Is Sensory Processing Disorder Neurodivergent? How Autism, SPD and ADHD Overlap

How do autism, sensory processing disorder and ADHD overlap?

Autism Spectrum Disorder (ASD), Sensory Processing Disorder (SPD) and Attention Deficit Hyperactivity Disorder (ADHD) overlap in two ways. They often occur in the same person, and they share features, sensory differences above all, that make them hard to tell apart.⁠^3,14 Sensory differences are one of the diagnostic criteria for autism, are more common than usual in ADHD, and can also occur in children with neither diagnosis.⁠^4,5,7 Parents, clinicians, teachers and therapists who know where the three overlap are better placed to ask for the right assessment, because the American Academy of Pediatrics advises that other developmental conditions always be considered when a child has sensory difficulties.⁠⁶

Is sensory processing disorder neurodivergent?

In the way the word is usually used, yes. Neurodivergent is a nonmedical term for people whose brains develop or work differently, and Cleveland Clinic lists sensory processing disorders among the conditions most common in people who describe themselves as neurodivergent, alongside autism, ADHD, dyslexia and dyspraxia.⁠¹ Because there are no medical criteria for being neurodivergent, other conditions can fall under the term, and people with any of these conditions may choose not to use it.⁠¹ Cleveland Clinic’s page on SPD describes a strong link between sensory processing disorder and neurodivergence.⁠⁵

Researchers draw the boundary in different places. A review of neurodiversity at work names ADHD, autism, developmental coordination disorder and dyslexia as the conditions most often included, notes that others add mental health conditions, and calls the concept poorly and inconsistently defined; it also describes differences in sensory perception as a hallmark of neurodivergent experience.⁠¹⁸

What does neurodivergent mean?

Neurodiversity refers to the broad diversity in human neurobiology. A neurodivergent person is one whose neurodevelopment falls outside the range usually considered typical; the word neurodiversity was coined in 1998 by the autistic sociologist Judy Singer and the journalist Harvey Blume.⁠¹⁹ The idea is that people experience the world in many different ways and that differences are not viewed as deficits.⁠²⁰ It is closely aligned with the social model of disability, and it does not deny that autistic people need supports to reach their goals.⁠¹⁹

A survey of 657 people found that recognizing the difficulties of autism and embracing it as an identity were not opposites: parenting that celebrates and supports autistic children, without trying to eliminate autism, was endorsed regardless of people’s relation to autism or awareness of neurodiversity.⁠²¹ A review of the concept adds that neurodiversity should not be used as a synonym for disability.⁠¹⁸

Is SPD a diagnosis in the DSM-5-TR or ICD-11?

No. Sensory processing disorder is not recognized in the DSM-5-TR or the ICD-11; in the DSM-5-TR, sensory processing appears only as one of the criteria for restricted and repetitive patterns of behavior in autism.⁠² Cleveland Clinic likewise says SPD is not currently an official medical diagnosis, although providers see benefits in identifying it and treating it when it affects daily life.⁠⁵

The reason is unsettled evidence about what the difficulties are. The American Academy of Pediatrics wrote that it is unclear whether sensory-based problems are a disorder of their own or a characteristic of other developmental conditions, and that without a universally accepted framework, sensory processing disorder generally should not be diagnosed.⁠⁶ Researchers studying over-responsivity point to the absence of formal diagnostic criteria and its high rates in conditions such as autism as reasons for the debate.⁠²²

How are sensory features part of the autism criteria?

The DSM-5 criteria require at least two of four types of restricted, repetitive behavior, and the fourth is hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment: indifference to pain or temperature, distress at particular sounds or textures, excessive smelling or touching of objects, or fascination with lights or movement.⁠⁷ The ICD-11 lists lifelong hypersensitivity or hyposensitivity to sensory stimuli among the features of autism, including sounds, light, textures of clothing and food, smells, tastes, heat, cold and pain.⁠⁸ Neither manual has a parallel sensory criterion for ADHD; studies describe sensory differences there as an associated feature.⁠^4,23

How often do autism and ADHD occur together?

Often, though the figure depends on the study. The largest pooled estimate comes from a 2019 meta-analysis of 96 studies that used confirmed clinical diagnoses: 28% of autistic people also had ADHD, with higher figures in clinic samples than in population and registry samples.⁠³ A review of the literature cites estimates of 50 to 70% and notes that single studies range from 10 to 90%, arguing that the spread matters more than any single average, which can look more precise than it is.⁠⁹

The overlap runs both ways. A meta-analysis of 22 publications covering 61,985 children and adolescents found that 21% of those with ADHD met the threshold for autism, with no significant difference between community samples (19%) and clinical samples (24%).⁠¹⁰ In a community sample of twins at age 8, 41% of children who met criteria for autism had suspected ADHD, and 22% of those with suspected ADHD met criteria for autism.⁠¹²

Can autism and ADHD be diagnosed together?

Yes. The DSM-IV and ICD-10 treated ADHD and autism as mutually exclusive diagnoses, while the DSM-5 describes each condition in the description of the other and allows both.⁠⁹ The ICD-11 says the two can co-occur and both diagnoses may be assigned when the requirements for each are met.⁠⁸

Do autism and ADHD share genetic roots?

The evidence points that way. In a register study of 1,899,654 people born in Sweden, autistic people had 22 times the odds of an ADHD diagnosis, their relatives were also at higher risk, and the pattern across twins, siblings and other relatives supported a genetic overlap between the two.⁠¹¹ In twins aged 8, autistic traits and ADHD behaviors correlated at about 0.5, and the genetic correlations were above 0.5, a moderate overlap in genetic influences.⁠¹² Genes also play an important role in ADHD on its own.⁠²⁶

How common are sensory differences in autism and ADHD?

