Occupational therapy pediatric clients with sensory processing/integration dysfunction often have co-occurring neurodevelop-mental conditions, such as autism spectrum, attention deficit hyperactivity, learning, and motor planning/coordination disor-ders. The research evidence indicates that unique patterns of neu-rological/neurodevelopmental soft signs (NSS) occur frequently in these populations, and correlated central nervous system structures and processes are increasingly being identified through advances in neuroimaging and other technologies. Integrating clinical observations of NSS with advanced brain-based research expands our understanding of the sensorimotor scaffolding that leads to higher functions of behavior organization, communica-tion, and cognition. This knowledge has the potential to notably enhance our theory, evaluation, interpretation, and intervention strategies for children with sensory processing and integration challenges that ultimately affect occupation and participation.