Sensory integration is a long-standingand growing area of practice in occupa-

tional therapy. Debate and discussion withcolleagues have led us to develop a pro-posed taxonomy reflecting a new classifica-tion scheme to enhance diagnostic speci-ficity. The nosology proposed here is rootedin empirical data first published by Ayres(Ayres, 1972b, 1989) that has evolvedbased on empirical and theoretical infor-mation. This new nosology provides aviewpoint for discussion and research.

Two sociopolitical trends contribute tothe timeliness of the ideas presented. First,a call exists throughout health and develop-mental services for evidence-based practice(Sackett, Richardson, Rosenberg, &Haynes, 1997). Diagnostic precision is cru-cial for homogeneity of samples in empiri-cal research, affecting the validity of theresearch findings. Second, the condition ofsensory processing disorders (SPD) hasrecently been acknowledged outside theoccupational therapy profession in threediagnostic classification references: theDiagnostic Classification of Mental Healthand Developmental Disorders of Infancy andEarly Childhood, Revised (known as theDC: 0–3R) (Zero to Three, 2005), theDiagnostic Manual for Infancy and EarlyChildhood of the Interdisciplinary Councilon Developmental and Learning Disorders(ICDL, 2005), and the PsychodynamicDiagnostic Manual (PDM Task Force,2006). Both manuals include diagnostictaxonomies with subtypes of SPD sug-gested by a committee of occupational ther-apists, who assisted in developing guide-lines for diagnostic specificity related to

sensory-based disorders (Miller, Cermak,Lane, Anzalone, & Koomar, 2004).

Legacy of Dr. A. Jean AyresThe term sensory integration dysfunction wasfirst used by Ayres in 1963 (Ayres, 1963). Apioneer with educational degrees in occu-pational therapy and academic psychologyand postdoctoral training as a neuroscien-tist, Ayres explored the association betweensensory processing and the behavior of chil-dren with learning, developmental, emo-tional, and other disabilities in scientificjournals and later in her groundbreakingbook, Sensory Integration and LearningDisorders (Ayres, 1972a). On the basis ofknowledge of neural science and detailedobservation of child behavior, Ayres theo-rized that impaired sensory processingmight result in various functional prob-lems, which she labeled sensory integrationdysfunction. The condition was initiallybased on studies of the Southern CaliforniaSensory Integration Tests (Ayres, 1972b)and later from studies of the SensoryIntegration and Praxis Tests (SIPT; Ayres,1989) and related clinical observations.

Later scholars clarified the many usesof the term sensory integration (Bundy, Lane,& Murray, 2002; Clark & Primeau, 1988).Sensory integration theory refers to con-structs that discuss how the brain processessensation and the resulting motor, behavior,emotion, and attention responses. Sensoryintegration assessment is the process of eval-uating persons for problems in processingsensation. Sensory integration treatment is amethod of intervention. Ayres’s original

The American Journal of Occupational Therapy 135

Shelly J. Lane

FROM THE GUEST EDITOR

Concept Evolution in Sensory Integration:A Proposed Nosology for Diagnosis

Lucy Jane Miller, Marie E. Anzalone, Shelly J. Lane, Sharon A. Cermak, Elizabeth T. Osten

Lucy Jane Miller, PhD, OTR, FAOTA, is AssociateClinical Professor, Departments of Rehabilitation Medicineand Pediatrics, University of Colorado at Denver and HealthSciences Center; Director, Sensory Therapies and Research(STAR) Center; and Director, KID Foundation, GreenwoodVillage, CO.

Marie E. Anzalone, ScD, OTR, FAOTA, is AssistantProfessor, Department of Occupational Therapy, VirginiaCommonwealth University, Richmond.

Shelly J. Lane, PhD, OTR, FAOTA, is Professor andChair, Department of Occupational Therapy, VirginiaCommonwealth University, Richmond.

Sharon A. Cermak, EdD, OTR, FAOTA, is Professor ofOccupational Therapy, Sargent College of Health andRehabilitation Sciences, Boston University, Boston.

Elizabeth T. Osten, MS, OTR, is Director, Osten andAssociates, Pediatric Therapy Services, Skokie, IL.

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136 March/April 2007, Volume 61, Number 2

term, sensory integration dysfunction, hadreferred to the disorder as a whole.

