Fact-checked by Grok 2 weeks ago

Sensory processing disorder

Sensory processing disorder (SPD) is a neurological condition characterized by difficulties in the brain's ability to receive, organize, and respond to sensory information from the environment, leading to atypical reactions to stimuli such as touch, sound, sight, smell, taste, and movement.^[1] This disorder, previously known as sensory integration dysfunction, can manifest as over-responsivity (hypersensitivity), under-responsivity (hyposensitivity), or sensory seeking behaviors, impacting an individual's participation in daily activities and social interactions.^[2]^[3] SPD affects an estimated 5% to 16% of school-aged children in the general population, with higher rates observed among those with neurodevelopmental conditions such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD).^[4]^[5] Although sensory processing issues are included as a criterion in the DSM-5 diagnostic criteria for ASD—specifically hyper- or hyporeactivity to sensory input—SPD itself is not recognized as an independent disorder in the DSM-5, leading to ongoing debates about its classification and validity as a distinct condition.^[6] Research indicates structural and functional brain differences in individuals with SPD, supporting a biological basis for the disorder.^[4] Symptoms of SPD vary widely but commonly include aversion to certain textures or noises, clumsiness, excessive touching or mouthing of objects, or difficulty with transitions between activities due to sensory overload or understimulation.^[7]^[1] Diagnosis typically involves a multidisciplinary evaluation by occupational therapists, using standardized tools such as the Sensory Profile questionnaire to assess sensory modulation, discrimination, and integration.^[1] Treatment primarily consists of occupational therapy incorporating sensory integration techniques, which aim to improve sensory processing through structured play and environmental adaptations, with mixed evidence regarding improvements in functional behaviors.^[8]^[9]

Signs and symptoms

Overview of sensory challenges

Sensory processing disorder (SPD) is a condition characterized by difficulties in the brain's ability to receive, organize, and respond to sensory input from the environment and the body, leading to atypical reactions that can interfere with daily functioning. This processing challenge affects how individuals interpret multisensory information, resulting in either over-responsivity (hypersensitivity), where stimuli feel overwhelmingly intense, or under-responsivity (hyposensitivity), where individuals may seek out more intense sensory experiences to compensate.^[10] Common manifestations of these sensory challenges include hypersensitivity, such as an aversion to loud noises that causes a child to cover their ears or scream during everyday sounds like a vacuum cleaner, or discomfort from clothing textures leading to refusal to wear certain fabrics. In contrast, hyposensitivity might appear as seeking intense sensory input, for example, crashing into furniture or walls for proprioceptive feedback, or not noticing pain from minor injuries. These responses can occur across multiple senses, often leading to sensory overload that triggers emotional meltdowns, withdrawal, or avoidance behaviors in overwhelming environments.^[11]^[1] The core sensory difficulties in SPD involve eight primary sensory systems: visual (sight), auditory (hearing), tactile (touch), olfactory (smell), gustatory (taste), vestibular (balance and movement), proprioceptive (body position and muscle sense), and interoceptive (internal body states such as hunger, thirst, temperature, or pain). For instance, tactile dysfunction may manifest as hypersensitivity causing tactile defensiveness, where light touch feels painful, prompting avoidance of hugs or handshakes, while hyposensitivity leads to excessive touching of objects or people for stimulation. Auditory challenges include hypersensitivity to background noise interfering with focus, or hyposensitivity resulting in unresponsiveness to verbal cues like a parent's call. Visual sensitivities might involve distress from fluorescent lights or crowded visual fields, whereas vestibular issues could show as fear of swings due to hypersensitivity or constant spinning for hyposensitivity. Olfactory and gustatory problems often contribute to picky eating, with hypersensitivity causing gagging at mild odors or food textures, and hyposensitivity driving cravings for spicy or strong flavors. Proprioceptive dysfunction appears as clumsy movements from poor body awareness in hypersensitivity, or rough, aggressive play in hyposensitivity. Interoceptive challenges may include difficulty recognizing internal signals, such as hunger leading to overeating or irregular meals, or poor awareness of bodily needs contributing to hygiene issues or emotional dysregulation. These challenges impact basic activities, such as eating due to taste aversions, sleeping disrupted by noise or bedding sensations, and social interactions hindered by overload in group settings.^[11]^[12]^[13]

Patterns in daily functioning

Individuals with sensory processing disorder (SPD) often exhibit behavioral indicators that disrupt engagement with their environment, such as withdrawal from sensory-rich settings like crowded rooms or noisy playgrounds due to overwhelming tactile or auditory input.^[1] Poor attention and distractibility arise from hypersensitivity to background stimuli, while motor clumsiness stems from proprioceptive or vestibular processing difficulties, leading to frequent bumping into objects or challenges with balance during activities.^[14] These patterns manifest as avoidance behaviors in approximately 21% of children in the general population showing elevated sensory responses, resulting in reduced participation in play and social interactions.^[14] In infants, patterns include excessive crying or irritability in response to routine stimuli like clothing textures or bright lights, which can interfere with feeding and sleep routines.^[1] School-aged children commonly avoid playgrounds or group activities due to fear of unpredictable sensory experiences, such as the feel of sand or sudden movements, contributing to isolation during recess.^[14] Among adults, anxiety in crowded spaces or public transportation emerges from auditory or olfactory overload, prompting avoidance of social outings and heightened stress levels.^[15] Sensory seeking behaviors, observed in about 3% of children, may lead to excessive touching or movement, contrasting with avoidance but still disrupting focused tasks.^[14] These patterns significantly impact self-care, with resistance to grooming activities like hair brushing or toothbrushing due to tactile sensitivities, often resulting in inconsistent hygiene routines.^[16] In learning environments, difficulty focusing in noisy classrooms exacerbates academic challenges, as sensory distractions hinder information processing and sustained attention.^[1] Social skills suffer from misinterpreting cues, such as overlooking nonverbal signals amid auditory processing issues, leading to misunderstandings in conversations.^[16] Real-world examples include a child refusing textured foods like fruits with skins, limiting nutritional intake, or an adult experiencing discomfort from fluorescent lighting in offices, prompting frequent breaks and reduced productivity.^[14] Over time, these disruptions foster secondary issues like low self-esteem from repeated failures in daily tasks and increased anxiety from social withdrawal.^[16] SPD patterns can overlap with those in autism spectrum disorder, where sensory sensitivities similarly affect daily routines, though SPD may occur independently.^[17]

Classification

Sensory modulation disorder

Sensory modulation disorder (SMD) is a primary subtype of sensory processing disorder (SPD), characterized by challenges in the brain's ability to regulate the intensity and nature of responses to sensory stimuli from the environment.^[10] Individuals with SMD struggle to achieve an appropriate level of arousal or behavioral response, often resulting in reactions that are either exaggerated, diminished, or excessively sought after relative to the sensory input received.^[2] This dysregulation affects multiple sensory systems, including tactile, auditory, vestibular, and proprioceptive, leading to difficulties in everyday interactions.^[18] The core characteristics of SMD manifest in three main patterns: over-responsivity, under-responsivity, and sensory seeking. Over-responsivity involves heightened sensitivity to sensory input, where individuals exhibit intense emotional or behavioral reactions to stimuli that others might find tolerable, such as an exaggerated startle response to everyday sounds or discomfort from light touch.^[10] Under-responsivity, in contrast, features muted or delayed responses, exemplified by a lack of reaction to painful stimuli, extreme temperatures, or loud noises, which can make individuals appear oblivious or lethargic.^[10] Sensory seeking entails an active pursuit of intense sensory experiences to increase arousal levels, such as through constant fidgeting, crashing into objects, or seeking out strong smells and tastes, often to compensate for a perceived lack of input.^[10] Within SMD, these patterns are further classified into specific subtypes: Type I (sensory over-responsivity), Type II (sensory under-responsivity), and Type III (sensory seeking or craving).^[18] Type I predominates in clinical presentations, where low neurological thresholds lead to avoidance behaviors and overwhelm from accumulated sensory input. Type II arises from high neurological thresholds, resulting in passive disengagement and a need for more intense stimulation to elicit responses. Type III involves high thresholds combined with active behavioral strategies to obtain sensory input, potentially leading to disruptive or risky actions.^[19] Failures in sensory modulation frequently contribute to emotional dysregulation, as unregulated sensory input can overwhelm the nervous system and trigger heightened anxiety, irritability, or meltdowns. For instance, prolonged exposure to subtle environmental noises in over-responsive individuals may build up to intense anxiety due to unfiltered sensory accumulation, impairing emotional regulation and social participation.^[20] Sensory modulation issues are the most prevalent subtype of SPD.

