What Is Sensory Processing Disorder in Toddlers?

What is sensory processing disorder in toddlers?

Sensory processing is how the brain takes in information from the senses and pieces it together into a picture of what is happening around the body and within it, usually without conscious thought.⁠¹⁰ Sensory processing disorder (SPD) is the name used when that process works differently enough to get in the way. Cleveland Clinic describes it as a difference in the way the brain understands and responds to information from the senses, including what a child sees, hears, smells, tastes and touches, and how they move.⁠¹

For a toddler, that can mean a sock seam that feels unbearable, a vacuum cleaner that sets off panic, or the opposite: a child who barely seems to notice a hard fall.⁠^6,12 The STAR Institute, a sensory processing research and treatment center, describes SPD as sensory signals that are either not detected or not organized into appropriate responses, and as difficulties that are chronic and disrupt everyday life.⁠⁷ It can occur with or without other conditions such as autism or ADHD.⁠¹

Clinicians describe three patterns: modulation differences change how strongly a child reacts, discrimination differences make similar sensations hard to tell apart, and sensory-based motor differences affect posture and the planning of movement.⁠^1,6 The types of SPD can affect any of the eight sensory systems, including the vestibular, proprioceptive and interoceptive senses.⁠⁶

Is sensory processing disorder a real diagnosis?

Not in the main medical manuals. Cleveland Clinic notes that SPD is not an official medical diagnosis, although providers recognize the benefit of identifying it and treating it when it affects daily life.⁠¹ In 2012 the American Academy of Pediatrics (AAP) advised that, because there is no universally accepted framework for diagnosis, sensory processing disorder generally should not be diagnosed, and that other developmental and behavioral conditions must always be considered.⁠¹⁸

Early childhood is the exception. The DC:0-5, a classification of mental health and developmental disorders of infancy and early childhood published by ZERO TO THREE in 2016, lists three sensory processing disorders: sensory over-responsivity disorder, sensory under-responsivity disorder and other sensory processing disorder.⁠⁹ Whatever the label, the American Occupational Therapy Association advises against sensory-based interventions without documented assessment results.⁠¹⁹

How common are sensory issues in toddlers?

Estimates depend on the child’s age and the questionnaire used. In the Wisconsin Twin Project, 294 of 3,058 two-year-olds (9.4%) screened positive for tactile or auditory over-responsivity.⁠⁸ Among kindergarten children in one U.S. school district, parent reports put the figure between 5.3% and 13.7%, and in a representative sample of 925 children aged 7 to 11, 16% of parents said at least four touch or sound sensations bothered their child.⁠^20,21

What are the signs of sensory issues in toddlers?

The STAR Institute notes that many symptoms on its checklists are common at a given age, suggests thinking about a child’s behavior over the past six months, and advises talking to a doctor when more than a few are present.⁠¹¹ Over-responsive children react more intensely, quicker or for longer than others; under-responsive children react less intensely, after a delay or in a muted way.⁠⁶ One toddler can show both, depending on the sense.⁠¹⁰

What does sensory over-responsivity look like in a toddler?

An over-responsive toddler feels ordinary sensations more easily or more intensely, as if bombarded, and often has a fight-or-flight response: pulling away from touch, covering their ears, or trying to avoid the sensation altogether.⁠⁶ Researchers who studied 1,394 toddler-aged twins described the touch version, tactile defensiveness, as fussing about stiff new clothes and labels inside collars, being bothered by sock seams, disliking light touch on the face and protesting vigorously at nail trimming and tooth brushing. The sound version includes highly aversive reactions to vacuum cleaners and sirens.⁠¹²

• Touch. In school-age children, the touch sensations parents most often reported were tags in clothing (39%), nail cutting (19%), hair brushing (16%) and mud (11%).⁠²¹
• Sound. In older children, alarms, sirens and concerts were the sounds most often reported.⁠²¹
• Movement. Being moved or moving can feel overwhelmingly big, and in one study the toddlers whose over-responsivity persisted to age seven had more motion sensitivity at four.⁠^8,10
• Sight, smell and taste. Cleveland Clinic lists reacting to bright lights and gagging at certain food textures among common symptoms, and smells can feel just as intense.⁠^1,10

Over-responsivity in toddlers often goes with a fearful temperament, and was modestly linked with anxiety in twins.⁠^12,13 More on sensory over-responsivity.

What does sensory under-responsivity look like in a toddler?

An under-responsive toddler needs more intensity and repetition before a sensation registers. They may seem quiet and passive, or oblivious to sounds and touch of ordinary strength.⁠⁶ Signs include:

• Not noticing pain, or being slow to respond when hurt.⁠¹¹
• Not noticing that something is too hot or too cold, or not reacting to bumps, falls, cuts and scrapes.⁠⁶
• Poor body awareness, clumsiness, or movements that are too forceful or too weak, from under-registering touch and deep pressure.⁠⁶
• Being unaware of sensations, or slower to respond to them than other children.⁠¹

In autism, under-responsivity is the pattern that differs most from other children.⁠²² Read more about sensory under-responsivity.

What does sensory seeking look like in a toddler?

A sensory-seeking toddler craves strong sensation. Cleveland Clinic describes sensory craving as needing and seeking out sensory input for stimulation, where getting it leads to disorganization rather than satisfying the craving.⁠¹ Signs include:

• Being extremely active, constantly moving or running endlessly.⁠¹¹
• Needing to touch everything, and not recognizing other people’s personal space.⁠¹
• Rocking, head banging or mouthing objects that are not food, which the AAP lists among the ways some children seek out sensation.⁠²³
• In older children, craving rough-housing and wrestling games.⁠¹¹

Many items on sensory checklists are common at a given age, so one burst of sensory seeking says little; the pattern over months is what counts.⁠¹¹

What do sensory-based motor problems look like in a toddler?

Some toddlers’ sensory differences show up in how they move. The STAR Institute’s toddler checklist includes a floppy body, bumping into things and poor balance, seeming delayed in crawling, standing, walking or running, and rarely playing with toys that need dexterity.⁠¹¹ In postural disorder a child has difficulty stabilizing the body at rest or in movement. In dyspraxia a child has trouble planning and carrying out new movements, so they may seem clumsy, awkward and accident-prone, break toys or prefer sedentary play.⁠⁶

What do sensory issues look like at 1, 2 and 3 years old?