As Ayres published and taught aboutsensory integration (Ayres, 1965, 1972a),her new frame of reference was used, pri-marily in occupational therapy. Ayres’s earlyconceptualizations defined six syndromes ofdysfunction (Ayres, 1972a), later refinedwith data from her new test battery (Ayres,1989). Although Ayres’s own conceptual-izations evolved frequently as she com-pleted new empirical studies, no suggestionof a substantive evolution from Ayres’s orig-inal diagnostic conceptualization has beenproposed since her last publication in 1989(Ayres, 1989).

Moving Beyond the LegacyDiscussion of a new diagnostic taxonomy isincreasingly important because the inter-vention, occupational therapy with a sen-sory integration approach (OT-SI), is usedwith many people who cannot be testedusing the SIPT. Importantly, the SIPTformed the primary empirical basis for thediagnostic categories. To achieve consensuson an alternative taxonomy for diagnosis,Miller and colleagues held focus groups in1998–2000 that resulted in three publica-tions (Hanft, Miller, & Lane, 2000; Lane,Miller, & Hanft, 2000; Miller & Lane,2000). Results were not unanimous, butmost participants agreed that terminologyfor the diagnosis and the treatment of thedisorder should diverge. In addition, con-cern was expressed related to use of the termsensory integration, which many participantsin the focus groups believed is often inter-preted differently within and outside thefield of occupational therapy. (For example,use of the term sensory integration oftenapplies to a neurophysiologic cellular pro-cess rather than a behavioral response tosensory input as connoted by Ayres.)

The committee consulting to the DC:0–3R and the ICDL examined publishedand unpublished empirical data and con-ferred numerous times over a 2-year periodto arrive at a consensus on a new nosologyfor SPD. The taxonomy resulting from thecommittee’s work was first summarized in2004 (Miller, Cermak, Lane, Anzalone, &Koomar, 2004) and, later, subtypes reflect-ing components of the work were pub-

lished in the diagnostic manuals of boththe ICDL (2005) and Zero to Three(2005). Our long-term intention is to pro-pose one or more subtypes for the upcom-ing revision of the Diagnostic and StatisticalManual of Mental Disorders IV–TR of theAmerican Psychiatric Association (2000),due out in 2012.

Kuhn (1996) discussed the process ofparadigm shift that explains the evolutionof ideas in science. During this process,each new study or theory builds on preced-ing ideas and slowly change evolves. Attimes, a substantial change is required tomove forward. Kuhn (1996) termed thisrevolutionary change because either newempirical evidence disproves previous con-ceptualizations, or enough evolutionarychanges have accumulated to create a needfor reconceptualization and paradigmadjustment. We believe that sensory inte-gration as a diagnosis has achieved the latterstate and thus has reached the tipping pointtoward a paradigm shift.

Since Ayres (1963) first proposed thetheory of sensory integration, many theo-rists, researchers, and clinicians have furtherdeveloped the theory. Models building onAyres’s work have been proposed (e.g.,Dunn, 2001; Miller, Reisman, McIntosh,& Simon, 2001; Mulligan, 1998; Parham,2002; Williamson & Anzalone, 2001), andnew empirical evidence providing insightinto differential diagnosis has been pub-lished (DeGangi, 2000; Mangeot et al.,2001; McIntosh, Miller, Shyu, &Hagerman, 1999; Miller et al., 1999;Schaaf, Miller, Seawell, & O’Keefe, 2003).

In an attempt to reach Kuhn’s (1996)state of equipoise, a state when a professionuniversally agrees to a shift in thinking, wepropose a nosology that differentiates diag-nostic subtypes. The intent of this proposalis to provide a structure for scholarlydebate.

Proposed NosologyThe categories proposed here are based onprevious work by many theorists andresearchers (e.g., DeGangi, 2000; Dunn,2001; Mulligan, 1998). This diagnostic tax-onomy does not suggest changes in termi-nology for sensory integration theory, sen-sory integration treatment, or the sensory

integration evaluation process, only in thediagnostic categorization of people withsensory-based processing challenges. Diag-nostic subgroups within sensory integrationdysfunction encompass immense individualdifferences in detecting, regulating, inter-preting, and responding to sensory input.We propose that a diagnosis of SPD bemade if, and only if, the sensory processingdifficulties impair daily routines or roles.

