How Sensory Processing Disorder Affects Learning

How does sensory processing disorder affect learning?

Research points mainly to attention and participation rather than understanding. In a study of 28 autistic children with average-range IQ, sensory patterns, especially difficulty filtering sound and sensory seeking, explained 47% of the differences in academic performance, while intelligence did not predict it.⁠¹ In another study of autistic students aged 8 to 14, school performance was lowest in children who were very sensitive but avoided input less.⁠¹⁵

A classroom is a demanding sensory place: posters on the walls, many voices, noise from inside and outside, and other students close by.⁠⁸ Autistic teens in mainstream classrooms said the most consistent effect of sensory difficulties on their learning was lost concentration.⁠² Noise affects every child’s listening and verbal work, and children with attention disorders more than most.⁠³

A review of the occupational therapy research found that children and adolescents with difficulty processing sensory information have functional difficulties in education, play and social participation.⁠¹⁶ Much of the classroom research is in autistic children, so findings are given here with the group they come from.⁠^1,8

What does SPD stand for in education?

In writing about children’s learning and therapy, including this page, SPD stands for sensory processing disorder: difficulty detecting, modulating, interpreting or responding to sensory input.⁠^17,18 It is not one of the disability categories in federal special education law, and it is not recognized as a diagnosis in the DSM-5-TR or ICD-11.⁠^11,19 The sensory processing disorder guide explains the condition itself.

How do sensory issues affect attention in class?

Sensory difficulties and inattention often go together. In autistic children, difficulty filtering sound went with inattention to schoolwork, and sensitivity to touch went with hyperactivity and inattention.⁠¹ In 11,210 children aged 9 to 12, sensory over-responsivity predicted more ADHD symptoms a year later.⁠²⁰

The classroom itself plays a part. Kindergartners taught in a heavily decorated room were more distracted, spent more time off task and learned less than when the decorations were removed.⁠⁴ In autistic children, those who struggle to follow spoken instructions in noisy rooms seem more likely to underachieve.⁠¹

Is it ADHD or sensory processing in the classroom?

It can be either or both. Sensory processing problems are more common in children with ADHD than in other children, and when researchers compared the groups, inattention was greater in ADHD while children with sensory modulation difficulties had more sensory issues and anxiety.⁠^21,22 A child who is fine in a quiet room and lost in a noisy one is worth an assessment that looks at both.⁠^1,23 See ADHD vs sensory processing disorder.

Do sensory issues affect handwriting?

Possibly, but the evidence is thin. In 16 children aged 10 to 12, those with poor handwriting had the same hand and finger sensitivity as good writers, though the authors note the sample was small.⁠²⁴ In 27 children with handwriting difficulties, being able to see their own writing improved legibility, and the authors linked poor legibility to spatial memory for the characters.⁠²⁵

Sensory-based motor disorder includes dyspraxia, difficulty planning and sequencing movements, which matters for any motor skill.⁠¹⁸ One small study of three students with ADHD found more legible words written when they sat on therapy balls, but three students cannot settle the question.⁠²⁶ If writing is the barrier, an occupational therapist can assess the cause, and an IEP can include supplementary aids and services.⁠^12,27 Dysgraphia covers writing difficulties in depth.

How do sensory issues affect behavior and participation at school?

Sensory reactions can look like defiance. Sensory processing difficulties show up as “fight, flight or freeze” responses such as aggression or withdrawal, and in autistic children, sensitivity to movement went with oppositional behavior.⁠^1,17

Participation suffers too. Children with elevated over-responsivity had lower levels of adaptive social behavior in elementary school, and teens in a classroom study described sensory input that left them tired and anxious.⁠^2,28

Why is my child fine one-to-one but struggling in class?

Because a one-to-one setting removes much of what makes a classroom hard: the noise, the visual displays and the closeness of other children.⁠⁸ A child who manages well in a quiet room and poorly in a busy one is showing that the setting matters, which is useful information for the school team.⁠^1,8

Which parts of the school day are hardest for children with sensory issues?

