Notes on Sensory Modulation Terminology Across Disciplines - Part Two
Sensory Modulation
Context and purpose
Part Two of the examination of sensory-related terminology across disciplines (OT, neuroscience, behavioral science).
Sensory integration (SI) theory and related intervention techniques are widely used in pediatric occupational therapy practice; understanding terminology across disciplines improves collaboration, research, and clinical reasoning.
Part I reviewed terminology such as sensory integration, multisensory integration, sensory processing, sensory modulation, and sensory discrimination. Part II discusses terms linked to sensory modulation: sensory registration, arousal, and self-regulation.
Table 1 (not reproduced here) summarizes how terms are defined across disciplines.
Key historical developments in sensory modulation
Ayres (1950s–2005) introduced the idea of modulating as a balance between excitatory and inhibitory CNS functions in response to sensory signals; observable behaviors are used to infer how well CNS modulation operates.
Early examples of CNS modulation problems: tactile defensiveness and gravitational insecurity (vestibular-related) as observers’ negative responses to sensory input.
Knickerbocker (1980) and Royeen & Lane (1991) expanded modulation to a continuum of behavioral responses from hypo- to hyper-reactivity.
Dunn and Brown: developed a caregiver- or self-report questionnaire to assess how sensory inputs affect behavior; Dunn (1999) proposed four quadrants for behavioral responses to sensory input:
Low registration
Sensation seeking
Sensory sensitivity
Sensation avoiding
Lane et al. (2000) defined sensory modulation as the capacity to regulate and organize the degree, intensity, and nature of response to sensory input in a graded and adaptive manner (p. 2).
Over time, terminology became diverse and confusing; however, at the neuronal level, sensory modulation is understood as the excitatory and inhibitory CNS functions in response to sensory signals (Ayres, 2005).
Cross-disciplinary terminology
Neuroscience: a term not routinely used for behavioral modulation; closest concept is neuromodulation (physiological regulation of nerve activity) (Katz & Calin-Jageman, 2009).
Behavioral sciences: sensory modulation is not a common term; behavioral responses to sensory input are typically described as hyper- or hyporeactive (per DSM-5 criteria for autism; American Psychiatric Association, 2013).
Sensory Registration (OT, neuroscience, behavioral science)
OT perspective (Ayres, 2005): registration is a behavioral orientation to sensory input; three aspects of poor sensory processing in autism are registration, modulation, and motivation/interest; linked to decreased responses and often termed hyporeactivity/hyporesponsiveness (Baranek et al., 2019).
Neuroscience perspective: term registration is not commonly used; preferred term is detection (firing of one or more neurons in response to a single sensory event) and sometimes sensory transduction (conversion of stimulus energy into a sensory signal) (Purves et al., 2012; Jones, 2016).
Behavioral science: registration describes conscious and non-conscious responses to sensory events and subsequent behavior (Rissling & Light, 2010; Schauder & Bennetto, 2016).
Arousal
Occupational therapy view: arousal is a complex, heterogeneous process; Ayres used “aroused attention” to describe neural reactions linked to detection preparing the nervous system for fight/flight; activation is discussed relative to an “optimal” band of engagement (Baranek et al., 2001).
Neuroscience view: arousal is a process observable in responses to sensory events, motor activity, and emotional reactivity; includes tonic (baseline) arousal and phasic (responsive) arousal; phasic arousal relates to sensory reactivity (Wass et al., 2015).
Behavioral science view: arousal is used in relation to cortical arousal and linked to personality traits, anxiety, attention, and behavioral responses (Corr, 2011; Zuckerman, 2014).
Self-Regulation
OT perspective: no single unified definition; varies with theoretical framework; within a sensory processing framework, self-regulation is linked to using sensory strategies to control alertness/arousal, sensory processing, and SI intervention (Williams & Shellenberger, 1996; Boyd et al., 2009; Roberts et al., 2007).
Neuroscience perspective: term is not routinely used; some research differentiates emotional regulation (prefrontal cortex) from sensory over-responsivity (amygdala activity; Green et al., 2015).
Behavioral science perspective: self-regulation is tied to observable behaviors and factors such as behavior, emotions, social competence, psychopathology, cognition, and executive functions (Barkley, 2001; Bridgett et al., 2013).
