Types of Sensory Processing Disorder

What are the 3 types of sensory processing disorder?

Sensory processing disorder (SPD) is usually divided into three types. The framework was proposed in 2007 by Lucy Jane Miller and colleagues, who suggested diagnosing it only when sensory difficulties impair daily routines or roles.⁠¹ The STAR Institute, which Miller founded, still lists them as the three major patterns of sensory processing differences: modulation, discrimination and sensory-based motor.⁠^2,16

• Modulation

  How strongly the nervous system responds to input. Three subtypes: over-responsivity, under-responsivity and seeking. Support points toward changing how much input arrives, and when.⁠^1,13

• Discrimination

  Telling similar sensations apart: two textures, two sounds, how hard you are pressing. Support points toward checking hearing and vision first, then more processing time.⁠^1,14,15

• Sensory-based motor

  Using sensation to steady the body and plan movement. Two subtypes: postural disorder and dyspraxia. Support points toward practicing the activities themselves.⁠^1,10

Where does the SPD classification come from?

A. Jean Ayres, an occupational therapist trained in psychology and neuroscience, first used the term sensory integration dysfunction in 1963. Her categories rested on her own test battery, which many children in therapy could not take, so Miller’s group held focus groups from 1998 to 2000, two early-childhood manuals published sensory subtypes in 2005, and the 2007 paper set out the full classification, with the stated aim of proposing subtypes for the next DSM.⁠¹

Ayres’ own test-based patterns continue in a parallel line of work. A re-analysis of 273 children’s evaluations found patterns close to hers, among them visuodyspraxia and somatodyspraxia, bilateral integration and sequencing, tactile and visual discrimination, and tactile defensiveness and attention, and an analysis of more than 10,000 children confirmed her somatosensory and bilateral integration dyspraxias.⁠^17,18

Has the SPD classification changed since 2007?

In places. The STAR Institute’s current table lists two modulation patterns, over-responsive and under-responsive, suggests heightened and lowered responsivity as more neutral names, describes seeking and avoiding as behavioral responses to them, and adds interoception, the sense of the body’s internal state, to the senses where discrimination can differ.⁠^2,16 It also notes that many people’s modulation fits neither box neatly: some register everything around them with the same intensity.⁠¹⁶ Cleveland Clinic still lists six types: over-responsivity, under-responsivity, sensory craving, discrimination disorder, postural disorder and dyspraxia.⁠⁵

Is sensory processing disorder a real diagnosis?

The differences are real; the diagnosis is not official. Sensory processing disorder is not a standalone diagnosis in the DSM-5-TR, the American Psychiatric Association’s current manual, or in the ICD-11, and Cleveland Clinic calls it not an official medical diagnosis, though providers see value in identifying and treating it.⁠^4,5,19 It is the umbrella term the sensory processing hub is built around, and the STAR Institute still describes inclusion in the DSM and ICD as a goal.⁠²⁰

The American Academy of Pediatrics advised in 2012 that, without a universally accepted framework, sensory processing disorder generally should not be diagnosed, noting that sensory difficulties are seen in autism, ADHD, developmental coordination disorder and childhood anxiety and that other conditions must always be considered.⁠²¹ The 2007 classification has not entered either manual.⁠^1,19

Which diagnostic manual does include sensory processing disorders?

One for young children. The DC:0-5, ZERO TO THREE’s diagnostic classification for infancy and early childhood, published in 2016, has a sensory processing disorders section with sensory over-responsivity disorder, sensory under-responsivity disorder and other sensory processing disorder; its crosswalk maps all three to other specified neurodevelopmental disorder in the DSM-5 and to F88 in the ICD-10.⁠^8,24 Seeking and discrimination have no category of their own in that list, while coordination problems fall under developmental coordination disorder, which it lists among neurodevelopmental disorders.⁠⁸

How common is sensory processing disorder?

Estimates vary widely, because studies measure different things.⁠^11,12

Those are not two attempts at one number: one screens broadly and depends on an assumption about the families who did not reply, the other counts one pattern against a set threshold. Ahn’s authors call for rigorous epidemiological studies, and the STAR Institute and a 2011 study give the range as 5% to 16% of children; Cleveland Clinic puts it at 1 to 3 people in 20.⁠^5,11,16,25

What are the 8 senses?

Sensory processing covers eight senses: sight, hearing, smell, taste and touch; the vestibular sense and proprioception, which with touch are the three Ayres focused on; and interoception, the sense of the body’s internal state.⁠²⁶

The STAR Institute calls interoception the often neglected but frequently problematic eighth sense.⁠²⁶ In the classification, under-responsivity to touch and body position usually brings poor body awareness and clumsiness, and dyspraxia includes difficulty grading force.⁠¹ Many specialists consider W-sitting harmful, but a systematic review published in January 2025 found no scientific evidence against it and no link with hip dysplasia.⁠²⁸

Type 1: What is sensory modulation disorder?

Modulation is how the nervous system grades its response to sensation. Miller’s group define the disorder as difficulty responding to sensory input with behavior graded to its degree, nature or intensity, so that responses do not fit the situation.⁠¹

• Over-responsivity: responding faster, harder or longer than most people, such as covering ears, avoiding textures or distress at ordinary sensation.⁠^1,2
• Under-responsivity: not noticing sensation others notice, including pain and extreme heat or cold; often seen first as an easy baby, later as a passive or “lazy” child.⁠¹
• Seeking and craving: an insatiable appetite for intense input, with constant moving, crashing, bumping, spinning and touching people and things.⁠¹

What research says about how these separate. In 117 children aged 8 to 12 with autism, ADHD, anxiety or sensory concerns, a statistical analysis found five sensory subtypes: typical, intermediate or mixed, over-responsive, seeking and under-responsive. The over-responsive group had distinctively high anxiety, the seeking and under-responsive groups high ADHD scores, and all three had more emotion dysregulation, which the authors suggest may be a shared mechanism.⁠⁹ A cluster analysis of 98 children with sensory modulation disorder found two phenotypes: one seeking, hyperactive and impulsive, the other movement-sensitive, withdrawn and low in energy.⁠²⁵

That is a useful finding for a parent: the pattern may point to the co-occurring difficulty most worth checking, and therefore which specialist is worth seeing.⁠⁹

Type 2: What is sensory discrimination disorder?

