Evaluation in Ayres Sensory Integration: An OT assessment guide

As clinicians, we hear a lot about sensory processing and sensory integration (the way a person’s brain filters sensory information from the environment). One way we can assess a client for sensory processing concerns is to use Evaluation in Ayres Sensory Integration (EASI)®. 

This blog post covers signs of sensory integration difficulties, what the Evaluation in Ayres Sensory Integration (EASI) is, what it tests for, EASI scoring and interpretation, EASI certification requirements for OTs, other sensory assessments, and how the information can help support clients' sensory processing needs. 

What are signs of sensory integration difficulties?

Sensory integration difficulties vary widely because each person processes sensory information differently. Below is a list of common sensory integration difficulties. A client may have sensory difficulties that do not require intervention. Sensory difficulties should be addressed when they impact a client’s function.

An OT should always assess sensory processing to determine the best interventions. It is important for clients who have sensory integration concerns to be evaluated by an occupational therapist. The American Occupational Therapy Association (AOTA) strongly recommends that sensory integration therapy activities not be recommended without assessment first. 

Sensory integration difficulties may include:

Tactile (touch)

1. Tactile defensiveness: Avoids or becomes distressed by unexpected touch, certain textures, or messy play.

2. Poor tactile discrimination: Has difficulty identifying objects by touch without looking.

3. Grooming sensitivities: Becomes distressed during hair brushing, nail trimming, toothbrushing, or bathing.

Vestibular (movement and balance)

1. Gravitational insecurity: Becomes fearful or anxious when feet leave the ground or when changing positions.

2. Movement intolerance: Avoids swings, slides, elevators, or other movement activities.

3. Excessive movement seeking: Constantly spins, rocks, jumps, or moves to satisfy sensory needs.

4. Poor balance: Has difficulty maintaining balance during standing, walking, or dynamic activities.

Proprioceptive (body awareness)

1. Poor body awareness: Frequently bumps into people or objects or misjudges body position.

2. Grading force difficulties: Uses too much or too little force when writing, handling objects, or playing.

3. Postural instability: Has difficulty maintaining an upright seated or standing position during activities.

4. Motor planning difficulties (praxis): Has difficulty figuring out how to plan and execute unfamiliar motor tasks.

Auditory (hearing and sound processing)

1. Auditory hypersensitivity: Becomes distressed by loud, sudden, or background noises.

2. Difficulty filtering auditory input: Has trouble attending to a teacher's voice when other sounds are present.

3. Auditory under-responsiveness: Appears not to notice sounds or respond consistently to auditory cues.

Visual (sight)

1. Visual hypersensitivity: Is bothered by bright lights, glare, or visually busy environments.

2. Visual discrimination difficulties: Has difficulty distinguishing similar shapes, letters, or visual details.

3. Visual attention difficulties: Becomes overwhelmed or distracted by excessive visual information.

Oral and olfactory (taste, smell, and oral input)

1. Oral sensory defensiveness: Avoids certain food textures, temperatures, or consistencies.

2. Olfactory hypersensitivity: Becomes distressed by odors that others tolerate.

3. Oral sensory seeking: Frequently chews, mouths, or bites nonfood objects to obtain additional sensory input.

What is the EASI and what happened to the SIPT?

The Evaluation in Ayres Sensory Integration (EASI) is an updated and modernized version of the Sensory Integration and Praxis Test (SIPT)® developed by Dr. A. Jean Ayres in 1989. The SIPT has been phased out over the last 10 years, beginning in 2016 when training ended, and in early 2026 the physical tests and kits were no longer available. Although the training and assessment have been discontinued, SIPT certification is still recognized.

Clinicians can now receive training in the Evaluation in Ayres Sensory Integration (EASI) and/or use other sensory processing assessments such as the Sensory Processing Measure 2 or the Sensory Profile 2.

The EASI was designed to be low-cost and easily accessible. It was developed outside the “for-profit model,” making its materials available to clinicians who have training. There are no copyright restrictions, so therapists can use and build the assessment specifically for the individual. CLASI also sells a full EASI test kit to U.S. participants.