How common are sensory differences in autism?

Very common. A 2009 meta-analysis of 14 studies found a large difference between autistic and typically developing groups in sensory symptoms, greatest for under-responsivity, then over-responsivity and sensation seeking, and largest in children aged 6 to 9.⁠²⁷ Its 2019 update, covering 55 questionnaire studies and 4,606 autistic people, found large differences for all three, and over-responsivity remained higher in autism even against other clinical groups, which the authors read as a sign that sensory symptoms are a core part of autism.⁠¹³ One study it cites put over-responsivity at 56% of autistic children.⁠²²

Do children with ADHD have sensory issues?

Many do, though not all. An early systematic review of 11 studies found sensory processing problems more common in children with ADHD than in typically developing children, and more severe when anxiety or oppositional defiant disorder was also present.⁠²⁸ A 2025 meta-analysis of 30 studies and 5,374 participants found more severe sensory sensitivity, avoiding, low registration and seeking in ADHD than in controls, with high variation between studies and only 9 studies at low risk of bias.⁠⁴ Researchers in the field stress that not all children with ADHD show sensory over-responsivity, but when they do, it influences other aspects of their behavior.⁠²³

Adults show the same pattern. In 116 adults with ADHD, sensory hyper- and hyposensitivity were related to ADHD symptom scores but not to autistic symptoms, and 43% of women reported them compared with 22% of men.⁠²⁴

How common are sensory differences in children without a diagnosis?

Less common, but not rare. In one school district, 13.7% of the kindergartners whose parents returned a screening survey met criteria for sensory processing disorder, or 5.3% of all enrolled children if every non-responder was assumed not to.⁠²⁵ In a representative sample of 925 children aged 7 to 11, 16.5% were bothered by at least four touch or sound sensations.⁠²² Cleveland Clinic cites an estimate of 1 to 3 in every 20 people, higher in people with neurodevelopmental conditions, and notes that a person can have SPD without any other condition.⁠⁵

What symptoms do autism, SPD and ADHD share?

The three share four broad areas: attention, sensory reactions, social difficulties and emotional regulation. In each, the same visible behavior can have different roots, so the reason behind a behavior matters as much as the behavior itself.⁠^8,14,23

How do attention difficulties differ between autism and ADHD?

Attention differences are common in autism: the ICD-11 notes that being overly focused or easily distracted, impulsivity and physical hyperactivity are often seen in autistic people. What separates ADHD is the absence of autism’s persistent social communication differences and restricted, repetitive patterns.⁠⁸ The attention difference most characteristic of autism is reduced joint attention, sharing attention with another person, and executive functioning difficulties typical of ADHD are also found in autism.⁠⁹ In children with similar sensory profiles, attention problems still differed between the autism and ADHD groups.⁠¹⁵

Why are sound, light and touch hard for many neurodivergent children?

Because hypersensitivity to stimuli is common to all three. Autistic children and children with ADHD show raised sensory sensitivity and avoiding compared with typically developing children, and in one direct comparison of 239 children the two groups did not differ in their overall sensory patterns.⁠^4,14 The differences were in the details: autistic children had the most oral processing differences, children with ADHD the highest visual processing scores.⁠¹⁴ Common sensory complaints include discomfort in certain clothing and strong reactions to sudden movements, touch, loud noises or bright lights.⁠⁵

Are social difficulties part of all three?

In different ways. Persistent differences in social communication and interaction are a core criterion of autism.⁠⁷ ADHD can profoundly affect a child’s social interactions, though without autism’s persistent social communication differences.⁠^8,16 Children with elevated sensory over-responsivity showed lower adaptive social behavior in a school-age sample.⁠²²

Is emotional dysregulation shared?

Emotional dysregulation appears across all three. Parents of children with elevated over-responsivity reported more internalizing, externalizing and dysregulation problems, both early in life and at school age.⁠²² In children with ADHD, sensory over-responsivity is linked with anxiety, and anxiety predicts more severe sensory problems.⁠^23,28 Anxiety is also among the most common co-occurring conditions in autism, at 20% in the 2019 meta-analysis.⁠³

What is the difference between sensory issues in ADHD and autism?

Less than many people expect. In children aged 3 to 14, autism and ADHD groups did not differ in sensory processing patterns, and both were elevated compared with typically developing children.⁠¹⁴ In the ELENA cohort, atypical sensory processing was as frequent in ADHD as in autism.⁠¹⁵ The clearest difference in the research is over-responsivity: in the 2019 meta-analysis it stayed higher in autism even when autistic people were compared with other clinical groups.⁠¹³ In adults with ADHD, sensory sensitivity tracked ADHD symptoms rather than autistic traits.⁠²⁴

What does sensory overload look like in ADHD and autism?

Sensory overload is the point at which input from the surroundings becomes too much to manage. Autistic adults describe overwhelming environments producing sensory overload and stress, sometimes alongside racing thoughts, and use stimming to regulate it.⁠²⁹ In children with over-responsivity, sensory challenge triggers a stress-hormone response whether or not they have ADHD.⁠²³ It can show up in several ways:

• Avoidance or withdrawal. Leaving or avoiding noisy places; one autistic adult described spending lunch breaks in her car for quiet.⁠²⁹
• Distress at specific input. Strong reactions to sudden movements, touch, loud noises or bright lights.⁠⁵
• More movement or restlessness. Adults with ADHD reported sensory differences most in activity level and hearing.⁠²⁴
• Self-soothing behaviors. Stimming, such as hand-flapping, rocking or vocal sounds, which autistic adults describe as a way to regulate overwhelming sensations and emotions.⁠²⁹

Why are autism, ADHD and sensory differences hard to tell apart?