Sensory discrimination difficulties mean trouble interpreting the qualities of a sensation: the child notices it and can regulate the response, but cannot tell precisely what or where it is, in any sense and to different degrees in each. The STAR Institute’s examples: Do I see a P or a Q? Do I hear cat or cap? Do I feel a quarter or a dime in my pocket?⁠^1,2

Why this pattern gets missed. Discrimination difficulty is quiet. A child may need extra time to process what they see, hear or feel, which reads as slow, and may look awkward or inattentive; low self-confidence and frustration can follow.⁠^1,2

Type 3: What is sensory-based motor disorder?

Here sensory problems show up as poor posture or poorly planned movement. There are two subtypes.⁠¹

• Postural difficulties: trouble stabilizing the body at rest or in motion, so a child slumps, props on walls, leans on an arm or lays the head down to write, and may avoid movement altogether.⁠^1,20
• Dyspraxia: trouble conceiving, planning, sequencing or carrying out new actions. A child may struggle to come up with an idea for what to do, or to plan and time the movement, needs far more practice than peers and finds ball games and fine motor tasks hard.⁠^1,18

That gives this type a formal route the other two lack. If coordination is the main concern, ask whether an assessment for dyspraxia and developmental coordination disorder fits, since DCD has its own criteria and guidelines.⁠¹⁰ The two subtypes together make up sensory-based motor disorder.⁠¹

Is dyspraxia the same as developmental coordination disorder?

Not exactly, and the words cause confusion. The UK’s Dyspraxia Foundation uses dyspraxia in a broader sense that takes in DCD, others draw a line between them, and the international recommendations say dyspraxia has not become recognized as a separate entity or subgroup of DCD and do not recommend the term.⁠¹⁰ In the 2007 classification, dyspraxia is a sensory-based motor planning pattern that most often comes with under-responsivity or discrimination problems in touch, body position or movement.⁠¹

What this type is mistaken for: laziness, poor attention or plain clumsiness. Under-responsive children are often labeled lazy or unmotivated, and children with dyspraxia are teased as clumsy and may be seen as controlling.⁠^1,20

What are Dunn’s four sensory processing patterns?

Winnie Dunn’s model is the other framework in wide use, and it describes everyone, not only people with a disorder. It crosses two continua: neurological threshold, how much input it takes to notice something, and self-regulation, whether a person acts to control input or lets it happen and reacts.⁠³

Dunn’s questionnaires found the four patterns from birth to age 90, and each person has some of every pattern rather than one or another.⁠³⁰ Most people respond moderately; what matters is whether a pattern gets in the way of everyday life.⁠³ The Sensory Profile 2 measures the patterns for children from birth to 14, and the Adolescent/Adult Sensory Profile from age 11.⁠^31,32

How do Dunn’s patterns map onto the three types?

Loosely. Over-responsivity corresponds to Dunn’s low-threshold side, the sensitivity and avoiding patterns; under-responsivity resembles low registration; and seeking appears in both models.⁠^1,3,12 Dunn’s four patterns have no counterpart for the discrimination and motor types, and a 2024 review treats Dunn’s four-quadrant model and Miller’s ecological model of sensory modulation as separate developments from Ayres’ work.⁠^3,19 Questionnaires reflect both: the Sensory Profile 2 reports Dunn’s patterns, and the Sensory Processing Measure, Second Edition rates reactivity, seeking, perception and praxis in each sense.⁠^31,33

Which type of sensory processing disorder am I seeing?

1. Reacts too much

   Covers ears, pulls away from touch, distressed by ordinary sensation → modulation, over-responsive.⁠^1,2

2. Does not notice

   Misses pain, cold or bumps, or needs more intensity before a sensation registers → modulation, under-responsive.⁠²

3. Pursues intense input

   Crashes, spins, bumps and touches everything → modulation, seeking.⁠¹

4. Cannot tell similar things apart

   Confuses similar sounds or textures; slow and inaccurate rather than distressed → discrimination.⁠^1,2

5. Knows what to do but cannot make the body do it

   Or seems weak and slumps when sitting → sensory-based motor.⁠^1,27

Can a child have more than one type of SPD?

Yes, and it is the usual picture: in Dunn’s words, no one has only one pattern. A child who covers their ears at hand dryers, does not notice a scraped knee and crashes into furniture is showing three patterns at once.⁠^1,3

• Covers ears at hand dryers

  Over-responsive, auditory

• Does not notice a scraped knee

  Under-responsive, pain and touch

• Crashes into furniture

  Seeking, proprioception

The types combine in predictable ways. Over-responsivity often comes with discrimination problems or dyspraxia, under-responsivity with poor body awareness and clumsiness, and postural disorder with other subtypes; some over-responsive children seek certain sensations to calm themselves.⁠¹ Thresholds can differ from one sense to the next, and even within one sense: one person may feel a gentle touch intensely while barely registering temperature.⁠^3,16

What this means for you: stop looking for the label that fits your whole child, and look instead at which sense, in which situation. “He is sensory seeking” explains less than “he seeks movement and deep pressure, is fine with touch, and cannot tolerate loud, unpredictable noise.”

How do sensory patterns change with age?

The profile often persists while its presentation changes, though not always: in twins followed from 2 to 7, over-responsivity faded in some children and appeared in others, and it was most stable in those born early or with fearful temperaments.⁠³⁴

Sensory input also adds up through the day, so a sudden big reaction to something trivial can be accumulated load rather than a setback; planning the day around that load is part of living with sensory processing differences.⁠¹

How do SPD types relate to autism, ADHD and anxiety?

Sensory differences cut across diagnoses. The AAP lists them as a feature of autism, ADHD, developmental coordination disorder and childhood anxiety, and Cleveland Clinic notes that sensory processing disorder often comes with autism or ADHD but can also occur on its own.⁠^5,21

In autism, sensory reactivity is one of the behaviors that count toward the diagnosis, and sensory processing and autism overlap closely.⁠⁶ In 281 autistic children aged 3 to 6, 95% showed some sensory processing difference, and a meta-analysis of 14 studies found the largest gap from typical development in under-responsivity, then over-responsivity, then seeking.⁠^36,37 Compared with children who had sensory modulation disorder alone, autistic children had lower physiological arousal and more taste and smell sensitivity and under-responsivity, while the sensory group had more seeking.⁠³⁸

In ADHD, a 2025 meta-analysis of 30 studies found higher scores than controls on all four of Dunn’s patterns, and children with sensory modulation disorder differed from children with ADHD in having more anxiety and physiological reactivity and less inattention.⁠^39,40 In one study of 239 children, autistic and ADHD groups did not differ from each other in Dunn’s patterns.⁠³⁵ Comparisons like these are how ADHD and sensory processing disorder are told apart.