Sensory discrimination disorder

Sensory discrimination disorder is a subtype of sensory processing disorder defined by difficulties in accurately detecting, interpreting, and differentiating subtle qualities of sensory stimuli across various sensory systems.^[21] This involves challenges in discerning nuances such as the intensity, duration, location, or specific attributes of sensations, leading to imprecise sensory perception without the over- or under-responsivity seen in modulation issues.^[22] Unlike sensory modulation disorder, which centers on regulating arousal levels to sensory input, discrimination disorder emphasizes deficits in perceptual precision and can co-occur with modulation problems but is distinct in its focus on detail interpretation.^[18] The disorder affects multiple sensory domains, with common manifestations including auditory discrimination challenges, such as difficulty localizing the source of sounds or distinguishing phonemes that sound alike (e.g., confusing "cat" and "hat").^[23] In the visual domain, individuals may exhibit poor depth perception or trouble differentiating similar shapes and letters, resulting in frequent reversals like mistaking "b" for "d."^[22] Tactile discrimination issues often involve an inability to identify objects solely by touch (stereognosis) or detect subtle texture differences, such as distinguishing between smooth and rough surfaces without visual cues.^[18] Proprioceptive discrimination deficits manifest as imprecise awareness of body position or force application, leading to challenges in grading movements appropriately.^[23] These perceptual inaccuracies contribute to significant functional consequences, particularly in academic settings where visual and auditory discrimination problems can cause struggles with reading, writing, and spelling due to letter or word confusions.^[22] For instance, children may reverse letters in writing or mishear instructions, impacting learning efficiency.^[18] Coordination difficulties also arise from poor proprioceptive feedback, such as applying excessive force when handling objects, which can affect fine motor tasks like buttoning clothes or using utensils.^[23] Overall, these issues lead to lower adaptive behavior scores, with affected individuals scoring approximately 1 standard deviation below norms on daily functioning measures.^[22] Diagnosis of sensory discrimination disorder relies on unique indicators, such as performance deficits on targeted discrimination tasks that assess the ability to differentiate sensory stimuli.^[21] Common assessments include auditory localization tests, where individuals fail to pinpoint sound origins accurately; visual figure-ground tasks revealing poor shape discrimination; tactile identification exercises like graphesthesia (recognizing drawn shapes on the skin); and proprioceptive tests evaluating force grading or joint position sense.^[18] Standardized tools, such as the Sensory Processing Measure's discrimination subscale, show low scores in these areas, with internal consistency reliabilities ranging from 0.80 to 0.92, helping to isolate this subtype from others.^[22]

Sensory-based motor disorder

Sensory-based motor disorder (SBMD) is a subtype of sensory processing disorder (SPD) in which individuals experience challenges in utilizing sensory information, particularly from the vestibular and proprioceptive systems, to support effective motor planning, execution, and coordination. This poor integration of sensory inputs leads to dyspraxia-like symptoms, including difficulties with ideation (conceiving motor actions), postural instability, and overall motor disorganization, despite normal muscle strength and joint function. According to the classification proposed by Miller et al., SBMD reflects disruptions in how the brain translates sensory cues into adaptive motor responses, often resulting in apparent clumsiness or delayed motor milestones.^[1]^[24] SBMD encompasses two primary types: postural disorder and dyspraxia. Postural disorder involves impaired ability to stabilize the body against gravity or during movement, manifesting as poor balance, slouching, frequent leaning on objects for support, or an exaggerated fear of movement that limits exploration and physical activity. Dyspraxia, on the other hand, pertains to deficits in motor planning and sequencing, where individuals struggle to organize and execute non-habitual or complex actions, such as tying shoelaces, using utensils, or navigating obstacles in novel environments. These types often overlap, stemming from inadequate sensory feedback that hinders the development of coordinated movements.^[18]^[25] The impacts of SBMD extend to both gross and fine motor skills, contributing to everyday challenges like frequent falls, avoidance of sports or playground activities, and delays in self-care tasks. Children with this subtype may exhibit reduced participation in physical play, leading to secondary effects on social engagement and self-esteem, while adults might face ongoing coordination issues in professional or recreational settings. In a study of young children diagnosed with idiopathic SPD, SBMD was identified in 40% of cases, highlighting its prominence among motor-related sensory challenges, though broader prevalence estimates for SPD subtypes vary. This disorder manifests in daily functioning through patterns of clumsiness and motor avoidance.^[18]^[24]

Causes and mechanisms

Etiological factors

Sensory processing disorder (SPD) exhibits significant genetic influences, with twin studies estimating heritability between 38% and 76% for sensory defensiveness traits such as tactile and auditory sensitivities in young children.^[26] These genetic factors often involve variations in genes related to neural connectivity.^[27] Prenatal and perinatal risks contribute to SPD vulnerability, with exposures to toxins such as alcohol or elevated cortisol levels during pregnancy increasing the prevalence of sensory over-responsivity symptoms.^[28] Premature birth and low birth weight further elevate susceptibility, as preterm infants experience interrupted neurosensory development, leading to heightened sensory processing difficulties in early childhood.^[29] Complicated pregnancies involving intrauterine infections or maternal stress also serve as key risk variables, necessitating targeted developmental monitoring for affected children.^[30] Postnatal environmental factors play a role in exacerbating or shaping SPD manifestations, including chronic stress from adverse caregiving environments and limited exposure to sensory-rich experiences in early childhood, as well as indoor chemical exposures.^[31] SPD arises from a multifactorial model involving interactions between genetic predispositions and environmental influences, where gene-environment interplay heightens vulnerability to sensory processing deficits without a single dominant cause; however, due to SPD's lack of recognition as an independent disorder, the precise etiological factors remain under investigation.^[32]^[33] These etiological factors can disrupt neurodevelopment, as detailed in subsequent discussions of underlying mechanisms.^[33]

Neurobiological processes

Sensory processing disorder (SPD) involves disruptions in the brain's sensory integration network, which is responsible for filtering, organizing, and modulating multisensory inputs to produce adaptive responses. This network primarily encompasses the thalamus, which acts as a relay station for sensory signals from the periphery to the cortex; the parietal lobe, crucial for spatial awareness and multisensory integration; and the cerebellum, which coordinates sensory information with motor output to refine perception and action. In individuals with SPD, these structures exhibit inefficient connectivity, leading to difficulties in prioritizing relevant stimuli and suppressing irrelevant ones, as evidenced by diffusion tensor imaging (DTI) studies showing reduced white matter integrity in thalamocortical and cerebello-thalamic pathways.^[34]^[35] Atypical neural responses in SPD are characterized by hyper- or hypo-reactivity in sensory cortices, often demonstrated through functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) research. fMRI investigations reveal prolonged activation and reduced habituation in primary sensory areas, such as the auditory and somatosensory cortices, when exposed to repeated stimuli, indicating a failure to dampen responses over time.^[36] EEG studies further support this by showing heightened event-related potentials (ERPs) and diminished sensory gating in response to multisensory inputs, particularly in children with sensory over-responsivity, where neural oscillations fail to adapt efficiently.^[37] These findings suggest inefficient thalamocortical filtering, contributing to sensory overload or under-registration.^[35] Imbalances in excitatory and inhibitory neurotransmission underlie many of these atypical responses in SPD, with dysregulation of glutamate (excitatory) and GABA (inhibitory) systems playing a central role. Research indicates elevated glutamate levels and reduced GABAergic inhibition in sensory processing regions, leading to over-responsivity where sensory inputs are amplified without adequate modulation.^[38] This excitatory-inhibitory (E/I) disequilibrium disrupts the balance necessary for precise sensory discrimination, as observed in neuroimaging correlates of sensory modulation challenges.^[39] The developmental trajectory of SPD involves immature neural pruning and myelination in early childhood, exacerbating processing delays in the sensory integration network. Longitudinal studies highlight delayed refinement of synaptic connections in thalamic and parietal regions during critical periods (ages 2-7 years), resulting in persistent inefficiencies in multisensory organization.^[1] These maturational lags, potentially influenced by genetic factors that alter pathway development, contribute to the chronic nature of sensory challenges if not addressed early.^[35]

Diagnosis and assessment

Clinical evaluation methods

The clinical evaluation of sensory processing disorder (SPD) employs a multidisciplinary approach, involving occupational therapists, psychologists, pediatricians, and sometimes speech-language pathologists or other specialists, to conduct initial screening and ensure a holistic assessment of the child's sensory experiences. This collaboration allows for the integration of insights from various domains, such as developmental, behavioral, and physical health, to identify how sensory processing difficulties manifest across home, school, and clinical settings. Occupational therapists typically lead the process, coordinating with team members to evaluate the child's overall functioning and rule out confounding factors early in the diagnostic journey.^[40] A foundational element of the evaluation is the collection of a comprehensive developmental history through structured interviews and reports from parents, caregivers, and teachers, emphasizing sensory-related behaviors observed from infancy onward. These accounts utilize timelines to map the emergence and progression of sensory sensitivities or seeking behaviors, such as aversions to loud noises or excessive movement preferences, and their impact on daily routines like eating, sleeping, or social interactions. This history-taking helps clinicians contextualize current symptoms within the child's developmental trajectory, highlighting patterns that may indicate SPD rather than transient developmental phases.^[40] Observational assessments form a core component, involving structured play sessions in clinical or naturalistic environments to provoke and observe sensory responses, including reactions to novel textures, sounds, proprioceptive inputs, or balance demands. During these sessions, clinicians note the child's adaptive strategies, emotional responses, and motor coordination in real-time, providing direct evidence of sensory integration challenges without relying solely on verbal reports. Such observations are particularly valuable for young or non-verbal children, revealing subtleties in sensory modulation that inform the evaluation's direction.^[40] Differential diagnosis is an essential step, requiring the systematic exclusion of medical or neurological conditions that could mimic SPD symptoms, such as hearing loss, visual impairments, or neurological disorders, through targeted referrals to audiologists, ophthalmologists, or physicians for further testing. This process ensures that sensory difficulties are not misattributed to SPD when they stem from treatable physiological issues, acknowledging the condition's lack of recognition as a distinct diagnosis in systems like the DSM-5. These clinical methods are often supplemented by standardized tools to enhance objectivity, as detailed in subsequent assessments.^[40]^[41]

