Sensory Processing Disorder in Children: Signs and Tests

What is sensory processing disorder in children?

Sensory processing disorder (SPD) describes difficulty detecting, modulating, interpreting or responding to sensory experiences, strongly enough to interfere with daily life and routines.⁠^1,2 A child may react too strongly to ordinary input, barely notice it, or crave more of it, and these responses can show up as “fight, flight or freeze” behaviors such as aggression or withdrawal.⁠¹

This page also says “sensory processing differences” and “difficulties,” because SPD is not recognized as a diagnosis in the DSM-5-TR or ICD-11.⁠³ What matters is not the label but whether the pattern gets in the way of eating, dressing, sleeping, playing, learning or being with others.⁠^2,16

What are the eight senses?

Besides sight, hearing, touch, taste and smell, sensory processing frameworks include the vestibular sense (balance and movement), proprioception (body position) and interoception (signals from inside the body).⁠² A child can process one sense typically and another very differently, which is why assessments score each sense separately.⁠¹ Interoception and vestibular and proprioceptive processing each have their own guide.

What are the signs of sensory processing disorder in children?

The signs are reactions to everyday sensations that are much stronger, weaker or more driven than a child’s age would explain, and that happen often enough to affect daily life.⁠^2,6 Every child dislikes some things: in a study of 925 children aged 7 to 11, half were bothered by one to three everyday sensations, and 16% by four or more.⁠⁸

• Sound

  Distress at loud sounds; alarms, sirens and concerts were the sounds parents reported most often. Under-responsive children may barely respond to sensory cues at all.⁠^1,8

• Touch

  Tags in clothing bothered 39% of school-age children in one study, nail cutting 19% and hair brushing 16%; some children instead barely notice touch or pain.⁠^8,17

• Movement and balance

  Insecurity about movement and heights, which therapists call gravitational insecurity, or the opposite: constant moving and crashing into things, with little sense of personal space or danger.⁠^1,6

• Body position

  Clumsiness, awkwardness, and trouble with balance, posture or planning new movements, the sensory-based motor pattern.⁠^1,6

• Taste and smell

  Strong reactions to food textures, tastes and smells, and a narrow range of accepted foods; food selectivity is one of the challenges linked with over-responsivity in young children.⁠^1,18,19

• Sight

  Distress with bright light, or a fascination with lights or movement, both examples the autism criteria give.⁠^17,18

• Signals from inside the body

  Current descriptions of sensory modulation include interoception, the sense of the body’s inner signals, alongside the other senses.⁠²

• Across the day

  Irritability, sleep problems and stomach trouble have all been linked with sensory over-responsivity in young children.⁠¹⁹

Is it sensory or behavior?

It can be both, and the two are easy to confuse. Sensory reactions can look like aggression, withdrawal or a child who seems preoccupied with what might happen next, and children with elevated over-responsivity have more behavioral and emotional problems on average.⁠^1,8 An assessment looks at which sensations set off a reaction, which helps separate the two.⁠^2,4 The sensory or behavior quiz walks through the difference.

Why is my child fine at school but falls apart at home?

Research has not pinned down a single reason, but several findings fit. Sensory reactions are not constant: autistic teens in a classroom study said input bothered them depending on the situation, for example “only when I’m stressed.”⁠²⁰ Some autistic children hide their differences in social situations, which researchers call camouflaging; in 733 autistic children and teens aged 4 to 17, camouflaging predicted anxiety, low mood and physical complaints, and autistic adults name exhaustion as one of its costs.⁠^21,22

The Sensory Processing Measure has separate home and school forms, and the Sensory Profile 2 a school companion form, so an assessment can compare the two settings; describe what happens after school as well as during it.⁠^1,23

What do sensory issues look like at different ages?

Sensory reactions change as children grow, so the same child can look very different at 2, 5 and 9.⁠^15,24

What do sensory issues look like in babies and toddlers?

Some infants are over-responsive enough that it limits their ability to interact with people and explore their surroundings.⁠²⁴ In a study that followed 521 children from about 18 months to about 8 years, early sensory sensitivities, and how they changed, were linked with over-responsivity at school age.⁠²⁴

In infants and toddlers seen at an occupational therapy sleep clinic, more than half showed increased sensory responses, most often sensitivity, and greater sensitivity went with taking longer to settle to sleep.⁠²⁵ Questionnaires exist even for this age: the Sensory Profile 2 has an infant form from birth to 6 months and a toddler form from 7 to 35 months.⁠²³ Early sensitivity often passes, though: of children at risk at age 2 in a twin study, more improved by age 7 than stayed high.⁠¹⁵ The toddler development guide covers what else to expect.

What do sensory issues look like in preschoolers?

From about 2 to 5, sensory over-responsivity tends to show up alongside worries, picky eating, irritability, sleep problems and stomach complaints. In 917 children aged 2 to 5, 43% of those with over-responsivity also had an impairing anxiety disorder, and over-responsivity predicted more anxiety at age 6.⁠¹⁹

In autistic preschoolers, ICD-11 notes that sensitivities to everyday sounds or to foods can overshadow the social differences that point to autism.⁠¹⁸ Preschool forms of the SPM-2 cover ages 2 to 5, at home and at preschool.⁠²⁶

What do sensory issues look like in school-age children?

By school age, tactile sensations top the list: in 925 children aged 7 to 11, the most common bothersome sensations were tags in clothing, nail cutting, hair brushing and mud, and among sounds, alarms, sirens and concerts.⁠⁸ Children with elevated over-responsivity had more emotional and behavioral problems and fewer adaptive social behaviors.⁠⁸

School adds its own demands, and sensory difficulties can affect learning, play and social participation.⁠¹⁶ Sensory processing and learning at school covers the classroom, and sensory processing disorder in teens the years after 12.

What are the types of sensory processing disorder?

