When you think back to school, would you say you were a ‘good’ or ‘bad’ student? Did you struggle to sit still, concentrate, or were often overwhelmed and avoided certain tasks or work?
Rather than being a poorly behaved student, it is possible that the school environment was actually poor for your sensory processing. Consequently, you couldn’t engage at school as your best self, causing negative behavior and/or lower grades.
Armed with new research and understanding, occupational therapists in school settings can support children to improve their social, academic, and emotional performance through their in-depth knowledge of sensory processing and modifying the school environment.
But, what does this mean? And, how can occupational therapists actually help? I spoke with Dr Aimee Piller, the recent award receipt of the A Jean Ayres award to explain this further.
What is sensory processing?
Sensory processing is an important part of all of our lives. Our bodies take in information through our senses, integrate this information, and provide a motor and/or behavioral response. Besides the five senses of taste, touch, smell, sight, and auditory, there is also vestibular, proprioceptive, and interoception.
Vestibular is our movement system. Its receptors are in our inner ear, and it responds to the pull of gravity. It is crucially important in telling us if we are right-side up or upside down, moving or sitting still, direction of movement, and has a direct impact on our attention and level of arousal. Have you ever felt tired and got up to walk around in order to stay awake? This is you using your vestibular system to change your level of alertness.
Proprioceptive processing has its receptors in our muscles and joints. This system is responsible for grading the force of movement and allows us to know where our arm or leg is without looking. It helps with body awareness and together with the vestibular system is responsible for balance, postural control, and body awareness.
These two systems, along with the tactile (touch) system are the cornerstones for knowing our body in relation to the world.
Interoception is known as the eighth sensory system and gives us feedback about our internal body senses such as hunger, thirst, heart rate, etc. Throughout the day each of the sensory systems relays information from the environment to our brains to process, organize, and use the information to obtain our goals for the day.
What happens when we have difficulties processing sensory input?
Everyone has different levels of processing sensory input. Some people may have difficulties processing incoming sensory information, which can lead them to have challenges with motor skills, regulating behavior and emotions, language and communication, and social interactions.
Some individuals with sensory processing difficulties are “hypo” responsive to input, meaning they do not notice sensory information that would generally bring about a response. This can cause a person to be lethargic or under-aroused. They may seek out a lot of additional sensory input like movement, visual input, or auditory input in an attempt to meet their sensory needs.
Other times an individual may be “hyper” responsive to sensory input, meaning there is too much incoming sensory information for them to process. This person may appear defensive to sensory input, meaning they show signs of distress with everyday sensory input. This can cause feelings of anxiety or distress and a person may avoid situations where sensory stimuli is too much. A person’s sensory processing can fluctuate throughout the day or from one sensory system to another.
What is the impact of sensory processing on learning and behavior in the school setting?
Sensory processing is the foundation for everything we do. I like to think of sensory processing as the foundation of a house. If we have adequate sensory processing, we have a strong foundation to engage with others, manage and regulate our emotions and behaviors, and learn. If I have an unmet sensory need, that will impact my ability to do all of my other tasks because that need must be fulfilled to perform at my optimal level.
In addition, motor planning is a result of good sensory processing. When my brain takes in sensory input, it processes it and generates a motor response. When sensory processing is disrupted, motor responses are also disrupted. For example, if a person is walking down the street they may see a curb and pick up their foot to step over the curb and continue walking. A person with sensory processing differences may see the curb, process the sensory input to pick up their foot, but since they have poor sensory processing they do not pick up their foot high enough, causing them to trip over.
Children with sensory-related motor planning difficulties often struggle with day-to-day tasks, even if tasks are familiar. They are frequently aware of their inability to perform tasks accurately and may avoid tasks or “act out” in order not to have to perform a task they know their body is not able to perform successfully. It is important to know that sometimes what we may label as negative behaviors are actually due to poor motor planning, not defiant behavior.
How can occupational therapists support students and teachers in treating sensory processing difficulties in the school environment?
Occupational therapists can provide sensory supports at all levels in the school under a multi-tiered systems of support (MTSS) model. At the Tier 1 level, the occupational therapist can work with teachers to design sensory environments that provide lower levels of sensory input or create opportunities to gain additional sensory input. Occupational therapists should work with teachers to train them on sensory strategies and how to incorporate them into the routine of the classroom.
At Tier 2 levels, occupational therapists can help identify students with sensory needs through participation in the universal screening process and design sensory groups to address the unique needs of small groups of students.
At Tier 3 level, occupational therapists can provide individualized one-on-one support. While sensory-based interventions and sensory strategies are important at this level, occupational therapists should not neglect the importance of providing Ayres Sensory Integration® (ASI) to students. ASI is an individualized approach to help children with sensory integration and processing differences to improve sensory integration and participation. It is often thought of as an intervention performed outside of the school environment due to specialized training and equipment needed to perform this type of intervention, but research is showing its effectiveness in the school environment on academics and school participation.
What general strategies would you recommend to school personnel to help their students with sensory processing?
School personnel should be mindful of the sensory environment and create different sensory spaces in the classroom or school. Some spaces should be lower sensory stimuli by having dimmed lights, free of clutter and few things on the walls, being scent free, and low levels of noise. Other environments can provide additional sensory stimuli with increased visual stimuli with lots of things to look at and brighter lights.
Teachers and school personnel should also encourage movement throughout the day. Opportunities for free movement and engaging in gross motor activities provide increased opportunities for students to gain vestibular, proprioceptive, and tactile input that they need to organize and complete their school day.
Finally, it is key to provide multiple choices of sensory input. Do not neglect asking the child what type of sensory environment or input they need. Kids know themselves best and are often able to identify what type of sensory input they need.
If you found the information in this article helpful, you can read more about Aimee’s work on her website and Facebook.
You can also read more about the role of the occupational therapist in the school setting in her forthcoming book, Implementing School-Based Occupational Therapy Services: A Multi-Tiered Approach to Sensory Processing Needs (Routledge, 2026)
About Aimee
Dr. Piller is owner and director of Piller Child Development, an outpatient pediatric therapy company with three locations in the greater Phoenix area. She has advanced training in sensory integration and also specializes in feeding therapy. She received her masters in occupational therapy from Temple University and her PhD in occupational therapy from Texas Woman’s University. Dr. Piller performs research in practice with a focus on knowledge translation and the development of evidence based treatment protocols. She volunteers with the American Occupational Therapy Association in various capacities and with the American Occupational Therapy Foundation.
She is the author of Implementing School-Based Occupational Therapy Services: A Multi-Tiered Approach to Sensory Processing Needs (Routledge, 2026) and has several national and international publications, presentations, and podcasts. Most recently, she won the A Jean Ayres award. This award is in honor of Dr Ayres, the founder of sensory integration theory and treatment.
You can see a copy of Dr. Piller’s CV here.
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