Standardized tools

The Sensory Profile (SP) is a standardized caregiver questionnaire designed to evaluate sensory processing patterns in children aged 3 to 10 years, focusing on how children respond to sensory stimuli across four quadrants: low registration, sensation seeking, sensory sensitivity, and sensation avoiding.^[1] Developed by Winnie Dunn, it consists of 125 items rated on a 5-point Likert scale, providing a profile of sensory responsiveness that helps identify potential sensory processing challenges.^[42] The tool demonstrates strong psychometric properties, with internal consistency coefficients exceeding 0.80 and test-retest reliability ranging from 0.80 to 0.90 across quadrants, supporting its use in clinical settings for children with suspected sensory processing disorder (SPD).^[42] The Sensory Processing Measure (SPM) is a norm-referenced set of rating scales for children aged 5 to 12 years, assessing sensory processing, planning and ideation (praxis), and social participation through home, school, and main classroom forms completed by parents, teachers, or aides.^[43] It evaluates impacts on daily functioning across eight sensory scales (e.g., visual, tactile, auditory processing) and generates an Environment Interaction Sensorimotor Profile to highlight how sensory issues affect participation.^[44] Normed on a diverse U.S. sample of over 1,000 typically developing children, the SPM shows high reliability, with internal consistency alphas of 0.71 to 0.94 and test-retest coefficients of 0.69 to 0.96, making it a reliable indicator of SPD-related difficulties in school-age children.^[45] The Sensory Integration and Praxis Tests (SIPT) is a performance-based assessment for children aged 4 to 8 years and 11 months, comprising 17 subtests that measure sensory perception (e.g., tactile, vestibular, proprioceptive), discrimination, and praxis abilities underlying learning and behavior.^[46] Administered individually by trained professionals over approximately 2 hours, it includes tasks like space visualization, figure-ground perception, and standing/walking balance, with scores compared to norms from a national sample of over 2,000 children to identify sensory integration deficits associated with SPD.^[46] The SIPT provides detailed profiles of sensory-motor functioning but requires specialized training for administration and interpretation.^[47] These standardized tools are not intended for standalone diagnosis of SPD but serve as supportive measures in comprehensive clinical evaluations, often integrated with behavioral observations to inform intervention planning.^[40] A key limitation is the absence of a single gold-standard instrument, as current tools like the SP, SPM, and SIPT were primarily normed on U.S. populations, necessitating cultural adaptations to ensure validity and reduce bias in diverse groups.^[44]

Associations with neurodevelopmental disorders

Sensory processing disorder (SPD) exhibits high rates of comorbidity with neurodevelopmental disorders, particularly autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Studies indicate that up to 90% of individuals with ASD display atypical sensory processing, including hyper- and hypo-reactivity to stimuli, which aligns closely with SPD characteristics such as sensory over-responsivity and under-responsivity.^[48] In ADHD populations, prevalence estimates range from 50% to 80% for atypical sensory processing patterns, with nearly half of affected children showing significant sensory modulation and discrimination deficits that contribute to inattention and hyperactivity.^[49]^[50] Shared symptoms between SPD and these disorders underscore their overlap. In ASD, sensory over-responsivity often manifests as heightened aversion to tactile or auditory inputs, mirroring SPD's modulation issues and potentially intensifying social withdrawal by making interpersonal interactions overwhelming.^[51] Similarly, in ADHD, sensory discrimination challenges, such as difficulty filtering irrelevant stimuli, parallel inattention symptoms, where low registration of sensory cues exacerbates executive function impairments like working memory deficits.^[52] These commonalities suggest that sensory atypicalities may serve as a bridging mechanism, with neural correlates indicating shared disruptions in sensory integration pathways across ASD and ADHD.^[53] Recent research from 2023 to 2025 positions SPD as a transdiagnostic factor spanning ASD, ADHD, and even anxiety disorders. For instance, studies highlight sensory processing subtypes that predict emotional dysregulation across neurodevelopmental conditions, emphasizing SPD's role in unifying diverse symptom profiles.^[54] A 2025 analysis further describes atypical sensory processing as a core transdiagnostic dimension, influencing self-regulation and stress responses in comorbid cases.^[55] These findings advocate for integrated assessments that address sensory elements to mitigate broader neurodevelopmental challenges. Bidirectional influences amplify the impact of these associations, where SPD traits can exacerbate core symptoms of comorbid disorders. In ASD, unresolved sensory sensitivities heighten anxiety and behavioral rigidity, perpetuating social impairments through avoidance of stimulating environments.^[51] In ADHD, sensory overload intensifies inattention and impulsivity, creating a feedback loop that worsens daily functioning and emotional regulation.^[52] This interplay underscores the need for targeted interventions that disentangle sensory contributions from primary disorder symptoms.

Distinctions from similar syndromes

Sensory processing disorder (SPD) is not recognized as a standalone diagnosis in the DSM-5 or ICD-11, with sensory sensitivities incorporated into the diagnostic criteria for autism spectrum disorder (ASD) rather than as an independent condition. In clinical practice, SPD symptoms are frequently coded using the ICD-10 category F88, which encompasses other disorders of psychological development, including sensory integration issues.^[56]^[57] A key distinction exists between SPD and sensory processing sensitivity (SPS), where SPS represents a normal temperamental trait involving heightened perceptual awareness and deeper emotional processing of sensory stimuli without causing functional impairment. In contrast, SPD entails atypical neural organization of sensory input that disrupts modulation, integration, and behavioral responses, leading to significant challenges in everyday activities.^[58]^[1] SPD differs from the sensory features observed in ASD, as the latter are embedded within DSM-5 criteria for restricted and repetitive behaviors in autism, often co-occurring with core social communication deficits. However, SPD can manifest independently of ASD, affecting individuals without pervasive developmental impairments and focusing primarily on sensory dysregulation rather than broader neurodevelopmental traits.^[59]^[60] Unlike typical sensory development, where individuals demonstrate adaptive detection, modulation, and integration of sensory information to support learning and interaction, SPD involves persistent, impairing atypicalities in these processes that hinder participation in routine tasks. Normal sensory preferences, such as disliking certain textures or sounds, occur on a continuum without compromising overall function, whereas SPD responses are maladaptive and require intervention.^[10]^[1]

Treatment

Sensory integration therapy

Sensory integration therapy, also known as Ayres Sensory Integration (ASI), is a primary intervention for sensory processing disorder developed by occupational therapist and educational psychologist A. Jean Ayres in the 1970s. It operates on the foundational principle that the brain can be retrained through controlled, playful exposure to sensory stimuli to better organize and integrate sensory information from the body and environment, thereby facilitating more effective adaptive behaviors.^[61] This approach posits that sensory processing difficulties arise from inefficient neural organization, and targeted therapy can enhance the central nervous system's ability to process inputs from tactile, vestibular, proprioceptive, and other sensory systems.^[62] Implementation typically involves individualized sessions in a specialized therapy room equipped with sensory tools, such as swings, balls, and textured materials, where activities are child-led and play-based to promote engagement. Sessions generally last 30 to 60 minutes and are conducted 2 to 5 times per week, with the frequency and duration adjusted based on the client's age, sensory profile, and therapeutic goals.^[63] Key techniques focus on providing specific sensory inputs to address processing challenges. For vestibular stimulation, therapists may use swinging or spinning on platforms to help with balance and spatial awareness. Tactile modulation often involves deep pressure techniques, such as hugging weighted vests or using therapeutic brushes, to reduce hypersensitivity to touch. Praxis development incorporates obstacle courses or sequencing tasks that require motor planning, such as navigating tunnels or assembling puzzles while incorporating sensory elements.^[62] The therapy aims to foster adaptive responses by gradually exposing individuals to sensory challenges in a supportive context, thereby improving self-regulation, motor skills, and overall participation in daily activities—for instance, decreasing defensiveness to noise or textures through progressive desensitization. Interventions are customized to the subtype of sensory processing disorder, ensuring that activities align with whether the primary issue involves modulation, discrimination, or seeking behaviors.^[62] Delivery of sensory integration therapy requires occupational therapists with specialized certification, such as the Certificate in Ayres Sensory Integration (CASI) from the Center for the Study of Ayres Sensory Integration, who undergo rigorous training in theory, assessment, and intervention fidelity. Plans are developed collaboratively with families and regularly reassessed to maintain individualization and effectiveness.^[64]