Some of the hardest moments come outside lessons. Reviewers describe the playground, hallways and cafeteria as inherently loud parts of school, and suggest giving students access to quieter spaces and, for older students, lockers at the end of hallways.⁠⁸ A study cited in the classroom research documented anxiety in autistic children from moving through corridors crowded with people pushing into each other.⁠²

Sudden loud sounds are another flashpoint: alarms and sirens were the sounds parents most often said bothered their school-age children, which makes a fire drill worth planning for.⁠²⁸ When you meet the school team, ask about these times specifically, since they fall outside lessons.⁠^2,8

What classroom accommodations help with sensory processing?

So far, changes to the room have better support than gadgets given to one child, and many of them help the whole class.⁠^3,4,8 The evidence for each is uneven, and it is worth knowing which is which.⁠^6,29

Do noise-canceling headphones help in class?

For some children. Earmuffs helped some autistic children cope with sounds, and noise-canceling earbuds improved auditory attention and classroom listening in 13 autistic children aged 6 to 13.⁠^10,31 Reviewers suggest headphones for independent work, when a child does not need to hear the teacher.⁠⁸ They are not a general fix: in 271 second graders, earmuffs lowered scores on an attention test.⁠⁶

Do movement breaks help children focus?

They help time on task. In a meta-analysis of elementary school studies, classroom physical activity improved on-task behavior, and a second review found classroom behavior improved after most movement breaks it examined; effects on academic achievement were less certain.⁠^5,30 Movement breaks in the classroom has ideas teachers can use.

Do fidgets and wobble cushions help?

A randomized trial suggests not, for most children. In that trial of 271 second graders, a tangle fidget, a wobble cushion and earmuffs each lowered attention scores, and every tool hurt accuracy for children who already got the right amount of sensory input.⁠⁶ Fidget spinners went with poorer attention in young children with ADHD.⁠³² The authors call for research on longer-term, personalized use, so a tool should be tried with one child and checked, not handed to everyone.⁠⁶

Do weighted vests help at school?

No good evidence says so. A review of seven studies found weighted vests ineffective and not recommended, and a later review of classroom research found little to no benefit for autistic students.⁠^8,9

What school support can a child with sensory issues get?

A 504 plan or an IEP, depending on need. Section 504 covers a student whose impairment substantially limits a major life activity such as learning, concentrating or reading, and provides regular or special education with related aids and services.⁠⁷ A diagnosis alone does not qualify a student; what counts is how much an impairment limits learning or another major life activity.⁠⁷

An IEP under IDEA is for a child in one of its disability categories who needs special education. SPD is not a category, but sensory responses can be part of others: IDEA’s definition of autism mentions unusual responses to sensory experiences, and other health impairment includes heightened alertness to environmental stimuli due to health problems such as ADHD.⁠¹¹ An IEP lists the services and supplementary aids a child will get, and occupational therapy can be one of them.⁠^12,27

Is sensory processing disorder a learning disability?

No. Under IDEA, a specific learning disability is a disorder in the basic processes of understanding or using spoken or written language, such as dyslexia, and it excludes learning problems that are primarily the result of visual, hearing or motor disabilities.⁠¹¹ A child with sensory difficulties can still be evaluated for a learning disability if reading, writing or math are behind.⁠^11,33

How do you request a school evaluation?

A parent can ask the school for an initial evaluation, and it must be done within 60 days of the parent’s consent, or within the state’s own timeframe.⁠³³ Describe what happens, when and what it prevents; a 504 evaluation weighs teacher recommendations, test results and adaptive behavior alongside any diagnosis.⁠⁷ The school evaluation letter and IEP vs 504 plan guides walk through it.

Are there special schools for sensory processing disorder?

Federal law presumes that children with disabilities learn in regular classrooms with support where possible: it allows separate classes or schools only when a child cannot be educated satisfactorily in regular classes with supplementary aids and services.⁠³⁴ Schools must still offer a continuum of placements, from regular classes to special classes and special schools, decided by the child’s needs.⁠³⁵

How does a school occupational therapist help?