A typology proposed by Miller and colleagues in 2007 has three main types: sensory modulation disorder, sensory discrimination disorder and sensory-based motor disorder, each with subtypes.⁠^2,6

Most children do not fit one box. In 78 young children with sensory processing disorder and no other diagnosis, the most common type was over-responsivity and 53% had more than one type, and the authors suggested the typology may have more types than are clinically useful.⁠² There is more in sensory modulation disorder, sensory discrimination disorder and sensory-based motor disorder.

How common is sensory processing disorder in children?

Published estimates run from about 5% to 18% of children, and there is no single agreed figure, because the studies measure different things.⁠^7,8,9 The figure often quoted, 5% to 16%, comes from the first two studies below; the 2023 study found 18%, but it and the 16% study counted over-responsivity alone, not every type of sensory processing difficulty.⁠^8,9,27

All three rely on parent reports rather than clinical assessment, which is one reason the numbers differ.⁠^7,8,9 Sensory differences are far more common in some groups: they are thought to occur in up to 90% of autistic people and in 50% to 64% of children with ADHD.⁠¹

What causes sensory processing differences?

No one knows for sure; the causes of sensory over-responsivity are still described as largely unknown.⁠^8,15 Several factors have been linked with it.⁠^6,15 Causes and risk factors goes into the research in more detail.

• Genes

  In twin studies, over-responsivity to touch was far more often shared by identical twins than by fraternal twins.⁠⁶

• Premature birth

  A review of 18 studies supports sensory modulation problems in preterm children, though their nature and severity vary widely.⁠²⁸ Children with lasting over-responsivity were more often born early or at low birth weight.⁠¹⁵

• Temperament

  Over-responsivity was more stable in children with more fearful and less soothable temperaments.⁠¹⁵

• Brain wiring

  A small imaging study of 16 boys with SPD found differences in white matter, mainly toward the back of the brain.⁠²⁷

Is sensory processing disorder a diagnosis?

Not in the DSM-5-TR or ICD-11: SPD is not recognized in either, and in both, sensory differences appear only within the criteria for autism.⁠^3,17 It is recognized in DC:0–5, a classification for mental health and developmental disorders of infancy and early childhood.⁠²

In 2012 the American Academy of Pediatrics advised that, “because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed,” and that other developmental and behavioral disorders must always be considered.⁠⁵ Researchers continue to debate whether sensory over-responsivity is its own condition, partly because there are no formal diagnostic criteria and its causes are unknown.⁠^2,8

None of this means the difficulties are not real. In practice, what a family gets is an occupational therapy assessment describing the child’s sensory pattern, and school support depends on how much a difficulty limits learning, not on the label.⁠^10,29 The sensory processing disorder guide covers the debate in depth.

What is a sensory assessment?

A sensory assessment is an evaluation of how a child takes in and responds to sensory input, and how that affects daily life. It combines standardized tests, questionnaires completed by parents and teachers, and clinical observation.⁠⁴ The result is a description of the child’s sensory pattern that guides support, not a diagnosis code.⁠^3,10

Who does a sensory assessment?

Occupational therapists play a key role in assessing sensory processing in children and in providing therapy to support daily living, school, play and social activities.⁠¹⁰ Because other developmental and behavioral conditions must always be considered, a pediatrician should be part of the picture, and some clinics assess with a team that includes a developmental pediatrician, an occupational therapist and a speech-language pathologist.⁠^2,5 Find an occupational therapist lists clinics by state.

What should be ruled out before a sensory assessment?

Hearing and vision come first. CDC advises a hearing test any time there is a concern about a child’s hearing, and notes that a child who turns when they see you but not when you only call their name may have hearing loss rather than an attention problem.⁠³⁰ The AAP recommends checking the eyes and vision at routine well-child visits through childhood, with referral when a child fails a vision assessment.⁠³¹

Other explanations matter too: the AAP advises that other developmental and behavioral disorders always be considered, and for a child who eats very few foods, ICD-11 asks that medical conditions such as food allergies be ruled out as the cause.⁠^5,32 Your child’s doctor can check these before or alongside an occupational therapy assessment.⁠^5,30

What happens during a sensory assessment?

1. History. The therapist interviews you about development, daily routines and when reactions happen.⁠^2,33
2. Questionnaires. Parents, and often teachers, rate how often the child shows specific sensory behaviors.⁠^1,4
3. Standardized tests. For some children, hands-on tests of sensory perception, balance and motor planning.⁠^2,4
4. Observation. The therapist observes how the child moves, plays and responds.⁠⁴
5. Results and plan. The findings are explained, with goals for home and school.⁠^10,33

In one research clinic, SPD was identified from experienced occupational therapists’ overall clinical impression after a comprehensive evaluation, including motor tests, parent questionnaires and interviews, and a performance-based sensory measure.⁠² No single tool identifies every SPD type.⁠²

A 2017 review found the SIPT, the Sensory Processing Measure and the Sensory Profile were the most commonly used tools.⁠⁴

What is a sensory profile?

A sensory profile is the pattern of a child’s responses to sensation, and also the name of the questionnaire that measures it. The child form of the Sensory Profile 2 has 86 items and scores four patterns: seeking, avoiding, sensitivity and registration.⁠¹ Results are described as “more than others” or “less than others,” compared with children of the same age.⁠¹⁰

What does the Sensory Processing Measure assess?

The Sensory Processing Measure looks at vision, hearing, touch, body awareness, balance and motion, motor planning and social participation, with forms for home and school so a child can be compared across settings.⁠¹ Its second edition, the SPM-2, extends from infancy to adulthood.⁠²⁶

What do the results of a sensory assessment mean?

They describe which senses and patterns differ from other children’s and how that affects daily life, which is what therapy goals are built on.⁠¹⁰ Because sensory reactions change with age, researchers suggest assessment over time may be needed before calling a pattern a disorder.⁠¹⁵ How to test for sensory processing disorder walks through the process step by step.

How does occupational therapy help with sensory processing?