Practical implications for practice and communication
Terminology variations across disciplines can affect clinical reasoning, evaluation, and intervention planning.
Documentation without specifying hypo- vs. hyper-responsivity (modulation) can leave readers to infer; precise terminology improves clarity.
The term sensory integration is sometimes misused to describe any intervention with sensory input; not all such interventions are SI per se.
Training OT practitioners to recognize and bridge disciplinary differences enhances interdisciplinary communication and research collaboration.
The Sensory Integration & Processing Special Interest Section (SIPSIS)
Formerly referred to as the Sensory Integration Special Interest Section.
Focuses on research and development of sensory integration theory, assessment, and intervention as applied to OT practice.
Mission: enrich occupational performance and participation across the lifespan by focusing on neurobiological, sensory, and praxis foundations of occupation.
Resources: Meet the SIPSIS committee at www.aota.org/SIPSIS; participate in the CommunOT discussion at www.aota.org/SIPSIS-forum.
Sensory Registration
In OT, registration relates to how an individual notices or responds to salient environmental information; associated with reduced responsiveness.
Historical viewpoint (Miller & Lane, 2000): registration = failure to record/notice/respond to salient environmental information; hypo- or hyper-responsivity signs of poor modulation.
Current OT research position: registration is linked to decreased responses and often termed hyporeactivity/hyporesponsiveness (Baranek et al., 2019).
Neuroscience stance: registration is not commonly used; detection is preferred (Jones, 2016).
Behavioral science stance: registration describes conscious and non-conscious responses to sensory events and subsequent behavior (Rissling & Light, 2010; Schauder & Bennetto, 2016).
Arousal
OT perspective: arousal is a complex, heterogeneous process; relates to neural preparation for action and may align with an optimal band of engagement.
Historical reference: Ayres’ concept of aroused attention linked to detection and preparation for fight/flight (p. 108).
Neuroscience perspective: arousal includes tonic (baseline) and phasic (responsive) components; phasic arousal ties to sensory reactivity (Wass et al., 2015).
Behavioral science perspective: arousal intersects with cortical arousal and traits like anxiety, attention, and personality (Corr, 2011; Zuckerman, 2014).
Self-Regulation
OT perspective: no single definition; depends on the theoretical framework; within sensory processing, self-regulation involves using sensory strategies to influence alertness/arousal, processing, and participation in activities (Williams & Shellenberger, 1996; Roberts et al., 2007).
Neuroscience perspective: not routinely labeled as self-regulation; some findings distinguish emotional regulation (prefrontal cortex) from sensory over-responsivity (amygdala; Green et al., 2015).
Behavioral science perspective: self-regulation is tied to observable behavior and constructs like emotion, social competence, psychopathology, cognition, and executive functions (Barkley, 2001; Bridgett et al., 2013).
The Sensory Integration & Processing Special Interest Section (SIPSIS)
Description: A forum within OT focused on research and development of SI theory, assessment, and intervention as applied in practice.
Purpose: To support OT practice that enhances participation and performance by addressing neurobiological, sensory, and praxis foundations of occupation.
Resources: Visit www.aota.org/SIPSIS for committee information and www.aota.org/SIPSIS-forum for discussion.
Summary
Across OT, neuroscience, and behavioral science, terms related to sensory modulation are variably defined, reflecting each discipline’s history, concepts, and priorities.
For clinicians, awareness of cross-disciplinary definitions improves communication, evaluation, and intervention planning.
Documentation should specify the type of modulation (hypo- vs. hyper-responsivity) rather than using a broad term like modulation alone to avoid misinterpretation.
There is a tension between the OT use of “sensory integration” as an intervention framework and how other disciplines use or interpret sensory input-based practices.
Effective OT training should include an understanding of how other disciplines term similar constructs to facilitate collaboration and evidence-informed practice.
Formulas and Equations
None explicitly provided in the transcript. The material discusses concepts and terminology rather than mathematical relationships.
Key References (selected from the transcript)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Ayres, A. J. (2005). Sensory integration and the child: 25th anniversary edition. Los Angeles: Western Psychological Services.