A school occupational therapist works on what gets in the way of school. Under IDEA, occupational therapy is a related service, provided when a child needs it to benefit from special education, and it includes improving the ability to perform tasks independently.⁠¹² Occupational therapists also play a key role in assessing sensory processing.⁠¹³

1. Assess in the classroom. Look at how the child responds to the room, the noise and the routine; researchers recommend a sensory profile for each student.⁠^2,13
2. Adjust the setting. Suggest changes such as seating, quieter spaces and fewer distractions.⁠⁸
3. Coach the adults. Show parents and teachers strategies; training caregivers in sensory strategies has strong evidence.⁠²⁹
4. Write it into the plan. Put services and supports into the IEP or 504 plan so they happen every day.⁠^7,27

A clinic occupational therapist and a school one can share reports, with your consent, so the plan at home and at school matches. To find a clinic, use the occupational therapist directory, and see occupational therapy for school-age children.⁠¹³

How can teachers support students with sensory differences?

Start with the room: a review of classroom research notes that many changes that help sensory-sensitive students would benefit all students.⁠⁸

When a student refuses a task, melts down or leaves, ask what they were reacting to. Sensory reactions can look like aggression or withdrawal, and teens describe anxiety about noises they expect.⁠^2,17 Teachers’ observations also count in a 504 evaluation.⁠⁷ Supporting a child with SPD and ADHD at school has more ideas.

What is a sensory learner?

“Sensory learner” is not a diagnosis or a special education category; IDEA’s categories do not include it.⁠¹¹ The phrase is sometimes used for a child who seems to learn best by touching and doing, which is the idea of learning styles: that teaching should match a child’s preferred way of taking in information.⁠¹⁴

That idea has not held up. A review in Psychological Science in the Public Interest found “virtually no evidence” that matching teaching to learning styles improves learning, and concluded there is no adequate evidence base for using learning-styles assessments in general education, though not every version has been tested.⁠¹⁴

Sensory processing differences are something else: real differences in how a child responds to sensation, which can affect attention and participation and are assessed by occupational therapists.⁠^1,13 A child who needs to move or who struggles with noise needs support for that, not lessons designed around a style.⁠^3,5

How can parents work with the school on sensory needs?

Bring specifics. A 504 evaluation draws on teacher recommendations, test results and adaptive behavior alongside any diagnosis, so concrete examples of what happens, when and what it stops your child from doing carry weight.⁠⁷ An occupational therapy report that describes your child’s sensory pattern helps the team plan.⁠¹³

1. Write it down. Note when problems happen and what was going on around your child.⁠^1,8
2. Ask in writing. Request an evaluation; the school then has 60 days from your consent, or the state’s timeframe.⁠³³
3. Share reports. Give the team any outside occupational therapy assessment.⁠¹³
4. Agree on changes. Favor room changes and supports with evidence, and review tools after a trial.⁠^6,8
5. Include your child. Older students can say what bothers them and what helps; teens in one study did.⁠²

If your child is also anxious or struggling at home, the guide to sensory processing in children covers assessment and support outside school, and sensory processing in teens covers the later years.⁠¹⁶

Related on DrSensory

• Sensory processing disorder

  The eight senses, the patterns, and what helps.

• Sensory processing in children

  Signs by age and what a sensory assessment involves.

• Sensory processing in teens

  Middle and high school, and self-advocacy.

• IEP vs 504 plan

  How to request school support.

• SPD and ADHD at school

  Supporting a child who has both.

• Sensory avoidance and school refusal

  When sensory overload keeps a child from school.

• Movement breaks

  Short activity breaks teachers can use.

• Monotropism

  A theory of autistic attention and why switching is costly.

• Learning differences

  Dyslexia, dysgraphia, dyscalculia and more.