Over-responsivity is the type most tied to anxiety. It predicted later anxiety in autistic toddlers and in community preschoolers, not the reverse, and the over-responsive subtype had the highest anxiety in the mixed group described above.⁠^9,41,42

What helps each type of sensory processing disorder?

The types point in different directions, which is why identifying the right one changes what helps. Occupational therapists’ own guidance is to base sensory interventions on documented assessment results, not a generic plan.⁠²⁹

Getting the pattern right is what makes everyday sensory activities and strategies fit the child rather than an average one.⁠²⁹

What does the evidence say about sensory integration therapy?

It depends on the group. For autistic children, Ayres Sensory Integration delivered to its fidelity standard has strong evidence for meeting individual goals and moderate evidence that it does not reduce behaviors of concern, and a 2019 review rated it an evidence-based practice for ages 4 to 12.⁠^45,46 For sensory modulation disorder, a pilot trial of 24 children found larger gains on individual goals and attention than an activity program or no treatment.⁠⁴⁷ For coordination problems, the evidence is inconclusive and the DCD guidelines do not recommend it.⁠¹⁰

Among specific techniques, a 2025 review of 21 studies found strong evidence for deep pressure touch and caregiver training, moderate evidence that alternative seating does not improve attention, and too little research on environmental changes to judge them, while weighted vests have not held up.⁠^43,48 The AAP’s 2012 statement called the evidence for sensory integration therapy limited and inconclusive and suggested a trial period with clear ways to judge whether it works.⁠²¹

How is sensory processing disorder assessed?

An occupational therapist usually assesses it, watching how the child responds to sensory experiences and asking about symptoms, behavior and history, often with standardized questionnaires such as the Sensory Profile 2 or the Sensory Processing Measure, Second Edition.⁠^5,31,33 Expect a report describing a profile across senses and patterns rather than one label; that profile is the useful part.⁠³

A good assessment also considers what else could explain the picture: hearing, vision, autism, ADHD, developmental coordination disorder, anxiety and language disorder, as the AAP advises.⁠^14,15,21 If the assessment stops at “sensory,” ask what else was ruled out.

The diagnosis process often starts with the pediatrician, who may refer to an occupational therapist, and leads into therapy and treatment built on the profile; you can also find a pediatric occupational therapist directly.⁠⁵