Because they share behaviors and sit in the same children. Researchers have long reported that autism and ADHD are difficult to distinguish when making a diagnosis.⁠⁹ The ICD-11 warns that ADHD symptoms can dominate the picture so that some autistic features are less apparent, and that in a substantial share of cases a co-occurring condition is what first brings an autistic person to clinical attention.⁠⁸ Many questions on sensory parent-report tools overlap with ADHD features such as emotional responses and activity levels, so a high sensory score alone does not show which condition is behind it.⁠²³

Other conditions can mimic all three. Anxiety, depression, sleep problems and some learning disabilities can produce symptoms similar to ADHD, and sensory difficulties also appear in developmental coordination disorder and childhood anxiety.⁠^6,26

What does a combined picture mean for assessment?

It means looking at all three together rather than stopping at the first explanation. The American Academy of Pediatrics advises that other developmental and behavioral conditions always be considered and a thorough evaluation completed when a child has sensory difficulties.⁠⁶ Its ADHD guideline asks clinicians to screen for coexisting conditions, including autism, and its autism report asks them to recognize co-occurring conditions such as ADHD, anxiety and sleep and feeding problems.⁠^16,17 A thorough assessment usually includes:

1. History from more than one setting. An ADHD diagnosis needs symptoms and impairment documented in more than one major setting, from parents, teachers and other school staff.⁠¹⁶
2. Observation as well as report. Autism assessment rests on parents’ descriptions of development and a professional’s observation, and no single tool should decide the diagnosis.⁠⁷
3. A screen for coexisting conditions. The AAP guideline asks clinicians evaluating ADHD to screen for anxiety, depression, learning and language disorders, autism, tics and sleep apnea.⁠¹⁶
4. Look-alike causes ruled out. Anxiety, depression, sleep problems and some learning disabilities can produce symptoms similar to ADHD.⁠²⁶
5. A sensory assessment. An occupational therapist can assess sensory processing by watching a child with sensory experiences and taking a history, and a 2025 meta-analysis argues sensory processing should be explored in every ADHD evaluation.⁠^4,5
6. Shared decisions. The AAP calls for collaboration with families in evaluation and in the choice of interventions.⁠¹⁷

Who diagnoses autism, ADHD and sensory processing differences?

Different professionals. Autism is usually diagnosed by specialists such as developmental-behavioral pediatricians, neurodevelopmental pediatricians, child neurologists or early intervention teams, and a diagnosis by an experienced professional can be considered reliable by age 2.⁠^7,30 ADHD can be diagnosed by a psychologist, psychiatrist or primary care provider such as a pediatrician.⁠²⁶ Sensory processing is assessed by an occupational therapist, often after a referral from the child’s pediatrician.⁠⁵

What does a combined diagnosis change?

Mainly the plan. Identifying coexisting conditions matters for building the most appropriate treatment plan, and the guideline names misdiagnosing them as the main risk of the step.⁠¹⁶ ADHD is usually treated with behavior therapy and medication, with parent training first for preschool children, while there are no medications for the core features of autism.⁠^26,31 Sensory difficulties are addressed by occupational therapy, which the AAP considers acceptable as one part of a broader plan while noting that research on sensory integration therapy is limited.⁠^5,6

Can a child have sensory processing differences without autism or ADHD?

Yes. Cleveland Clinic notes that SPD can occur without any other condition, and a 2025 study describes it as able to occur independently of other childhood disorders.⁠^2,5 Several research groups have identified children with over-responsivity and no other diagnosis.⁠²³

What helps with sensory overload in autism, ADHD and SPD?

Many of the same adjustments help across all three, because they work on the environment rather than the diagnosis.⁠^5,20

• Environmental adjustments. A quiet break space, warning before expected loud noises, noise-canceling headphones, fidget tools and movement breaks.⁠^5,20
• Routine and visual structure. Advance notice when plans change, and daily routines written or drawn and placed in clear sight.⁠^20,31
• Planned sensory breaks. A designated break for walking, spinning or swinging during the school day.⁠⁵
• Occupational therapy. Sensory integration therapy and sensory strategies tailored to the child, considered acceptable as one part of a broader plan.⁠^6,31
• Treatment of the other conditions. Behavior therapy and medication for ADHD, and help with anxiety where it is present.⁠^26,31

Sensory strategies are meant to be personal: an occupational therapist recommends specific ones for each child.⁠⁵ More ideas are collected in our sensory activities guide.

What does neurodiversity-affirming support look like?

It treats differences as differences while still meeting needs. Neurodiversity holds that there is no single right way of thinking, learning and behaving, and advocates encourage asking people how they prefer to be described rather than assuming.⁠²⁰ Supporting a child does not mean trying to remove who they are: a survey found broad agreement on parenting that celebrates and supports autistic children without seeking to eliminate autism.⁠²¹ Autistic adults ask for the same with stimming, which they describe as a useful way to regulate.⁠²⁹

Which everyday areas often need support?