Baranek, G. T., Carlson, M., Sideris, J., Kirby, A. V., Watson, L. R., Williams, K. L., & Bulluck, J. (2019). Longitudinal assessment of stability of sensory features in children with autism spectrum disorder or other developmental disabilities. Autism Research, 12, 100-111.
Baranek, G. T., Reinhartsen, D. B., & Wannamaker, S. W. (2001). Play: Engaging young children with autism. In R. A. Huebner (Ed.), Autism: A sensorimotor approach to management (pp. 313-351). Gaithersburg, MD: Aspen Publishers.
Barkley, R. A. (2001). The executive functions and self-regulation: An evolutionary neuropsychological perspective. Neuropsychology Review, 11, 1-29.
Bodison, S. C. (2018). A comprehensive framework to embed sensory interventions within occupational therapy practice. SIS Quarterly Practice Connections, 3(2), 14-16.
Bodison, S. C., Stein Duker, L. I., Cermak, S. A., & Blanche, E. I. (2019). An examination of sensory-related terminology across disciplines: Part one. SIS Quarterly Practice Connections, 4(2), 5-7.
Boyd, B. A., McBee, M., Holtzclaw, T., Baranek, G. T., & Bodfish, J. W. (2009). Relationships among repetitive behaviors, sensory features, and executive functions in high functioning autism. Research in Autism Spectrum Disorders, 3, 959-966.
Bridgett, D. J., Oddi, K. B., Laake, L. M., Murdock, K. W., & Bachmann, M. N. (2013). Integrating and differentiating aspects of self-regulation: Effortful control, executive functioning, and links to negative affectivity. Emotion, 13, 47-63.
Brown, C., & Dunn, W. (2002). Adolescent/adult sensory profile user’s manual. San Antonio: Psychological Corporation.
Dunn, W. (1999). The sensory profile: User’s manual. (Multiple related works cited: Brown & Dunn, 2002; Lane et al., 2000.)
Jones, S. (2016). [Source cited for detection terminology in neuroscience].
Purves, D., et al. (2012). Neuroscience. Sunderland, MA: Sinauer Associates.
Pfaff, D., et al. (2008). [Source cited for arousal concepts in neuroscience].
Green, S. A., et al. (2015). [Study on emotional regulation and amygdala activity in sensory over-responsivity].
Wass, S., et al. (2015). [On phasic arousal and sensory reactivity].
Corr, P. J. (2011). [Personality and arousal-related discussion].
Zucker-man, E. (2014). [Personality, anxiety, attention and arousal discussion].
Sensory Modulation
Context and purpose
This note serves as Part Two of an in-depth examination of sensory-related terminology as understood and utilized across various disciplines, specifically Occupational Therapy (OT), neuroscience, and behavioral science. This interdisciplinary approach is crucial because sensory integration (SI) theory and its associated intervention techniques are foundational and widely applied in pediatric occupational therapy practice. A comprehensive understanding of terminology across these distinct disciplines significantly improves interprofessional collaboration, strengthens research efficacy, and refines clinical reasoning for practitioners.
Part I of this examination previously reviewed core terms such as sensory integration, multisensory integration, sensory processing, sensory modulation, and sensory discrimination. Part II builds upon this foundation by delving into terms that are specifically linked to the broader concept of sensory modulation: sensory registration, arousal, and self-regulation.
(Note: Table 1, referenced in the original context, provides a summary of how these terms are defined across disciplines but is not reproduced here.)
Key historical developments in sensory modulation
Ayres (1950s–2005) pioneered the concept of sensory modulation, describing it as a dynamic balance between excitatory and inhibitory central nervous system (CNS) functions in response to incoming sensory signals. Ayres emphasized that observable behaviors serve as critical indicators from which to infer the efficiency and effectiveness of CNS modulation.
Early examples of CNS modulation problems identified by Ayres included tactile defensiveness (an adverse reaction to touch, often perceived as irritating or threatening) and gravitational insecurity (a vestibular-related issue characterized by an excessive fear of movement or changes in head position). These were initially observed as negative and sometimes disproportionate behavioral responses to specific types of sensory input.
Knickerbocker (1980) and Royeen & Lane (1991) significantly expanded the understanding of modulation by conceptualizing it as a continuum of behavioral responses. This continuum ranges from hypo-reactivity (under-responsiveness or a diminished reaction to sensory input) to hyper-reactivity (over-responsiveness or an exaggerated reaction to sensory input).