Sensory “processing” rather than sen-sory “integration,” when used for the diag-nosis of sensory-based processing chal-lenges, distinguishes the disorder from boththe theory (i.e., sensory integration theory)and the intervention (i.e., OT-SI). In addi-tion, the terminology differentiates the con-dition of SPD from the cellular process ofsensory integration. Diagnostic specificitywill enhance the homogeneity of the sam-ples used for empirical research and will promote targeting of interventionapproaches to specific diagnostic subtypes.

The proposed nosology depicted inFigure 1 and described below includes threeclassic categories of SPD. Each pattern isfurther refined into subtypes, delineatedbelow.

Pattern 1: Sensory Modulation Disorder (SMD)

Sensory modulation occurs as the centralnervous system regulates the neural mes-sages about sensory stimuli. SMD resultswhen a person has difficulty responding tosensory input with behavior that is gradedrelative to the degree, nature, or intensity ofthe sensory information. Responses areinconsistent with the demands of the situa-tion, and inflexibility adapting to sensorychallenges encountered in daily life isobserved. Difficulty achieving and main-taining a developmentally appropriaterange of emotional and attentionalresponses often occurs. Three subtypes ofSMD exist as detailed below.

SMD Subtype 1: Sensory Overresponsi-vity (SOR). People with SOR respond tosensation faster, with more intensity, or fora longer duration than those with typicalsensory responsivity. Overresponsivity mayoccur in only one sensory system (e.g., tac-tile defensiveness) or in multiple sensorysystems (e.g., sensory defensiveness). Thewide variation observed in the expression of

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SOR depends on various personal and con-textual factors. SOR prevents people frommaking effective functional responses.Difficulties are particularly evident in newsituations and during transitions. Theintrapersonal range of responses may appearas willful behavior, seemingly illogical andinconsistent.

However, the atypical responsesobserved are not willful; they are automatic,unconscious physiologic reactions to sensa-tion. More intense responses generallyoccur if the stimulation is unexpectedrather than self-generated. In addition, sen-sory input often has a summative effect;thus, a sudden exaggerated response mayoccur to a seeming trivial event because ofthe accumulated events of the day. Behav-iors in SOR range from active, negative,impulsive, or aggressive responses to morepassive withdrawal or avoidance of sensa-tion. Sympathetic nervous system activa-tion is a marker of SOR (Miller et al.,1999), which may result in exaggeratedfight, flight, fright, or freeze responses(Ayres, 1972a). Emotional responsesinclude irritability, moodiness, inconsola-bility, or poor socialization. People withSOR are often rigid and controlling. SORmay occur in combination with other sen-sory modulation disorders (e.g., sensoryseeking, sensory overresponsivity in vestibu-lar and proprioceptive systems) and is oftenobserved concomitantly with sensorydiscrimination disorder (SDD), dyspraxia,or both.

SMD Subtype 2: Sensory Underresponsi-vity (SUR). People with SUR disregard, ordo not respond to, sensory stimuli in their

environments. They appear not to detectincoming sensory information. This lack ofinitial awareness may lead to apathy,lethargy, and a seeming lack of inner driveto initiate socialization and exploration.However, in SUR, inaction is not due to alack of motivation but rather to a failure tonotice the possibilities for action. A failureto respond to pain (e.g., bumps, falls, cuts)or extreme temperatures (hot or cold) istypical. Behavior of people with SOR isoften described as withdrawn, difficult toengage, inattentive, or self-absorbed. Com-pensatory strategies may lead to procrasti-nation, and people with SUR are oftenlabeled “lazy” or “unmotivated.”

Commonly, SUR is not detected ininfancy or toddlerhood. The child may beconsidered a “good baby” or “easy child”because few demands are made on care-givers. However, because people with SURneed high-intensity salient input to becomeinvolved in a task or interaction, when chil-dren are older, the necessary arousal level toparticipate across contexts may not be avail-able. Reports of inconsistency are common(e.g., the child’s behavior is acceptable athome but not at school). SUR occurring intactile and proprioceptive systems usuallyleads to poor tactile discrimination and apoor body scheme with clumsiness. Thus,people with SUR often have concomitantSDD, dyspraxia, or both.

SMD Subtype 3: Sensory Seeking/Craving (SS). People with SS crave anunusual amount or type of sensory inputand seem to have an insatiable desire forsensation. They energetically engage inactions that add more intense sensations to

their bodies in many modalities (e.g., spicyfood, loud noises, visually stimulatingobjects, constant spinning). Invasive SSbehaviors can influence social interactionswith peers (e.g., other people are crowdedand touched, physical boundaries are notobserved). Active SS often leads to sociallyunacceptable or unsafe behavior, includingconstant moving, “crashing and bashing,”“bumping and jumping,” impulsiveness,carelessness, restlessness, and overexpressionof affection. The actions of these peopleoften are interpreted as demanding orattention-seeking behavior.