Sources

1. Miller LJ, Anzalone ME, Lane SJ, Cermak SA, Osten ET. Concept evolution in sensory integration: a proposed nosology for diagnosis. American Journal of Occupational Therapy. 2007;61(2):135–140. PMID 17436834. Checked October 10, 2026.
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   “The proposed new nosology differentiates three classic patterns: SMD, SDD, and SBMD, with subtypes in each pattern”; “We propose that a diagnosis of SPD be made if, and only if, the sensory processing difficulties impair daily routines or roles.” History: “The term sensory integration dysfunction was first used by Ayres in 1963”; the intervention “is used with many people who cannot be tested using the SIPT. Importantly, the SIPT formed the primary empirical basis for the diagnostic categories”; focus groups were held “in 1998–2000,” and subtypes “were published in the diagnostic manuals of both the ICDL (2005) and Zero to Three (2005)”; “Our long-term intention is to propose one or more subtypes for the upcoming revision of the Diagnostic and Statistical Manual”; and “Sensory ‘processing’ rather than sensory ‘integration,’ when used for the diagnosis ... distinguishes the disorder from both the theory (i.e., sensory integration theory) and the intervention.” Modulation: “SMD results when a person has difficulty responding to sensory input with behavior that is graded relative to the degree, nature, or intensity of the sensory information”; SOR, responding “faster, with more intensity, or for a longer duration,” is “often observed concomitantly with sensory discrimination disorder (SDD), dyspraxia, or both”; people with SUR “disregard, or do not respond to, sensory stimuli,” may fail to respond to pain or extreme temperatures, are often first seen as a “good baby” or “easy child,” “need high-intensity salient input to become involved in a task,” are “often labeled ‘lazy’ or ‘unmotivated,’” and in touch and proprioception SUR “usually leads to poor tactile discrimination and a poor body scheme with clumsiness”; people with sensory seeking “crave an unusual amount or type of sensory input,” with “constant moving, ‘crashing and bashing,’ ‘bumping and jumping,’” are “frequently labeled ‘trouble-maker,’ ‘risk-taker,’ ‘bad,’ and ‘dangerous,’” and “obtaining additional sensory stimulation, if unstructured, may increase the overall state of arousal, resulting in even more disorganized behavior. Specific, directed types of sensory input, however, can have an organizing or self-regulatory effect”; “Some children with SOR will engage in SS behaviors as an attempt at self-regulation.” Discrimination: people with SDD “can perceive that stimuli are present and can regulate their response to stimuli but cannot tell precisely what or where the stimulus is”; it “can be observed in any sensory modality”; in touch, proprioception and movement it “results in awkward motor abilities,” and “SDD in the visual and auditory systems can lead to a learning or language disability”; a person with SDD “may require extra time to process the salient aspects of sensory stimuli, leading to ‘slow’ performance. Low self-confidence, attention-seeking behavior, and temper tantrums may result.” Sensory-based motor: “People with SBMD have poor postural or volitional movement as a result of sensory problems”; with postural disorder people “often slump in a standing or sitting position,” may “lay their head on their arm as they write,” and some “may tend to avoid movement”; “PD commonly occurs in combination with one or more other subtypes”; “Dyspraxia is an impaired ability to conceive of, plan, sequence, or execute novel actions,” which “most commonly occurs in the presence of SUR or SDD in the tactile, proprioceptive, or vestibular domains”; people with dyspraxia may be “frequently breaking toys or objects because of difficulty grading force,” “usually have poor skills in ball activities,” “require significantly more practice than is typical,” have trouble with “fine motor manipulative activities,” and “may be perceived as manipulative or controlling.”
2. STAR Institute for Sensory Processing. Patterns or Subtypes of Differences in Sensory Integration & Processing. Sensoryhealth.org, undated. Checked October 10, 2026.
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   Under “Major Patterns of Sensory Processing Differences,” the page lists sensory modulation, sensory discrimination and sensory-based motor differences. Its table lists two modulation patterns, “Sensory Over-Responsive” (“Predisposition to respond more intensely, quicker, and/or longer to sensory stimuli”) and “Sensory Under-Responsive” (“Predisposition to respond less intensely to sensory stimuli, to have a delay before responding, and/or responses are muted”); discrimination differences in auditory, visual, tactile, vestibular, proprioceptive, gustatory, olfactory and interoceptive sensation, the last “Related to interpreting stimulation from internal organs (stomach, heart, gut, lungs etc.) and sensations related to emotion that are ‘felt’ inside the body”; and sensory-motor differences, postural disorder and dyspraxia. “A more neutral term might be heightened responsivity” (for SOR) and “lowered responsivity” (for SUR). Under-responsive people “require more intensity and repetition of sensation than others” and “may not notice pain in response to bumps, falls, cuts, or scrapes.” Discrimination: “(Do I see a ‘P’ or a ‘Q’? Do I hear ‘cat’ or ‘cap’? Do I feel a quarter or a dime in my pocket? Am I falling to the side or backwards?)”; “Individuals with poor sensory discrimination may appear awkward in both gross and fine motor abilities and/or inattentive to people and objects in their environment. They may take extra time to process the important aspects of sensory stimuli.”
3. Dunn W. Supporting children to participate successfully in everyday life by using sensory processing knowledge. Infants & Young Children. 2007;20(2):84–101. Checked October 10, 2026.
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   A threshold is “the point at which there is enough input to cause a nerve cell or a system to activate,” and self-regulation runs from a passive strategy (“they let things happen around them, and then react”) to an active one (“they tend to do things to control the amount and type of input”); “The 4 patterns that result are (a) sensation seeking, which represents high thresholds and an active self-regulation strategy; (b) sensation avoiding, which includes low thresholds and an active self-regulation strategy; (c) sensory sensitivity, which includes low thresholds and a passive self-regulation strategy; and (d) low registration, which represents a high threshold and a passive self-regulation strategy.” Seekers “will touch everything” or “make sounds”; avoiders “might withdraw by moving away from noisy spaces, getting out of crowded rooms ..., or may be very picky eaters”; children with sensitivity “may be irritable, short-tempered, or demanding,” may “cover their ears,” and with movement “may be hard to carry”; with low registration people “fail to notice what other people notice readily” and “may seem oblivious to their environments.” “No one has only one pattern of sensory processing”; thresholds “may be different for each type of sensory input”; “Most children and adults have more moderate responses to sensory events in everyday life ... When responses are more extreme, then sensory processing is more likely to interfere with daily life”; and “what matters is how that pattern affects the person’s ability to participate in everyday life.”
4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). Psychiatry.org, undated. “The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) features the most current text updates based on scientific literature with contributions from more than 200 subject matter experts.” Checked October 10, 2026.
5. Cleveland Clinic. Sensory Processing Disorder (SPD). Health Library, last updated March 20, 2025. Checked October 10, 2026.
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   “Currently, SPD isn’t an official medical diagnosis. But providers recognize the benefits of identifying SPD and using therapy to manage it”; types listed: sensory over-responsivity, sensory under-responsivity, sensory craving, sensory discrimination disorder, postural disorder and dyspraxia; “Researchers estimate that about 1 to 3 out of every 20 people in the general U.S. population have sensory processing disorder”; “SPD commonly affects people with neurodevelopmental and neurodivergent conditions, like autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD). But you can also have SPD without any other condition”; symptoms include “Gagging when eating certain food textures”; and a pediatrician “may refer you to an occupational therapist. These professionals can assess your child for SPD by watching them interact with certain sensory experiences. They’ll also ask about your child’s symptoms, behavior and medical history.”
