A Comparative Trial of Occupational Therapy Using Ayres Sensory Integration and Applied Behavior Analysis Interventions for Autistic Children.
Thirty hours of ABA or OT-ASI give equal, modest gains on parent-chosen goals for autistic kids with sensory issues.
01Research in Context
What this study did
Researchers randomly assigned autistic children to three groups. One group got 30 one-hour ABA sessions. Another got 30 one-hour OT-ASI sessions. The third group got no treatment.
Parents picked two goals for their child. The team tracked how well each child met these goals after the sessions.
What they found
Both ABA and OT-ASI beat the no-treatment group on parent goals. Daily-living skills rose a little and equally in both active groups.
In short, 30 hours of either approach helped about the same.
How this fits with other research
Park et al. (2026) pooled 23 OT-ASI trials and found small-to-large gains in motor and daily skills. The new trial lines up: OT-ASI worked, but gains were modest.
Esposito et al. (2025) reviewed ABA for social skills and warned that gains often fade without extra generalization work. The current study shows ABA still lifts parent-set goals in only 30 hours, yet it does not test long-term upkeep.
Kotsopoulos et al. (2021) tracked kids for three years of community ABA and saw big adaptive jumps plus regular-school placement. Their longer view suggests the 30-hour RCT may understate what sustained ABA can do.
Peterson et al. (2016) also ran ABA head-to-head against a sensory method, but for feeding. ABA won that match, while the new trial calls it a draw on daily skills. The difference is the target: feeding is clear-cut; broad adaptive skills move more slowly.
Why it matters
You can tell families that a short block of either ABA or OT-ASI is likely to help with their top two goals. Pick the method the family will carry out. If they already love sensory gym work, OT-ASI is fine. If they want behavior skills, ABA is fine. Either way, plan extra generalization and longer follow-up for bigger life changes.
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02At a glance
03Original abstract
Many autistic children demonstrate sensory integration differences that impact their participation in daily living activities and tasks. Occupational Therapy using Ayres Sensory Integration (OT-ASI) is an evidence-based intervention for autistic children that addresses the sensory integrative factors impacting daily living skills and participation in a variety of tasks and activities. Applied Behavior Analysis (ABA) is the recommended evidence-based practice for autism to improve a range of developmental domains. This study compared Occupational Therapy using Ayres Sensory Integration, Applied Behavior Analysis, and no treatment on daily living skills and individualized goals for autistic children who also show sensory differences. A parallel arm comparative effectiveness trial design with participants randomized equally to OT-ASI, ABA, or no treatment. Intervention consisted of 30 one-hour sessions. Significant gains in individualized goals, measured by Goal Attainment Scaling, were found in both treatment arms over the no treatment group. Both the OT-ASI and the ABA groups improved in daily living skills measured on the Pediatric Evaluation of Disabilities Inventory; although the improvements over the no treatment group were not significant. Both OT-ASI and ABA improved individualized goals and daily living skills at comparable levels. These findings are discussed in light of their implications for intervention. Trial Registration: NCT02536365.
Autism research : official journal of the International Society for Autism Research, 2025 · doi:10.1002/aur.70099