• Social situations. Social communication differences are central to autism, and ADHD affects social interactions too.⁠^7,16
• Organization and executive functioning. Executive functioning difficulties typical of ADHD are also found in autism.⁠⁹
• Emotional regulation. Over-responsivity is linked with dysregulation and anxiety.⁠^22,23
• Sensory behaviors. Seeking and avoiding are both raised in autism and ADHD.⁠^4,13
• Self-soothing. Autistic adults describe stimming as calming and object to efforts to eliminate it.⁠²⁹
• Routines. Insistence on sameness and difficulty with transitions are among the autism criteria.⁠⁷
• Sleep. Sleep-wake disorders affected 13% of autistic people in the 2019 meta-analysis.⁠³
• Eating. Feeding problems are a recognized co-occurring condition, and the ICD-11 notes food textures among sensory sensitivities in autism.⁠^8,17

RelatedADHD vs SPDStimmingSPD and ADHD at schoolTypes of SPDTwice-exceptional children

Sources

1. Cleveland Clinic. Neurodivergent. Health Library, last updated June 2, 2022. Checked October 11, 2026.
   Show the passageHide the passage

   “Neurodivergent is a nonmedical term that describes people whose brains develop or work differently for some reason”; “’Neurodivergent’ isn’t a medical term, condition or diagnosis”; “since there aren’t any medical criteria or definitions of what it means to be neurodivergent, other conditions also can fall under this term as well. People with these conditions may also choose not to identify themselves as neurodivergent.” Conditions “most common among those who describe themselves as neurodivergent” include autism spectrum disorder, ADHD, dyslexia, dyspraxia, intellectual disabilities and “Sensory processing disorders.”
2. Valencia M, D’Ocon A, Plata R, Simo S, Cantero MJ. Internalizing/externalizing problems and sensory processing alteration in children referred to child mental health centers. Children (Basel). 2025;12(6):664. PMID 40564622. Checked October 11, 2026.
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   “SPD is a condition that may occur independently of other childhood disorders”; “Despite this body of evidence, SPD is not recognized in diagnostic classification systems such as the DSM-5-TR or ICD-11. SP alteration is only included as one of the criteria for restrictive and repetitive patterns of behavior, interests, or activities in the diagnosis of ASD (DSM-5-TR).”
3. Lai MC, Kassee C, Besney R, Bonato S, Hull L, Mandy W, Szatmari P, Ameis SH. Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(10):819-829. PMID 31447415. Checked October 11, 2026.
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   The abstract: studies reporting “confirmed clinical diagnoses of the co-occurring conditions and autism using DSM or ICD criteria”; “100 studies were eligible for inclusion in our qualitative synthesis, of which 96 were included in our meta-analyses”; “we found overall pooled prevalence estimates of 28% (95% CI 25-32) for attention-deficit hyperactivity disorder; 20% (17-23) for anxiety disorders; 13% (9-17) for sleep-wake disorders”; “Estimates in clinical sample-based studies were higher than in population-based and registry-based studies”; and “Careful assessment of mental health is an essential component of care for all people on the autism spectrum”.
4. Jurek L, Duchier A, Gauld C, Henault L, Giroudon C, Fourneret P, Cortese S, Nourredine M. Sensory processing in individuals with attention-deficit/hyperactivity disorder compared with control populations: a systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry. 2025;64(10):1132-1147. PMID 40250555. Checked October 11, 2026.
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   The abstract: “30 studies (reported in 32 publications) encompassing 5,374 participants were included, with 23 studies focusing on children and 7 focusing on adults. Patients with ADHD presented with significantly more severe sensory atypicities than the control group in multiple domains: sensory sensitivity ..., sensory avoiding ..., low sensory registration ..., and sensory seeking”; “Heterogeneity was high in all analyses. Only 9 studies were deemed at overall low risk of bias.” “Even though available ADHD clinical guidelines do not specifically mention the need to assess sensory processing in ADHD, this meta-analysis suggests that this should be systematically explored in the evaluation of children and adults referred for ADHD.”
5. Cleveland Clinic. Sensory Processing Disorder (SPD). Health Library, last updated March 20, 2025. Checked October 11, 2026.
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   “SPD commonly affects people with neurodevelopmental and neurodivergent conditions, like autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD). But you can also have SPD without any other condition.” “Currently, SPD isn’t an official medical diagnosis.” “Researchers estimate that about 1 to 3 out of every 20 people in the general U.S. population have sensory processing disorder. These estimates are higher for people with neurodevelopmental conditions.” Sensory craving: “you need and seek out sensory information for stimulation. But getting the stimulation results in disorganization and doesn’t satisfy the craving.” Common symptoms include “Feeling discomfort in certain types of clothing and fabric” and “Reacting to sudden movements, touches, loud noises and/or bright lights”. “There’s a strong link between sensory processing disorder and neurodivergence.” “your child’s pediatrician may refer you to an occupational therapist. These professionals can assess your child for SPD by watching them interact with certain sensory experiences. They’ll also ask about your child’s symptoms, behavior and medical history”; at school a child may need “Access to headphones to block out background noises while they work” and “A designated break to do a sensory activity, like walking, spinning or swinging”.
6. Zimmer M, Desch L; Section on Complementary and Integrative Medicine; Council on Children with Disabilities; American Academy of Pediatrics. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129(6):1186-1189. PMID 22641765. Checked October 11, 2026.
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   The abstract: “it is unclear whether children who present with sensory-based problems have an actual “disorder” of the sensory pathways of the brain or whether these deficits are characteristics associated with other developmental and behavioral disorders. Because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed. Other developmental and behavioral disorders must always be considered, and a thorough evaluation should be completed. Difficulty tolerating or processing sensory information is a characteristic that may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders. Occupational therapy with the use of sensory-based therapies may be acceptable as one of the components of a comprehensive treatment plan. However, parents should be informed that the amount of research regarding the effectiveness of sensory integration therapy is limited and inconclusive.”