Some degree of sensory-seeking behav-ior is typical in children as they learn,explore, and master new challenges; how-ever, children and adults who meet criteriafor SS are extreme in their quest for sensoryinput. When unable to meet sensory needs,children may become explosive and aggres-sive. They are frequently labeled “trouble-maker,” “risk-taker,” “bad,” and “danger-ous” and expelled from preschool.Disciplinary trouble in elementary school isalso common. Extreme SS can disruptattention so profoundly that learning iscompromised or activities of daily living aredifficult to complete.

SS may also occur to obtain enhancedinput when reduced perception of sensationoccurs. For example, if a child cannot feelhis zipper well, he may play with the zipperover and over until he has adequate percep-tions of the feel and movement of the zip-per so that he can complete a zipping task.

SS often occurs as the person tries toincrease his or her arousal level. For thosewith SS, the need for constant stimulationis difficult to fulfill, particularly in environ-ments where quiet behavior is expected.Unfortunately, obtaining additional sensorystimulation, if unstructured, may increasethe overall state of arousal, resulting in evenmore disorganized behavior. Specific,directed types of sensory input, however,can have an organizing or self-regulatoryeffect. Some children with SOR will engagein SS behaviors as an attempt at self-regulation (e.g., stereotypy in a child withautism). A challenge is that overactive andimpulsive symptoms in SS can easily beconfused with (and often co-occur with)attention deficit hyperactivity disorder(ADHD).

The American Journal of Occupational Therapy 137

Figure 1. A proposed new nosology for sensory processing disorder.

SENSORY PROCESSING DISORDER (SPD)

Sensory ModulationDisorder (SMD)

Sensory-Based MotorDisorder (SBMD)

Sensory DiscriminationDisorder (SDD)

SOR SUR SS Dyspraxia Postural DisordersVisualAuditoryTactileVestibularProprioceptionTaste/Smell

SOR = sensory overresponsivity.SUR = sensory underresponsivity.SS = sensory seeking/craving.

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Pattern 2: Sensory DiscriminationDisorder (SDD)

People with SDD have difficulty interpret-ing qualities of sensory stimuli and areunable to perceive similarities and differ-ences among stimuli. They can perceivethat stimuli are present and can regulatetheir response to stimuli but cannot tellprecisely what or where the stimulus is.SDD can be observed in any sensorymodality. A person with SDD may havedifferent capacities in each modality (e.g., avisual or auditory discrimination disorderbut good discrimination in all othermodalities).

Traditional models of sensory discrim-ination focus on visual, auditory, and tactileperceptions. Unique to the model proposedhere is the focus on somatic senses.Discrimination in the tactile, propriocep-tive, and vestibular systems leads tosmooth, graded, coordinated movement.SDD in these three systems results in awk-ward motor abilities. SDD in the visual andauditory systems can lead to a learning orlanguage disability. A person with SDDmay require extra time to process thesalient aspects of sensory stimuli, leading to“slow” performance. Low self-confidence,attention-seeking behavior, and tempertantrums may result.

Normal sensory discrimination formsthe foundation of adequate body schemebecause accurate interpretation of sensorystimulation is the basis of feed-forwardmechanisms for planning movement andpostural responses. SDD frequently co-occurs with SUR, resulting in poor bodyscheme and dyspraxia. However, peoplewith SDD also may have SOR; in this situ-ation, overresponsivity is seen to override thediscriminative perceptions from the body.

Pattern 3: Sensory-Based MotorDisorder (SBMD)

People with SBMD have poor postural orvolitional movement as a result of sensoryproblems. The two subtypes of SBMD aredetailed below.

SBMD Subtype 1: Postural Disorder.Postural disorder (PD) is difficulty stabilizingthe body during movement or at rest tomeet the demands of the environment or ofa given motor task. PD is characterized by

inappropriate muscle tension, hypotonic orhypertonic muscle tone, inadequate controlof movement, or inadequate muscle con-traction to achieve movement against resis-tance. Poor balance between flexion andextension of body parts, poor stability, poorrighting and equilibrium reactions, poorweight shifting and trunk rotation, and poorocular–motor control also may be noted.