No sign means the same thing at every age. Developmental milestones are things most children, 75% or more, can do by a certain age, so the timing of a skill varies, and many behaviors on sensory checklists are common at a given age.⁠^11,24 Standardized questionnaires take age into account: the Sensory Profile 2 has separate infant and toddler forms, on which caregivers report how the child responds to sensory events through the day.⁠²⁵

What can sensory issues look like in a 1-year-old?

By one, most children pull up to stand, walk holding on to furniture, pick up small bits of food between thumb and pointer finger and drink from a cup held for them.⁠²⁶ Sensory differences at this age show up mostly in the routines of care: feeding problems, trouble falling or staying asleep, extreme irritability when dressed, resisting cuddles and arching away, being easily startled, and being hard to settle.⁠¹¹ Early sensitivity matters. In a study that followed 521 children from about 18 months to age eight, both early sensory sensitivity and how it changed over the toddler years were linked with over-responsivity at school age.⁠²⁷

What does sensory processing disorder look like in a 2-year-old?

By two, most children run, kick a ball, walk up a few stairs with or without help and eat with a spoon.⁠²⁴ Two is also the age of the largest studies of toddler sensory issues. In 1,026 twin pairs assessed at about two years and two months, over-responsivity to touch and sound went with more fear and negative mood, and complications in pregnancy predicted touch symptoms.⁠¹³

Two is also the peak age for ordinary tantrums and picky eating. The AAP says tantrums happen most between one and three, and that toddlers may eat one or two preferred foods for weeks.⁠^4,5 Refusing a new vegetable is typical at two. Gagging at certain textures or eating problems that persist are worth raising, and the AAP advises talking with the pediatrician about any concern over a child’s diet.⁠^1,5,11

What does sensory processing disorder look like in a 3-year-old?

By three, most children put on some clothes by themselves, use a fork, string large beads and calm down within 10 minutes after a parent leaves.⁠²⁸ The STAR Institute’s preschool checklist includes difficulty with toilet training, big reactions to touch, noise or smells, avoiding crayons and clothing fasteners, being hard to calm with difficulty in transitions, and sudden mood changes and meltdowns.⁠¹¹

Ordinary tantrums tend to get better after three.⁠⁴ In a community sample of 917 children aged two to five, 43% of the preschoolers with over-responsivity also had an impairing anxiety disorder.⁠²⁹ More on SPD in children as they reach school age.

How do sensory issues differ from typical toddler behavior?

Being bothered by a few sensations is common: half of the school-age children in one large study were bothered by one to three, while 16% were bothered by four or more.⁠²¹ What sets sensory difficulties apart is a pattern that is chronic, involves more than a few signs and gets in the way of eating, sleep, play and family life.⁠^7,11

Toddler sensory symptoms also change. In the Wisconsin twins, over-responsivity at two was only modestly related to over-responsivity at seven (correlations of .22 for touch and .11 for sound), and the researchers concluded that assessment over time may be needed for a valid diagnosis.⁠⁸

Is it sensory processing disorder or autism in a toddler?

Sensory differences are one of the possible signs of autism, so the question comes up often. Under the DSM-5, an autism diagnosis needs persistent differences in all three areas of social communication and interaction plus at least two of four kinds of restricted, repetitive behavior. One of those four is hyper- or hyporeactivity to sensory input, such as indifference to pain or adverse responses to specific sounds or textures.⁠¹⁵

Early social signs the CDC lists include not responding to their name by 9 months, using few or no gestures by 12 months, not pointing to show something interesting by 18 months and not noticing when others are hurt or upset by 24 months.⁠³⁰ All children should be screened for autism at the 18- and 24-month well-child visits, and by age two a diagnosis by an experienced professional can be considered very reliable.⁠¹⁶

The overlap is large. Researchers estimate that 45% to 96% of autistic children have sensory difficulties, and a meta-analysis of 14 studies found the biggest difference from other children in under-responsivity, followed by over-responsivity and sensation seeking.⁠^22,31 The comparison of autism and sensory processing disorder goes further, as does sensory processing in autism.

Can a toddler have sensory issues without autism?

Yes. Cleveland Clinic notes that SPD often occurs with autism or ADHD but can occur without any other condition, and the twin studies found tactile and auditory defensiveness in toddlers with no accompanying disorder.⁠^1,12 Sensory difficulties also appear with ADHD, developmental coordination disorder and childhood anxiety, which is one reason the AAP asks that other conditions always be considered.⁠¹⁸ More on sensory processing disorder without autism.

What causes sensory processing disorder in toddlers?

No single cause has been identified. Cleveland Clinic says researchers do not yet know the cause and that genetics and environmental factors likely play a role; the STAR Institute adds that it is often inherited and that prenatal and birth complications have been implicated.⁠^1,7 Many parents worry that they are somehow to blame.⁠⁷ Two kinds of study have looked at this most directly: twin studies and studies of children born early.⁠^12,13,14 More on what causes sensory processing disorders and the risk factors.

Is sensory processing disorder genetic?

Partly. In 1,394 toddler-aged twins, heritability was estimated at 52% for tactile defensiveness and 38% for auditory defensiveness, with shared environment accounting for about a third of the variation in the auditory kind.⁠¹² A second study of 1,026 twin pairs at about age two also found both touch and sound over-responsivity heritable.⁠¹³

Does premature birth raise the risk of sensory issues?

It appears to. Among 107 children born at 32 weeks of gestation or earlier and assessed between one and eight years old, 39% had an atypical score in at least one area of the Sensory Profile, with auditory, touch and movement processing most often affected.⁠¹⁴ In the twins followed from two to seven, those whose over-responsivity persisted had been born at a younger gestational age and were more often low birth weight.⁠⁸ In another twin sample, complications in pregnancy predicted touch over-responsivity at age two.⁠¹³

What does brain research show about sensory processing disorder?

Imaging studies are small and involve older children. In one, 16 boys aged 8 to 11 with SPD had differences in white matter, the brain’s wiring, mainly in posterior tracts, compared with 24 matched boys, and the differences tracked their auditory, multisensory and attention scores.⁠³² The authors suggest abnormal white matter as a biological basis for SPD.⁠³²

How can sensory issues affect a toddler’s development?