Alternative interventions and adaptations

Occupational therapists often recommend adaptations such as weighted vests to provide deep pressure and proprioceptive input, which can help individuals with sensory processing disorder (SPD) achieve a sense of calm and improved focus during daily activities.^[65] These vests apply gentle, distributed pressure to the torso, mimicking the calming effects of being hugged, and are typically customized to weigh about 5-10% of the user's body weight for safety and efficacy.^[66] Similarly, noise-canceling headphones serve as an auditory modulation tool by reducing environmental sounds, thereby minimizing sensory overload for those hypersensitive to noise in SPD.^[67] These headphones block out up to 30-40 decibels of ambient noise through active cancellation technology, allowing users to maintain participation in social or work settings without distress.^[68] Behavioral interventions, such as parent training programs based on the Developmental, Individual-Difference, Relationship-Based (DIR/Floortime) model, enable caregivers to integrate sensory needs into interactive play sessions.^[69] In DIR/Floortime, parents learn to follow the child's lead in play while incorporating sensory-modulating elements, like textured toys or movement-based activities, to foster emotional regulation and sensory processing skills over 20-30 minute daily sessions.^[70] This approach emphasizes building affective relationships and addressing individual sensory profiles, helping families create responsive environments that support the child's developmental progress.^[71] Educational accommodations outlined in Individualized Education Programs (IEPs) for students with SPD commonly include scheduled sensory breaks and access to fidget tools to promote self-regulation in school settings.^[72] Sensory breaks, lasting 5-10 minutes, might involve quiet zones or movement opportunities to reset overstimulation, while fidget tools like stress balls or chewable necklaces provide tactile input to enhance attention without disrupting class.^[73] These adaptations are tailored via occupational therapy input in the IEP process, ensuring they align with the student's specific sensory challenges to improve academic engagement and reduce behavioral outbursts.^[74] Emerging approaches for adults with SPD include mindfulness-based sensory regulation techniques, such as guided body scans or mindful breathing paired with sensory grounding exercises. A 2024 systematic review linked sensory processing differences to stress in adults, highlighting the relevance of such strategies for management.^[58]^[75] These interventions involve guided practices over 8-week programs to enhance awareness and modulation of sensory inputs. Additionally, animal-assisted therapy provides calming multisensory input through interactions with trained animals, like petting a dog to deliver rhythmic tactile and proprioceptive feedback that reduces anxiety.^[76]^[77] Such sessions, often 30-45 minutes weekly, leverage the oxytocin release from animal contact to support emotional stability in individuals with SPD. As of 2025, neuroplasticity-based approaches, including neurofeedback and transcranial direct current stimulation (tDCS), are being explored to improve sensory processing by targeting brain plasticity.^[78] These methods can complement core occupational therapy by addressing sensory needs in relational or self-directed contexts.

Evidence and outcomes

Research on treatment efficacy

A 2024 systematic review and meta-analysis of 24 randomized controlled trials and quasi-experimental studies conducted primarily in Korea demonstrated the effectiveness of sensory integration therapy in enhancing social skills, adaptive behavior, sensory processing, and gross and fine motor skills among children with cerebral palsy, autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), developmental disorders, and intellectual disabilities.^[79] The analysis indicated moderate positive effects across these domains, with standardized mean differences suggesting clinically meaningful improvements, particularly in motor outcomes for children with cerebral palsy and ASD (approximating Cohen's d values of 0.5–0.7 in subgroup analyses for motor function).^[79] Interventions typically involved 20–40 sessions of 30–45 minutes each, delivered in one-on-one settings by occupational therapists.^[79] Recent randomized controlled trials from 2023 to 2025 have reported positive outcomes for sensory integration interventions in sensory processing disorder (SPD). For instance, a 2025 trial involving children with developmental coordination disorder found significant gains in motor coordination and daily activity participation after an intensive Ayres Sensory Integration program, with standardized scores improving by approximately 15–20 percentile points on motor proficiency measures.^[80] Similarly, a 2025 study on sensory integration-based sports training in children with motor challenges showed an average 17.2-point increase in Bruininks-Oseretsky Test of Motor Proficiency composite scores following 30 sessions, equivalent to gains of 10–15 percentiles in sensory-motor function.^[81] In cases comorbid with ADHD, a 2025 randomized trial combining sensory integration and treadmill therapy reported notable enhancements in attention and sensory modulation, with pre- to post-intervention shifts in sensory profile scores indicating improved focus and reduced hyperactivity.^[82] Despite these findings, research on SPD treatment efficacy reveals mixed results from randomized controlled trials, with several studies yielding null outcomes attributed to small sample sizes (often n < 30) and heterogeneous participant characteristics.^[83] For example, a 2024 analysis of interventions for SPD in ASD highlighted inconsistencies, where some trials showed no significant differences between sensory integration therapy and control groups due to limited statistical power.^[84] Evidence is generally stronger and more consistent for pediatric populations than for adults, where studies remain sparse and primarily exploratory, focusing on associations between sensory processing and stress without robust intervention data.^[58] Key gaps in the literature include the scarcity of longitudinal studies tracking sustained benefits beyond 6–12 months post-intervention.^[85] A 2024 medRxiv preprint addressed some conflicts in prior results through subgroup analyses, revealing that effects were more pronounced in younger children (ages 4–8) with specific sensory subtypes, such as tactile defensiveness, thereby clarifying methodological limitations in earlier mixed findings.^[84] Overall, while short-term efficacy is supported, larger-scale, long-term trials are needed to establish durability and generalizability across diverse SPD presentations.^[86]

Long-term prognosis

Sensory processing disorder (SPD) traits demonstrate considerable stability in early childhood when left untreated, with studies indicating moderate to high persistence of symptoms from ages 1 to 8 years in affected children.^[87]^[88] This persistence underscores the chronic nature of SPD without intervention, potentially leading to ongoing challenges in daily functioning and social interactions. Longitudinal research highlights that early identification and therapeutic engagement can alter this trajectory, significantly reducing symptom severity over time.^[89] Longitudinal research shows a significant decrease in the severity of sensory processing challenges from childhood to adulthood (effect size d = 0.74), supporting the potential for improvement over time with or without intervention.^[89] Positive prognostic factors include the initiation of intensive sensory integration therapy early in childhood, which has been associated with decreased severity and normalization of sensory processing in approximately 50% of cases by adulthood.^[89] In contrast, the presence of comorbidities, such as autism spectrum disorder or attention-deficit/hyperactivity disorder, tends to exacerbate outcomes, correlating with greater retention of sensory difficulties and poorer overall adaptation. Neuroplasticity supports continued improvements into adulthood, allowing for gains through targeted interventions even after early childhood.^[20] In adulthood, longitudinal studies indicate that approximately 20% of individuals diagnosed with SPD in childhood continue to experience definite sensory processing difficulties, with 30% showing mild issues; these are often associated with higher rates of anxiety and comorbid mental health conditions such as depression.^[89]^[90] These outcomes emphasize the importance of sustained support, as about half of affected adults achieve typical sensory functioning, frequently following early therapeutic exposure. Family support and environmental modifications, such as sensory-friendly adaptations in living and work spaces, further enhance long-term adaptation by promoting coping strategies and reducing symptom interference, even in cases without complete remission.^[10]

Epidemiology

Prevalence estimates

Estimates of sensory processing disorder (SPD) prevalence in the general population vary due to differences in diagnostic criteria and assessment methods, but studies consistently indicate that 5-16% of children exhibit clinically significant SPD traits.^[91] A 2023 study from the University of Southern California found that 3% of children display elevated sensory issues that worsen from infancy through early childhood.^[92] These rates are higher in specific subgroups, such as those with neurodevelopmental disorders, though standalone SPD prevalence remains the focus here. Prevalence appears to vary by age, with higher rates observed in early childhood.^[25] In adults, SPD is understudied.^[10] Globally, prevalence estimates are similar across Western populations, around 5-16%. A 2025 study estimated severe SPD prevalence at 5% in the U.S. and 15.9% in Europe.^[12] Challenges in measurement contribute to these variations; for instance, parent-report surveys, such as the 2004 American Occupational Therapy Association study, identified 13.7% of kindergarten children with SPD traits.^[93]

