The above assessment results indicate underlying sensory integrative dysfunction. Kianah's functional difficulties and the problems presented in this protocol are the end result of inefficient and erratic sensory processing of specific sensory information by the brain. Ayres (2005:54) believed that although the integration of sensory inputs develops together, some functions lead to others and that there are many processes involved in the integration of sensory information. The first level of integration occurs when the five major sensory systems are stimulated adequately and their impulses travel from the receptors to the brain. Integration occurs primarily within the vestibular, proprioceptive, and tactile systems at this level because the organization of a child's central nervous system depends on these more basic sensations, rather than visual and auditory sensations (Ayres, 2005:54) . Kianah's vestibular system appears to register, modulate, and discriminate sensory inputs efficiently and integrate these stimuli to generate an appropriate adaptive response. Functionally, this is observed in his well-developed postural control such as well-organized eye movements, posture, balance and postural reactions, postural adjustments and muscle tone. It also responds appropriately to vestibular input and is not overly sensitive to movement or disorganized by it. Kianah's efficient vestibular system is an area of ​​strength for her and she uses it when she needs to employ self-regulation strategies to try to maintain a calm and alert state in the classroom. However, Kianah does not appear to adequately register tactile input, which in turn affects its ability to accurately discriminate tactile input. If it fails to register the… medium of paper… worship, rather than integrative sensory dysfunction. Functionally, this contributes to his poor motor skills and stamina when writing. In conclusion, Kianah has sensory integrative dysfunction in her somatosensory system that impacts her somatopraxy, bilateral integration and sequencing, tactile form, and spatial perception. Furthermore, his poor visual spatial perception leads to visuopraxia problems. These areas of dysfunction negatively impact his gross and fine motor skills and lead to functional difficulties in self-care, school, and recreational activities. Kianah has additional attention and concentration difficulties, which may be the result of her sensory integrative dysfunction or as a result of other neurological conditions such as ADHD. He also has residual weakness in the proximal stability of the upper limbs.