7. Centers for Disease Control and Prevention. Clinical Testing and Diagnosis for Autism Spectrum Disorder. Page reviewed May 8, 2025, reproducing the DSM-5 criteria. Checked October 11, 2026.
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   “a child must have persistent deficits in each of three areas of social communication and interaction ... plus at least two of four types of restricted, repetitive behaviors”; the first is “Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases)” and the fourth “Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).” “no single tool should be used as the basis for diagnosis”; tools “rely on two main sources of information’parents’ or caregivers’ descriptions of their child’s development and a professional’s observation of the child’s behavior.” Specialists include “neurodevelopmental pediatricians, developmental-behavioral pediatricians, child neurologists, geneticists, and early intervention programs that provide assessment services.”
8. World Health Organization. 6A02 Autism spectrum disorder. ICD-11 for Mortality and Morbidity Statistics, release 2026-01, with the clinical descriptions and diagnostic requirements. Checked October 11, 2026.
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   Essential features include “Repetitive and stereotyped motor movements, such as whole body movements (e.g., rocking), atypical gait (e.g., walking on tiptoes), unusual hand or finger movements and posturing. These behaviours are particularly common during early childhood.” and “Lifelong excessive and persistent hypersensitivity or hyposensitivity to sensory stimuli or unusual interest in a sensory stimulus, which may include actual or anticipated sounds, light, textures (especially clothing and food), odors and tastes, heat, cold, or pain.” “Co-occurrence of Autism Spectrum Disorder with other Mental, Behavioural or Neurodevelopmental Disorders is common across the lifespan. In a substantial proportion of cases, particularly in adolescence and adulthood, it is a co-occurring disorder that first brings an individual with Autism Spectrum Disorder to clinical attention.” “Self-injurious behaviours (e.g., hitting one’s face, head banging) occur more often in individuals with co-occurring Disorder of Intellectual Development.” Boundary with ADHD: “Specific abnormalities in attention (e.g., being overly focused or easily distracted), impulsivity, and physical hyperactivity are often observed in individuals with Autism Spectrum Disorder”; “Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder can co-occur and both diagnoses may be assigned if diagnostic requirements are met for each. Attention Deficit Hyperactivity Disorder symptoms may sometimes dominate the clinical presentation such that some Autism Spectrum Disorder symptoms are less apparent.” Boundary with stereotyped movement disorder: “Although such stereotypies are typical in Autism Spectrum Disorder, if they are severe enough to require additional clinical attention, for example because of self-injury, a co-occurring diagnosis of Stereotyped Movement Disorder may be warranted.”
9. Hours C, Recasens C, Baleyte JM. ASD and ADHD comorbidity: what are we talking about? Frontiers in Psychiatry. 2022;13:837424. PMID 35295773. Checked October 11, 2026.
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   “The prevalence of ADHD in people with ASD ranges from 50 to 70%, according to the literature”; the variability between studies matters “more than a mean prevalence, a precise yet illusory value”; “reported rates of comorbidity range from 10 to 90%”; “While the DSM-4 and ICD-10 give mutually exclusive diagnoses of ADHD and ASD, the DSM-5 mentions each condition in its description of the other, admitting the possibility of comorbidity.” “It has often been stated in the literature that ASD and ADHD are difficult to distinguish when making a diagnosis”; “multiple executive functioning impairments typically associated with ADHD are also found in people with ASD”; “The attentional impairment best described for ASD is diminished joint attention.”
10. Hollingdale J, Woodhouse E, Young S, Fridman A, Mandy W. Autistic spectrum disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analytical review. Psychological Medicine. 2020;50(13):2240-2253. PMID 31530292. Checked October 11, 2026.
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    The abstract: “Twenty-two publications met inclusion criteria (total N = 61 985)”; “The overall pooled effect for children and adolescents with ADHD who met threshold for ASD was 21%. There was no significant difference between community samples (19%) and clinical samples (24%)”; “Children and adolescents with ADHD had substantially more dimensionally-measured ASD traits compared with those who did not have ADHD”.
11. Ghirardi L, Brikell I, Kuja-Halkola R, Freitag CM, Franke B, Asherson P, Lichtenstein P, Larsson H. The familial co-aggregation of ASD and ADHD: a register-based cohort study. Molecular Psychiatry. 2018;23(2):257-262. PMID 28242872. Checked October 11, 2026.
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    The abstract: “We studied 1 899 654 individuals born in Sweden between 1987 and 2006”; “Individuals with ASD were at higher risk of having ADHD compared with individuals who did not have ASD (odds ratio (OR)=22.33”; “Relatives of individuals with ASD were at higher risk of ADHD”; “The pattern of association across different types of relatives supports the existence of genetic overlap between clinically ascertained ASD and ADHD”.
12. Ronald A, Simonoff E, Kuntsi J, Asherson P, Plomin R. Evidence for overlapping genetic influences on autistic and ADHD behaviours in a community twin sample. Journal of Child Psychology and Psychiatry. 2008;49(5):535-542. PMID 18221348. Checked October 11, 2026.
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    The abstract: 6,771 families of twins at age 8; “Significant correlations were found between autistic and ADHD traits in the general population (.54 for parent data, .51 for teacher data)”; “all genetic correlations were >.50, indicating a moderate degree of overlap in genetic influences”; “41% of children who met criteria for an ASD had suspected ADHD; 22% with suspected ADHD met criteria for an ASD”.
13. Ben-Sasson A, Gal E, Fluss R, Katz-Zetler N, Cermak SA. Update of a meta-analysis of sensory symptoms in ASD: a new decade of research. Journal of Autism and Developmental Disorders. 2019;49(12):4974-4996. PMID 31501953. Checked October 11, 2026.