Dunn (1999) and Brown & Dunn (2002) further developed this understanding by introducing a comprehensive model, often assessed through caregiver or self-report questionnaires (e.g., the Sensory Profile). This model examines how sensory inputs influence behavior and proposed four distinct quadrants for classifying behavioral responses to sensory input:
Low registration: Individuals may miss or not notice sensory input, requiring more intense or prolonged stimulation to respond.
Sensation seeking: Individuals actively seek out intense sensory experiences.
Sensory sensitivity: Individuals are easily distracted or bothered by sensory input, noticing more input than others.
Sensation avoiding: Individuals actively avoid or try to minimize sensory input.
Lane et al. (2000) provided a more formal definition, describing sensory modulation as the inherent capacity to regulate and organize the degree, intensity, and nature of the response to sensory input in a manner that is both graded (appropriately scaled) and adaptive (contributing positively to function and interaction with the environment) (p. 2).
Over time, the terminology related to sensory modulation became increasingly diverse and, at times, confusing across different professional domains. However, at the fundamental neuronal level, sensory modulation consistently refers to the intricate interplay of excitatory and inhibitory CNS functions that occur in response to sensory signals (Ayres, 2005).
Cross-disciplinary terminology
Neuroscience: In neuroscience, sensory modulation is not a routinely used term for describing behavioral modulation. The closest and more widely accepted concept in this field is neuromodulation, which refers to the physiological regulation of nerve activity. This involves processes where specific neurons use one or more chemical messengers to regulate diverse populations of neurons, affecting functions like attention, sleep, and mood (Katz & Calin-Jageman, 2009).
Behavioral sciences: Similarly, sensory modulation is not a common term within behavioral sciences. Instead, behavioral responses to sensory input are typically described using more direct terms such as hyper- or hyporeactive. These descriptions are often utilized, for example, within the diagnostic criteria for conditions like autism spectrum disorder (ASD) as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013).
Sensory Registration (OT, neuroscience, behavioral science)
OT perspective (Ayres, 2005): Sensory registration is conceptualized as a behavioral orientation or initial awareness of sensory input. Ayres often linked poor sensory processing in autism to three key aspects: registration, modulation, and motivation/interest. Within this framework, poor registration is frequently characterized by decreased responses to sensory stimuli and is often termed hyporeactivity/hyporesponsiveness (Baranek et al., 2019).
Neuroscience perspective: The term "registration" is not commonly used in neuroscience. Preferred terms include detection (which refers to the firing of one or more neurons in response to a single sensory event, indicating the initial processing of a stimulus) and, at a more fundamental level, sensory transduction (the critical process where stimulus energy is converted into a neural or sensory signal that the nervous system can interpret) (Purves et al., 2012; Jones, 2016).
Behavioral science: In behavioral science, "registration" describes both conscious (e.g., explicitly noticing a sound) and non-conscious (e.g., a reflexive startle response) responses to sensory events and the subsequent influence these responses have on observable behavior (Rissling & Light, 2010; Schauder & Bennetto, 2016).
Arousal
Occupational therapy view: Arousal is understood as a complex and heterogeneous process. Ayres used the concept of “aroused attention” to describe neural reactions linked to the detection of salient stimuli, which would prepare the nervous system for a
Sensory Modulation
Context and purpose
This note serves as Part Two of an in-depth examination of sensory-related terminology as understood and utilized across various disciplines, specifically Occupational Therapy (OT), neuroscience, and behavioral science. This interdisciplinary approach is crucial because sensory integration (SI) theory and its associated intervention techniques are foundational and widely applied in pediatric occupational therapy practice. A comprehensive understanding of terminology across these distinct disciplines significantly improves interprofessional collaboration, strengthens research efficacy, and refines clinical reasoning for practitioners.
Part I of this examination previously reviewed core terms such as sensory integration, multisensory integration, sensory processing, sensory modulation, and sensory discrimination. Part II builds upon this foundation by delving into terms that are specifically linked to the broader concept of sensory modulation: sensory registration, arousal, and self-regulation.
(Note: Table 1, referenced in the original context, provides a summary of how these terms are defined across disciplines but is not reproduced here.)