Children build motor skills, problem solving and a sense of self on early sensory and movement experiences.⁠¹⁰ When processing is atypical, the effects tend to show up in four places.⁠^6,29,33,34

Can sensory issues affect a toddler’s sleep?

In 177 infants and toddlers seen at a community occupational therapy sleep clinic, 55% showed heightened sensory processing in at least one area, most often sensitivity (36%). Greater sensitivity went with taking longer to settle to sleep, and more sensory seeking went with shorter daytime sleep, though the links were small.⁠³³ In preschoolers followed to age six, early over-responsivity predicted later anxiety, which in turn was linked with more sleep problems.⁠²⁹ Two-year-olds need 11 to 14 hours of sleep a day including naps, and the CDC recommends steady routines and a calm, quiet bedtime.⁠²⁴

Can sensory issues cause picky eating in toddlers?

Picky eating is often the norm for toddlers; the AAP notes that a favorite food one day may hit the floor the next.⁠⁵ Sensory sensitivity can add to it. Children aged 4 to 10 who disliked how materials felt in their hands also liked foods less, especially the younger ones, and children with tactile defensiveness have been described as hesitating over unfamiliar foods, refusing foods because of smell or temperature and eating about half the vegetables other children eat.⁠^34,35

If you are concerned about your child’s diet, the AAP advises talking with the pediatrician, who can check that your child is getting the nutrients they need.⁠⁵ When eating is very limited, ask about feeding therapy.

How do sensory issues affect play and motor skills?

Toddlers learn through play and movement.⁠¹⁰ Praxis, the ability to plan and carry out purposeful movements, depends on the tactile, vestibular and proprioceptive systems working together, and it underlies everything from rolling over to riding a bike.⁠¹⁰ A child who struggles to plan movement may avoid new motor tasks and prefer sedentary play, and a child who under-registers touch and pressure may seem clumsy.⁠⁶ Occupational therapists help children meet fine and gross motor milestones and improve play and social skills.⁠¹ More on vestibular and proprioceptive processing.

How are sensory issues linked to meltdowns and anxiety?

Over-responsive children often have a fight-or-flight response to sensation, such as being touched unexpectedly or a loud noise.⁠⁶ Over time the link with emotional health is well documented. In 917 children aged two to five, preschool over-responsivity predicted anxiety symptoms at six, and the relationship ran one way, from sensory to anxiety.⁠²⁹ School-age children with elevated over-responsivity had more anxiety, behavior and dysregulation problems, and fewer adaptive social behaviors.⁠²¹ More on sensory processing and anxiety.

How are sensory issues in toddlers evaluated?

The usual route starts with the pediatrician, who may refer the child to an occupational therapist. The therapist watches the child respond to sensory experiences and asks about symptoms, behavior and medical history, and the pediatrician may also refer to other specialists.⁠¹ Because sensory difficulties occur in many developmental and behavioral conditions, the AAP calls for a thorough evaluation that considers them.⁠¹⁸

Parent questionnaires are a standard part of the assessment. The Sensory Profile 2, by Winnie Dunn, covers birth to 14 years 11 months, with infant and toddler forms on which caregivers report how the child responds to sensory events through the day.⁠²⁵ More on testing for sensory processing disorder.

Can early intervention evaluate a toddler for sensory issues?

Yes, if the child is under three. Every state and territory runs a publicly funded early intervention program for babies and young children with developmental delays and disabilities.⁠² Eligibility is based on an evaluation of the child’s skills, each state sets its own rules, and a doctor’s referral is not necessary: a parent can call and ask for an evaluation.⁠² Under federal rules, evaluation and assessment are carried out at public expense, with no fees charged to parents.⁠³ From age three, the CDC advises calling the local public elementary school to ask for a preschool special education evaluation.⁠² More on early intervention and private therapy.

What is the treatment for sensory processing disorder in toddlers?

There is no cure, but occupational therapy can help manage the symptoms that affect daily life. Therapists work on developmental milestones, self-care, play and social skills, and self-regulation.⁠¹ The AAP’s 2012 statement calls sensory-based therapy acceptable as one part of a wider plan, says the research on it is limited and inconclusive, and encourages a trial period with a way to judge whether it works.⁠¹⁸ More on occupational therapy for sensory processing disorder and occupational therapy for infants and toddlers.

What is sensory integration therapy?

Sensory integration therapy was developed in the 1970s by occupational therapist A. Jean Ayres. Sessions are play-based and may use swings, trampolines and slides.⁠²³ The approach now called Ayres Sensory Integration has the most research in autistic children. In a randomized trial of children aged four to eight, those who had 30 sessions scored much higher on their individual goals and needed less help with self-care than a usual-care group.⁠³¹ A 2019 review rated it an evidence-based practice for autistic children aged 4 to 12, and a 2025 review of nine randomized trials found strong evidence that it helps autistic children meet their goals, no benefit for behaviors such as irritability, and too little research in other groups of children.⁠^36,37 More on sensory integration therapy and how it compares with occupational therapy in general.

What is a sensory diet for a toddler?

A sensory diet is a plan of sensory activities built into a child’s day, such as a break to walk, spin or swing, customized by an occupational therapist.⁠^1,17 The evidence for individual techniques is mixed. A 2025 systematic review found strong evidence for deep pressure touch and for training caregivers to use sensory strategies, while a study of sensory diets during the school day had varied results.⁠¹⁷ An earlier review found limited evidence for weighted vests and too little to judge slow swinging or multisensory activities added to preschool routines.⁠³⁸ More on building a sensory diet with a therapist.

How does an occupational therapist work with a toddler and family?

With young children, much of the work happens through the family. The 2025 review found strong evidence for training caregivers to use sensory strategies.⁠¹⁷ The American Occupational Therapy Association advises therapists to start from the child’s occupational profile and set goals together with the family.⁠¹⁹ Useful questions for a first visit: what goals the therapist suggests, how progress is measured, and how long a trial makes sense before reviewing it.⁠¹⁸ You can find a pediatric occupational therapist by city and state.

