Sensory Processing Disorder and ADHD in Children: Tips for Parents
Rachel Ann Melegrito Occupational Therapist
July 19, 2024
When you tell people you have a child with ADHD, they often picture a restless, energetic kid who has trouble focusing or controlling impulses. However, children with ADHD might also show unusual behaviors that don’t fit this stereotype, such as avoiding new food textures and displaying extreme sensitivity towards particular sounds or inappropriately touching and hugging others.
This confusion might come from the possibility that the child has both sensory processing disorder and ADHD.
Sensory processing disorder and ADHD are two separate conditions, but they can co-occur or be confused with each other. This article aims to help you understand the two conditions better and see their unique differences, where they overlap, and how they affect each other.
| What are Key Differences Between SPD and ADHD in Children? |
| The key difference between SPD and ADHD is their preferences and responses towards sensory input: Children with ADHD respond and quickly get used to the stimuli. Children with SPD either ignore or have unusual responses to them (craving or avoidance). Children with ADHD prefer novel and exciting experiences. Children with SPD prefer familiar, predictable routines. Children with ADHD are impulsive regardless of sensory input. Children with SPD get overwhelmed or upset by new stimuli. Children with ADHD need constant novelty and prompts to focus. SPD children need specific sensory input to calm down or focus and may become dysregulated during certain activities or times of the day. |
Understanding ADHD and Sensory Processing Disorder
ADHD stands for attention-deficit hyperactivity disorder. This common neurodevelopmental disorder affects around 7 million children aged 3 to 17 in the US, according to a 2022 national survey [1]. Characteristics tend to appear at an early age and include inattention, hyperactivity, and impulsivity.
Sensory processing disorder, or simply SPD, affects how the brain processes and makes sense of the sensory information it receives. This can lead children to display inappropriate responses to certain stimuli, such as aversion, delayed responses, or intense cravings. Studies estimate that SPD affects 5% to 16.5% of the general population [2].
Both conditions impact the brain and cause symptoms that interfere with daily life. Adding to the confusion, SPD and ADHD share common symptoms and tend to co-occur. One study reported that 40% of children with SPD also have attention deficit symptoms [3]. Meanwhile, half of children with ADHD exhibit abnormal sensory processing [4]. Additionally, atypical sensory profiles are considered a core feature of adults with ADHD. However, sensory processing disorder in adults may manifest differently.
A 2019 study found that children with ADHD also tend to have sensory processing problems, particularly sensory over-responsivity, a category of SPD [5]. SOR is a subtype of sensory modulation disorder (SMD) and causes children to respond to sensations longer, with more intensity, or faster than others [6].
A similar study found that compared to typically developing peers, children with ADHD had higher rates of sensory sensibility, sensory seeking, and low registration. In addition, these might be related to their inattention, hyperactivity, and motor coordination [7].
Learn more about SPD subtypes in our article on how to help a child with sensory processing disorder.
Identifying Symptoms in Your Child
SPD and ADHD also show overlapping symptoms, making the process of distinguishing the two conditions much more difficult. Both conditions share the following traits:
- Inattention and distractibility
- Problems with focus and concentration
- Emotional reactivity and difficulties with self-regulation
- Restlessness and hyperactivity
The two conditions may also affect each other. For instance, a child with SPD may appear hyperactive as they seek more input, such as by spinning and jumping endlessly. A child with ADHD tends to lack focus. However, having a low threshold for specific input (SOR) can make it harder for a child to tune out irrelevant stimuli, worsening inattention.
Experts currently view SPD as a feature of ADHD, while some argue that it is a separate condition. Many professionals support the latter view due to differences in their presentations. Here is a table highlighting distinct behaviors and responses among kids with SPD and ADHD:
| Differences | ADHD | SPD |
| Novel or unexpected stimuli | responds and attends to the sensation before getting used to (habituate) and forgetting about it | Either they do not respond to (or ignore) the novel stimulus, or it triggers a fight-or-flight response |
| Preferred Environment | Prefers novel experiences and excitement | Prefers familiar, predictable, and routine-based environments |
| Impulsive behavior | Tends to be impulsive regardless of sensory input | Generally not impulsive but becomes dysregulated when given novel stimuli |
| Preferred activities | Prefers constant novelty and seeks out experiences that are not related to specific sensations | Specific sensory input helps them calm down or focus better. Dysregulation happens during certain activities or times of day |
Of note, sensory processing vs autism also share some similarities and might co-exist.
The Importance of Proper Diagnosis
Finding out whether your child has ADHD, SPD, or both can be a challenge, especially because of their overlapping characteristics.
To diagnose ADHD, a healthcare provider, typically a pediatrician, psychologist, or psychiatrist, will observe the child and gather information from their parents, teachers, and other adults who care for the child in different settings through interviews and questionnaires.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 TR), the child should have at least 6 of 9 symptoms and should be present in various settings, like both school and home [8].