Key historical developments in sensory modulation
Ayres (1950s–2005) pioneered the concept of sensory modulation, describing it as a dynamic balance between excitatory and inhibitory central nervous system (CNS) functions in response to incoming sensory signals. Ayres emphasized that observable behaviors serve as critical indicators from which to infer the efficiency and effectiveness of CNS modulation.
Early examples of CNS modulation problems identified by Ayres included tactile defensiveness (an adverse reaction to touch, often perceived as irritating or threatening) and gravitational insecurity (a vestibular-related issue characterized by an excessive fear of movement or changes in head position). These were initially observed as negative and sometimes disproportionate behavioral responses to specific types of sensory input.
Knickerbocker (1980) and Royeen & Lane (1991) significantly expanded the understanding of modulation by conceptualizing it as a continuum of behavioral responses. This continuum ranges from hypo-reactivity (under-responsiveness or a diminished reaction to sensory input) to hyper-reactivity (over-responsiveness or an exaggerated reaction to sensory input).
Dunn (1999) and Brown & Dunn (2002) further developed this understanding by introducing a comprehensive model, often assessed through caregiver or self-report questionnaires (e.g., the Sensory Profile). This model examines how sensory inputs influence behavior and proposed four distinct quadrants for classifying behavioral responses to sensory input:
Low registration: Individuals may miss or not notice sensory input, requiring more intense or prolonged stimulation to respond.
Sensation seeking: Individuals actively seek out intense sensory experiences.
Sensory sensitivity: Individuals are easily distracted or bothered by sensory input, noticing more input than others.
Sensation avoiding: Individuals actively avoid or try to minimize sensory input.
Lane et al. (2000) provided a more formal definition, describing sensory modulation as the inherent capacity to regulate and organize the degree, intensity, and nature of the response to sensory input in a manner that is both graded (appropriately scaled) and adaptive (contributing positively to function and interaction with the environment) (p. 2).
Over time, the terminology related to sensory modulation became increasingly diverse and, at times, confusing across different professional domains. However, at the fundamental neuronal level, sensory modulation consistently refers to the intricate interplay of excitatory and inhibitory CNS functions that occur in response to sensory signals (Ayres, 2005).
Cross-disciplinary terminology
Neuroscience: In neuroscience, sensory modulation is not a routinely used term for describing behavioral modulation. The closest and more widely accepted concept in this field is neuromodulation, which refers to the physiological regulation of nerve activity. This involves processes where specific neurons use one or more chemical messengers to regulate diverse populations of neurons, affecting functions like attention, sleep, and mood (Katz & Calin-Jageman, 2009).
Behavioral sciences: Similarly, sensory modulation is not a common term within behavioral sciences. Instead, behavioral responses to sensory input are typically described using more direct terms such as hyper- or hyporeactive. These descriptions are often utilized, for example, within the diagnostic criteria for conditions like autism spectrum disorder (ASD) as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013).
Sensory Registration (OT, neuroscience, behavioral science)
OT perspective (Ayres, 2005): Sensory registration is conceptualized as a behavioral orientation or initial awareness of sensory input. Ayres often linked poor sensory processing in autism to three key aspects: registration, modulation, and motivation/interest. Within this framework, poor registration is frequently characterized by decreased responses to sensory stimuli and is often termed hyporeactivity/hyporesponsiveness (Baranek et al., 2019).
Neuroscience perspective: The term "registration" is not commonly used in neuroscience. Preferred terms include detection (which refers to the firing of one or more neurons in response to a single sensory event, indicating the initial processing of a stimulus) and, at a more fundamental level, sensory transduction (the critical process where stimulus energy is converted into a neural or sensory signal that the nervous system can interpret) (Purves et al., 2012; Jones, 2016).
Behavioral science: In behavioral science, "registration" describes both conscious (e.g., explicitly noticing a sound) and non-conscious (e.g., a reflexive startle response) responses to sensory events and the subsequent influence these responses have on observable behavior (Rissling & Light, 2010; Schauder & Bennetto, 2016).
Arousal
Occupational therapy view: Arousal is understood as a complex and heterogeneous process. Ayres used the concept of “aroused attention” to describe neural reactions linked to the detection of salient stimuli, which would prepare the nervous system for a