Sensory Processing Disorder (SPD)

What sensory processing involves

The brain constantly takes in information from the senses and decides what to pay attention to and how to respond. Besides the five familiar senses, two others matter:

• vestibular sense: balance and movement, from the inner ear
• proprioception: awareness of body position, from muscles and joints
• interoception: sensing internal states such as hunger, thirst and needing the toilet

In SPD, the response is out of proportion to the input, or the brain struggles to use sensory information to plan movement.

Types of sensory processing differences

A child can be over-responsive to some senses and under-responsive or seeking in others.

Signs at different ages

Babies and toddlers

• difficulty with feeding, especially textures
• extreme fussiness with bathing, dressing or being held
• unusual sleep problems
• delayed motor milestones or very high activity

Children

• meltdowns in noisy or busy places
• refusing certain clothes, socks or haircuts
• picky eating based on texture
• falling, bumping into things, or rough play
• difficulty sitting still or focusing in class
• trouble with handwriting, buttons and sports

Adults

• feeling overwhelmed by noise, lights or crowds
• strong reactions to textures, smells or tastes
• needing movement or fidgeting to concentrate
• avoiding social situations because of sensory overload
• clumsiness or difficulty with coordination

SPD, autism and ADHD

Sensory over- or under-reactivity is part of the diagnostic criteria for autism spectrum disorder, and most autistic people have sensory differences. Sensory issues are also common in ADHD, anxiety, developmental coordination disorder, fragile X syndrome and after premature birth. Some children have sensory processing differences without another diagnosis.

The American Academy of Pediatrics advises that children with sensory difficulties be evaluated for these related developmental conditions, rather than receiving an SPD label alone, so that all needs are addressed.

Assessment

There is no blood test or scan. Assessment usually involves:

• a developmental evaluation by a pediatrician, psychologist or developmental specialist
• an occupational therapy assessment, using parent questionnaires (such as the Sensory Profile) and observation of play, movement and daily tasks
• screening for autism, ADHD, anxiety and motor coordination problems
• hearing and vision tests

Treatment and support

Occupational therapy

Occupational therapists help children and adults understand their sensory needs and build skills for daily life. Approaches include:

• sensory integration therapy (Ayres Sensory Integration): play-based activities that provide controlled sensory input; evidence is mixed but growing for some children
• sensory diets: scheduled activities throughout the day to help regulate arousal, such as swinging, heavy work (carrying, pushing), deep pressure or quiet breaks
• motor skill training for coordination and handwriting

Practical strategies

• noise-canceling headphones or earplugs in loud places
• tag-free, soft clothing and socks without thick seams
• predictable routines and warnings before transitions
• quiet spaces at home and school
• fidget tools, movement breaks and alternative seating
• gradual, gentle exposure to new foods and textures
• weighted blankets or deep pressure, if helpful and used safely

Related support

• cognitive behavioral therapy for anxiety
• treatment for ADHD if present
• feeding therapy for very restricted eating
• school accommodations through an IEP or 504 plan

Outlook

Sensory sensitivities often improve with age, maturity and good coping strategies, though many people continue to have sensory preferences as adults. Understanding a person's sensory profile reduces stress and helps them participate more fully at home, school and work.

Frequently asked questions

What is sensory processing disorder?

Sensory processing disorder is difficulty processing and responding to sensory information, such as sounds, touch, movement, tastes and smells. People may be overwhelmed by sensations, seek out intense sensations, or not notice them. It is not a separate DSM-5 diagnosis.

What are the signs of sensory processing disorder in a child?

Signs include extreme reactions to noise, clothing textures or haircuts, very picky eating based on texture, frequent meltdowns in busy places, constantly seeking movement or crashing into things, clumsiness, and either over-reacting or under-reacting to pain.

Is sensory processing disorder a form of autism?

Not necessarily. Sensory differences are a core feature of autism, but many children with sensory processing difficulties are not autistic. Children with sensory issues should be assessed for autism, ADHD and other developmental conditions.

Can adults have sensory processing disorder?

Yes. Many adults have lifelong sensory sensitivities, such as being overwhelmed by noise, crowds or textures, or needing movement to focus. Occupational therapy and practical adjustments can help adults manage daily life and work.

How is sensory processing disorder treated?

Treatment usually involves occupational therapy, sensory strategies built into the daily routine, environmental changes such as quiet spaces and headphones, and support for related conditions like anxiety or ADHD.