Sources

1. Ashburner J, Ziviani J, Rodger S. Sensory processing and classroom emotional, behavioral, and educational outcomes in children with autism spectrum disorder. American Journal of Occupational Therapy. 2008;62(5):564–573. doi:10.5014/ajot.62.5.564 (PMID 18826017). Checked October 22, 2026.
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   “Twenty-eight children with ASD (with average-range IQ) were compared with 51 age- and gender-matched typically developing peers”; for the autistic children, “Underresponsive/Seeks Sensation and Auditory Filtering explained 47% of the variance in academic performance, yet estimated intelligence was not a significant predictor of academic performance”; correlations between “(1) auditory filtering and inattention to cognitive tasks, (2) tactile hypersensitivity and hyperactivity and inattention, and (3) movement sensitivity and oppositional behavior”; “Children who have difficulty processing verbal instructions in noisy environments and who often focus on sensory-seeking behaviors appear more likely to underachieve academically”.
2. 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”; the paper cites earlier work: “Humphrey and Lewis (2008) documented anxiety in children with ASC caused by having to move through corridors full of people pushing into each other”.
3. Klatte M, Bergström K, Lachmann T. Does noise affect learning? A short review on noise effects on cognitive performance in children. Frontiers in Psychology. 2013;4:578. doi:10.3389/fpsyg.2013.00578 (PMID 24009598; PMC3757288). Checked October 22, 2026.
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   “Experimental studies addressing the impact of acute exposure showed negative effects on speech perception and listening comprehension”; “Children with language or attention disorders and second-language learners are still more impaired than age-matched controls”; “Indoor noise and reverberation in classroom settings were found to be associated with poorer performance of the children in verbal tasks”; “the reported effects are usually small in magnitude”.
4. Fisher AV, Godwin KE, Seltman H. Visual environment, attention allocation, and learning in young children: when too much of a good thing may be bad. Psychological Science. 2014;25(7):1362–1370. doi:10.1177/0956797614533801 (PMID 24855019). Checked October 22, 2026.
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   Kindergarten children in a laboratory classroom for six science lessons: “Children were more distracted by the visual environment, spent more time off task, and demonstrated smaller learning gains when the walls were highly decorated than when the decorations were removed”.
5. Watson A, Timperio A, Brown H, Best K, Hesketh KD. Effect of classroom-based physical activity interventions on academic and physical activity outcomes: a systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity. 2017;14(1):114. doi:10.1186/s12966-017-0569-9 (PMID 28841890; PMC5574081). Checked October 22, 2026.
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   39 articles, 16 in the meta-analyses, elementary school children: “classroom-based physical activity had a positive effect on improving on-task and reducing off-task classroom behaviour (standardised mean difference = 0.60 (95% CI: 0.20,1.00))”; “it is not possible to draw definitive conclusions due to the level of heterogeneity in intervention components and academic-related outcomes assessed”.
6. van der Wurff I, Meijs C, Hurks P, et al. The influence of sensory processing tools on attention and arithmetic performance in Dutch primary school children. Journal of Experimental Child Psychology. 2021;209:105143. doi:10.1016/j.jecp.2021.105143 (PMID 34089920). Checked October 22, 2026.
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   Randomized trial in “Children attending Grade 2 (N = 271)” using “tangle, wobble cushion, earmuffs, or nothing (control condition)”: “Negative effects of the use of the tangle, earmuffs, and wobble cushion on the Bourdon-Vos total”; “a negative effect of the use of all tools was shown on the Bourdon-Vos correct for children who already received an optimal amount of stimuli”; “more research is needed to investigate the effect of longer-term personalized sensory processing tool use”.
7. 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”; FAPE under Section 504 “consists of the provision of regular or special education and related aids and services designed to meet the student's individual educational needs as adequately as the needs of nondisabled students are met”; evaluations consider, with any diagnosis, “aptitude and achievement tests, teacher recommendations, physical condition, social and cultural background, and adaptive behavior”.
8. Mallory C, Keehn B. Implications of Sensory Processing and Attentional Differences Associated With Autism in Academic Settings: An Integrative Review. Frontiers in Psychiatry. 2021;12:695825. doi:10.3389/fpsyt.2021.695825 (PMID 34512416; PMC8430329). Checked October 22, 2026.