Which sensory treatments lack good evidence?

The AAP notes that auditory integration training and behavioral optometry, both offered as ways of controlling sensory input, have not been shown to be scientifically valid.⁠²³ Weighted vests have limited evidence.⁠³⁸ Alternative seating did not improve attention, and there is little evidence on changing the sensory environment.⁠¹⁷

Which everyday strategies help a toddler with sensory issues?

Small changes to routines can help while you wait for an assessment, and an occupational therapist can tailor them to your child.⁠¹

• Keep a log. Note what upsets or calms your child, and when; the STAR Institute’s checklist asks about behavior over the past six months.⁠¹¹
• Keep sleep and meals predictable. The CDC recommends steady routines for sleeping and feeding and a calm, quiet bedtime.⁠²⁴
• Plan around the hard moments. If upsets come when your child is hungry or tired, carry a snack and protect nap time; during an upset, offer small, directed choices rather than yes-or-no questions.⁠⁴
• Go slowly with new foods. Avoid pressure. It can take 10 or more tastes before a toddler accepts a food, and food bridges move from an accepted food to others with a similar color, flavor and texture.⁠⁵
• Ask to be coached. Deep pressure touch and training parents to use sensory strategies both have strong evidence, so ask a therapist to show you what to do at home.⁠¹⁷

Ideas for living with SPD day to day build on the same principles.

Do toddlers outgrow sensory processing disorder?

Often they do not. In the twin study that screened children at two and again at seven, 75 of the 99 toddlers who screened positive for over-responsivity no longer did at seven, 24 still did, and 112 children screened positive for the first time at seven.⁠⁸ Symptoms were more stable in children born prematurely or with more fearful, less soothable temperaments.⁠⁸

For children whose difficulties persist, the long view is encouraging. Among 102 adults who had sensory integration and processing challenges as children and received occupational therapy using sensory integration, severity had decreased, and 51% now scored in the typical range.⁠³⁹

When should I talk to a doctor about my toddler’s sensory issues?

Also raise it if:

• More than a few signs on a sensory checklist have been present over the past six months.⁠¹¹
• Sensory reactions limit eating, sleep, dressing or play.⁠^1,7
• There are social signs of autism, such as not responding to their name, few gestures or not pointing to share interest.⁠³⁰
• Your child does not seem to notice pain, heat or cold.⁠⁶

What should I do next if I think my toddler has sensory issues?

1. Write down what you see. Note which sensations, how often, how intense, and what they stop your child doing.⁠¹¹
2. Talk to your pediatrician and ask about developmental screening; autism screening is recommended at 18 and 24 months.⁠^16,24
3. Call early intervention if your child is under three. No referral is needed and the evaluation is free; from three, contact your local public school.⁠^2,3
4. Ask for an occupational therapy evaluation. Ask how the therapist assesses sensory processing, what goals they would set and how you can tell whether therapy is working.⁠^1,18,19 You can find a pediatric occupational therapist near you.

RelatedOver- and under-responsivityDevelopmental milestonesSensory processing quiz