Occupational therapy for sensory processing aims at participation: helping a child eat, dress, sleep, learn and play with less distress.⁠¹⁰ It takes several forms.⁠^33,35

• Sensory integration therapy

  Clinic-based sessions using sensory-rich, child-directed activities to improve how a child responds to sensory experiences; Ayres Sensory Integration is the version studied against its own fidelity measure.⁠^11,35

• Sensory-based strategies

  Single-sense tools used during the day, such as weighted vests or therapy balls, meant to change a child’s state of arousal.⁠³⁵

• Parent coaching

  Working with parents on daily routines using the child’s sensory pattern; in one study, parents felt more competent and children took part more in everyday life.⁠³³

• Changing the environment

  Adjusting a setting rather than the child, such as a dental clinic adapted for autistic children.⁠³⁶

Does sensory integration therapy work?

The evidence is mixed. The AAP describes the research on sensory integration therapy as “limited and inconclusive” and suggests pediatricians talk with families about a trial period and how to judge whether a therapy is working.⁠⁵

So therapy may help a child reach specific everyday goals, while broader claims, such as reducing difficult behavior, are not supported.⁠^11,12 Sensory integration therapy and the full treatment guide go further.

Do weighted vests work for sensory issues?

The evidence says probably not. A review of seven studies concluded that weighted vests appear ineffective and cannot be recommended, and a later review found only limited evidence for them.⁠^13,36 Alternative seating did not improve attention in the 2025 review.⁠¹⁴

How is sensory processing related to autism, ADHD and anxiety?

Closely. The AAP notes that sensory difficulties can be part of autism, ADHD, developmental coordination disorder and childhood anxiety disorders, and that other conditions must always be considered.⁠⁵ Children can also have sensory processing difficulties without autism or ADHD.⁠¹

Is it autism or sensory processing disorder?

Sensory differences are one of the diagnostic features of autism, which also requires differences in social communication and restricted or repetitive behavior.⁠^17,18 When researchers compared the groups, autistic children had more taste and smell sensitivity and more under-responsiveness, while children with sensory modulation disorder had more sensory seeking.⁠² Autism or sensory processing disorder? compares them in depth.

Is it ADHD or sensory processing disorder?

They overlap: sensory processing problems are more common in children with ADHD than in other children, and in one screening study 40% of children with symptoms of either had symptoms of both.⁠^6,38 Inattention was greater in ADHD, while children with sensory modulation disorder had more sensory issues, physical complaints, anxiety and difficulty adapting.⁠² See ADHD vs sensory processing disorder.

Can sensory issues cause anxiety in children?

They may contribute. Preschool over-responsivity predicted anxiety symptoms at age 6, and the authors describe it as a risk factor for anxiety disorders.⁠¹⁹ In children aged 9 to 12, over-responsivity predicted more anxiety a year later.⁠⁹ Sensory over-responsivity or anxiety? explains how to tell them apart.

What can parents do at home for a child with sensory issues?

Quite a lot, and parent coaching is one of the better-supported approaches: a 2025 review found strong evidence for training caregivers in sensory strategies.⁠¹⁴ Working from the child’s own sensory pattern and the family’s routines helped parents feel more competent and children take part more in daily life.⁠³³

Changing the environment has little research behind it, so watch what actually helps your child.⁠¹⁴ Sleep matters throughout childhood: in children aged 8 to 12, sensory processing was linked with sleep habits.⁠⁴¹ More ideas are in sensory diet strategies, the sensory-friendly home guide and sensory parenting tips.

Will my child outgrow sensory processing issues?

Many children improve, some do not, and some first show difficulties later. In 978 twins assessed at 2 and 7, 75 children who were at risk at 2 had improved by 7, 24 stayed high, and 112 developed over-responsivity later.⁠¹⁵

In autistic people, abnormal sensory processing was lower at older ages, except sensitivity to touch.⁠⁴² In adults who looked back, high childhood sensory symptoms went with high adult symptoms.⁠⁴³ Therapy aims at daily goals rather than a cure, which is where the evidence is strongest.⁠¹¹ Sensory processing in adults covers the later years.

When should you talk to your child’s doctor about sensory issues?

When sensory reactions regularly get in the way of eating, dressing, sleeping, playing, learning or family life, or your child seems distressed much of the time.⁠^2,16

For a child under 3, the local early intervention system can evaluate; the evaluation and service coordination must be free, though states may charge some fees for services.⁠^44,45 From age 3, the local public school can evaluate, even if your child does not attend it; schools must identify and evaluate children who may need special education, and occupational therapy can be a related service.⁠^44,46,47 Sensory processing disorder is not one of IDEA’s disability categories, but a child may qualify under another, such as autism or other health impairment.⁠⁴⁸

How do sensory issues affect children at school?

Sensory difficulties can affect education, play and social participation, and a 504 plan depends on whether a difficulty substantially limits learning or another major life activity.⁠^16,29 The guide to sensory processing and learning covers classroom supports, IEPs and 504 plans.

Related on DrSensory

• Sensory processing disorder

  The eight senses, the patterns, and what helps.

• Testing for sensory processing disorder

  Who assesses it, the tools, and what you get at the end.

• Sensory processing in teens

  How sensory differences change from 13 to 17.

• Sensory processing and learning

  Attention, handwriting and classroom supports.

• SPD treatment

  The therapy options and what the evidence shows.

• Occupational therapy for SPD

  What an OT does in sessions.

• Over- vs under-responsivity

  How to tell which pattern you are seeing.

• W-sitting

  What the sitting position means and when to mention it.

• Sensory processing quiz

  A short screener of the patterns parents notice.