6. Centers for Disease Control and Prevention. Clinical Testing and Diagnosis for Autism Spectrum Disorder. Page dated May 8, 2025, reproducing the DSM-5 criteria. Checked October 10, 2026.
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   “To meet diagnostic criteria for ASD according to DSM-5, a child must have persistent deficits in each of three areas of social communication and interaction ... plus at least two of four types of restricted, repetitive behaviors”; the fourth reads “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).”
7. World Health Organization. 6A02 Autism spectrum disorder. ICD-11 for Mortality and Morbidity Statistics, release 2026-01. Checked October 10, 2026.
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   Among the restricted, repetitive features: “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.” Boundary with avoidant-restrictive food intake disorder: autistic people “may also restrict intake of certain foods because of their sensory characteristics.” Boundary with oppositional defiant disorder: in autism, aggressive outbursts “are often associated with a specific trigger (e.g., a change in routine, aversive sensory stimulation, anxiety, or rigidity ...), rather than reflecting an intention to be defiant, provocative, or spiteful.”
8. ZERO TO THREE. Numerical Codes for DC:0–5. PDF, undated. “The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0–5) was published by ZERO TO THREE in 2016”; its list includes “20 Sensory Processing Disorders: 20.1 Sensory Over-Responsivity Disorder, 20.2 Sensory Under-Responsivity Disorder, 20.3 Other Sensory Processing Disorder.” Checked October 10, 2026.
9. Brandes-Aitken A, Powers R, Wren J, Chu R, Shapiro KA, Steele M, Mukherjee P, Marco EJ. Sensory processing subtypes relate to distinct emotional and behavioral phenotypes in a mixed neurodevelopmental cohort. Scientific Reports. 2024;14:29326. PMID 39592662. Checked October 10, 2026.
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   “We recruited a sample of 117 participants (8-12 years) with a diverse range of neurodevelopmental concerns including autism, ADHD, anxiety, and sensory processing differences”; “latent profile analysis identified five sensory processing subtypes categorized by modality: Typical Processing, Intermediate/Mixed, Sensory Over-Responsive, Sensory Seeking, and Sensory Under-Responsive. Notably, the Sensory Over-Responsive group exhibited distinctively elevated anxiety scores, while the Sensory Seeking and Sensory Under-Responsive groups showed heightened ADHD scores. Intriguingly, the Sensory Over-Responsive, Sensory Under-Responsive, and Sensory Seeking subgroups all demonstrated elevated emotion dysregulation scores, suggesting a potential shared mechanism.”
10. Blank R, Barnett AL, Cairney J, Green D, Kirby A, Polatajko H, Rosenblum S, Smits-Engelsman B, Sugden D, Wilson P, Vincon S. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology. 2019;61(3):242–285. PMID 30671947. Checked October 10, 2026.
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    The full text defines DCD “according to DSM-5”; “Current prevalence estimates for DCD range from 2% to 20% of children, with 5% to 6% being the most frequently quoted percentage”; “DCD is largely underrecognized by health care and educational professionals”; identification draws on “interviews, examining the individual’s developmental history, medical history, questionnaires, clinical examination, and motor tests”; the Dyspraxia Foundation (UK) uses ‘dyspraxia’ to incorporate DCD with a broader definition, others draw a distinction, but “the term ‘dyspraxia’ has not become recognized as a separate entity or subgroup of DCD. The international consensus does not recommend use of the term ‘dyspraxia’”; the authors “recommend using activity-oriented approaches that stay close to the selected activities to be improved”; and “the evidence is inconclusive for the effectiveness of sensory integration therapy as an intervention for children with DCD,” so it “cannot be recommended.”
11. Ahn RR, Miller LJ, Milberger S, McIntosh DN. Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy. 2004;58(3):287–293. PMID 15202626. Checked October 10, 2026.
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    Parents of incoming kindergartners in one suburban US district answered the Short Sensory Profile: “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”; assuming all non-respondents failed to meet criteria, “5.3% (96 of 1796) of the kindergarten enrollment met screening criteria”; and “Findings suggest a need for rigorous epidemiological studies of sensory processing disorders.”
12. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology. 2009;37(5):705–716. PMID 19153827. Checked October 10, 2026.
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    The abstract: in “a representative sample of elementary school-aged children (n = 925, 50% boys, ages 7-11 years) who were followed from infancy. Sixteen percent of parents reported that at least four tactile or auditory sensations bothered their children”; 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”; and SOR “can impact children’s participation in academic and social activities.” The full text: the sensations reported most often were “tags in clothing (39%), cutting finger or toe nails (19%), hair brushing (16%), and mud (11%),” and among sounds “alarms (12%), sirens, and concerts (both 10%)”; of the children above the cutoff, “76.4% (n=113) had only elevated tactile scores”; the background reports a much higher prevalence in clinical groups, “ASD (e.g., 56% ...), Fragile X (e.g., ~40% ...) and ADHD (e.g., 69% ...)”; “According to Dunn’s model, SOR reflects a low neurological threshold” and Dunn describes two types of SOR behaviors, avoiding and sensitivity; and SOR “can be more pronounced in certain contexts in which specific aversive sensations are present, or in those that involve unexpected and intense sensation, hence may be missed in a one-time evaluation.”
13. Green SA, Hernandez L, Tottenham N, Krasileva K, Bookheimer SY, Dapretto M. Neurobiology of sensory overresponsivity in youth with autism spectrum disorders. JAMA Psychiatry. 2015;72(8):778–786. PMID 26061819. Checked October 10, 2026.
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    “More than half of youth with autism spectrum disorders (ASDs) have sensory overresponsivity (SOR), an extreme negative reaction to sensory stimuli”; in 19 autistic and 19 typically developing youths aged 9 to 17, autistic participants “displayed stronger activation in primary sensory cortices and the amygdala”; “The ASDs with SOR subgroup had decreased neural habituation to stimuli in sensory cortices and the amygdala”; the hyperresponsivity was seen “particularly to multiple modalities presented simultaneously” and is “due to failure to habituate”; “a subset of youth with ASDs can regulate their responses through prefrontal downregulation of amygdala activity”; and “Implications for intervention include minimizing exposure to multiple sensory modalities and building coping strategies for regulating emotional response to stimuli.”
14. American Speech-Language-Hearing Association. Central Auditory Processing Disorder. Practice Portal, undated. Checked October 10, 2026.
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    CAPD refers to deficits in neural processing of auditory information shown by poor performance in skills including “auditory discrimination”; “CAPD may co-occur with (and necessitate differentiation from) other disorders (e.g., attention-deficit/hyperactivity disorder, language delay or disorder, and learning disability). CAPD is not due to peripheral hearing loss”; “Assessment data may identify the presence of disorders with symptoms similar to CAPD (e.g., peripheral hearing loss, attention-deficit/hyperactivity disorder, speech-language disorder, cognitive deficits ...)”; and “Audiologists play a primary role in the identification, screening, assessment, diagnosis, and treatment of individuals with central auditory processing disorder.”