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    The abstract: “Fifty-five questionnaire studies included 4606 individuals with ASD”; “Compared to typical controls, effect size was large and significant for SOR, SUR, and Seeking but heterogeneous”; “Compared with developmental disorders (DDs) groups, effect size was significantly positive for SOR and Seeking; whereas compared with other clinical groups, only SOR was significant. These findings highlight the core nature of sensory symptoms in ASD and particularly SOR.”
14. Little LM, Dean E, Tomchek S, Dunn W. Sensory processing patterns in autism, attention deficit hyperactivity disorder, and typical development. Physical & Occupational Therapy in Pediatrics. 2018;38(3):243-254. PMID 29240517. Checked October 11, 2026.
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    The abstract: “Participants included 239 children (ASD = 77; ADHD = 78; TD = 84) matched on age and gender”; “Children with ASD and ADHD did not differ in sensory processing patterns which were elevated as compared to a TD group. Children with ASD showed the highest rate of oral processing differences, followed by ADHD and TD. Children with ADHD had higher visual processing scores than children with ASD and TD. Older children had lower scores for seeking, auditory, visual, movement, touch, and conduct than younger children, regardless of diagnosis.” “sensory features may be an area of overlap of behaviors in ASD and ADHD”.
15. Dellapiazza F, Michelon C, Vernhet C, Muratori F, Blanc N, Picot MC, Baghdadli A; ELENA study group. Sensory processing related to attention in children with ASD, ADHD, or typical development: results from the ELENA cohort. European Child & Adolescent Psychiatry. 2021;30(2):283-291. PMID 32215734. Checked October 11, 2026.
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    The abstract: 120 children aged 6 to 12 in four groups, “ASD alone (N = 43), ASD + ADHD (N = 18), ADHD alone (N = 28), and TD (N = 31). Atypical sensory processing was more frequent in ASD and/or ADHD than in TD, without a significant difference between ASD and ADHD. However, the variance analysis of attention problems revealed differences between the ADHD and ASD groups.”
16. Wolraich ML, Hagan JF Jr, Allan C, et al.; Subcommittee on Children and Adolescents With Attention-Deficit/Hyperactive Disorder. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528. PMID 31570648. Checked October 11, 2026.
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    Key action statement 2: diagnosis requires “documentation of symptoms and impairment in more than 1 major setting (ie, social, academic, or occupational), with information obtained primarily from reports from parents or guardians, teachers, other school personnel, and mental health clinicians” and the clinician “should also rule out any alternative cause”. Key action statement 3: “the PCC should include a process to at least screen for comorbid conditions, including emotional or behavioral conditions (eg, anxiety, depression, oppositional defiant disorder, conduct disorders, substance use), developmental conditions (eg, learning and language disorders, autism spectrum disorders), and physical conditions (eg, tics, sleep apnea)”; “The majority of both boys and girls with ADHD also meet diagnostic criteria for another mental disorder.” “Identifying comorbid conditions is important in developing the most appropriate treatment plan”; “The major risk is misdiagnosing the comorbid condition(s) and providing inappropriate care.” ADHD “can profoundly affect children’s academic achievement, well-being, and social interactions.”
17. Hyman SL, Levy SE, Myers SM; Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):e20193447. PMID 31843864. Checked October 11, 2026.
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    The abstract: “Primary care providers should be familiar with the diagnostic criteria for ASD, appropriate etiologic evaluation, and co-occurring medical and behavioral conditions (such as disorders of sleep and feeding, gastrointestinal tract symptoms, obesity, seizures, attention-deficit/hyperactivity disorder, anxiety, and wandering) that affect the child’s function and quality of life.” “Shared decision making calls for collaboration with families in evaluation and choice of interventions.”
18. Doyle N. Neurodiversity at work: a biopsychosocial model and the impact on working adults. British Medical Bulletin. 2020;135(1):108-125. PMID 32996572. Checked October 11, 2026.
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    “from an academic point of view, neurodiversity is not yet well captured, suffers from poor and conflicting definitions”; “ADHD, autism, DCD and dyslexia are the conditions most frequently referred to under this banner, though others have also included mental health conditions such as depression and anxiety”; “Differences in sensory perception have been reported as a hallmark of neurominority internal experience”; and “Neurodiversity should not be used as a synonym for disability”.
19. Pellicano E, den Houting J. Annual Research Review: Shifting from ‘normal science’ to neurodiversity in autism science. Journal of Child Psychology and Psychiatry. 2022;63(4):381-396. PMID 34730840. Checked October 11, 2026.
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    “In 1998, autistic sociologist Judy Singer and journalist Harvey Blume coined the word ‘neurodiversity’”; “Neurodivergent: A person or people whose neurodevelopment falls outside of (or ‘diverges’ from) the range usually considered to constitute ‘typical’ development”; “neurodiversity refers to the broad diversity that exists in human neurobiology”; “Neurodiversity is closely aligned with the social model of disability”; and “None of this is to suggest, of course, that autistic people do not require supports to enable them to achieve their goals.”
20. Harvard Health Publishing. What is neurodiversity? By Nicole Baumer, MD, MEd, and Julia Frueh, MD. November 23, 2021. Checked October 11, 2026.
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    “Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one ‘right’ way of thinking, learning, and behaving, and differences are not viewed as deficits.” “rather than making assumptions, it is best to ask directly about a person’s preferred language”. Workplace adjustments for sensory needs: “Sound sensitivity: Offer a quiet break space, communicate expected loud noises (like fire drills), offer noise-cancelling headphones.” “Movements: Allow the use of fidget toys, allow extra movement breaks, offer flexible seating.” “Try to give advance notice if plans are changing, and provide a reason for the change.”
21. Kapp SK, Gillespie-Lynch K, Sherman LE, Hutman T. Deficit, difference, or both? Autism and neurodiversity. Developmental Psychology. 2013;49(1):59-71. PMID 22545843. Checked October 11, 2026.
