, A. J., Lewkowicz, D. J., & Spence, C. (2012). Multisensory development. OUP.
Bundy, A. C., Lane, S. J., & Murray, E. A. (2002). Sensory integration theory and practice (2nd ed.). Philadelphia: F.A. Davis.
Dunn, W. (2001). The sensations of everyday life. Am J OT, 55, 608–620.
Hanft, B. E., Miller, L. J., & Lane, S. J. (2000). Toward a consensus in terminology in sensory integration theory and practice: Part 3. Observable behaviors: Sensory integration dysfunction. Sensory Integration Special Interest Section Quarterly, 23(3), 1–4.
Kandel, E. R., Schwartz, J. H., Jessell, T. M., Siegelbaum, S. A., & Hudspeth, A. J. (2013). Principles of neural science (5th ed.). New York: McGraw-Hill.
Lane, S. J., Miller, L. J., & Hanft, B. E. (2000). Toward a consensus in terminology in sensory integration theory and practice: Part 2. Sensory integration patterns of function and dysfunction. Sensory Integration Special Interest Section Quarterly, 23(2), 1–3.
Miller, L. J., & Lane, S. J. (2000). Toward a consensus in terminology in sensory integration theory and practice: Part 1. Taxonomy of neurophysiological processes. Sensory Integration Special Interest Section Quarterly, 23(1), 1–4.
Miller, L. J., Nielsen, D. M., Schoen, S. A., & Brett-Green, B. A. (2009). Perspectives on sensory processing disorder: A call for translational research. Frontiers in Integrative Neuroscience, 3, Article 22.
Parham, L. D., Ecker, C., Kuhaneck, H. M., Henry, D. A., & Glennon, T. J. (2007). Sensory Processing Measure manual. Los Angeles: Western Psychological Services.
Powers, A. R., Hillcock, A. R., & Wallace, M. T. (2009). Perceptual training narrows the temporal window of multisensory binding. J Neurosci, 29, 12265–12274.
Schauder, K. B., & Bennetto, L. (2016). Interdisciplinary understanding of sensory dysfunction in autism: Neural and symptom literatures. Front Neurosci, 10, 268.
Stein, B. E. (2012). The new handbook of multisensory processing. MIT Press.
Stein, B. E., & Meredith, M. A. (1993)). The merging of the senses. MIT Press.
Wolfe, J. M., Kluender, K. R., Levi, D. M., Bartoshuk, L. M., Herz, R. S., Klatzky, R., … Merfeld, D. M. (2012)). Sensation & Perception (3rd ed.). Sinauer Associates.
Cascio, C. J., Woynaroski, T., Baranek, G. T., & Wallace, M. T. (2016)). Toward an interdisciplinary approach to understanding sensory function in autism spectrum disorder. Autism Res, 9, 920–925.
Dunn, W. (2001)). The sensations of everyday life: Empirical, theoretical, and pragmatic considerations. Am J OT, 55, 608–620.
Fung, W. et al. (2013)). Sleep interventions for occupational therapy practice in IDD: Postural and environmental considerations. (Referenced in sleep section).
Hill, E. M., & Goldsmith, C. H. (2010)). Related work on sleep and sensorimotor considerations. (Referenced in sleep discussion).
Innocente, L. (2014)). Night Time Positioning Equipment (NTPE) in IDD. (NTPE definition and rationale).
Ho, J., & Siu, A. (2018)). Conceptual framework for OT sleep management. (Sleep framework).
Casey, J., Hoffman, L., Hutson, J., & Kittelson-Aldred, T. (NTPE sleep article). (Casey et al., article title in transcript)
Paraphrased references reflect the cross-disciplinary dialogue around sensory terminology and practice implications across OT, neuroscience, and behavioral science.
Notes for Exam Preparation
Expect comprehensive questions about how Occupational Therapy (OT), neuroscience, and behavioral science distinctly define and apply key concepts such as Sensory Integration (SI), Multisensory Integration (MSI), Sensory Processing (SP), sensory modulation, and sensory discrimination/perception. Be thoroughly prepared to elucidate how these definitions diverge across disciplines and articulate the critical importance of effective cross-disciplinary collaboration.
Be ready to discuss in detail how a lack of terminological clarity can significantly impact the accuracy and effectiveness of assessment, the strategic planning and implementation of intervention, and especially interprofessional communication within the context of pediatric practice.
Develop a clear understanding of how the Sensory Integration & Processing Special Interest Section (SIPSIS) specifically contributes to occupational therapy research and the ongoing development of SI theory and practice, including familiarity with its provided resources and online forums for clinicians.
For topics related to sleep-focused OT practice, ensure you confidently know the comprehensive rationale behind Night Time Positioning Equipment (NTPE), understand precisely how NTPE effectively addresses complex sensorimotor and musculoskeletal factors to improve sleep, and be aware of the current state of evidence supporting its use. Furthermore, recognize the fundamental role of sleep as a core occupation within the Occupational Therapy Practice Framework and appreciate the significant value of utilizing a structured sleep-management framework when working with individuals with intellectual and developmental disabilities (IDD).
Be prepared to accurately cite key studies and authors, including Ayres, Dunn, Parham, Stein, Wolfe, Powers, Powers et al., and Parham et al. Demonstrate familiarity with their substantial contributions and how their scholarly work continues to shape contemporary thinking and practice concerning sensory processing across various scientific and clinical disciplines.