15. Centers for Disease Control and Prevention. Keep an Eye on Your Child’s Vision. Vision and Eye Health, undated. “If your child has an uncorrected vision problem, it may affect their ability to learn”; and “If you notice your child squinting, rubbing their eyes, or complaining of headaches after doing schoolwork, have their vision checked.” Checked October 10, 2026.
16. STAR Institute for Sensory Processing. Understanding the Sensory Integration Process. Sensoryhealth.org, undated. Checked October 10, 2026.
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    “Studies indicate that 5% to 16% of children exhibit symptoms of SPD” (citing Ahn 2004 and Ben-Sasson 2009); Lucy Jane Miller is named as the institute’s “Founder and current Executive Director”; “many neurodivergent individuals have sensory modulation differences that don’t fit neatly into categories of hypersensitivity (SOR) or hyposensitivity (SUR). Some register everything around them with the same level of intensity”; under “A Note About Behavioral Responses to Sensory Modulation Differences,” “Some individuals might actively seek out strong sensations ... Others avoid sensation”; and “One person might feel a gentle touch intensely while being less aware of temperature changes, while another might find certain textures unbearable yet enjoy the sensation of soft fabrics.”
17. Mailloux Z, Mulligan S, Roley SS, Blanche E, Cermak S, Coleman GG, Bodison S, Lane CJ. Verification and clarification of patterns of sensory integrative dysfunction. American Journal of Occupational Therapy. 2011;65(2):143–151. PMID 21476361. Checked October 10, 2026.
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    A retrospective study of “273 children ages 4-9 who had received occupational therapy evaluations”: “Exploratory factor analysis identified patterns similar to those found in early studies by Ayres ..., namely Visuodyspraxia and Somatodyspraxia, Vestibular and Proprioceptive Bilateral Integration and Sequencing, Tactile and Visual Discrimination, and Tactile Defensiveness and Attention.”
18. Lane SJ, Mailloux Z, Schoen S, Bundy A, May-Benson TA, Parham LD, Smith Roley S, Schaaf RC. Neural foundations of Ayres Sensory Integration. Brain Sciences. 2019;9(7):153. PMID 31261689. Checked October 10, 2026.
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    The full text: praxis “comprises three components: ideation (conceptualization of actions), motor planning, and execution”; and “Mulligan conducted a large-scale (N > 10,000) confirmatory factor and cluster analyses of SIPT data and confirmed Ayres’ findings of a somatosensory-based dyspraxia and bilateral integration and sequencing dyspraxia.”
19. Grobelna N, Rutkowski R, Rybakowski F, Rybakowski J, Ferensztajn-Rochowiak E. The phenomenon of sensory processing: historical overview, theoretical models, and neurophysiological underpinnings. Acta Neurobiologiae Experimentalis. 2024;84(4):359–370 (published January 14, 2025). PMID 39812532. Checked October 10, 2026.
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    The abstract notes interest in sensory processing in adults “despite the lack of a formal diagnosis in DSM-5 and ICD classifications.” The full text: sensory processing sensitivity, introduced by Elaine and Arthur Aron in 1997, “overlaps in part with the concepts of neuroticism and introversion but is not identical to them”; “about 20% of the population is highly sensitive”; “the SPS trait is currently understood as a continuum of sensitivity in the population”; “the key feature of SPS is the depth of processing of stimuli in higher cortical centers”; “the HSPS scale primarily examines emotional responses, and the Adolescent/Adult Sensory Profile ... mainly measures behavioral responses to sensory stimuli”; and “using different concepts and terminology regarding sensory processing interchangeably can complicate the interpretation of research results and lead to wrong conclusions.”
20. STAR Institute for Sensory Processing. About SPD. Sensoryhealth.org, undated. Checked October 10, 2026.
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    Children with postural disorder “are the ‘floppy’ children who prop themselves up on walls when standing, lean over on their hand when writing”; with dyspraxia “children are awkward and clumsy and get called ‘klutz’ and ‘spaz’ on the playground”; adults “may have difficulty performing routines and activities involved in work, close relationships, and recreation”; and “We also have a vision of a world where SPD is an accepted diagnosis, is included in diagnostic manuals such as the DSM and ICD, and where treatment is covered by insurance.”
21. Zimmer M, Desch L; Section on Complementary and Integrative Medicine; Council on Children with Disabilities; American Academy of Pediatrics. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129(6):1186–1189. PMID 22641765. Checked October 10, 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 tolerating or processing sensory information is a characteristic that may be seen in many developmental behavioral disorders, including autism spectrum disorders, attention-deficit/hyperactivity disorder, developmental coordination disorders, and childhood anxiety disorders. Occupational therapy with the use of sensory-based therapies may be acceptable as one of the components of a comprehensive treatment plan. However, parents should be informed that the amount of research regarding the effectiveness of sensory integration therapy is limited and inconclusive”; clinicians may talk with families “about a trial period of sensory integration therapy” and teach them “how to evaluate the effectiveness of a therapy.”
22. U.S. Department of Education, Office for Civil Rights. Frequently Asked Questions: Section 504 Free Appropriate Public Education (FAPE). Page last reviewed June 30, 2025. Checked October 10, 2026.
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    “The determination of whether a student has a physical or mental impairment that substantially limits a major life activity must be made on the basis of an individual inquiry”; “A medical diagnosis of an illness does not automatically mean a student can receive services under Section 504. The illness must cause a substantial limitation on the student’s ability to learn or another major life activity”; and an eligible student “may receive adjustments in the regular classroom.”
23. U.S. Department of Education. 34 CFR 300.8, Child with a disability. Electronic Code of Federal Regulations, up to date as of October 8, 2026. Checked October 10, 2026.
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    The categories are “intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance ..., an orthopedic impairment, autism, traumatic brain injury, an other health impairment, a specific learning disability, deaf-blindness, or multiple disabilities”; autism’s definition adds that “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”; and “Other health impairment means having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that (i) Is due to chronic or acute health problems ... and (ii) Adversely affects a child’s educational performance.”
24. ZERO TO THREE. DC:0–5 Crosswalk to DSM and ICD-10. DC:0–5 training handout, 2018. Sensory Over-Responsivity Disorder, Sensory Under-Responsivity Disorder and Other Sensory Processing Disorder each map to “Other Specified Neurodevelopmental Disorder” in the DSM-5 and to “Other Disorders of Psychological Development”, F88, in the ICD-10. Checked October 10, 2026.
25. James K, Miller LJ, Schaaf R, Nielsen DM, Schoen SA. Phenotypes within sensory modulation dysfunction. Comprehensive Psychiatry. 2011;52(6):715–724. PMID 21310399. Checked October 10, 2026.
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    Sensory modulation disorder “is estimated to affect 5% to 16% of the general population of children”; in “a cohort of 98 children,” “Two subtypes of SMD were identified through cluster analysis ... The first subtype is characterized by sensory seeking/craving, hyperactive, impulsive, externalizing ..., unsocial, inadaptive, and impaired cognitive/social behavior. The second subtype is characterized by movement sensitivity, emotionally withdrawal, and low energy/weak behavior.”
26. STAR Institute for Sensory Processing. Your 8 Senses. Sensoryhealth.org, undated. Checked October 10, 2026.