Postural control provides a stable yetmobile base for refined movement of thehead, eyes, and limbs, which arises fromintegration of vestibular, proprioceptive,and visual information. When postural con-trol is good, the child is able to executefunctional behaviors such as reaching andresistance against gravity. When posturalcontrol is poor, people often slump in astanding or sitting position and cannot eas-ily move body and limbs in antigravity posi-tions. They also may exhibit difficultymaintaining or automatically adjusting aposition so tasks can be performed effi-ciently. For example, when writing at adesk, they may need to bend far over thepaper or lay their head on their arm as theywrite.

PD commonly occurs in combinationwith one or more other subtypes. Thearousal level of the person (e.g., SOR orSUR) and discrimination of sensory infor-mation (e.g., SDD) can affect postural con-trol. PD also can occur with dyspraxia,which usually includes difficulty with bilat-eral integration activities and problems withrhythmic activities.

Some people with PD may tend toavoid movement, preferring sedentaryactivities. Others with PD may be physi-cally active but lack body control and there-fore engage in unsafe movements. Avoid-ance of movement due to PD can bedifferentiated from avoidance of movementdue to SOR in the vestibular system byobserving whether the child (a) is unstableor fearful in challenging positions (PD) or(b) seems to have an aversive response tothe movement (SOR).

SBMD Subtype 2: Dyspraxia. Dyspraxiais an impaired ability to conceive of, plan,sequence, or execute novel actions. Peopleappear awkward and poorly coordinated ingross, fine, or oral–motor areas. Dyspraxiacan occur in the presence of either SOR orSUR but most commonly occurs in the

presence of SUR or SDD in the tactile, pro-prioceptive, or vestibular domains. Visual–motor deficits also are common in thisdisorder.

People with dyspraxia seem unsure ofwhere their body is in space and have trou-ble judging their distance from objects,people, or both. They may seem accident-prone, frequently breaking toys or objectsbecause of difficulty grading force duringmovement. People with dyspraxia usuallyhave poor skills in ball activities and sports.They display difficulty with projectedaction sequences that require timing.People with dyspraxia, like most children,learn by trial and error, but they require sig-nificantly more practice than is typical anddemonstrate decreased ability to generalizeskills to other motor tasks.

Often dyspraxia is associated withideational problems (e.g., formulating goalsor ideas for actions). Because people withdyspraxia are unable to generate new ideasof what to do, they may resort to rigid orinflexible strategies, perseverating and pre-ferring the familiar to the novel. Executionof discrete motor skills (e.g., standing,walking, pincer grasp) may be age appro-priate and of adequate quality. However,the performance of more complex tasks aspart of functional activities in a dynamicenvironment is compromised. Particulardifficulty is observed when tasks requiresubtle adaptation of timing in movement.

Many people with dyspraxia also havetrouble with fine motor manipulative activ-ities as well as oral–motor activities. Dailyactivities, such as using utensils and dress-ing, often are slow to develop or are impre-cise. People with dyspraxia often are disor-ganized and may appear disheveled.

Some people with dyspraxia are highlycreative and verbal, preferring fantasygames to actual “doing.” They may try tomask their dyspraxia by clowning around asa way to mask their reticence for participat-ing in new activities. People with dyspraxiaoften are inactive, preferring sedentaryactivities such as watching TV, playingvideo games, or reading a book, which canresult in a tendency toward obesity. How-ever, dyspraxia may co-occur with ADHD,in which case the child’s behavior is charac-terized by increased activity in the contextof poor coordination. Self-esteem may be

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poor because of dissatisfaction with abilitiesand repeated feelings of failure. Childrenoften have low frustration tolerance andmay be perceived as manipulative or con-trolling. Some children with dyspraxia havean overreliance on language as a compen-satory tool. However, dyspraxia also can co-occur with language or speech impairments.

ConclusionAyres based her original diagnostic classifi-cations primarily on analysis of standard-ized test data, although clinical observationsalso were considered. The model proposedhere is based on empirical analysis of sub-groups of children diagnosed with sensoryintegration dysfunction. The proposed newnosology differentiates three classic pat-terns: SMD, SDD, and SBMD, with sub-types in each pattern.