Sources

1. Passarello N, Tarantino V, Chirico A, et al. Sensory Processing Disorders in Children and Adolescents: Taking Stock of Assessment and Novel Therapeutic Tools. Brain Sciences. 2022;12(11):1478. doi:10.3390/brainsci12111478 (PMID 36358404; PMC9688399). Narrative review. Checked October 22, 2026.
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   SPDs “involving difficulty detecting, modulating, interpreting and/or responding to sensory experiences”; responses “can be categorized in three different patterns: sensory over-responsiveness, sensory under-responsiveness, or craving for sensory input”; under-responsive children “show low arousal, seem uninterested, and daydream, and they often have low endurance”; children with sensory craving “constantly touch, move, crash into objects, and have little to no awareness of personal space or boundaries” and “may also demonstrate decreased safety awareness”; over-responsive children “may react negatively to certain food groups, and they avoid social situations”; “Atypical sensory experiences are believed to occur in up to 90% of individuals with ASD” and “in 50-64% of children with ADHD”; “Children can also experience sensory processing dysfunction outside the clinical conditions of ASD or ADHD”. The Adolescent/Adult Sensory Profile is “a 60-item self-report questionnaire assessing levels of sensory processing in everyday life”; the SP-2 “is an 86-item caregiver-report measure of a child’s sensory processing characteristics” that “measures the four quadrants of sensory processing patterns: sensation seeking, sensory avoiding, sensory sensitivity, and sensory registration”; the SPM “is a caregiver-/teacher-report questionnaire in two versions: one for home (SPM-home) and one for school (SPM-school)” assessing “social participation, vision, hearing, touch, body awareness, balance and motion, and motor planning”; SPDs manifest in ““fight, flight or freeze” behaviours such as aggression, withdrawal, or preoccupation with the expectation of sensory input”; over-responsive children “show tactile defensiveness and gravitational insecurity”; under-responsive children “lack the ability to respond to sensory cues”; children with sensory craving “tend to be clumsy and awkward”.
2. Mulligan S, Douglas S, Armstrong C. Characteristics of Idiopathic Sensory Processing Disorder in Young Children. Frontiers in Integrative Neuroscience. 2021;15:647928. doi:10.3389/fnint.2021.647928 (PMID 33994966; PMC8113623). Checked October 22, 2026.
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   “A typology developed in a seminal paper by experts in the field characterized SPD as having three main types”; SPD “has been recognized as its own diagnostic entity in the most recent version of the diagnostic classification of mental and developmental disorders of infancy and early childhood-revised (DC: 0–5, zero to three)”; “the question of whether deficits in sensory processing represent symptomology of another disorder such as autism spectrum disorder (ASD), or developmental coordination disorder (DCD), or SPD is its own distinct condition remains”; in a study cited there, SPD “was identified based upon the global clinical impression of experienced occupational therapists following a comprehensive evaluation”; there is “no tool available for specifically identifying and measuring the SPD types as described in the typology by Miller et al. (2007)”; comparing children with ADHD and with sensory modulation disorder, “inattention was greater in children with ADHD compared to SMD, and children with SMD had more sensory issues, somatic complaints, anxiety/depression, and difficulty adapting than those with ADHD”; children in the study had been “evaluated by an interdisciplinary team of professionals including a developmental pediatrician, occupational therapist, speech-language pathologist”; “Results revealed that all SPD types as described by current typologies were well represented with the most common being the over-responsivity sensory modulation subtype”; “Within the sample, 53% of the children displayed more than one SPD type”; “current typologies may include more types/subtypes than are necessary or clinically useful”; SMD “considers the visual, auditory, tactile, vestibular, proprioception, gustatory, olfactory sensory systems, as well as interoception”; “The ASD group had more taste/smell sensitivity and sensory under-responsivity, while the SMD group had more atypical sensory seeking behavior”; the SIPT “has long been the gold standard for measuring sensory integration and praxis in children 4 to 9 years of age, although it does not measure sensory modulation”.
3. Valencia M, D’Ocon A, Plata R, Simó S, Cantero MJ. Internalizing/Externalizing Problems and Sensory Processing Alteration in Children Referred to Child Mental Health Centers. Children (Basel). 2025;12(6):664. doi:10.3390/children12060664 (PMID 40564622; PMC12191171). Checked October 22, 2026.
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   “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)”.
4. Jorquera-Cabrera S, Romero-Ayuso D, Rodriguez-Gil G, Triviño-Juárez JM. Assessment of Sensory Processing Characteristics in Children between 3 and 11 Years Old: A Systematic Review. Frontiers in Pediatrics. 2017;5:57. doi:10.3389/fped.2017.00057 (PMID 28424762; PMC5371598). Checked October 22, 2026.
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   “The assessment of sensory processing is a process that includes the use of standardized tests, administration of caregiver questionnaires, and clinical observations”; “the most commonly used tools are the Sensory Integration and Praxis Test, the Sensory Processing Measure, and the Sensory Profile”.
5. 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. doi:10.1542/peds.2012-0876 (PMID 22641765). Policy statement. Checked October 22, 2026.
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   “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 with sensory information “may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders”; “parents should be informed that the amount of research regarding the effectiveness of sensory integration therapy is limited and inconclusive”; pediatricians’ roles may include “talking with families about a trial period of sensory integration therapy, and teaching families how to evaluate the effectiveness of a therapy”.
6. Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA. Perspectives on sensory processing disorder: a call for translational research. Frontiers in Integrative Neuroscience. 2009;3:22. doi:10.3389/neuro.07.022.2009 (PMID 19826493; PMC2759332). Checked October 22, 2026.