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    The abstract: an online survey of 657 participants; “Recognition of the negative aspects of autism and endorsement of parenting practices that celebrate and ameliorate but do not eliminate autism did not differ based on relation to autism or awareness of neurodiversity. These findings suggest a deficit-as-difference conception of autism wherein neurological conditions may represent equally valid pathways within human diversity.”
22. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology. 2009;37(5):705-716. PMID 19153827. Checked October 11, 2026.
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    A representative sample of 925 children aged 7 to 11: “We found that 16.5% (n= 148) of children in this study had SOR scores that were above this cutoff (i.e., at least four bothering sensations)”; parents of children with elevated SOR “reported higher frequencies of early and co-occurring internalizing, externalizing, and dysregulation problems, and lower levels of concurrent adaptive social behaviors”; “there is an ongoing debate in disciplines such as psychiatry and psychology as to its justification as an independent diagnostic entity”, influenced by “an absence of formal diagnostic criteria”; and SOR rates in clinical groups such as “autism spectrum disorders (ASD) (e.g., 56% Ben-Sasson et al. 2007)” and “ADHD (e.g., 69%; Parush et al. 2007)”.
23. Lane SJ, Reynolds S. Sensory over-responsivity as an added dimension in ADHD. Frontiers in Integrative Neuroscience. 2019;13:40. PMID 31555103. Checked October 11, 2026.
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    “many of the questions on the SMD parent-report tools include behaviors that overlap with the diagnostic features associated with ADHD (e.g., emotional and social responses, activity levels)”; “we identified two sub-groups of children with ADHD: those with ADHD and SOR (ADHDs) and those with ADHD but no SOR”; “several investigative groups have identified individuals with SOR and no additional diagnosis”; “Not all children with ADHD show SOR, but when they do, the SOR influences other aspects of behavior.” “We also substantiated a previously described relationship between SOR and anxiety in children with ADHD”; children with SOR “release cortisol in response to threat (in this case, sensory challenge) regardless of the presence or absence of the ADHD diagnosis”; and sensory responsivity differences “form one component of the DSM V diagnostic criteria” for autism.
24. Bijlenga D, Tjon-Ka-Jie JYM, Schuijers F, Kooij JJS. Atypical sensory profiles as core features of adult ADHD, irrespective of autistic symptoms. European Psychiatry. 2017;43:51-57. PMID 28371743. Checked October 11, 2026.
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    The abstract: 116 adults diagnosed with ADHD “had both more hyper- and hyposensitivity compared to norm groups. This was especially apparent in the Activity level and Auditory sensory modalities. Sensory hypo- and hypersensitivity were both related to an increased ADHD score, even showing a dose-response relationship, but not to any autistic symptom or comorbid disorder. As much as 43% of the females with ADHD reported sensory hypo- and/or hypersensitivity, compared to 22% of the men.”
25. Ahn RR, Miller LJ, Milberger S, McIntosh DN. Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy. 2004;58(3):287-293. PMID 15202626. Checked October 11, 2026.
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    The abstract: of 703 surveys returned for one district’s incoming kindergartners, “96 children (13.7% of 703) met criteria for sensory processing disorders based upon parental perceptions”; a more conservative estimate “suggests that based on parents’ perceptions, 5.3% (96 of 1796) of the kindergarten enrollment met screening criteria”; “Findings suggest a need for rigorous epidemiological studies of sensory processing disorders.”
26. Centers for Disease Control and Prevention. ADHD in Children. Page for families. Checked October 11, 2026.
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    “ADHD is one of the most common neurodevelopmental disorders of childhood.” “Symptoms can change over time and might increase when the demands of daily life increase.” “Genes play an important role in a person’s risk of ADHD.” “The diagnosis can be made by a mental health professional, like a psychologist or psychiatrist, or by a primary care provider, like a pediatrician.” “Many other problems, such as anxiety, depression, sleep problems, and certain types of learning disabilities, can have similar symptoms to ADHD.” “In most cases, ADHD is best treated with a combination of behavior therapy and medication. For preschool-aged children (4-5 years of age) with ADHD, behavior therapy, particularly training for parents, is recommended as the first line of treatment before medication is tried.”
27. Ben-Sasson A, Hen L, Fluss R, Cermak SA, Engel-Yeger B, Gal E. A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders. 2009;39(1):1-11. PMID 18512135. Checked October 11, 2026.
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    The abstract: “Results from 14 studies indicated a significant high difference between ASD and typical groups in the presence/frequency of sensory symptoms, with the greatest difference in under-responsivity, followed by over-responsivity and sensation seeking.” “Sensory differences were highest for studies of children ages 6-9 years”.
28. Ghanizadeh A. Sensory processing problems in children with ADHD, a systematic review. Psychiatry Investigation. 2011;8(2):89-94. PMID 21852983. Checked October 11, 2026.
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    Eleven studies on sensory problems in children with ADHD: “Sensory processing problems in children with ADHD is not a well studied area. Sensory processing problems in children with ADHD are more common than in typically developing children.” “co-morbidity with oppositional defiant disorder and anxiety are predictors of more severe sensory processing problems in children with ADHD.”
29. Kapp SK, Steward R, Crane L, Elliott D, Elphick C, Pellicano E, Russell G. ‘People should be allowed to do what they like’: autistic adults’ views and experiences of stimming. Autism. 2019;23(7):1782-1792. PMID 30818970. Checked October 11, 2026.
