Objective: This study examined sensory-motor integration training effects on activities of daily living (ADLs) in children with Erb’s palsy. Methods: A randomized controlled trial enrolled 32 children aged 2–6 years with Narakas Type I Erb’s palsy. This assessor-blinded study randomly allocated participants using sequentially numbered, sealed opaque envelopes to control group (60 minutes of an upper-limb rehabilitation program) or study group (45 minutes of the same upper-limb rehabilitation program plus 15 minutes of sensory-motor integration training; total 60 minutes/session). Interventions were delivered three times weekly for 12 weeks. The primary outcome was the Jebsen–Taylor Hand Function Test (JTHFT) Simulated Feeding subtest; secondary outcomes included other JTHFT subtests and grip strength, measured at baseline and week 12. Results: Both groups showed significant within-group improvements in grip strength (p<0.001). Post-intervention, the study group demonstrated significantly greater grip strength versus control (5.42±0.81 vs. 3.36±0.46), with a between-group difference of 2.06 units (95% CI: 1.58–2.54) and very large effect size (Cohen’s d=3.13; p<0.001). The study group showed greater improvement in feeding performance (Δ=13.93s; 60% improvement) than control (Δ=11.27s; 51% improvement). Conclusion: Combined with an upper limb rehabilitation program, sensory-motor integration training significantly improves functional abilities and daily living skills in children with Erb’s palsy. ClinicalTrials.gov ID:NCT06324643.