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   “The new nosology proposes three main categories within SPD: sensory modulation disorder (SMD), sensory discrimination disorder and sensory-based motor disorder”; over-responsive “(responds too much, for too long, or to stimuli of weak intensity)”; under-responsive “(responds too little, or needs extremely strong stimulation to become aware of the stimulus)”; seeking/craving “(responds with intense searching for more or stronger stimulation)”; sensory discrimination disorder “refers to difficulty interpreting the specific characteristics of sensory stimuli”; “Postural disorder, which reflects problems in balance and core stability, and dyspraxia, which encompasses difficulties in motor planning and sequencing movements”. Of children screened for ADHD or sensory over-responsivity symptoms, “40% had symptoms of both”; twin studies: “concordance rates of tactile over-responsivity in identical twins was 0.82 compared to 0.27 in fraternal twins”.
7. 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. doi:10.5014/ajot.58.3.287 (PMID 15202626). Checked October 22, 2026.
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   Short Sensory Profile surveys from parents of incoming kindergartners in one suburban US district: “A total of 703 completed surveys were returned, which represents 39% of the kindergarten enrollment (n = 1,796)”; “96 children (13.7% of 703) met criteria for sensory processing disorders based upon parental perceptions”; assuming all non-respondents screened negative, “5.3% (96 of 1796) of the kindergarten enrollment met screening criteria for sensory processing disorders”.
8. 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. doi:10.1007/s10802-008-9295-8 (PMID 19153827; PMC5972374). Checked October 22, 2026.
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   Representative birth cohort of 925 children aged 7 to 11 (50% boys): “Sixteen percent of parents reported that at least four tactile or auditory sensations bothered their children”; the most frequent tactile sensations were “tags in clothing (39%), cutting finger or toe nails (19%), hair brushing (16%), and mud (11%)”; sounds “alarms (12%), sirens, and concerts (both 10%)”; “Fifty percent of school-age children were bothered by one to three 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 “unknown etiology”.
9. Schwarzlose RF, Tillman R, Hoyniak CP, Luby JL, Barch DM. Sensory Over-responsivity: A Feature of Childhood Psychiatric Illness Associated With Altered Functional Connectivity of Sensory Networks. Biological Psychiatry. 2023;93(1):92–101. doi:10.1016/j.biopsych.2022.09.004 (PMID 36357217; PMC10308431). Checked October 22, 2026.
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   Adolescent Brain Cognitive Development Study, children aged 9 to 12 (N = 11,210): “Children with SOR constituted 18% of the overall sample but comprised more than half of” children “with internalizing or externalizing scores in the clinical range”; “SOR predicted increased anxiety”, ADHD and “prodromal psychosis symptoms” a year later; the measure was “parent-reported SOR”.
10. Marozza A, Hay K, Frakking T. Use of sensory processing information in the diagnosis of autism spectrum disorder and attention deficit hyperactivity disorder in children at an Australian community hospital. Australian Occupational Therapy Journal. 2025;72(2):e70007. doi:10.1111/1440-1630.70007 (PMID 40083066; PMC11906904). Checked October 22, 2026.
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    “Occupational therapists play a key role in the assessment of sensory processing disorder in children and provide intervention to support children's engagement and participation in activities of daily living, education, leisure and play, and social activities”; sensory processing assessment “is a recommended part of the diagnostic workup for neurodiversity as outlined in the Australian guidelines”.
11. Acuña C, Gallegos-Berrios S, Barfoot J, Meredith P, Hill J. Ayres Sensory Integration® With Children Ages 0 to 12: A Systematic Review of Randomized Controlled Trials. American Journal of Occupational Therapy. 2025;79(3):7903205180. doi:10.5014/ajot.2025.051023 (PMID 40193295). Checked October 22, 2026.
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    “Nine RCTs (N = 344 participants), six with autistic children and three with other child populations, were included”; “Strong evidence from five RCTs (four Level 1b) indicates that ASI supports autistic children in meeting their individualized goals”; “Moderate evidence from three RCTs (two Level 1b) indicates no benefits of ASI for behaviors of concern, such as noncompliance or irritability”; “Bias concerns persist among included studies”; the trials “compared implementation of ASI with its Fidelity Measure”; ASI “is not recommended to address behaviors of concern, such as resistance to change or irritability”.
12. Randell E, Wright M, Milosevic S, et al. Sensory integration therapy for children with autism and sensory processing difficulties: the SenITA RCT. Health Technology Assessment. 2022;26(29):1–140. doi:10.3310/tqge0020 (PMID 35766242). Checked October 22, 2026.
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    Children in mainstream primary education in Wales and England; “A total of 138 participants were randomised”; “There were no significant main effects of the intervention at 6 or 12 months”; “The intervention did not demonstrate clinical benefit above standard care”; “The intervention is likely to be effective for individualised performance goals, although it is unclear whether effects were in addition to standard care or were maintained”.
13. Stephenson J, Carter M. The use of weighted vests with children with autism spectrum disorders and other disabilities. Journal of Autism and Developmental Disorders. 2009;39(1):105–114. doi:10.1007/s10803-008-0605-3 (PMID 18592366). Seven studies: “on balance, indications are that weighted vests are ineffective”; “weighted vests cannot be recommended for clinical application at this point”. Checked October 22, 2026.
14. Piller A, McHugh Conlin J, Glennon TJ, et al. Systematic review of sensory-based interventions for children and youth (2015–2024). Frontiers in Pediatrics. 2025;13:1720179. doi:10.3389/fped.2025.1720179 (PMID 41321460; PMC12658592). Checked October 22, 2026.
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    Participants “aged 0-21 years with sensory integration/processing challenges”; “Twenty-one studies were included”; “Strong strength of evidence supported use of deep pressure tactile input and caregiver training on the use of sensory strategies”; “Moderate strength of evidence supported that alternative seating did not improve attention”; “There is a lack of evidence on the impact of sensory environmental modifications”.
15. Van Hulle C, Lemery-Chalfant K, Goldsmith HH. Trajectories of Sensory Over-Responsivity from Early to Middle Childhood: Birth and Temperament Risk Factors. PLoS One. 2015;10(6):e0129968. doi:10.1371/journal.pone.0129968 (PMID 26107259; PMC4481270). Checked October 22, 2026.