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    The five basic systems are visual, auditory, olfactory, gustatory and tactile; “The three sensory systems Ayres focused on” are tactile, vestibular (“sense of head movement in space”) and proprioceptive (“sensations from muscles and joints of body”); and interoception is “The eighth, often neglected, but frequently problematic sensory system in SPD,” which “detects responses that guide regulation, including hunger, heart rate, respiration and elimination.” Visual information includes “color, shape, orientation, and motion”; touch processing “integrates touch, pressure, temperature, and pain”; the vestibular system “contributes to balance and orientation in space”; and proprioception “senses the position, location, orientation, and movement of the body muscles and joints” and the “effort used to move body parts.”
27. STAR Institute for Sensory Processing. Symptoms Checklist. Sensoryhealth.org, undated. Checked October 10, 2026.
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    Infant and toddler items include “has problems eating,” “has trouble falling asleep or staying asleep,” “is extremely irritable when I dress him/her,” “resists cuddling” and “is easily startled”; preschool items, “has difficulty being toilet trained,” “is highly sensitive to stimulation, has big reactions to / does not like touch, noise, smells,” “is in constant motion,” “seems weak, slumps when sitting/standing” and difficulty with “fine motor tasks”; school-age items, “is easily overwhelmed at the playground, during recess and in class,” “is slow to perform tasks,” “has difficulty performing or avoids fine motor tasks such as handwriting” and “confuses similar sounding words”; an adult item, “I use an inappropriate amount of force when handling objects”; and “While this checklist cannot diagnose Sensory Processing Disorder, it can be a helpful guide to see if additional testing should be done.”
28. Nordon DG, Passone CGB, da Silva CAA, Grangeiro PM. W-sitting in childhood: a systematic review. Acta Ortopedica Brasileira. 2024;32(6):e279277 (published January 10, 2025). PMID 39802577. Checked October 10, 2026.
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    “Despite the lack of science-based evidence, many specialists and non-specialists consider W-sitting detrimental to children”; and “This review found no scientific evidence advise against W-sitting in children and no association with hip dysplasia.”
29. American Occupational Therapy Association. Practice Smart! Undated web page; AOTA published the recommendations from 2018 to 2021 under the Choosing Wisely campaign. Checked October 10, 2026.
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    “2. Don’t provide sensory-based interventions to individual children or youth without documented assessment results of difficulties processing or integrating sensory information”; “6. Don’t initiate occupational therapy interventions without completion of the client’s occupational profile and setting collaborative goals”; and “7. Don’t provide interventions for autistic persons to reduce or eliminate ‘restricted and repetitive patterns of behavior, activities, or interests’ without evaluating and understanding the meaning of the behavior to the person, as well as personal and environmental factors.”
30. Dunn W. The sensations of everyday life: empirical, theoretical, and pragmatic considerations. American Journal of Occupational Therapy. 2001;55(6):608–620. PMID 12959225. Checked October 10, 2026.
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    On the Sensory Profile questionnaires, “persons birth to 90 years of age demonstrate four sensory processing patterns: sensory seeking, sensory avoiding, sensory sensitivity, and low registration. These patterns are based on a persons neurological thresholds and self-regulation strategies”; and “each person has some level of responsiveness within each sensory processing preference (i.e., a certain amount of seeking, avoiding, etc., not one or the other).”
31. Pearson Assessments. Sensory Profile 2. Product page for the questionnaires by Winnie Dunn, published 2014. Checked October 10, 2026.
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    “The Sensory Profile™ 2 family of assessments provides standardized tools to help evaluate a child’s sensory processing patterns in the context of home, school, and community-based activities”; “Age range: Birth–14:11”; and “caregivers and teachers report on the child’s response to sensory events throughout the day.”
32. Pearson Assessments. Adolescent/Adult Sensory Profile. Product page for the questionnaire by Catana Brown and Winnie Dunn, published 2002. “An individual answers questions regarding how he or she generally responds to sensations”; “Age range: 11 years and older.” Checked October 10, 2026.
33. WPS. Sensory Processing Measure, Second Edition (SPM-2). Product page for the rating scales by L. Diane Parham and colleagues, published 2021. “Ages: 4 months to 87 years”; “The SPM-2 items provide descriptive clinical information on processing vulnerabilities within each sensory system, including under- and over-reactivity, sensory-seeking behavior, and difficulties with perception.” Checked October 10, 2026.
34. 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. PMID 26107259. Checked October 10, 2026.
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    In “a population-based, typically developing sample of twins (N=978) at age two years ... and again at age seven years,” children fell into “low symptom (N=768), remitted (N=75), late-onset (N=112), and chronic (N=24)” groups; “Children in the chronic group had more severe symptoms of sensory sensitivity at age four years, including more motion sensitivity”; they “had a younger gestational age and were more likely to be low birth-weight than the low symptom group”; “Sensory over-responsivity was modestly correlated across ages (r = .22 for tactile over-responsivity and r = .11 for auditory over-responsivity), but symptoms were more stable among children born prematurely or who had more fearful and less soothable temperaments”; and “assessment over development may be necessary for a valid sensory processing disorder diagnosis.”
35. Little LM, Dean E, Tomchek S, Dunn W. Sensory processing patterns in autism, attention deficit hyperactivity disorder, and typical development. Physical & Occupational Therapy in Pediatrics. 2018;38(3):243–254. PMID 29240517. Checked October 10, 2026.
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    “Participants included 239 children (ASD = 77; ADHD = 78; TD = 84)” aged 3 to 14; “Children with ASD and ADHD did not differ in sensory processing patterns which were elevated as compared to a TD group”; and “Older children had lower scores for seeking, auditory, visual, movement, touch, and conduct than younger children, regardless of diagnosis.”
36. Tomchek SD, Dunn W. Sensory processing in children with and without autism: a comparative study using the Short Sensory Profile. American Journal of Occupational Therapy. 2007;61(2):190–200. PMID 17436841. Checked October 10, 2026.
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    In “281 children with ASD” aged 3 to 6, “Ninety-five percent of the sample of children with ASD demonstrated some degree of sensory processing dysfunction on the SSP Total Score.”
37. Ben-Sasson A, Hen L, Fluss R, Cermak SA, Engel-Yeger B, Gal E. A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders. 2009;39(1):1–11. PMID 18512135. Checked October 10, 2026.
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    “Results from 14 studies indicated a significant high difference between ASD and typical groups in the presence/frequency of sensory symptoms, with the greatest difference in under-responsivity, followed by over-responsivity and sensation seeking.”
38. Schoen SA, Miller LJ, Brett-Green BA, Nielsen DM. Physiological and behavioral differences in sensory processing: a comparison of children with autism spectrum disorder and sensory modulation disorder. Frontiers in Integrative Neuroscience. 2009;3:29. PMID 19915733. Checked October 10, 2026.
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    “Physiological arousal and sensory reactivity were lower in children with ASD whereas reactivity after each sensory stimulus was higher in SMD”; and “The ASD group had more taste/smell sensitivity and sensory under-responsivity while the SMD group had more atypical sensory seeking behavior.”
39. Jurek L, Duchier A, Gauld C, et al. Sensory processing in individuals with attention-deficit/hyperactivity disorder compared with control populations: a systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry. 2025;64(10):1132–1147. PMID 40250555. Checked October 10, 2026.