Demographic patterns

Sensory processing disorder (SPD) exhibits distinct demographic patterns, with diagnosis rates varying significantly by gender, age, ethnicity, and socioeconomic status. Overall prevalence estimates for SPD in children range from 5% to 16%, but subgroup analyses reveal disparities in identification and reporting.^[94] Gender differences in SPD diagnosis may follow patterns similar to those in broader neurodevelopmental conditions, with potential underreporting in females due to subtler symptoms such as anxiety or withdrawal.^[95]^[96] Age trends indicate that SPD symptoms are most prominently identified during early childhood, when sensory sensitivities most prominently affect daily functioning and development. Symptoms tend to stabilize or diminish in intensity by school age for some individuals, though persistent challenges can extend into adolescence. According to 2023 Centers for Disease Control and Prevention (CDC) data on sensory features—closely related to SPD—these issues are less frequently reported in older children overall.^[87]^[97] Socioeconomic factors influence SPD recognition, with higher identification rates in families of higher socioeconomic status (SES) owing to greater access to specialized evaluations and therapies. In contrast, children from lower-SES backgrounds, particularly those in poverty, face barriers such as limited healthcare resources, resulting in higher rates of undiagnosed cases. These access disparities exacerbate unmet needs in vulnerable populations. Ethnic disparities further compound underrecognition of SPD, with lower diagnosis rates among non-White populations compared to White children. For instance, 2023 CDC findings on sensory features show significantly lower reporting among Black and Hispanic children, attributed to systemic biases in screening, cultural differences in symptom expression, and inequities in early intervention services. These patterns suggest that true prevalence may be underestimated in ethnic minority groups, perpetuating gaps in support.^[98]^[99]

Society and culture

Recognition and controversy

Sensory processing disorder (SPD) has faced significant historical skepticism within the medical and psychological communities, often dismissed as a secondary symptom of other conditions such as autism spectrum disorder or attention-deficit/hyperactivity disorder rather than a standalone diagnosis.^[100] For instance, the American Academy of Pediatrics issued a 2012 policy statement cautioning against the use of sensory integration therapies as a primary intervention, citing insufficient evidence for their efficacy outside of established disorders.^[41] This perspective reflected broader doubts about SPD's distinct validity, with early critiques emphasizing overlapping symptoms and the absence of standardized diagnostic tools.^[101] As of 2025, SPD remains excluded from major diagnostic manuals, including the DSM-5 and ICD-11, where sensory sensitivities are primarily framed as features of neurodevelopmental conditions like autism rather than an independent disorder.^[56] However, it is acknowledged in occupational therapy frameworks, with the American Occupational Therapy Association (AOTA) endorsing sensory integration approaches for addressing processing challenges in children and youth to enhance participation in daily activities. The neurodiversity movement has increasingly advocated for SPD's inclusion as a legitimate aspect of human variation, promoting acceptance and support without pathologizing sensory differences.^[102] Criticisms of SPD continue to center on the lack of reliable biomarkers and validated diagnostic measures, which some experts argue could lead to overdiagnosis and unnecessary interventions by conflating normal sensory variations with pathology.^[100] Proponents respond by pointing to neuroimaging evidence, such as a 2013 study identifying abnormal white matter microstructure in children with SPD, distinct from patterns seen in typical development or other disorders, supporting its neurological basis.^[103] Recent shifts indicate growing acceptance, particularly in contexts overlapping with autism, where 2024-2025 research has emphasized the need for targeted interventions to address sensory sensitivities and their impacts on quality of life. For example, a 2025 Frontiers in Psychiatry article calls for prioritized research on sensory processing in autism to inform clinical practice and policy, helping to mitigate ongoing debates by underscoring empirical support for recognition.^[104]

Representation in media and policy

Sensory processing disorder (SPD) has gained visibility in media through educational articles and discussions on neurodiversity, particularly in the 2020s. For instance, the Child Mind Institute published pieces in 2025 explaining sensory processing issues and their impact on children, highlighting atypical reactions to stimuli like noise and textures to raise public awareness.^[11] These portrayals often frame SPD as part of broader neurodivergent experiences, with characters in television shows depicting sensory sensitivities, such as in autism-themed narratives that include traits like aversion to loud environments.^[105] In policy, SPD is addressed through accommodations in educational frameworks, though not always as a standalone category. In the United States, students with SPD can qualify for protections under Section 504 of the Rehabilitation Act or the Individuals with Disabilities Education Act (IDEA) if the condition substantially limits major life activities, enabling individualized education programs (IEPs) with sensory supports like quiet spaces or weighted vests.^[106] Similarly, efforts to create sensory-friendly public environments have emerged in Europe, including the Sensoria Neurodivergent Friendly Festival in Ireland and the Autism Friendly Towns initiative, with guidelines promoting adaptable spaces in schools and community settings to accommodate sensory needs of neurodivergent individuals.^[107]^[108] Advocacy organizations play a central role in elevating SPD's profile. The STAR Institute for Sensory Processing, a leading nonprofit, funds research and collaborates with entities like the National Institutes of Health to advance studies on SPD, while offering scholarships and awareness events to support families and professionals.^[109] In 2025, neurodiversity campaigns, such as Sensory Processing Awareness Month and EmphaSIze events, have positioned SPD as a valid neurological variation, emphasizing inclusion and evidence-based interventions over pathologization.^[110]^[111] Despite these advances, challenges persist in reducing stigma and aligning policy with evidence, particularly in non-Western countries. Cross-cultural studies indicate higher levels of stigma toward neurodevelopmental disorders, such as autism spectrum disorder (ASD) which often involves sensory processing issues, in regions like parts of Asia and the Middle East compared to Western countries, where symptoms may be attributed to behavioral or cultural factors rather than neurological differences, leading to limited policy support and access to accommodations.^[112]^[113]^[114] Efforts to bridge this gap include international awareness initiatives, but policy development lags behind Western models in integrating sensory supports into public health and education systems.^[115]

History

Foundational theories

The foundational theories of sensory processing disorder originated in the 1970s through the pioneering work of occupational therapist A. Jean Ayres, who introduced the concept of sensory integration dysfunction in her 1972 book Sensory Integration and Learning Disorders.^[61] Ayres, drawing from her clinical observations, proposed that sensory integration dysfunction underlies many learning and behavioral challenges in children, marking a shift toward understanding sensory issues as neurological rather than purely behavioral problems.^[116] This theory laid the groundwork for later conceptualizations of the disorder by emphasizing the brain's role in sensory organization.^[117] At its core, Ayres' theory described sensory integration as the neurological process by which the brain organizes sensations from the body and environment to facilitate adaptive responses and interaction with the world.^[61] She posited that dysfunction occurs when the brain inadequately processes or integrates these sensations, leading to difficulties in motor planning, attention, and learning—particularly evident in children with learning disabilities whom she observed in her practice.^[116] For instance, children might exhibit over- or under-responsivity to tactile, vestibular, or proprioceptive inputs, disrupting their ability to use sensory information effectively for daily activities.^[117] Early evidence for Ayres' theory came from data collected in her occupational therapy clinic, where she treated hundreds of children and documented improvements in sensory processing, motor skills, and academic performance following sensory integration interventions.^[118] Ayres developed assessment tools, such as the Southern California Sensory Integration Tests (introduced in 1972 and refined in 1989), to quantify dysfunction patterns and evaluate therapy outcomes, revealing correlations between sensory issues and learning challenges in clinical samples.^[118] These findings supported the efficacy of play-based sensory activities in reorganizing neural pathways, though the terminology evolved in the 2000s, particularly with the introduction of "sensory processing disorder" by Lucy Jane Miller in her 2006 book Sensational Kids, to better reflect the processing focus.^[21]^[119] Ayres' framework was influenced by advancements in neurology, including neurophysiological models of sensory-motor development, and educational theories on child learning, integrating insights from fields like developmental psychology to explain how sensory disorganization impairs adaptive behavior.^[117] This interdisciplinary approach positioned sensory integration as a bridge between brain function and educational outcomes, influencing subsequent models in occupational therapy.^[116]

Evolution of models

The evolution of models for sensory processing disorder (SPD) began with refinements to earlier theoretical foundations, emphasizing individual differences in sensory responses. In 1997, occupational therapist Winnie Dunn proposed the quadrant model, which classifies sensory processing patterns based on two dimensions: neurological threshold (low or high, referring to the amount of sensory input needed to detect stimuli) and self-regulation (active or passive behavioral responses to that input). This results in four quadrants: low registration (high threshold, passive response, characterized by missing sensory cues); sensation seeking (high threshold, active response, involving pursuit of intense input); sensory sensitivity (low threshold, passive response, marked by noticing subtle stimuli without overt action); and sensation avoiding (low threshold, active response, featuring deliberate efforts to control or limit input).^[120]^[121] Dunn's model extended prior ideas by integrating environmental and behavioral factors to explain daily functioning challenges, providing a framework for assessment tools like the Sensory Profile. An updated version, the Sensory Profile-2, was published in 2014, refining quadrant classifications with improved psychometrics and age-specific norms for children aged 3 to 14, while maintaining the core structure to better capture functional impacts across contexts.^[121] Building on this, in 2007, Lucy Jane Miller and colleagues introduced the sensory processing model through a proposed nosology for SPD, identifying three primary patterns derived from clinical research at the Sensory Treatment and Research (STAR) Institute: sensory modulation disorder (difficulties regulating responses to sensory input, with subtypes including over-responsivity, under-responsivity, and seeking/craving); sensory discrimination disorder (challenges distinguishing fine details within sensory modalities, such as tactile or auditory); and sensory-based motor disorder (impaired praxis or postural control linked to sensory processing, with subtypes like dyspraxia and postural disorder). This model shifted focus toward diagnostic specificity, hypothesizing SPD as a distinct neurophysiological condition with six subtypes overall, informed by empirical clustering of symptoms in children.^[122]^[118] In the 2020s, models have integrated elements of Dunn's quadrants and Miller's patterns into hybrid frameworks, incorporating neurodiversity perspectives to emphasize functional outcomes rather than isolated deficits. For instance, a 2024 latent profile analysis of 117 children with neurodevelopmental concerns identified five transdiagnostic SPD clusters—typical, mixed, over-responsive, seeking, and under-responsive—validating subtype distinctions through behavioral associations like heightened anxiety in over-responsivity and ADHD traits in seeking/under-responsivity patterns, supporting broader applicability across conditions.^[123] These developments reflect a move from therapy-centric views to transdiagnostic approaches, with 2024-2025 studies highlighting SPD's role in emotional regulation and psychopathology progression via cluster methods, aligning with Dunn and Miller's constructs while prioritizing neurodiverse lived experiences.^[124]^[123]