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    978 twins assessed at 2 and 7 years: “low symptom (N=768), remitted (N=75), late-onset (N=112), and chronic (N=24)”; “Children in the chronic group had a younger gestational age and were more likely to be low birth-weight than the low symptom group”; “symptoms were more stable among children born prematurely or who had more fearful and less soothable temperaments”; “assessment over development may be necessary for a valid sensory processing disorder diagnosis”; “The etiology and developmental course of sensory over-responsivity is still largely unknown”.
16. Koenig KP, Rudney SG. Performance challenges for children and adolescents with difficulty processing and integrating sensory information: a systematic review. American Journal of Occupational Therapy. 2010;64(3):430–442. doi:10.5014/ajot.2010.09073 (PMID 20608274). Checked October 22, 2026.
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    AOTA Evidence-Based Literature Review Project, covering “play and leisure, social participation, activities of daily living, instrumental activities of daily living, rest and sleep, education, and work”: “children and adolescents with difficulty processing and integrating sensory information do exhibit functional performance difficulties in key areas of occupation”.
17. Centers for Disease Control and Prevention. Clinical Testing and Diagnosis for Autism Spectrum Disorder. Checked October 22, 2026.
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    DSM-5 criterion B4: “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)”.
18. World Health Organization. 6A02 Autism spectrum disorder. ICD-11 for Mortality and Morbidity Statistics, release 2026-01, with diagnostic requirements. Checked October 22, 2026.
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    “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”; “During the school age years and adolescence, these repetitive sensorimotor behaviours begin to lessen in intensity and number”; “By adolescence, the capacity to cope with increasing social complexity in peer relationships at a time of increasingly demanding academic expectations is often overwhelmed”; “Depressive symptoms are often a presenting feature”; “social adjustment difficulties outside the home may not be detected until school entry or adolescence when social communication problems lead to social isolation from peers”; “Some individuals with Autism Spectrum Disorder are capable of functioning adequately by making an exceptional effort to compensate for their symptoms during childhood, adolescence or adulthood. Such sustained effort, which may be more typical of affected females, can have a deleterious impact on mental health and well-being”; “Individuals with Autism Spectrum Disorder may also restrict intake of certain foods because of their sensory characteristics or because of inflexible adherence to particular routines”; “If a pattern of restricted eating in an individual with Autism Spectrum Disorder has caused significant weight loss or other health consequences or is specifically associated with significant functional impairment, an additional diagnosis of Avoidant-Restrictive Food Intake Disorder may be assigned”.
19. Carpenter KLH, Baranek GT, Copeland WE, et al. Sensory Over-Responsivity: An Early Risk Factor for Anxiety and Behavioral Challenges in Young Children. Journal of Abnormal Child Psychology. 2019;47(6):1075–1088. doi:10.1007/s10802-018-0502-y (PMID 30569253; PMC6508996). Checked October 22, 2026.
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    Community sample of 917 children aged 2 to 5, 191 followed to age 6: “Forty three percent of preschool children with sensory over-responsivity also had a concurrent impairing anxiety disorder”; “Preschool sensory over-responsivity symptoms significantly and positively predicted anxiety symptoms at age six”; challenges studied: “irritability, food selectivity, sleep problems, and gastrointestinal problems”; sensory over-responsivity is “characterized by heightened and unusual reactions to everyday sensory stimuli, such as the sound of a blender or the feel of a shirt tag”.
20. Howe FE, Stagg SD. How Sensory Experiences Affect Adolescents with an Autistic Spectrum Condition within the Classroom. Journal of Autism and Developmental Disorders. 2016;46(5):1656–1668. doi:10.1007/s10803-015-2693-1 (PMID 26791372; PMC4826419). Checked October 22, 2026.
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    Sixteen autistic students “aged between 12 and 17 (mean age of 14.4 years)” in mainstream schools: “88 % of the participants were affected by issues relating to hearing, 75 % by touch, 50 % by vision and 38 % smell”; “the most consistent theme across all four senses is a reduction in concentration”; one student: “when I am in mainstream classrooms I can hear lots of conversation/noise and it makes me feel tired”; comments described “the anxiety that is caused by anticipating an unexpected adverse input”; a comment coded as positive: “you know what bothers you”; “schools need to create sensory profiles for each individual with ASC”; “sensory experiences are not a constant state, but are dependent on changing variables, for example sensory modality, specific sensory inputs and the situation a person is in at the time”; one student: “only when I’m stressed”.
21. Ross A, Grove R, McAloon J. The relationship between camouflaging and mental health in autistic children and adolescents. Autism Research. 2023;16(1):190–199. doi:10.1002/aur.2859 (PMID 36416274). Checked October 22, 2026.
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    “Camouflaging involves the masking of autistic traits in social situations”; in “359 female and 374 male autistic children and adolescents (4-17 years, 48.9% females)”, “camouflaging was a significant predictor of internalizing (i.e., anxiety, depression, somatic complaints) symptoms”.
22. Hull L, Petrides KV, Allison C, et al. “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders. 2017;47(8):2519–2534. doi:10.1007/s10803-017-3166-5 (PMID 28527095; PMC5509825). Checked October 22, 2026.
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    92 autistic adults: motivations “included fitting in and increasing connections with others”; “short- and long-term consequences of camouflaging included exhaustion, challenging stereotypes, and threats to self-perception”.
23. Pearson Assessments. Sensory Profile 2. By Winnie Dunn, 2014. Checked October 22, 2026.
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    Age range: “Birth–14:11”; “Child Record Forms for ages 3:0-14:11”; “caregivers and teachers report on the child's response to sensory events throughout the day”; “Combined questionnaire and score forms: Infant, Toddler, Child, Short, and School Companion forms in one manual”; “Infant Record Forms for ages Birth-6 months”; “Toddler Record Forms for ages 7-35 months”; completion time “5–20 minutes”.
24. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. The development of sensory over-responsivity from infancy to elementary school. Journal of Abnormal Child Psychology. 2010;38(8):1193–1202. doi:10.1007/s10802-010-9435-9 (PMID 20623174). Checked October 22, 2026.