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   In classrooms, “With the multiple visuals posted, numerous peers talking, noise from inside and outside the classroom, and close proximity of peers, students are exposed to multisensory stimulation from a variety of sources”; suggested auditory changes include “the installation of sound absorbing walls, use of carpets” and “use of noise-reduction headphones for independent work”; “Sound-field amplification (SFA), a system that amplifies the teacher's voice above the ambient noise in the room”; visual: “inclusion of less intense lighting sources (e.g., halogen lights instead of fluorescent) and limited but relevant background visual displays” and “placing desks so that they are not facing out the windows or other external distractors”; tactile: “strategic spacing of students could reduce unpredictable tactile input”; “students with ASD experienced little to no benefit from these vests in the classroom”; on flexible seating, “Limited research has been done demonstrating efficacy of this strategy, however, results overall have shown a positive effect on classroom behavior and participation”; “the use of many of these modifications would be beneficial for all students”; “for inherently loud environments in a school such as the playground, hallways, and cafeteria, it is suggested that schools provide access to quieter spaces as well as lockers at the end of hallways for older students”.
9. 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.
10. Zanin J, Tomlin D, Rance G. Effectiveness of Noise Cancelling Earbuds in Reducing Hearing and Auditory Attention Deficits in Children with Autism. Journal of Clinical Medicine. 2024;13(16):4786. doi:10.3390/jcm13164786 (PMID 39200929; PMC11355770). Checked October 22, 2026.
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    “Thirteen children aged 6-13 years diagnosed with ASD participated”; “Auditory attention, however, significantly improved when the children were using the earbuds”; the earbuds could offer classroom benefits, “potentially minimising the stigma associated with traditional assistive listening devices”.
11. 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”; autism: “Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences”; other health impairment: “having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment” due to health problems such as “attention deficit disorder or attention deficit hyperactivity disorder”; specific learning disability: “a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written”; it “does not include learning problems that are primarily the result of visual, hearing, or motor disabilities”.
12. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.34 Related services. Checked October 22, 2026.
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    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”; related services are those “as are required to assist a child with a disability to benefit from special education”.
13. 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”.
14. Pashler H, McDaniel M, Rohrer D, Bjork R. Learning Styles: Concepts and Evidence. Psychological Science in the Public Interest. 2008;9(3):105–119. doi:10.1111/j.1539-6053.2009.01038.x (PMID 26162104). Checked October 22, 2026.
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    The meshing hypothesis holds that “instruction is best provided in a format that matches the preferences of the learner”; the authors “found virtually no evidence for the interaction pattern mentioned above”; “at present, there is no adequate evidence base to justify incorporating learning-styles assessments into general educational practice”; “it would be an error to conclude that all possible versions of learning styles have been tested and found wanting”.
15. Butera C, Ring P, Sideris J, et al. Impact of Sensory Processing on School Performance Outcomes in High Functioning Individuals with Autism Spectrum Disorder. Mind, Brain, and Education. 2020;14(3):243–254. doi:10.1111/mbe.12242 (PMID 34367324; PMC8341443). Checked October 22, 2026.
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    26 autistic youths and 26 controls aged 8 to 14: “school performance is lowest for children with greater hypersensitivity and fewer avoidance behaviors”; “Results indicate a strong impact of sensory processing on school performance in ASD”.
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. 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”.
18. 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”.
19. 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)”.
20. 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.
21. 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.
22. 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”.
23. 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”.
24. Brink AO, Jacobs AB. Kinesthetic sensitivity and related measures of hand sensitivity in children with nonproficient handwriting. Pediatric Physical Therapy. 2011;23(1):88–94. doi:10.1097/PEP.0b013e318208cc81 (PMID 21304346). Checked October 22, 2026.
