Several critical gaps exist in the delivery of Sensory Integration therapy in India, primarily related to access, affordability, practitioner training, and a lack of localized research. SI is an occupational therapy approach that helps people with sensory processing difficulties, but its implementation in a non-Western context like India faces unique challenges. Access and availability •Geographical disparity: Access to specialized SI therapy is largely concentrated in major urban centers. This leaves individuals in rural and smaller towns with limited or no options for treatment, particularly those who have low income. •Long waitlists: Even in cities where therapy centers exist, high demand and a limited number of qualified therapists lead to extensive waiting periods for families seeking intervention. •Logistical barriers: For families in remote areas, the long travel time and costs associated with visiting therapy centers in distant cities present a major obstacle. Training of therapists •Scarcity of trained practitioners: There is a shortage of occupational therapists in India who have undergone advanced, evidence-based training and are certified to provide SI therapy. Many practitioners may claim to offer sensory integration but lack the specific training required for true Sensory Integration. •Limited training opportunities: Access to high-quality training programs for SI is limited. Existing opportunities, such as online courses, are often led by professionals with extensive experience but may still lack formalized, accessible certification processes. •Competency gaps: Clients report a perceived difference in competency among therapists. This results in erroneous diagnoses of sensory integration dysfunction, overdiagnosis of the condition, and disregard for the practice's guiding principles. Financial constraints •High cost of therapy: Therapy sessions are expensive, putting them out of reach for a significant portion of the population. The specialized equipment required for a "sensory gym" further increases operational costs, which are passed on to consumers. •Lack of insurance coverage: Limited or no coverage for SI and other specialized therapies through health insurance plans means that families must bear the entire financial burden themselves. Clients may be taken advantage of by clinic business models when there is no single cross-examination on the quality, frequency, and length of services due to a lack of awareness. •Limited government funding: Unlike many Western countries, India lacks sufficient government funding and robust programs to subsidize therapy for individuals with disabilities, especially those below the poverty line. Research and development •Lack of localized research: A major gap is the dearth of research on the feasibility and effectiveness of SI in non-Western nations like India. Most of the existing research on SI is conducted in Western countries. More local studies are needed to determine appropriate and culturally sensitive ways to implement SI in India. •Absence of protocols for telehealth: While telehealth services gained prominence during the COVID-19 pandemic, there is a lack of standardized protocols for delivering SI via this medium. This is a significant gap, as telehealth has the potential to overcome geographical barriers and long wait times. Societal and attitudinal barriers •Low awareness: Public knowledge and awareness about sensory processing disorders and the potential benefits of SI therapy are low, especially in rural communities. This leads to delayed identification and intervention. •Social stigma: Societal attitudes and stigma related to disability can lead to non-acceptance of conditions requiring therapies like SI. People may face pressure to hide their children's disabilities rather than seek professional help.