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    The abstract: “‘Stereotyped or repetitive motor movements’ are characterised as core features in the diagnosis of autism, yet many autistic adults (and the neurodiversity movement) have reclaimed them as ‘stimming’”; autistic adults “objected to treatment that aims to eliminate the behaviour”. Interviews and focus groups with 32 autistic adults: “we identified two themes: stimming as (1) a self-regulatory mechanism and (2) lacking in social acceptance, but can become accepted through understanding”; stimming was “commonly expressed through body movements (variously described as hand flapping, finger flicking, hair pulling or pinching, feet flexing, spinning, necklace playing) but also vocalisations (e.g. muttering, grunting, stuttering, whistling, singing). Many participants said they experienced it as involuntary and unconscious, at least at the beginning of the behaviour.” “no participants consistently and inherently disliked their stims (as opposed to their social consequences). Indeed, most participants described stimming itself as comfortable or calming”; one participant described “attending to a single point of focus over which one had control, to self-regulate by blocking or reducing excessive input” by rotating his wrist; another closed his eyes “to cut off additional stimuli”; another said waving her hands “actually managed to help me stave off some panic attacks”, “like if I’m in a crowded elevator”. Four subthemes: “overwhelming environment, sensory overload, noisy thoughts and uncontainable emotion”; “None of the participants described instances of too little sensory input or sensory hyposensitivities as a causal factor for stimming”; “Some participants described stimming in response to positive emotional states (e.g. excitement) and others in response to negative emotional states (e.g. anxiety)”; two participants “detailed that hand flapping due to positive states involves hands open and arms out in a waving-like motion, unlike hands and arms kept further down towards oneself”; “particular stims always responded to a particular emotion, which meant that the behaviours may have effectively communicated the person’s feelings”; “Stimming served a communicative, as well as a regulatory, function.” “Participants described feeling a variety of resentful emotions when told by others to stop stimming, including anger, nervousness, frustration, belittlement, shame and confusion”; “Other participants reported transmuting stims into a more socially acceptable form that provided similar feedback. For example, Ethan replaced arm stims with dancing”; one woman taught her students to hide stims, admitted suppressing her own made her feel “just sort of more on edge”, and said of training children to stop stimming, “to me it was abuse”; one man “repeatedly pressed his fingers together when anxious for sensory feedback” until they became “leathery”; another had pinched around her husband’s nails until he was “really sore”; “Participants professed no desire for self-injurious stims and largely wished to avoid stimming in ways harmful to others”; “even those who said they could suppress their stims described depleting, effortful costs”; “Task demands and physical and mental states (e.g. energy levels and emotional well-being) also reportedly influenced stimming”; “stimming became less socially acceptable as one got older”, with stims hidden or transmuted by secondary school; one participant avoided noise “by sitting in her car during her lunch break for ‘peace and quiet’”; “Several only stimmed freely when they had total privacy”; “Acceptance enabled participants the freedom to stim openly”; one participant could understand efforts to stop stimming “if it’s harmful to somebody else or it’s annoying to somebody else, but if it’s absolutely got no bearing on another person whatsoever I think people should be allowed to do what they like”; told not to stim as an adult, another feels “belittled”, as though he is “five”; “Understanding held the key to acceptance of non-harmful stimming” (an e-mail explaining his stimming at work “boosted his productivity as he worried less about stimming”); “We also extend the literature by providing accounts that suggest stimming helps with concentration and learning.” From the introduction: activists “decry practices such as ‘quiet hands’ (which teaches the suppression of hand flapping)” and “therapies continue to treat stimming despite lacking strong evidence of efficacy or ethics”; from the discussion: “Our participants’ perspective is consistent with the practice of making stims a target of treatment only when injurious, which (according to the DSM-5) would call for a co-occurring diagnosis of stereotypic movement disorder”, and “Behaviours like rocking and hand flapping typify infancy but become less common as children get older”.
30. Centers for Disease Control and Prevention. About Autism Spectrum Disorder. Page for families. Checked October 11, 2026.
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    “Autism spectrum disorder (ASD) is a developmental disability caused by differences in the brain.” “They may come to the attention of healthcare providers because they also have conditions such as anxiety, depression, or attention-deficit/hyperactivity disorder (ADHD)”; “Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child’s behavior and development to make a diagnosis.” “By age 2 years, a diagnosis by an experienced professional can be considered reliable.” “Treatment plans usually involve multiple professionals and are catered to the individual.”
31. Centers for Disease Control and Prevention. Treatment and Intervention for Autism Spectrum Disorder. Page for families. Checked October 11, 2026.
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    “Occupational therapy can also include” “Sensory integration therapy to help improve responses to sensory input that may be restrictive or overwhelming.” TEACCH “is based on the idea that people with autism thrive on consistency and visual learning”; “daily routines can be written or drawn and placed in clear sight” and “Verbal instructions can be complemented with visual instructions or physical demonstrations.” “There are no medications that treat the core symptoms of ASD.” “Some medications treat co-occurring symptoms (those that happen along with ASD)”; medication “might help manage high energy levels, inability to focus” or behavior “such as head banging or hand biting”.
32. McCarty MJ, Brumback AC. Rethinking stereotypies in autism. Seminars in Pediatric Neurology. 2021;38:100897. PMID 34183141. Checked October 11, 2026.
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    The abstract: “Stereotyped movements (‘stereotypies’) are semi-voluntary repetitive movements that are a prominent clinical feature of autism spectrum disorder. They are described in first-person accounts by people with autism as relaxing and that they help focus the mind and cope in overwhelming sensory environments. Therefore, we generally recommend against techniques that aim to suppress stereotypies in individuals with autism.” “We hypothesize that stereotypies improve sensory processing and attention by regulating brain rhythms”.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child.