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    Sixteen children aged 10 to 12: “No significant difference was found on tests of kinesthetic sensitivity or other measures of sensation”; “Failure to detect differences may result from a small sample size”.
25. Tse LF, Thanapalan KC, Chan CC. Visual-perceptual-kinesthetic inputs on influencing writing performances in children with handwriting difficulties. Research in Developmental Disabilities. 2014;35(2):340–347. doi:10.1016/j.ridd.2013.11.013 (PMID 24333804). Checked October 22, 2026.
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    27 children aged 9 to 11 with handwriting difficulties writing Chinese characters: “Visual feedback regarding one's own actions in writing can also improve legibility of characters among these children”; “Poor legibility seems to be related to the less-intact spatial representation of the characters in working memory”.
26. Schilling DL, Washington K, Billingsley FF, Deitz J. Classroom seating for children with attention deficit hyperactivity disorder: therapy balls versus chairs. American Journal of Occupational Therapy. 2003;57(5):534–541. doi:10.5014/ajot.57.5.534 (PMID 14527115). Checked October 22, 2026.
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    Single-subject design, “3 students (2 males, 1 female) with ADHD”: “Results demonstrated increases in in-seat behavior and legible word productivity for the students with ADHD when seated on therapy balls”.
27. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.320 Definition of individualized education program. Checked October 22, 2026.
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    Transition services: “Beginning not later than the first IEP to be in effect when the child turns 16, or younger if determined appropriate by the IEP Team”, the IEP must include “Appropriate measurable postsecondary goals based upon age appropriate transition assessments related to training, education, employment, and, where appropriate, independent living skills”; rights transfer: “Beginning not later than one year before the child reaches the age of majority under State law”; the IEP includes “A statement of the special education and related services and supplementary aids and services, based on peer-reviewed research to the extent practicable”.
28. 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”.
29. 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”.
30. Daly-Smith AJ, Zwolinsky S, McKenna J, et al. Systematic review of acute physically active learning and classroom movement breaks on children’s physical activity, cognition, academic performance and classroom behaviour: understanding critical design features. BMJ Open Sport & Exercise Medicine. 2018;4(1):e000341. doi:10.1136/bmjsem-2018-000341 (PMID 29629186; PMC5884342). Checked October 22, 2026.
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    “Classroom behaviour improved after longer moderate-to-vigorous (>10 min), or shorter more intense (5 min), CMB/PAL bouts (9 out of 11 interventions)”; “There was no support for enhanced cognition or academic performance due to limited repeated studies”; “CMB and PAL increased PA and enhanced time on task”.
31. 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”.
32. Graziano PA, Garcia AM, Landis TD. To Fidget or Not to Fidget, That Is the Question: A Systematic Classroom Evaluation of Fidget Spinners Among Young Children With ADHD. Journal of Attention Disorders. 2020;24(1):163–171. doi:10.1177/1087054718770009 (PMID 29676193; PMC13520153). Checked October 22, 2026.
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    60 children with ADHD, mean age 4.86 years: “Children's use of fidget spinners was associated with poorer attention across both phases of treatment”; “Fidget spinners negatively influence young children with ADHD's attentional functioning”.
33. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.301 Initial evaluations. Checked October 22, 2026.
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    “either a parent of a child or a public agency may initiate a request for an initial evaluation”; it “Must be conducted within 60 days of receiving parental consent for the evaluation” or within a state’s own timeframe.
34. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.114 LRE requirements. Checked October 22, 2026.
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    “Special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only if the nature or severity of the disability is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily”.
35. U.S. Department of Education, Individuals with Disabilities Education Act regulations (Electronic Code of Federal Regulations). 34 CFR § 300.115 Continuum of alternative placements. “a continuum of alternative placements is available to meet the needs of children with disabilities”, including “instruction in regular classes, special classes, special schools, home instruction, and instruction in hospitals and institutions”. Checked October 22, 2026.

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.