Sources

1. Cleveland Clinic. Sensory Processing Disorder (SPD). Health Library, last updated March 20, 2025. Checked October 11, 2026.
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   “Sensory processing disorder (SPD) is a difference in the way your brain understands and responds to information from your senses. This includes what you see, hear, smell, taste and touch. It can also affect your movement.” “Healthcare providers and parents typically identify SPD in children. But it can also affect adults. SPD commonly affects people with neurodevelopmental and neurodivergent conditions, like autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD). But you can also have SPD without any other condition.” “Currently, SPD isn’t an official medical diagnosis. But providers recognize the benefits of identifying SPD and using therapy to manage it, especially if it affects your ability to function day to day.” Sensory under-responsivity: “You may be unaware of sensory information and/or have a delay before responding, compared to most people.” Sensory craving: “In this type, you need and seek out sensory information for stimulation. But getting the stimulation results in disorganization and doesn’t satisfy the craving.” Common symptoms include “Constantly bumping into things (clumsiness)”, “Gagging when eating certain food textures”, “Needing to constantly touch things”, “Not recognizing personal space” and “Reacting to sudden movements, touches, loud noises and/or bright lights.” “Researchers don’t yet know the cause of sensory processing disorder. Studies show that genetics and environmental factors likely play a role.” “your child’s pediatrician may refer you to an occupational therapist. These professionals can assess your child for SPD by watching them interact with certain sensory experiences. They’ll also ask about your child’s symptoms, behavior and medical history to help in the diagnosis. Your pediatrician may also refer you to other specialists”. “There’s no cure for sensory processing disorder. But various types of occupational therapy can help manage the symptoms of SPD”; therapists help children “Meet developmental milestones (for children), like fine and gross motor skills”, “Improve self-care and activities of daily living”, “Improve play and social skills” and “Improve self-regulation skills and behavior.” “your child’s occupational therapist may recommend incorporating routine sensory activities and tools at home and school”, for example “Access to headphones to block out background noises while they work”, “Access to fidget toys” and “A designated break to do a sensory activity, like walking, spinning or swinging.”
2. Centers for Disease Control and Prevention. Early Intervention. Learn the Signs. Act Early., page dated February 16, 2026. Checked October 11, 2026.
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   Early intervention “Is the term used to describe services and supports available to babies and young children with developmental delays and disabilities and their families”; it “May include speech therapy, physical therapy, and other types of services based on the needs of the child and family”; “These publicly funded programs provide services for free or at reduced cost for any child who is eligible.” “Each state, territory, or commonwealth has its own early intervention program and rules about eligibility and services.” “Eligibility for early intervention services is based on an evaluation of your child’s skills and abilities.” “A doctor’s referral is not necessary.” “If your child is age 3 or older: call any local public elementary school (even if your child does not go to school there)” to ask for a preschool special education evaluation.
3. U.S. Department of Education. 34 CFR 303.521, System of payments and fees. Checked October 11, 2026.
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   Electronic Code of Federal Regulations (Part C of the Individuals with Disabilities Education Act). “(b) Functions not subject to fees. The following are required functions that must be carried out at public expense, and for which no fees may be charged to parents”, including “(2) Evaluation and assessment”.
4. American Academy of Pediatrics, HealthyChildren.org. Top Tips for Surviving Tantrums. By Wendy Sue Swanson, MD; last updated April 21, 2021. Checked October 11, 2026.
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   “Tantrums are a normal part of development. They happen most between ages 1 and 3 years”; “During a tantrum, give your child control over little things (offer small, directed choices with options rather than yes/no questions).” “If tantrums peak when your child is hungry, have a healthy snack with you when you’re out of the house. If they peak when your child is fatigued, prioritize sleep/nap time”. “Tantrums do tend to get better after the age of 3.”
5. American Academy of Pediatrics, HealthyChildren.org. 10 Tips for Parents of Picky Eaters. AAP Committee on Nutrition; last updated April 26, 2018. Checked October 11, 2026.
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   “Picky eating is often the norm for toddlers.” “A toddler’s favorite food one day may hit the floor the next”; “For weeks, they may eat 1 or 2 preferred foods – and nothing else.” “Pressuring kids to eat, or punishing them if they don’t, can make them actively dislike foods they may otherwise like.” “It can take as many as 10 or more times tasting a food before a toddler’s taste buds accept it.” “use what nutritionists call ‘food bridges’ to introduce others with similar color, flavor and texture”. “If you are concerned about your child’s diet, talk with your pediatrician, who can help troubleshoot and make sure your child is getting all the necessary nutrients to grow and develop.”
6. STAR Institute for Sensory Processing. Patterns or Subtypes of Differences in Sensory Integration & Processing. Sensoryhealth.org, undated. Checked October 11, 2026.
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   “These differences can affect multiple sensory systems, including visual, auditory, tactile, olfactory, gustatory, vestibular, proprioceptive, and interoceptive modalities.” The three major patterns are sensory modulation, sensory discrimination and sensory-based motor differences. Sensory over-responsive: “Predisposition to respond more intensely, quicker, and/or longer to sensory stimuli.” Sensory under-responsive: “Predisposition to respond less intensely to sensory stimuli, to have a delay before responding, and/or responses are muted.” “Individuals with sensory over-responsivity are more sensitive to sensory stimulation than most people. Their bodies feel sensation more easily and/or more intensely. They might feel as if they are being constantly bombarded with information. Consequently, these people often have a ‘fight or flight’ response to sensation, e.g. being touched unexpectedly or loud noise”; “They may try to avoid or minimize sensations, e.g. withdraw from being touched or cover their ears to avoid loud sounds.” “Individuals who are under-responsive to sensory stimuli require more intensity and repetition of sensation than others. They may appear quiet and passive, oblivious or not responding to stimuli of the usual intensity available in their sensory environment. Their under-responsivity to tactile and deep pressure input may lead to poor body awareness, clumsiness or movements that are not graded appropriately. These children may not perceive objects that are too hot or cold or they may not notice pain in response to bumps, falls, cuts, or scrapes.” Sensory discrimination: “(Do I see a ‘P’ or a ‘Q’? Do I hear ‘cat’ or ‘cap’?”); “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.” Discrimination differences are listed for auditory, visual, tactile, vestibular, proprioceptive, gustatory, olfactory and interoceptive sensation. “An individual with postural disorder has difficulty stabilizing his/her body during movement or at rest”; people with dyspraxia “have trouble processing sensory information properly, resulting in problems planning and carrying out new motor actions ... These individuals are clumsy, awkward, and accident-prone. They may break toys, have poor skill in ball activities or other sports, or have trouble with fine motor activities. They may prefer sedentary activities”.
7. STAR Institute for Sensory Processing. About SPD. Sensoryhealth.org, undated. Checked October 11, 2026.