This taxonomy is intended for use byboth clinicians and researchers to providehomogeneity for sample selection inresearch studies and substantive discrimina-tion of subtypes for planning intervention.Additional evolution in thought is expectedas our knowledge base in this field growsand empirical data expand. Use of samplesselected for specific attributes of SPD sub-types will increase the power of researchstudies (e.g., less unexplained variance insamples). Use of specific diagnoses also willincrease treatment specificity for clinicalpractice.

In summary, appropriate diagnosisforms the cornerstone of rigorous researchand high-quality practice. This new nosol-ogy is proposed as a step in that direction. ▲

AcknowledgmentsThis issue of the American Journal of Occupa-tional Therapy contains the work of manypeople, representing the range from clinicianto researcher. An effort has been made to beinclusive on all levels. Thus, readers will findinformation from clinicians and researchers,on humans and primates, using group andsingle-subject design, addressing the develop-ment of assessments and the effects of inter-vention, discussing OT-SI as the only treat-ment approach and OT-SI combined withother sensory and behavioral approaches. Inthese articles the definition of sensory integra-

tion deficits varies to some degree, reflectingour current struggle to empirically definethese constructs. This is where the proposednosology comes into play.

In the field of occupational therapywe have a relatively large number of pub-lished studies on sensory integration, butas noted above and in this volume, manyare fraught with methodological errors.We still have a long way to go, but thework included in this volume reflects ourcollective effort to continue to move ourfield forward and to do so from a broadperspective. My gratitude goes to the con-tributors; I appreciate the opportunity Ihave had to collect these works andadvance our understanding of SPD.

—Shelly J. Lane

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Diagnostic and statistical manual of mentaldisorders (DSM-IV-TR). Washington, DC:Author.

Ayres, A. J. (1963). Eleanor Clarke SlagleLecture—The development of perceptual–motor abilities: A theoretical basis for treat-ment of dysfunction. American Journal ofOccupational Therapy, 27, 221–225.

Ayres, A. J. (1965). Patterns of perceptual–motor dysfunction in children: A factoranalytic study. Perceptual and Motor Skills,20, 335–368.

Ayres, A. J. (1972a). Sensory integration andlearning disorders. Los Angeles: WesternPsychological Services.

Ayres, A. J. (1972b). Southern California SensoryIntegration Tests. Los Angeles: WesternPsychological Services.

Ayres, A. J. (1989). Sensory Integration and PraxisTests. Los Angeles: Western PsychologicalServices.

Bundy, A. C., Lane, S. J., & Murray, E. A.(Eds.). (2002). Sensory integration: Theoryand practice (2nd ed.). Philadelphia: F. A.Davis.

Clark, F., & Primeau, L. A. (1988). Obfuscationof sensory integration: A matter of profes-sional predation. American Journal ofMental Retardation, 92, 415–420.

DeGangi, G. A. (2000). Pediatric disorders of reg-ulation in affect and behavior: A therapist’sguide to assessment and treatment. SanDiego, CA: Academic Press.

Dunn, W. (2001). 2001 Eleanor Clarke SlagleLecture—The sensations of everyday life:

Empirical, theoretical, and pragmatic con-siderations. American Journal of Occupa-tional Therapy, 55, 608–620.

Hanft, B. E., Miller, L. J., & Lane, S. J. (2000,September). Toward a consensus in termi-nology in sensory integration theory andpractice: Part 3: Observable behaviors:Sensory integration dysfunction. SensoryIntegration Special Interest Section Quarterly,23, 1–4.

Interdisciplinary Council on Developmentaland Learning Disorders. (2005). Diagnosticmanual for infancy and early childhood:Mental health, developmental, regulatory–sensory processing and language disordersand learning challenges (ICDL–DMIC).Bethesda, MD: Author.

Kuhn, T. S. (1996). The structure of scientific rev-olutions (3rd ed.). Chicago: University ofChicago Press.

Lane, S. J., Miller, L. J., & Hanft, B. E. (2000,June). Toward a consensus in terminologyin sensory integration theory and practice:Part 2: Sensory integration patterns offunction and dysfunction. Sensory Integra-tion Special Interest Section Quarterly, 23,1–3.

Mangeot, S. D., Miller, L. J., McIntosh, D. N.,McGrath-Clarke, J., Simon, J., Hagerman,R. J., et al. (2001). Sensory modulationdysfunction in children with attentiondeficit hyperactivity disorder. Develop-mental Medicine and Child Neurology, 43,399–406.