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    “Some infants experience atypical levels of over-responsivity to sensations, which limit their ability to interact and explore their environment”; 521 children followed from about 18 months to about 8 years: “Both early sensory sensitivities and change in early sensitivities were associated with SOR status at school-age”.
25. Vasak M, Williamson J, Garden J, Zwicker JG. Sensory Processing and Sleep in Typically Developing Infants and Toddlers. American Journal of Occupational Therapy. 2015;69(4):6904220040. doi:10.5014/ajot.2015.015891 (PMID 26114460). Checked October 22, 2026.
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    Chart review of 177 infants and toddlers at a community occupational therapy sleep clinic: “More than half of participants (55%) demonstrated a pattern of increased sensory processing in one or more quadrants, with sensitivity being most common (36%)”; “between increased sensitivity and longer time to settle to sleep”.
26. Western Psychological Services. Sensory Processing Measure, Second Edition (SPM-2). By Parham, Ecker, Kuhaneck, Henry and Glennon, 2021. Checked October 22, 2026.
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    Ages: “4 months to 87 years”; “Rating scales completed by various raters in examinee’s life”; the adolescent kit “Includes Print Manual; 25 Adolescent Home Print Forms; 25 Adolescent School Print Forms; 25 Adolescent Self-Report Print Forms; Unlimited digital downloads of the Adolescent Driving Self-Report Form and Driving Rater Report Form”; “SPM-2 Adolescent Home Form, Ages 12-21 Years”; “SPM-2 Infant Form, Ages 4-9 Months”; “SPM-2 Toddler Form, Ages 10-30 Months”; “SPM-2 Preschool Home Form, Ages 2-5 Years”; “SPM-2 Preschool School Form, Ages 2-5 Years”; “SPM-2 Child Home Form, Ages 5-12 Years”; “SPM-2 Adult Rater Report Form, Ages 21-87 Years”; “20 to 30 minutes for each of the 12 main forms”.
27. Owen JP, Marco EJ, Desai S, et al. Abnormal white matter microstructure in children with sensory processing disorders. NeuroImage: Clinical. 2013;2:844–853. doi:10.1016/j.nicl.2013.06.009 (PMID 24179836; PMC3778265). Imaging of “16 boys, 8-11 years old, with SPD and 24 age-, gender-, handedness- and IQ-matched neurotypical controls”; differences “primarily involving posterior white matter”. Checked October 22, 2026.
28. Bröring T, Oostrom KJ, Lafeber HN, Jansma EP, Oosterlaan J. Sensory modulation in preterm children: Theoretical perspective and systematic review. PLoS One. 2017;12(2):e0170828. doi:10.1371/journal.pone.0170828 (PMID 28182680; PMC5300179). Eighteen studies: “Results of this review support the presence of sensory modulation problems in preterm children”; “the nature and severity of sensory modulation problems differ widely between studies”. Checked October 22, 2026.
29. U.S. Department of Education. Frequently Asked Questions About Section 504 and the Education of Children with Disabilities. Office for Civil Rights. Checked October 22, 2026.
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    Section 504 covers students “who have a physical or mental impairment that substantially limits one or more major life activities”; major life activities include “learning” and, added by Congress, “eating, sleeping, standing, lifting, bending, reading, concentrating, thinking, and communicating”; “A medical diagnosis of an illness does not automatically mean a student can receive services under Section 504”.
30. Centers for Disease Control and Prevention. About Hearing Loss in Children. Checked October 22, 2026.
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    A sign in babies: “Turns head when he or she sees you but not if you only call out his or her name. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss”; “Children should have their hearing tested before they enter school or any time there is a concern about the child's hearing”.
31. Donahue SP, Nixon CN; Section on Ophthalmology, American Academy of Pediatrics; et al. Visual System Assessment in Infants, Children, and Young Adults by Pediatricians. Pediatrics. 2016;137(1):28–30. doi:10.1542/peds.2015-3596 (PMID 29756730). Checked October 22, 2026.
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    Policy statement: “Examination of the eyes and visual system should begin in the nursery and continue throughout both childhood and adolescence during routine well-child visits in the medical home”; “Children found to have an ocular abnormality or who fail a vision assessment should be referred to a pediatric ophthalmologist or an eye care specialist appropriately trained to treat pediatric patients”.
32. World Health Organization. 6B83 Avoidant-restrictive food intake disorder. ICD-11 for Mortality and Morbidity Statistics, release 2026-01. Checked October 22, 2026.
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    Reasons for restriction include “avoidance of foods with certain sensory characteristics (e.g., smell, taste, appearance, texture, colour, temperature)”; it requires either an intake that “has resulted in significant weight loss, clinically significant nutritional deficiencies” or otherwise harmed physical health, or “significant impairment in personal, family, social, educational, occupational or other important areas of functioning (e.g., due to avoidance or distress related to participating in social experiences involving eating)”; “The pattern of eating behaviour is not motivated by preoccupation with body weight or shape”; the restriction must be such that it is “not a manifestation of another medical condition (e.g., food allergies, hyperthyroidism)”.
33. Dunn W, Cox J, Foster L, Mische-Lawson L, Tanquary J. Impact of a contextual intervention on child participation and parent competence among children with autism spectrum disorders: a pretest-posttest repeated-measures design. American Journal of Occupational Therapy. 2012;66(5):520–528. doi:10.5014/ajot.2012.004119 (PMID 22917118). Checked October 22, 2026.
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    Coaching 20 parents using “authentic activity settings, family's daily routines, and the child's sensory processing patterns (Sensory Profile)”: “parents felt more competent and children significantly increased participation in everyday life”.
34. Mailloux Z, Parham LD, Roley SS, Ruzzano L, Schaaf RC. Introduction to the Evaluation in Ayres Sensory Integration® (EASI). American Journal of Occupational Therapy. 2018;72(1):7201195030p1–7201195030p7. doi:10.5014/ajot.2018.028241 (PMID 29280717). The EASI is being developed as “a set of tests that will fully evaluate the constructs of ASI with psychometrically strong, internationally appropriate, and easily accessible measurement tools”. Checked October 22, 2026.
35. Case-Smith J, Weaver LL, Fristad MA. A systematic review of sensory processing interventions for children with autism spectrum disorders. Autism. 2015;19(2):133–148. doi:10.1177/1362361313517762 (PMID 24477447). Checked October 22, 2026.