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   “Sensory Processing Disorder (SPD), exists when sensory signals are either not detected or don’t get organized into appropriate responses.” Ayres “likened SPD to a neurological ‘traffic jam’ that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly.” “for children, adolescents, and adults with SPD, these difficulties are chronic, and they can significantly disrupt everyday life.” “Sensory Processing Disorder can affect people in only one sense–for example, just touch or just sight or just movement–or in multiple senses.” “Many worry that they are somehow to blame for their child’s sensory issues.” “Preliminary research suggests that SPD is often inherited.” “Prenatal and birth complications have also been implicated, and environmental factors may be involved.”
8. 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 11, 2026.
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   Twins from the Wisconsin Twin Project, “a population-based, typically developing sample of twins (N=978)”, assessed “at age two years via a caregiver report temperament questionnaire and again at age seven years via a sensory over-responsivity symptom inventory”; “294/3058 (9.4%) of children screened positive for SOR at age two years”; “Roughly equal numbers of males and females screened positive for SOR in toddlerhood (152 girls, 142 boys”). Trajectory groups: “low symptom (N=768), remitted (N=75), late-onset (N=112), and chronic (N=24)”; “Children in the chronic group had more severe symptoms of sensory sensitivity at age four years, including more motion sensitivity” and “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. A clear implication is that assessment over development may be necessary for a valid sensory processing disorder diagnosis”.
9. 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”. The code list includes “20 Sensory Processing Disorders”: “20.1 Sensory Over-Responsivity Disorder”, “20.2 Sensory Under-Responsivity Disorder” and “20.3 Other Sensory Processing Disorder”. Checked October 11, 2026.
10. STAR Institute for Sensory Processing. Understanding the Sensory Integration Process. Sensoryhealth.org, undated. Checked October 11, 2026.
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    “Studies indicate that 5% to 16% of children exhibit symptoms of SPD.” “Our bodies and brains use specialized systems to register all the different sensory information in our environment and piece it together to build a complete picture of: what is going on around us, with our bodies, within our bodies, where we are, and what time of day it is.” “Our ability to process sensory data does not usually require conscious thought or cognitive effort.” “In the early years of life, there are very few, if any, experiences that are not deeply sensory in nature.” “Also through play as we knock over blocks, shake a musical rattle, and drop items off the high chair tray.” “We develop sense-of-self through these early experiences, we learn how to solve problems, we learn that we can impact objects and people”; “We also develop motor skills”. “Most people are surprised to find out that we actually have eight sensory systems rather than five.” “Heightened Sensitivity: Some neurodivergent individuals experience heightened sensitivity to sensory input. This can make sounds, sights, smells, being moved or moving, and even internal sensations feel overwhelmingly ‘big,’ ‘loud,’ or ‘intense.’” “you can have heightened sensitivity to some sensory systems and reduced in others. You may even have some higher and lower responsivity within one system”; “Some register everything around them with the same level of intensity”, so that “the teacher’s voice, the ticking of the clock, the buzzing of the air conditioner, and the bell signaling time for transition may all be equally intense”. “Praxis is the ability to plan and carry out purposeful movements. This skill is essential for everything from learning to roll over, to riding a bike”; “Effective praxis depends on the integration of our tactile, vestibular, and proprioceptive systems”. “Sensory processing isn’t static; it can fluctuate based on factors like stress, fatigue, or environmental changes.”
11. STAR Institute for Sensory Processing. Symptoms Checklist. Sensoryhealth.org, undated. Checked October 11, 2026.
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    “Many of the symptoms listed in the following categories are common to that particular age group. Where more than a few symptoms are found in a child, we recommend you talk to your doctor”. The infant and toddler list: “My infant/toddler has problems eating”; “has trouble falling asleep or staying asleep”; “is extremely irritable when I dress him/her; seems to be uncomfortable in clothes”; “rarely plays with toys, especially those requiring dexterity”; “has difficulty shifting focus from one object/activity to another”; “does not notice pain or is slow to respond when hurt”; “resists cuddling, arches back away from the person holding him”; “can not calm self by sucking on a pacifier, looking at toys, or listening to my voice”; “has a ‘floppy’ body, bumps into things and has poor balance”; “is easily startled”; “is extremely active and is constantly moving body/limbs or runs endlessly”; “seems to be delayed in crawling, standing, walking or running.” The preschool list includes “My child has difficulty being toilet trained”, “is highly sensitive to stimulation, has big reactions to / does not like touch, noise, smells, etc.”, “is unaware of being touched/bumped unless done with extreme force/intensity”, “has difficulty learning and/or avoids performing fine motor tasks such as using crayons and fasteners on clothing”, “seems unsure how to move his/her body in space, is clumsy and awkward”, “is in constant motion”, “gets in everyone else’s space and/or touches everything around him”, “is intense, demanding or hard to calm and has difficulty with transitions” and “has sudden mood changes and meltdowns that are unexpected”; the school-age list, “My child craves rough housing, tackling/wrestling games”. “While this checklist cannot diagnose Sensory Processing Disorder, it can be a helpful guide to see if additional testing should be done. When filling out this checklist, think about the person’s behavior during the past six months.”
12. Goldsmith HH, Van Hulle CA, Arneson CL, Schreiber JE, Gernsbacher MA. A population-based twin study of parentally reported tactile and auditory defensiveness in young children. Journal of Abnormal Child Psychology. 2006;34(3):378–392. PMID 16649001. Checked October 11, 2026.
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    “Using a population-based sample of 1,394 toddler-aged twins, mothers reported on tactile and auditory defensiveness, temperament, and behavior problems”; “Girls were overrepresented in the extreme tactile defensiveness group. Both auditory and tactile defensiveness were modestly associated with fearful temperament and anxiety, but they were relatively distinct from other common dimensions of childhood behavioral dysfunction.” The symptoms “occur not only in subsets of children with ADHD, autism, and Fragile X syndrome, but also in the apparent absence of accompanying disorders.” “Some children fuss about stiff new clothes, turtleneck sweaters, and labels sewn inside collars. These children may be bothered by the seams of socks, dislike being touched lightly on the face, protest vigorously to fingernail trimming and tooth brushing”; “highly aversive reactions to vacuum cleaners and sirens, might indicate ‘auditory defensiveness.’” “Heritability was calculated at 38%, shared environment accounted for 33% of the variance” for auditory defensiveness; “For tactile defensiveness, the heritability was 52%”.
13. Keuler MM, Schmidt NL, Van Hulle CA, Lemery-Chalfant K, Goldsmith HH. Sensory overresponsivity: prenatal risk factors and temperamental contributions. Journal of Developmental and Behavioral Pediatrics. 2011;32(7):533–541. PMID 21743351. Checked October 11, 2026.
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    “The sample included 1,026 twin pairs (mean age = 2 years 2 months) from a population-based longitudinal study.” “Temperamental negative affect and fear were moderately correlated with auditory and tactile SOR symptoms. Prenatal complications significantly predicted tactile symptoms after controlling for child characteristics”; “Both auditory and tactile SOR domains were heritable.” Over-responsivity “also occurs in children without any apparent medical condition”.
14. Wickremasinghe AC, Rogers EE, Johnson BC, Shen A, Barkovich AJ, Marco EJ. Children born prematurely have atypical sensory profiles. Journal of Perinatology. 2013;33(8):631–635. PMID 23412641. Checked October 11, 2026.