Once a clinician has completed the EASI training/certification through one of several programs, they have access to the testing resources through The Collaborative for Leadership in Ayres Sensory Integration (CLASI).

EASI certification and training

Evaluation in Ayres Sensory Integration (EASI) certification and training are offered by CLASI and other training programs. Each certification program is different, and clinicians should look into which program best fits their needs.

The CLASI certificate is open to OTs, PTs, and SLPs. COTAs may join Modules 1, 5, and 6 with a supervising OT's letter of recommendation, but the EASI assessment modules (2 and 3) are not open to them. CLASI also provides access to its computerized scoring system, the EASI Scoring Program (ESP).

Training and certification typically involve a set of learning modules. Each module includes activities and assignments followed by quizzes to test knowledge. Participants are required to administer the EASI to several different clients to prove their knowledge and understanding.

Each organization offers its own certification and training, but in general there are six modules consisting of 30 hours of work each (180 hours total). Training is considered continuing education and meets the criteria for AOTA (American Occupational Therapy Association) CEU’s (continuing education units). Most of the program is offered online and is self-paced, but there are parts that require in-person attendance.

A 2025 systematic review of randomized controlled trials found strong evidence that ASI, delivered with fidelity, helps autistic children meet their individualized goals, and no benefit for behaviors of concern such as noncompliance or irritability. 

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How is the EASI designed?

The Evaluation in Ayres Sensory Integration is designed for ages three to 12. There are 20 subtests and the full test can take up to three hours to administer (this is usually broken up into two or three sessions).

The 20 subtests are:

1. Visual Praxis: Designs

2. Visual Perception: Search

3. Praxis: Ideation

4. Praxis: Positions

5. Postural Control

6. Balance

7. Proprioception: Force

8. Ocular: Motor & Praxis

9. Praxis: Sequences

10. Bilateral Integration

11. Praxis: Following Directions

12. Vestibular Nystagmus

13. Visual Praxis: Construction

14. Proprioception: Joint Position

15. Auditory: Localization

16. Tactile Perception: Localization

17. Tactile Perception: Designs

18. Tactile Perception: Shapes

19. Tactile Perception: Oral

20. Sensory Reactivity

These 20 subtests are divided into four subgroups:

1. Sensory perception

2. Praxis

3. Ocular, postural, and bilateral motor integration

4. Sensory reactivity

EASI scoring and interpretation

Scoring of the Evaluation in Ayres Sensory Integration (EASI) is managed through CLASI. Scoring for the EASI is open access through their Evaluation Scoring Program (ESP). To gain access to scoring, you must complete CLASI Modules 2 and 3.

After administration of the subtests, the clinician inputs the raw scores into the Evaluation Scoring Program (ESP), a computerized scoring system (available through CLASI), and receives standard metrics including standard scores and z-scores.

Scores are presented in a color-coded graph to help clinicians determine patterns across domains.

Other sensory processing assessments

Clinicians can use other assessments to evaluate a client’s sensory processing needs. The two most common assessments are

• Sensory Processing Measure 2

• Sensory Profile 2

Both are questionnaires that measure a client’s sensory processing function across environments. These assessments are frequently used in home, schools, and the community, and both have an age range from infant through adult. These assessments don’t require extensive training or certification and can be given in 20 to 30 minutes.

Sources

• Kılıç, B. K., Bumin, G., Öğütlü, H., & Türkçapar, M. H. (2026). Comprehensive effects of occupational therapy using Ayres Sensory Integration® in children With ADHD: A randomized controlled trial. Am J Occup Ther.

• Piller, A., Auld-Wright, K., Andelin, L., Glennon, T. J., Conlin, J. M., et al. (2025) Occupational therapy interventions using Ayres Sensory Integration® for children and youth (May 2015-January 2024). Am J Occup Ther.

• Schaaf, R., & Auld-Wright, K. (2024). Research supporting the use of the Evaluation in Ayres Sensory Integration®. The Collaborative for Ayres Sensory Integration.

• Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., et al. (2015). Evidence-based practices for children, youth and young adults with Autism Spectrum Disorder: A comprehensive review. Autism Dev Discord.

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