References

[1]
Sensory Processing Disorders in Children and Adolescents
Sensory processing disorders (SPDs) can be described as difficulty detecting, modulating, interpreting, and/or responding to sensory experiences.
[2]
Physiological and Behavioral Differences in Sensory Processing - NIH
Sensory processing involves the ability to take in, organize and make sense of different kinds of sensations received by the brain. Rates of sensory processing ...Sensory Processing In... · Sensory Modulation Disorder · Sensory-Related Behaviors
[3]
Sensory Processing Disorder: Symptoms, Causes, Treatment
Sep 20, 2019 · Sensory processing disorder is a neurological condition in children that can affect the way the brain processes information from the senses.
[4]
Archive: Breakthrough Study Reveals Biological Basis for Sensory ...
Jul 9, 2013 · “This is absolutely the first structural imaging comparison of kids with research diagnosed sensory processing disorder and typically developing ...
[5]
Sensory Processing Problems in Children with ADHD, a Systematic ...
Sensory processing disorders are impairments in responding to sensory stimuli such as impairments in detection, modulation, or interpretation of stimuli.Sensory Processing Problems · Tactile Sensory · Visual And Olfactory...<|control11|><|separator|>
[6]
Sensory Features as Diagnostic Criteria for Autism - NIH
Mar 4, 2015 · Although not officially recognized as a diagnosis, the term sensory processing disorder ... DSM-5 definition may be largely overlapping.
[7]
Sensory Processing Disorder in Adults: Symptoms, Treatment, More
Jul 9, 2024 · Sensory processing disorder (SPD) is a neurological disorder in which your brain has trouble receiving and responding to information from your senses.
[8]
Evaluating Sensory Integration/Sensory Processing Treatment
Nov 26, 2020 · For more than 50 years, “Sensory Integration” has been a theoretical framework for diagnosing and treating disabilities in children under ...
[9]
Sensory Processing Disorders are not a Diagnosis - UTMB Health
Dec 6, 2024 · Treatment is usually therapy by an occupational therapist. It has been shown that treatment started early can help.
[10]
Sensory Processing Disorder (SPD): Symptoms & Treatment
Sensory processing disorder (SPD) is a group of conditions that affect how your brain processes sensory information, like sights, sounds, movement and ...
[11]
Sensory Processing Issues Explained - Child Mind Institute
Jun 20, 2025 · Children, teens and adults with sensory challenges experience either over-sensitivity (hypersensitivity) or under-sensitivity (hyposensitivity).
[12]
Sensory Processing Disorder in Children—Description of the ... - NIH
Jun 10, 2025 · Sensory processing disorder (SPD) involves difficulties in receiving and responding to sensory information from the environment.Missing: definition | Show results with:definition
[13]
Prevalence Models to Support Participation: Sensory Patterns as a ...
The purpose of this study was to examine sensory patterns across a national sample of children in the general population and samples of children with ...
[14]
The association between sensory processing and stress in the adult ...
Jun 4, 2024 · The evidence is strong for an association between differences in sensory processing and self-reported stress in adults.
[15]
Relationship between Sensory Processing and Quality of Life
Aug 31, 2021 · Sensory processing has been referred to as the ability to analyze, modulate, and organize sensory incoming information to respond to ...
[16]
[PDF] sensory processing patterns in children and adults on the
The research implies that sensory processing abnormalities are common and continue throughout life for those on the autism spectrum. Crane et al. (2009) ...
[17]
Patterns or Subtypes of Differences in Sensory Integration ...
Sensory Modulation: This pattern involves how individuals respond to sensory input. Some may be overly sensitive to stimuli, leading to feelings of overwhelm, ...
[18]
Phenotypes within sensory modulation dysfunction - PubMed
The first subtype is characterized by sensory seeking/craving, hyperactive, impulsive, externalizing (eg, delinquent, aggressive), unsocial, inadaptive, and ...
[19]
A Path From Childhood Sensory Processing Disorder to Anxiety ...
Jul 8, 2019 · We found that sensory processing impairments in childhood may increase the risk of anxiety disorders through difficulties with emotion ...
[20]
Latest Research Findings | STAR Institute
75% of individuals with SPD-SOR evaluated in CT (Carter et al., 2011) 58% of individuals with SPD-SOR evaluated in WI (Van Hulle et al., 2012)
[21]
Perspectives on Sensory Processing Disorder: A Call for ...
Individuals with the disorder have impaired responses to, processing of, and/or organization of sensory information that effects participation in functional ...
[22]
Identification of Sensory Processing and Integration Symptom Clusters
Sensory processing dysfunction includes a heterogeneous set of symptoms that affects the manner in which individuals use sensory information for emotion ...
[23]
What Is Sensory Processing Disorder? - MyMichigan Health
Sep 1, 2022 · This includes visual, auditory and proprioceptive difficulties - for example, children who have a hard time distinguishing shapes and colors, ...
[24]
Characteristics of Idiopathic Sensory Processing Disorder in Young ...
Apr 27, 2021 · ... most common being the over-responsivity ... subtype despite many children showing all three subtypes of sensory modulation disorder.
[25]
Sensory processing disorder: Key points of a frequent alteration in ...
Summarizing, most SPD prevalence studies show a worrying cipher of 15%, however, SPD remains almost unknown for families, teachers and even health professionals ...
[26]
A Population-Based Twin Study of Parentally Reported Tactile and ...
Using a population-based sample of 1,394 toddler-aged twins, mothers reported on tactile and auditory defensiveness, temperament, and behavior problems. The ...
[27]
Serotonin transporter gene (SLC6A4) variation and sensory ... - NIH
This study examined whether the temperamental trait sensory processing sensitivity (SPS), characterized by increased responsivity to environmental stimuli, is ...
[28]
Sensory Over-Responsivity: Prenatal Risk Factors and ... - NIH
Prenatal exposure to alcohol, stress, or chronically high cortisol has been shown to increase the prevalence of sensory processing symptoms in rhesus monkeys.
[29]
Sensory Processing Disorder in Children Ages Birth–3 Years Born ...
Dec 24, 2014 · Within the 45 studies, 295 findings related to SPD. Of these, 130 (44%) were positive and 165 (56%) were negative. These findings were ...
[30]
[PDF] the-prenatal-and-perinatal-risk-variables-of-the-sensory-processing ...
Feb 23, 2018 · The purpose of this work was to determine the most common and presently occurring prenatal and perinatal problems that may serve as the ...
[31]
The Sensory Processing Dysfunction and Related Postnatal ...
Our results indicate that a social environment of parental guidance and an indoor environment of exposure to chemical are associated with SPD.
[32]
What Causes Sensory Disorders: Unraveling the Root of ... - PT Kids
Dec 19, 2024 · Environmental stresses after birth, such as accidents or trauma, can also affect how children process sensations. This means that what happens ...Missing: postnatal | Show results with:postnatal
[33]
The Occurrence of the Sensory Processing Disorder in Children ...
Jun 4, 2022 · The causes of the Sensory Processing Disorder include genetic factors, prenatal factors, such as medications, stimulants, complicated pregnancy ...<|separator|>
[34]
Gene by Environment Interactions in Sensory Processing Deficits
In this R21 proposal we investigate how gene by environmental interactions (GxE) impact developmental neurotoxicity linked to sensory processing deficits and ...
[35]
Investigating behavioral phenotypes related to autism spectrum ...
In this study, our primary goal was to study sensory processing behaviors in a multifactorial gene-environment interaction rodent model of ASD. The two risk ...
[36]
Abnormal white matter microstructure in children with sensory ...
Sensory processing disorders (SPD) affect 5–16% of children and can cause long-term impairment of intellectual and social development from disrupted processing ...
[37]
Neural Correlates of Sensory Abnormalities Across Developmental ...
Subsequently, the terms sensory processing disorder (SPD) and sensory modulation disorder (SMD) have been used seemingly interchangeably to describe peoples' ...
[38]
Over-Reactive Brain Responses to Sensory Stimuli in Youth With ...
This study demonstrates that youth with ASD show neural hyper-responsivity to sensory stimuli, and that behavioral symptoms of SOR may be related to both ...
[39]
Visual, Auditory, and Cross Modal Sensory Processing in Adults with ...
Apr 18, 2016 · Lower EEG beta power and lower left auditory cortex fMRI activity were seen in ASD compared to NT when they were presented with auditory stimuli ...
[40]
Shared and distinct biological mechanisms for anxiety and sensory ...
Oct 16, 2023 · ... Sensory Processing Disorder have been associated with a greater ... As SOR and anxiety co-occur so frequently and share similar underlying neural ...
[41]
Tackling hypo and hyper sensory processing heterogeneity in autism