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    A cross-sectional study of children born at 32 weeks of gestation or earlier, “followed at 1 to 8 years of age”: “Of our 107 participants, 39% had an atypical score in at least one section or quadrant”; “Children born prematurely were at risk of having atypical scores in the auditory, tactile and vestibular processing sections, and in the four Sensory Profile quadrants”.
15. 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 11, 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 (see A.1. through A.3. below) plus at least two of four types of restricted, repetitive behaviors (see B.1. through B.4. below).” B.4: “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).”
16. Centers for Disease Control and Prevention. Clinical Screening for Autism Spectrum Disorder. Page dated October 2, 2026. Checked October 11, 2026.
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    “All children should be screened specifically for autism spectrum disorder (ASD) during well-child doctor visits at 18 months and 24 months.” “Research has found that autism spectrum disorder (ASD) can sometimes be detected at 18 months or younger. By age 2 years, a diagnosis by an experienced professional can be considered very reliable.” The page attributes the screening schedule to the American Academy of Pediatrics.
17. 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 11, 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. Additionally moderate strength of evidence supported targeting a variety of sensory systems is more effective than targeting only one system. There is a lack of evidence on the impact of sensory environmental modifications.” “A third Level II (38) SSD study using sensory diets as part of the regular school day showed three of four participants improving behavior. While results were varied, each participant showed significant improvement in at least one phase of the intervention.” “Overall, the result of this systematic review supports the use of caregiver training to implement sensory strategies across populations of children with SI/SP challenges.”
18. Zimmer M, Desch L; Section on Complementary and Integrative Medicine; Council on Children with Disabilities; American Academy of Pediatrics. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129(6):1186–1189. PMID 22641765. Checked October 11, 2026.
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    The policy statement: “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. Important roles for pediatricians and other clinicians may include discussing these limitations with parents, talking with families about a trial period of sensory integration therapy, and teaching families how to evaluate the effectiveness of a therapy.”
19. American Occupational Therapy Association. Practice Smart! Undated web page; AOTA published the recommendations from 2018 to 2021 under the Choosing Wisely campaign. Checked October 11, 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.”
20. Ahn RR, Miller LJ, Milberger S, McIntosh DN. Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy. 2004;58(3):287–293. PMID 15202626. Checked October 11, 2026.
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    The abstract: of 703 surveys returned in one suburban U.S. district, “96 children (13.7% of 703) met criteria for sensory processing disorders based upon parental perceptions”; the cautious estimate “suggests that based on parents’ perceptions, 5.3% (96 of 1796) of the kindergarten enrollment met screening criteria for sensory processing disorders.”
21. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology. 2009;37(5):705–716. PMID 19153827. Checked October 11, 2026.
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    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 versus without elevated SOR in school-age reported higher frequencies of early and co-occurring internalizing, externalizing, and dysregulation problems, and lower levels of concurrent adaptive social behaviors.” “The sensations that parents reported bothered children most frequently were tactile, with the most frequently reported tactile sensations being: tags in clothing (39%), cutting finger or toe nails (19%), hair brushing (16%), and mud (11%)”; “the most frequent sounds being alarms (12%), sirens, and concerts (both 10%)”; “Fifty percent of school-age children were bothered by one to three sensations.”
22. Ben-Sasson A, Hen L, Fluss R, Cermak SA, Engel-Yeger B, Gal E. A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders. 2009;39(1):1–11. PMID 18512135. Checked October 11, 2026.
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    The abstract: “Results from 14 studies indicated a significant high difference between ASD and typical groups in the presence/frequency of sensory symptoms, with the greatest difference in under-responsivity, followed by over-responsivity and sensation seeking.”
23. American Academy of Pediatrics, HealthyChildren.org. Sensory Integration Therapy. Last updated October 7, 2019; adapted from the AAP book Autism Spectrum Disorders: What Every Parent Needs to Know. Checked October 11, 2026.
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    “Sensory integration is a term that has been used to describe processes in the brain that allow us to take information we receive from our 5 senses, organize it, and respond appropriately. We also have a vestibular sense (balance) that tells us how to position our bodies and heads, and a proprioceptive sense (awareness of body in space) that helps us know what we do with our joints, muscles, and ligaments.” “Some children will look for ways to seek out certain sensations and engage in self-stimulating behaviors like rocking back and forth, head banging, and oral exploration of nonedible objects.” “Sensory integration therapy, which was developed in the 1970s by an OT, A. Jean Ayres”; “Therapy sessions are play-oriented and may include using equipment such as swings, trampolines, and slides.” “You may also learn about auditory integration training or behavioral optometry as methods for controlling sensory input”; “neither method has proved to be scientifically valid.”
24. Centers for Disease Control and Prevention. Milestones by 2 Years. Learn the Signs. Act Early., page dated May 15, 2026. Checked October 11, 2026.
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    “Developmental milestones are things most children (75% or more) can do by a certain age.” By two years: “Kicks a ball”, “Runs”, “Walks (not climbs) up a few stairs with or without help”, “Eats with a spoon”. “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.” “Have steady routines for sleeping and feeding. Create a calm, quiet bedtime for your child”; “Children this age need 11 to 14 hours of sleep a day (including naps).” “Most children are not able to toilet train until 2 to 3 years old.”
25. Pearson Assessments. Sensory Profile 2. Product page for the questionnaires by Winnie Dunn, published 2014. Checked October 11, 2026.
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    The 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”; “caregivers and teachers report on the child’s response to sensory events throughout the day”; the forms are “Infant, Toddler, Child, Short, and School Companion”.
26. Centers for Disease Control and Prevention. Milestones by 1 Year. Learn the Signs. Act Early., page dated May 15, 2026. Checked October 11, 2026.
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    “Developmental milestones are things most children (75% or more) can do by a certain age.” By one year: “Pulls up to stand”, “Walks, holding on to furniture”, “Drinks from a cup without a lid, as you hold it”, “Picks things up between thumb and pointer finger, like small bits of food”.
27. Ben-Sasson A, Carter AS, Briggs-Gowan MJ. The development of sensory over-responsivity from infancy to elementary school. Journal of Abnormal Child Psychology. 2010;38(8):1193–1202. PMID 20623174. Checked October 11, 2026.
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    The abstract: “This study followed a representative sample of children (n = 521, 47% boys) at four time points from infancy (mean ages in months Year 1 = 18.23, Year 2 = 30.39, Year 3 = 39.40) to elementary school-age (mean age = 7.97 years)”; “Both early sensory sensitivities and change in early sensitivities were associated with SOR status at school-age.”
28. Centers for Disease Control and Prevention. Milestones by 3 Years. Learn the Signs. Act Early., page dated May 15, 2026. Checked October 11, 2026.