McIntosh, D. N., Miller, L. J., Shyu, V., &Hagerman, R. (1999). Sensory-modulationdisruption, electrodermal responses, andfunctional behaviors. Developmental Medi-cine and Child Neurology, 41, 608–615.

Miller, L. J., Cermak, S., Lane, S., Anzalone, M.,& Koomar, J. (2004, Summer). Positionstatement on terminology related to sen-sory integration dysfunction. S.I. Focus, pp.6–8.

Miller, L. J., & Lane, S. J. (2000, March).Toward a consensus in terminology in sen-sory integration theory and practice: Part 1:Taxonomy of neurophysiological processes.Sensory Integration Special Interest SectionQuarterly, 23, 1–4.

Miller, L. J., McIntosh, D. N., McGrath, J.,Shyu, V., Lampe, M., Taylor, A. K., et al.(1999). Electrodermal responses to sensorystimuli in individuals with Fragile X syn-drome: A preliminary report. AmericanJournal of Medical Genetics, 83, 268–279.

Miller, L. J., Reisman, J. E., McIntosh, D. N.,& Simon, J. (2001). An ecological modelof sensory modulation: Performance of

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children with Fragile X syndrome, autism,attention-deficit/hyperactivity disorder,and sensory modulation dysfunction. In S.S. Roley, E. I. Blanche, & R. C. Schaaf(Eds.), Understanding the nature of sensoryintegration with diverse populations (pp.57–88). San Antonio, TX: Therapy SkillBuilders.

Mulligan, S. (1998). Patterns of sensory integra-tion dysfunction: A confirmatory factoranalysis. American Journal of OccupationalTherapy, 52, 819–828.

Parham, L. D. (2002). Sensory integration andoccupation. In A. C. Bundy, S. J. Lane, &

E. A. Murray (Eds.), Sensory integration:Theory and practice (2nd ed., pp.413–434). Philadelphia: F. A. Davis.

PDM Task Force. (2006). Psychodynamic diag-nostic manual. Silver Spring, MD: Allianceof Psychoanalytic Organizations.

Sackett, D. L., Richardson, W. S., Rosenberg,W., & Haynes, R. B. (1997). Evidence-based medicine: How to practice and teachEBM. New York: Churchill Livingstone.

Schaaf, R. C., Miller, L. J., Seawell, D., &O’Keefe, S. (2003). Children with distur-bances in sensory processing: A pilot studyexamining the role of the parasympathetic

nervous system. American Journal of Occu-pational Therapy, 57, 442–449.

Williamson, G. G., & Anzalone, M. E. (2001).Sensory integration and self-regulation ininfants and toddlers: Helping very youngchildren interact with their environment.Washington, DC: Zero to Three.

Zero to Three. (2005). Diagnostic classification ofmental health and developmental disordersof infancy and early childhood, revised(DC:0–3R). Arlington, VA: NationalCenter for Clinical Infant Programs.

140 March/April 2007, Volume 61, Number 2

Session offerings are subject to change. Please refer to online and final Conference programs for updates.

Close to 500 education sessions in 25 different primary content focus areas! See p. 227.

AOTA’s 2007 Annual Conference & ExpoSt. Louis, MissouriFriday, April 20–Monday, April 23

March 28—Advance Registration Deadline

Look at this sampling of sensory integration sessions!For more, turn to page 169.

Complete details available at www.aota.org/conference

• Reliability and Validity of the Preschool Play Scale (Revised)of Preschool Children With Autism

• School-Based Practice: What Does Response to InterventionMean for You?

• Sensory and Motor Factors That Affect Participation inPreschool Children With Autism

• Sensory Integration Interventions and Therapeutic HorsebackRiding: A Whinnying Combination

• Sensory Integration: International Network to SupportOccupational Therapy Practice

• Sensory Processing and the Development of Self-Concept inYoung Children

• Sensory Processing Measure: Practical Applications forClinic- and School-Based Therapists

• Strategies for Managing Difficult Behavior in PediatricOccupational Therapy

• Teacher–Occupational Therapy Collaboration:Evaluation of Service

• The Effect of Adult-Directed Versus Child-Focused Strategieson Engagement in Children With Autism

• The Effects of Participation in Integrated Play Groups for Children With Autism and Typical Peers

• The Impact of Assistive Technology Devices and Services for Students With Learning Disabilities

• The Quality of Life of Students With Disabilities Who AreIncluded in General Education Settings

AC-187

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