Dec 4, 2022 · As an integral part of autism spectrum symptoms, sensory processing issues including both hypo and hyper sensory sensitivities.
[42]
Identifying Sensory Differences | STAR Institute
If a multi-disciplinary team is involved, the evaluative process may also include a general health and physical evaluation, speech/language evaluation, ...
[43]
Sensory Integration Therapies for Children With Developmental and ...
The AAP Policy Statement on Sensory Integration Therapies for Children with Developmental and Behavioral Disorders (Pediatrics 129:1186- 1189;2012) makes ...
[44]
Test–Retest Reliability of the Sensory Profile Caregiver Questionnaire
Jul 1, 2012 · This study suggests the SP has acceptable test–retest reliability and internal consistency and supports the use of quadrant scores over factor and section ...
[45]
(SPM™-2) Sensory Processing Measure, Second Edition and ... - WPS
SPM™-2 Sensory Processing Measure, Second Edition and SPM-2 Quick Tips™ gives a picture of sensory and process difficulties for ages 4 months to 87 years.
[46]
Sensory Processing Measure - Shirley Ryan AbilityLab
Apr 3, 2017 · The SPM examines sensory issues, praxis, and social participation of elementary school children aged 5 through 12.
[47]
Full article: The Sensory Processing Measure – Second Edition
The SPM-2 is considered a psychometrically sound tool that provides a reliable and valid approach to measuring aspects of the sensory processing construct ...
[48]
(SIPT) Sensory Integration and Praxis Tests - WPS
In stockThe SIPT Sensory Integration and Praxis Tests measure the sensory integration processes that underlie learning and behavior. For ages 4 to 8.
[49]
About the Sensory Integration and Praxis Test (SIPT) - ASI Wise
Rating 4.5 (527) Mar 16, 2018 · It is a collection of 17 tests that are designed to test various aspects of sensory perception, discrimination, reactivity and contribution to our praxis.
[50]
Sensory Abnormalities in Autism Spectrum Disorders: A Focus on ...
... sensory processing disorder” as comprising three primary groups (sensory modulation disorder, sensory discrimination disorder and sensory-based motor ...
[51]
Atypical sensory processing in adolescents with Attention Deficit ...
The results suggest that almost 50% of children with ADHD exhibit atypical sensory processing. In the studies conducted by Clince et al. (2016), individuals ...
[52]
Sensory processing patterns among children with autism spectrum ...
Jul 12, 2024 · We have observed sensory processing problems in 42–88% of children diagnosed with autism and approximately 50% of children diagnosed with ADHD.Missing: transdiagnostic | Show results with:transdiagnostic
[53]
The impact of atypical sensory processing on social impairments in ...
There is evidence that sensory dysregulation arises early in the progression of ASD and impacts social functioning.
[54]
Relationships between Sensory Processing and Executive ... - NIH
Jun 2, 2024 · ADHD is the most prevalent comorbidity in ASD, with approximately 40–70% of people with ASD exhibiting comorbid ADHD or significant subthreshold ...
[55]
Neural correlates of shared sensory symptoms in autism and ...
Symptoms of autism spectrum disorder and attention-deficit/hyperactivity disorder often co-occur. Among these, sensory impairment, which is a core diagnostic ...
[56]
Sensory processing subtypes relate to distinct emotional ... - Nature
Nov 26, 2024 · Results showed that 39% of NDC children met clinically concerning thresholds for emotion dysregulation, 19% for anxiety, and 62% for ADHD.
[57]
Feeling the World Differently: Sensory and Emotional Profiles in ...
Jul 21, 2025 · Background/Objectives: Atypical sensory processing is increasingly recognized as a transdiagnostic dimension of neurodevelopmental disorders ( ...
[58]
Sensory Processing Disorder | Psychology Today
Sensory issues are only officially recognized in the DSM-5 as a possible symptom of autism, and many children and adults who have sensory integration challenges ...
[59]
https://www.medicalnewstoday.com/articles/sensory-processing-disorder-vs-autism
[60]
The association between sensory processing and stress in the adult ...
Jun 4, 2024 · The authors concluded that the association between sensory hypersensitivity and attachment anxiety was largely accounted for by stress, ...Missing: transdiagnostic | Show results with:transdiagnostic
[61]
Sensory processing disorder vs. autism: Differences explained
Mar 8, 2024 · Sensory processing disorder (SPD) and autism often occur together. However, they can also occur independently and are separate conditions.
[62]
Sensory Processing Differences in Individuals With Autism Spectrum ...
Oct 31, 2023 · Sensory processing differences (SPDs) are commonly observed in individuals with ASD, leading to atypical responses to sensory stimuli.
[63]
Sensory Integration - StatPearls - NCBI Bookshelf - NIH
Sensory integration (SI) is a framework conceptualized by Dr. A. Jean Ayers, Ph.D. in the 1970s; hence it is currently known as Ayres Sensory Integration (ASI).
[64]
About ASI: Ayres Sensory Integration®
It is designed to improve sensory perceptual abilities, self-regulation, motor skills, and praxis. In doing so, it supports the client's ability to show ...
[65]
A systematic review of ayres sensory integration intervention ... - NIH
Dec 12, 2018 · The intervention frequency varied across studies; Pfeiffer participants received therapy three times per week for 6 weeks, Schaaf study ...
[66]
ASI Certificate
A six module hybrid program which provides the convenience of self-paced, online learning with onsite learning for hands-on concepts.
[67]
Pilot Study of the Effectiveness of Weighted Vests
Nov 1, 2011 · Wearing a weighted vest is believed to increase attention to task by providing needed proprioceptive input to the body and modulating activity ...Missing: adaptations | Show results with:adaptations
[68]
[PDF] USING A WEIGHTED VEST TO INCREASE ATTENTION TO TASK
It is common practice for occupational therapists to use weighted vests and pressure garments during the course of treatment for sensory processing disorders.Missing: adaptations | Show results with:adaptations
[69]
https://www.icdl.com/dir/guidelines-for-a-comprehensive-approach
[70]
Effectiveness of Noise-Attenuating Headphones on Physiological ...
Nov 12, 2019 · The findings of this study suggest that the use of noise attenuating headphones for individuals with ASD and hyperacusis may reduce sympathetic activation.
[71]
Home of DIRFloortime® (Floortime) - DIR Guidelines
Meanwhile parents need to incorporate language, sensory-modulation, sensory-processing, and motor-planning activities into their spontaneous DIRFloortime.
[72]
DIR/Floor Time in Engaging Autism: A Systematic Review - PMC - NIH
DIR model provides the framework for implementing daily floortime sessions, which enhances advanced order thinking, constant problem solving, reality-based ...
[73]
DIR®/Floortime™: A Developmental/Relational Play Therapy ...
Oct 29, 2015 · DIR®/Floor Time™: A developmental/relational approach towards the treatment of autism and sensory processing disorder. Paper presented at ...<|separator|>
[74]
Classroom accommodations for sensory processing challenges
Mar 29, 2024 · Provide a weighted lap pad, weighted vest, compression vest, air-filled seat cushion, or other OT-approved sensory tools. Provide earplugs or ...Building Self-Regulation... · Giving Instructions And... · Introducing ``through My...Missing: proprioceptive | Show results with:proprioceptive
[75]
IEP Preparation Tips For Students with Sensory Processing Disorder
Included in the IEP should be that the child is permitted to bring his own 'fidgets', or calm down tools from home, to use in the classroom as well. Having ...
[76]
Sensory Strategies and Supports for the Classroom - GriffinOT
Sensory items like fidget toys, weighted products and visual timers can be helpful. Each child is an individual so there is no one size fits all strategy. ...Sensory Strategies With Kim... · How To Embed Sensory... · Use Movement As A Sensory...
[77]
Understanding and Managing Sensory Processing Disorder in Adults
Treatment options, such as sensory integration therapy and coping strategies, can help adults with SPD manage their sensory issues effectively.
[78]
An Evaluation of Animal-Assisted Therapy for Autism Spectrum ...
An Evaluation of Animal-Assisted Therapy for Autism Spectrum Disorders ... Sensory stimulation releases oxytocin, which can have a calming effect.Missing: input | Show results with:input
[79]
Animals Help Children Overcome Challenges - Child Mind Institute
Jan 24, 2025 · Animals can really help children who have issues like autism, ADHD, learning disabilities, sensory processing challenges and anxiety.
[80]
Effectiveness of sensory integration therapy in children, focusing on ...
A meta-analysis was conducted on 24 selected studies. Sensory integration therapy has been proven effective in children with cerebral palsy, autism spectrum ...Missing: 2025 | Show results with:2025
[81]
Examining the Effectiveness of Ayres Sensory Integration ...
Jan 8, 2025 · The intervention group received one-to-one (therapist-child) 60-minute ASI therapy sessions twice a week for 10 weeks for a total of 20 ...
[82]
The impact of sensory integration based sports training on motor ...
Jun 6, 2025 · The mean pre-test BOT-2 score was 65.2, while the mean post-test score increased to 82.4, demonstrating an average improvement of 17.2 points.