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    19 studies (2000 to 2012): sensory integration therapies are “clinic-based interventions that use sensory-rich, child-directed activities to improve a child's adaptive responses to sensory experiences”; “Sensory-based interventions are characterized as classroom-based interventions that use single-sensory strategies, for example, weighted vests or therapy balls, to influence a child's state of arousal”; “Two randomized controlled trials found positive effects for sensory integration therapy on child performance using Goal Attainment Scaling”; “Few positive effects were found in sensory-based intervention studies”.
36. Bodison SC, Parham LD. Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: a systematic review. American Journal of Occupational Therapy. 2018;72(1):7201190040p1–7201190040p11. doi:10.5014/ajot.2018.029413 (PMID 29280714). Eight studies: “Strong evidence supported Qigong massage, moderate evidence supported sensory modifications to the dental care environment, and limited evidence supported weighted vests”. Checked October 22, 2026.
37. Schoen SA, Lane SJ, Mailloux Z, et al. A systematic review of ayres sensory integration intervention for children with autism. Autism Research. 2019;12(1):6–19. doi:10.1002/aur.2046 (PMID 30548827; PMC6590432). Of 19 studies screened, three were rated: “Based on CEC criteria, ASI can be considered an evidence-based practice for children with autism ages 4-12 years old”. Checked October 22, 2026.
38. Ghanizadeh A. Sensory processing problems in children with ADHD, a systematic review. Psychiatry Investigation. 2011;8(2):89–94. doi:10.4306/pi.2011.8.2.89 (PMID 21852983; PMC3149116). 11 studies: “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”. Checked October 22, 2026.
39. Ikuta N, Iwanaga R, Tokunaga A, Nakane H, Tanaka K, Tanaka G. Effectiveness of Earmuffs and Noise-cancelling Headphones for Coping with Hyper-reactivity to Auditory Stimuli in Children with Autism Spectrum Disorder: A Preliminary Study. Hong Kong Journal of Occupational Therapy. 2016;28(1):24–32. doi:10.1016/j.hkjot.2016.09.001 (PMID 30186064; PMC6091992). Checked October 22, 2026.
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    “Twenty-one children with ASD aged 4-16 years”; “Four participants refused to wear either the earmuffs or the NC headphones”; Goal Attainment Scaling scores were “significantly higher during the earmuff period than that in the baseline period”.
40. American Academy of Pediatrics, HealthyChildren.org. Healthy Sleep Habits: How Many Hours Does Your Child Need?. Checked October 22, 2026.
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    “sleep-wake cycles begin to shift up to two hours later at the start of puberty”; “The AAP recommends keeping all screens” out of children’s bedrooms; “Dim the lights prior to bedtime and control the temperature in the home”; “Keep to a regular daily routine”.
41. Foitzik K, Brown T. Relationship Between Sensory Processing and Sleep in Typically Developing Children. American Journal of Occupational Therapy. 2018;72(1):7201195040p1–7201195040p9. doi:10.5014/ajot.2018.027524 (PMID 29280718). 45 typically developing children aged 8 to 12: “Sensory processing factors were significantly associated with the children's sleep habits and patterns, as reported by parents and children”. Checked October 22, 2026.
42. Kern JK, Trivedi MH, Garver CR, et al. The pattern of sensory processing abnormalities in autism. Autism. 2006;10(5):480–494. doi:10.1177/1362361306066564 (PMID 16940314). Checked October 22, 2026.
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    104 autistic people aged 3 to 56: “At later ages for the group with autism, lower levels of abnormal sensory processing were found, except for low threshold touch, which did not improve significantly”; sensory abnormalities “have the potential to improve with age”.
43. McMahon K, Anand D, Morris-Jones M, Rosenthal MZ. A Path From Childhood Sensory Processing Disorder to Anxiety Disorders: The Mediating Role of Emotion Dysregulation and Adult Sensory Processing Disorder Symptoms. Frontiers in Integrative Neuroscience. 2019;13:22. doi:10.3389/fnint.2019.00022 (PMID 31338029; PMC6629761). Checked October 22, 2026.
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    231 adults with emotion regulation difficulties, reporting childhood symptoms in retrospect: “childhood SPD symptoms were significantly associated with a higher likelihood of a lifetime anxiety disorder diagnosis”; “high symptoms of SPD in childhood may lead to high SPD symptoms in adulthood”.
44. American Psychiatric Association. What Is Autism Spectrum Disorder?. Checked October 22, 2026.
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    Restricted interests and repetitive behaviors, per the DSM-5-TR (American Psychiatric Association, 2022), may include “Sensory hypersensitivity, e.g., aversion to loud noises”; Evaluations: “you can obtain an evaluation through your local early intervention system” under age 3; over age 3, “you can get an evaluation through your local school (even if your child does not go there)”.
45. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 303.521 System of payments and fees. Checked October 22, 2026.
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    A state system of payments may include a “schedule of sliding or cost participation fees that may be charged to the parent for early intervention services”; functions “that must be carried out at public expense, and for which no fees may be charged to parents” include child find, “Evaluation and assessment” and “Service coordination services”.
46. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.111 Child find. States must ensure that children with disabilities “who are in need of special education and related services, are identified, located, and evaluated”. Checked October 22, 2026.
47. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.34 Related services. Related services include “physical and occupational therapy”; occupational therapy “Means services provided by a qualified occupational therapist” and includes “Improving ability to perform tasks for independent functioning if functions are impaired or lost”. Checked October 22, 2026.
48. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.8 Child with a disability. Checked October 22, 2026.
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    Child with a disability means a child with “an intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance (referred to in this part as “emotional disturbance”), an orthopedic impairment, autism, traumatic brain injury, an other health impairment, a specific learning disability, deaf-blindness, or multiple disabilities”, “who, by reason thereof, needs special education and related services”.

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.