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    “30 studies (reported in 32 publications) encompassing 5,374 participants were included”; “Patients with ADHD presented with significantly more severe sensory atypicities than the control group in multiple domains: sensory sensitivity ..., sensory avoiding ..., low sensory registration ..., and sensory seeking”; “Heterogeneity was high in all analyses”; and sensory processing “should be systematically explored in the evaluation of children and adults referred for ADHD.”
40. Miller LJ, Nielsen DM, Schoen SA. Attention deficit hyperactivity disorder and sensory modulation disorder: a comparison of behavior and physiology. Research in Developmental Disabilities. 2012;33(3):804–818. PMID 22236629. Checked October 10, 2026.
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    “Inattention was greater in ADHD compared to SMD ... SMD had more sensory issues, somatic complaints, anxiety/depression, and difficulty adapting than ADHD. SMD had greater physiological/electrodermal reactivity to sensory stimuli than ADHD and typical controls”; “Evidence suggests ADHD and SMD are distinct diagnoses.”
41. Green SA, Ben-Sasson A, Soto TW, Carter AS. Anxiety and sensory over-responsivity in toddlers with autism spectrum disorders: bidirectional effects across time. Journal of Autism and Developmental Disorders. 2012;42(6):1112–1119. PMID 21935727. Checked October 10, 2026.
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    The title asks about effects in both directions; the finding runs one way: “Participants were 149 toddlers with ASD and their mothers, assessed at 2 annual time points. A cross-lag analysis showed that anxiety symptoms increased over time while SOR remained relatively stable. SOR positively predicted changes in anxiety over and above child age, autism symptom severity, NVDQ, and maternal anxiety, but anxiety did not predict changes in SOR. Results suggest that SOR emerges earlier than anxiety, and predicts later development of anxiety.”
42. Carpenter KLH, Baranek GT, Copeland WE, Compton S, Zucker N, Dawson G, Egger HL. 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. PMID 30569253. Checked October 10, 2026.
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    The abstract: symptoms were assessed “in a community sample of 917 at 2-5 and again in 191 of these children at 6 years old”; “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. This relationship was both specific and unidirectional. Finally, school-age anxiety symptoms mediated the relationship between preschool sensory over-responsivity symptoms and both irritability and sleep problems at school-age.” The full text: “Twenty percent of parents reported over-responsivity at least one sensory domain in our preschool sample. The most commonly reported sensory over-responsivity was to tactile experiences (18%), followed by auditory experiences (4%). Of the children with sensory over-responsivity at preschool who were assessed again at school-age, 56% of them still had a parent-reported sensory over-responsivity at school-age. Of children for whom their parents did not endorse any sensory over-responsivity as a preschooler, 16% ... endorsed at least one sensory over-responsivity by school-age”; “only 52% of children who had at least one sensory sensitivity as preschoolers in our sample went on to meet criteria for an anxiety disorder at school-age”; and “sensory over-responsivity is not, in and of itself, a sufficient marker for risk of anxiety.” The authors give, as an example of how over-responsivity may lead to anxiety, a child for whom “going to a restaurant or using a public bathroom” brings “unpredictable and uncontrollable auditory input that they experience as unpleasant.”
43. Piller A, McHugh Conlin J, Glennon TJ, Andelin L, Auld-Wright K, Teng K, Tarver T. Systematic review of sensory-based interventions for children and youth (2015–2024). Frontiers in Pediatrics. 2025;13:1720179. PMID 41321460. Checked October 10, 2026.
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    “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.” The full text: “Four studies supported the use of deep pressure tactile stimulation, two of which examined weighted items and two of which examined massage”; “Two studies found sleep behavior improvements, one with use of weighted blankets during sleep and one with massage and joint compressions prior to bedtime,” while improvements with a vest “were not significant,” and “All three of these studies focused on children with ADHD or SI/SP challenges”; “Only one study (56) explored sensory environmental modifications,” in a dental office; “noise-cancelling headphones (44) were not found to impact auditory participation goals,” though earmuffs improved auditory-related goals; and “The evidence indicates that caregiver training or coaching should be considered as part of any sensory intervention.”
44. American Speech-Language-Hearing Association. Tinnitus and Hyperacusis. Practice Portal, undated. Checked October 10, 2026.
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    “Hyperacusis is a heightened sensitivity to ordinary sounds in the environment that are tolerated well by those without hyperacusis”; “Audiologists play a central role in the assessment, diagnosis, and management/treatment of individuals with tinnitus and/or hyperacusis”; “Cognitive behavioral therapy (CBT) is a specific type of therapy that focuses on modifying problem emotions, thoughts, and behaviors”; “Sound therapy for hyperacusis requires the patient to listen to low-level sounds for long periods of time to encourage habituation,” with “gradual increases of the level and/or duration of the sound treatment ... along with positive reinforcement by the clinician”; and “Some individuals with hyperacusis feel that wearing hearing protection to avoid disturbing sounds is helpful. This is not generally advisable when environmental sound levels are safe. Avoiding sounds in the environment can make the auditory system become more sensitive to these sounds when protection is not used. This increased sensitivity can exacerbate hyperacusis (Formby et al., 2003). Using hearing protection when exposed to excessive noise is advisable for all individuals.”
45. Acuna 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. PMID 40193295. Checked October 10, 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.”
46. Schoen SA, Lane SJ, Mailloux Z, May-Benson T, Parham LD, Smith Roley S, Schaaf RC. A systematic review of Ayres Sensory Integration intervention for children with autism. Autism Research. 2019;12(1):6–19. PMID 30548827. “Based on CEC criteria, ASI can be considered an evidence-based practice for children with autism ages 4-12 years old.” Checked October 10, 2026.
47. Miller LJ, Coll JR, Schoen SA. A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. American Journal of Occupational Therapy. 2007;61(2):228–238. PMID 17436845. Checked October 10, 2026.
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    “Twenty-four children with SMD were randomly assigned to one of three treatment conditions; OT-SI, Activity Protocol, and No Treatment”; “The OT-SI group, compared to the other two groups, made significant gains on goal attainment scaling and on the Attention subtest and the Cognitive/Social composite of the Leiter International Performance Scale-Revised. Compared to the control groups, OT-SI improvement trends on the Short Sensory Profile, Child Behavior Checklist, and electrodermal reactivity were in the hypothesized direction.”
48. 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. PMID 18592366. Checked October 10, 2026.
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    “Seven studies examining weighted vests are reviewed. While there is only a limited body of research and a number of methodological weaknesses, on balance, indications are that weighted vests are ineffective ... weighted vests cannot be recommended for clinical application at this point.”
49. Centers for Disease Control and Prevention. CDC’s Developmental Milestones. Learn the Signs. Act Early., page dated May 15, 2026. Checked October 10, 2026.
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    “Don’t wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early. Talk with your child’s doctor, share your concerns, and ask about developmental screening.”

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. Sensory processing concerns are best assessed by an occupational therapist who can evaluate your individual child.