[83]
The Effect of Sensory Integration and Treadmill Therapy on Sensory ...
Apr 1, 2025 · Results: The results showed a significant improvement in sensory processing, with pre-test sensory scores averaging 97.62 and post-test ...
[84]
Effectiveness of Sensory Integration Interventions in Children With ...
... mixed results. ... These studies focused primarily on using a single-subject design or had very small sample sizes compared with the RCT design used for this ...
[85]
Effectiveness of Therapies Treating Sensory Processing Disorders ...
Sep 18, 2024 · The purpose of this paper is to gather and analyze research regarding therapies for Sensory Processing Disorder in Children with Autism Spectrum Disorder.Missing: meta- 2023 2025
[86]
Longitudinal analysis of sensory responsivity from infancy to school ...
Feb 22, 2024 · Gaps exist in our understanding of effective targets to intervene on early to support children at risk for poor outcomes. Research on early ...
[87]
Ayres Sensory Integration® With Children Ages 0 to 12
Apr 7, 2025 · Sensory integration is the neurological process through which sensory information is organized in the central nervous system (CNS), enabling the ...
[88]
Exploring the Prognosis: A Longitudinal Follow-Up Study of Children ...
Aug 29, 2023 · This study compared performance on sensory processing measures completed as children and as adults for a follow-up group of adults.
[89]
The Debate Over Sensory Processing Disorder - Psychiatry Online
Jun 28, 2022 · Children with difficulty tolerating or processing sensory information may go on to receive a diagnosis of autism spectrum disorder. Jumping to ...<|separator|>
[90]
Study finds 3 percent of children have elevated sensory issues that ...
Dec 29, 2022 · New results from a USC-led study reveal that 3 percent of all children have elevated sensory traits which seemingly worsen as they grow from infants/toddlers ...
[91]
Assessing Awareness, Knowledge, and Attitudes Toward Sensory ...
Aug 20, 2025 · The research addresses a critical gap in understanding how SLPs perceive and manage SPD, given its significant impact on behavior, communication ...
[92]
How Urban Vs. Rural Living Affects The Brain - Lone Star Neurology
Jul 3, 2025 · For example, a study from Public Health Reports in 2021 shows that urban dwellers often experience sensory overload. It leads to cognitive ...
[93]
Prevalence of Parents' Perceptions of Sensory Processing Disorders ...
Of the 703 children represented by the surveys, 96 children (13.7% of 703) met criteria for sensory processing disorders based upon parental ...
[94]
Early Identification of Sensory Processing Difficulties in High-Risk ...
Feb 28, 2019 · Currently, 5%–16.5% of school-age children are estimated to have sensory processing difficulties (SPD), which adversely affect a child's ability ...
[95]
Sex differences in sensory processing in children with autism ...
Jul 20, 2021 · This suggests that girls may show more sensory symptoms than boys with equivalent severity scores. Sensory issues could thus be a determinant ...
[96]
Sex differences in sensory processing in children with autism ...
Jul 20, 2021 · Our results showed that the magnitude of the differences in sensory processing between males and females is larger in ASD children relative to TD children.
[97]
Sensory features in autism: Findings from a large population-based ...
Sensory features were less common among girls, children of color, and children of mothers with fewer years of education, suggesting potential disparities in ...Missing: processing | Show results with:processing
[98]
Association of Socioeconomic Position With Sensory Impairment ...
Demographic factors: age, gender, race/ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, Hispanic, or non-Hispanic other), nativity ...Missing: patterns | Show results with:patterns
[99]
[PDF] Sensory features in autism: Findings from a large population
Apr 1, 2023 · Atypical responses to sensory stimuli, called sensory features, are understood to be highly common in autistic populations (authors' note: while ...
[100]
Prevalence and Characteristics of Autism Spectrum Disorder Among ...
Mar 24, 2023 · CDC presents findings from the Autism and Developmental Disabilities Monitoring Network for children aged 8 years in 2020.
[101]
Is Sensory Processing Disorder for Real? - Scientific American
Sep 1, 2015 · A debate rages over whether doctors should recognize this common childhood condition as a distinct disorder.
[102]
The Controversial Condition of Sensory Processing Disorder
May 25, 2022 · Some estimates suggest as many as 15 percent of the population has a form of SPD. SPD is currently a controversial condition, and the American ...
[103]
What Is Neurodiversity? - Child Mind Institute
Sep 15, 2025 · What are some forms of neurodiversity? Some forms of neurodiversity are ADHD, autism, learning disorders, and sensory processing disorders.
[104]
Abnormal white matter microstructure in children with sensory ...
Jun 23, 2013 · These findings suggest abnormal white matter as a biological basis for SPD and may also distinguish SPD from overlapping clinical conditions ...
[105]
Sensory processing in autism: a call for research and action - Frontiers
Research on treatments for heightened sensory sensitivity should be the top priority. Over sensitivity to stimuli, such as loud noises or scratchy clothes, ...Missing: 2024 | Show results with:2024
[106]
Representation of autism in fictional media: A systematic review of ...
Feb 19, 2023 · Media depictions of autism have the potential to have either positive or detrimental impacts on the lives of autistic people.
[107]
Do students with Sensory Processing Disorders have rights under ...
A sensory processing disorder may qualify for protections under Section 504 as a physical or mental impairment which substantially limits one or more major ...
[108]
Sensory Responsive Environments: A Qualitative Study on ... - MDPI
It is estimated that 15–20% of the global population falls under the umbrella of neurodivergence, with sensory processing sensitivities frequently affecting ...
[109]
SPD Research Collaborators | STAR Institute
This planning retreat brought together twelve researchers funded by National Institutes of Health grants to develop a blueprint for future research into SPD.
[110]
EmphaSIze October 2025: Sensory Awareness
Oct 1, 2025 · This live online event brings together voices from health, education, and social care to explore how sensory informed approaches can be used ...
[111]
Sensory Processing Disorder Awareness Month - Autism Unlimited
Oct 1, 2025 · Sensory Processing Disorder Awareness Month. Publish date: 1 October 2025 ... We have run 4 successful campaigns across 2022-2023, capturing ...<|control11|><|separator|>
[112]
[PDF] Cross-cultural comparison of sensory behaviors in children with ...
Israeli parents reported less unusual sensory responses than US parents. US children with ASD showed greater difficulty in Auditory Filtering and Visual/ ...Missing: bias | Show results with:bias
[113]
[PDF] Disability stigma in developing countries - GOV.UK
May 9, 2018 · People with intellectual disabilities, severe mental health conditions, albinism, and sensory disabilities are often more stigmatised than.
[114]
Sensory processing dysfunction among Saudi children with and ...
Non-Western cultures may offer valuable explanations and treatments for culturally diverse children and families.Missing: stigma policy
[115]
[PDF] Understanding Ayres' Sensory Integration | DigitalCommons@SHU
Sep 30, 2009 · This article articulates the core principles of sensory inte- gration as originally developed by Dr. A. Jean Ayres, explains the rationale for ...
[116]
Neural Foundations of Ayres Sensory Integration® - PMC
Jun 28, 2019 · In this paper we examine core constructs of ASI identified in the seminal work of Dr. Jean Ayres, and present current neuroscience research that ...
[117]
[PDF] Concept Evolution in Sensory Integration: A Proposed Nosology for ...
Ayres's early conceptualizations defined six syndromes of dysfunction (Ayres, 1972a), later refined with data from her new test battery (Ayres,. 1989). Although ...
[118]
W (1997) The impact of sensory processing abilities on the daily live
The article describes a proposed model for considering sensory processing an important factor in young children's performance.
[119]
Dunn's Model of Sensory Processing: An Investigation of the Axes of ...
Feb 7, 2019 · Dunn's Four Quadrant Model of Sensory Processing is based on two constructs: neurological thresholds and behavioral response. The neurological ...Missing: subtypes | Show results with:subtypes
[120]
Concept evolution in sensory integration: a proposed nosology for ...
Concept evolution in sensory integration: a proposed nosology for diagnosis. Am J Occup Ther. 2007 Mar-Apr;61(2):135-40. doi: 10.5014/ajot.61.2.135.Missing: 2006 | Show results with:2006
[121]
Sensory processing subtypes relate to distinct emotional and ... - NIH
Nov 26, 2024 · This study examined the relationship between clusters of sensory processing phenotypes and differential patterns of self-regulation behaviors.Missing: shifts | Show results with:shifts
[122]
The phenomenon of sensory processing: historical overview ...
Jan 14, 2025 · Over the years, based on theoretical considerations, the concepts of sensory processing disorder and sensory processing sensitivity were ...