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    By three years: “Calms down within 10 minutes after you leave her, like at a childcare drop off”, “Strings items together, like large beads or macaroni”, “Puts on some clothes by himself, like loose pants or a jacket”, “Uses a fork”.
29. 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 11, 2026.
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    “Children’s sensory and anxiety 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.”
30. Centers for Disease Control and Prevention. Signs and Symptoms of Autism Spectrum Disorder. Page dated May 16, 2024. Checked October 11, 2026.
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    Examples include “Does not respond to name by 9 months of age”, “Uses few or no gestures by 12 months of age (for example, does not wave goodbye)”, “Does not point to show you something interesting by 18 months of age”, “Does not notice when others are hurt or upset by 24 months (2 years) of age” and “Has unusual reactions to the way things sound, smell, taste, look, or feel”; “some people without ASD might also have some of these symptoms.”
31. Schaaf RC, Benevides T, Mailloux Z, Faller P, Hunt J, van Hooydonk E, Freeman R, Leiby B, Sendecki J, Kelly D. An intervention for sensory difficulties in children with autism: a randomized trial. Journal of Autism and Developmental Disorders. 2014;44(7):1493–1506. PMID 24214165. Checked October 11, 2026.
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    “This study evaluated a manualized intervention for sensory difficulties for children with autism, ages 4–8 years, using a randomized trial design”; “the children in the treatment group (n = 17) who received 30 sessions of the occupational therapy intervention scored significantly higher (p = 0.003, d = 1.2) on Goal Attainment Scales (primary outcome), and also scored significantly better on measures of caregiver assistance in self-care (p = 0.008 d = 0.9) and socialization (p = 0.04, d = 0.7) than the Usual Care control group (n = 15).” “Current estimates show that between 45 and 96 % of children with ASD demonstrate these sensory difficulties”.
32. Owen JP, Marco EJ, Desai S, Fourie E, Harris J, Hill SS, Arnett AB, Mukherjee P. Abnormal white matter microstructure in children with sensory processing disorders. NeuroImage: Clinical. 2013;2:844–853. PMID 24179836. Checked October 11, 2026.
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    “DTI was acquired in 16 boys, 8–11 years old, with SPD and 24 age-, gender-, handedness- and IQ-matched neurotypical controls”; differences were “primarily involving posterior white matter including the posterior corpus callosum, posterior corona radiata and posterior thalamic radiations”, with “Strong positive correlations ... between FA of these posterior tracts and auditory, multisensory, and inattention scores”; “These findings suggest abnormal white matter as a biological basis for SPD”.
33. Vasak M, Williamson J, Garden J, Zwicker JG. Sensory processing and sleep in typically developing infants and toddlers. American Journal of Occupational Therapy. 2015;69(4):6904220040. PMID 26114460. Checked October 11, 2026.
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    The abstract: “A retrospective chart review of 177 infants and toddlers from a community occupational therapy sleep clinic”; “More than half of participants (55%) demonstrated a pattern of increased sensory processing in one or more quadrants, with sensitivity being most common (36%). We found small but significant correlations between increased seeking and shorter daytime sleep duration (r=-.24, p=.002) and between increased sensitivity and longer time to settle to sleep (r=.27, p<.001).”
34. Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association. 2010;110(2):238–246. PMID 20102851. Checked October 11, 2026.
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    “Although picky eating is not uncommon among young children who are typically developing, pickiness in children with autism spectrum disorders (ASDs) may be even more restrictive”; “the factors parents felt influenced food selectivity were: texture (69%), appearance (58%), taste (45%), smell (36%), and temperature (22%)”. Of children with tactile defensiveness who did not have autism: “The children with tactile defensiveness were reported to have a fair to poor appetite, hesitated to eat unfamiliar foods, did not eat at other people’s houses, and refused certain foods because of smell and temperature. They also were resistant to eating vegetables, with overall vegetable consumption being half that of children without tactile defensiveness.”
35. Nederkoorn C, Jansen A, Havermans RC. Feel your food. The influence of tactile sensitivity on picky eating in children. Appetite. 2015;84:7–10. PMID 25261102. Checked October 11, 2026.
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    The abstract: “44 children between the ages of 4 and 10 were asked to feel different tactile stimuli with their hands and to taste different foods. Results showed a significant positive correlation between the evaluations of the two modalities, especially for the younger subjects. This suggests that tactile sensitivity might play a role in the acceptance of food.”
36. 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. Checked October 11, 2026.
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    “Two randomized controlled trials respectively met 100% and 85% of the CEC criteria items. One additional study met more than 50% of the criteria. Based on CEC criteria, ASI can be considered an evidence-based practice for children with autism ages 4–12 years old.”
37. 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 11, 2026.
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    The abstract: “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”; “More research is needed to determine ASI’s benefits for other child populations.”
38. Bodison SC, Parham LD. Specific sensory techniques and sensory environmental modifications for children and youth with sensory integration difficulties: a systematic review. American Journal of Occupational Therapy. 2018;72(1):7201190040. PMID 29280714. Checked October 11, 2026.
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    The abstract: “Eight studies met inclusion criteria”; “Strong evidence supported Qigong massage, moderate evidence supported sensory modifications to the dental care environment, and limited evidence supported weighted vests. The evidence is insufficient to draw conclusions regarding slow linear swinging and incorporation of multisensory activities into preschool settings.”
39. May-Benson TA, Easterbrooks-Dick O, Teasdale A. Exploring the prognosis: a longitudinal follow-up study of children with sensory processing challenges 8–32 years later. Children (Basel). 2023;10(9):1474. PMID 37761435. Checked October 11, 2026.
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    “researchers followed up with 102 adults who had known sensory integration and processing challenges as children”; “The results revealed that the severity of sensory integration and processing challenges experienced by the follow-up group decreased from childhood, with 51% of the follow-up group now scoring in the ‘typical’ range of sensory processing.” The adults had received “sensory-integration-based occupational therapy services as children”.
40. Cleveland Clinic. Interoception. Health Library, last updated February 19, 2025. Checked October 11, 2026.
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    “Interoception is the understanding of your body’s internal senses. You can feel that you’re hungry, that your heart is beating or that you need to pee. It’s a learned skill that you develop as you grow.” “As you grow and develop, you learn more about what important interoception skills are necessary, like feeling the need to pee or poop and knowing when to use the toilet.” Examples: “A full bladder”, “Hot or cold temperatures”, “Hunger”, “Itchy skin”, “Muscle tension”, “Nausea”, “Thirst”, “Your heartbeat”. The thalamus receives the signal and “sends the information to the insula to decode it”. “It varies significantly from person to person.” Signs of poor interoception: “Difficulty knowing when your bladder is full (when you need to pee)”, “Difficulty managing emotions”, “Feeling easily anxious”, “Having a high or low pain tolerance”, “Not feeling hungry or thirsty or not feeling full after a meal”; conditions that affect it include anxiety disorders, ADHD and autism. The first step: “An interoceptor (sensor in a neuron/nerve cell) detects a signal.”

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.