On the other hand, the DSM-5 TR does not yet recognize SPD as a formal condition. However, therapists who received special training for sensory integration can perform a thorough screening to identify and categorize the type of SPD your child may have. They may use a variety of assessment/evaluation tools like the Sensory Integration and Praxis Test (SIPT) and the Sensory Processing Measure (SPM) to gain more information about a child’s sensory and motor development.
Getting a proper diagnosis gives you a better understanding of the root cause of your child’s behavior. Knowing why they respond the way they do can help you work with them to develop strategies to cope better with their daily challenges. At the same time, a proper diagnosis is the first step in providing the best management for your kid.
If you think your child has ADHD or SPD, you might want to consider talking to a professional who can help you identify which condition aligns better with the traits your child is presenting.
Managing ADHD and SPD at Home
Creating a supportive home environment can be a big help for kids with ADHD and sensory processing disorder. Here are some things you can do to help them at home:
- Create a schedule: Following through a routine can help make daily life more predictable. This can reduce the anxiety commonly experienced by kids with SPD and reduce disorganization and transition difficulties commonly seen in kids with ADHD
- Identify triggers: Keep a list of the things that trigger your child and avoid these when possible.
- Reduce sensory input: Using dimmable lights, avoiding scented products, and reducing clutter can help reduce the tendency for sensory overload.
- Use sensory aids: Visual schedules, visual timers, noise-canceling headphones, and to-do lists are some tools that can help kids have a more predictable, organized day. Visual cues are helpful for kids with ADHD who typically struggle perceiving the passage of time.
- Plan your day: Make it to a point to avoid noisy and crowded places or those that are likely to cause sensory overload in your child. If unavoidable, prepare the child ahead and limit exposure.
- Get active: Physical activity is a great way to calm and regulate children with SPD. It can also help provide an outlet for the built-up energy kids with ADHD may have.
In addition to these tips, children with ADHD can greatly benefit from the following:
- Break down tasks into smaller, manageable chunks.
- Have breaks in between tasks.
- Establish a calming bedtime ritual.
- Limit stimulants like sweets and caffeine.
- Create easy-to-follow rules, and be sure to communicate them clearly.
Meanwhile, here are some helpful strategies for kids with SPD:
- Create a safe place where your child can retreat when they feel overwhelmed.
- Provide sensory tools like fidget toys, chew toys, weighted vests, and trampolines.
- Agree on a signal they can use to express feeling overwhelmed.
Treatment Options
The standard options for ADHD involve a combination of medications and therapy. Medications can help kids with ADHD focus better, become less impulsive, and feel calmer. These are generally categorized into two: stimulants and non-stimulants. Medication options for ADHD include [9]:
- Methylphenidate
- Atomoxetine
- Dexamfetamine
- Lisdexamfetamine
- Guanfacine
Therapy options include:
- Psychoeducation
- Behavior therapy
- Cognitive behavioral therapy (CBT)
- Social skills training
- Occupational therapy (OT)
- Speech Therapy
- Parent education and training
Similar to ADHD, there is no cure for SPD. However, treatment, usually through occupational therapy, can help the child manage and cope with their sensory issues.
Therapy typically occurs in a play-based setting in a sensory-rich environment that aims to help them develop more appropriate responses to sensory information around them. Read our article on occupational therapy for sensory processing disorder to learn more about how OTs can help your kid with SPD.
Other complementary treatment strategies for SPD can include:
- Listening therapies like Soundsory® and Forbrain®
- Music Therapy
- Speech Therapy
- Physical Therapy
Supporting Your Child at School
Many children with SPD and ADHD also find school challenging. Unlike homes, the school environment is more unpredictable and offers new challenges. Fortunately, you can help your child by being more involved. You can begin by educating yourself about your child’s rights and being involved in their learning needs, particularly in their IEP or 504 plan. Advocate for your child by requesting additional accommodations if necessary.
Communicate with teachers about your child’s specific needs and how they can support them. At the same time, ask teachers how you can help meet the learning goals and work together as a team. Stay in touch with teachers to monitor your child’s behavior and progress, and keep them informed of any changes, such as new medications or side effects to watch for.
Coping Strategies for Parents
Parenting kids with ADHD and SPD is hard, and you may neglect your own needs while caring for your children. Here are some techniques to help you meet the challenges and demands of caring for a child with SPD or ADHD:
- Take care of yourself: Eat right, exercise, and find ways to reduce stress, whether through a nightly bath or morning meditation.
- Take care of your relationship with your partner: If you are co-parenting, make sure to communicate your need for help and take time together without the kids.
- Have a break: Accept offers from friends and family to babysit, even for a short time, to recharge your energy.
- Ask for help: Reach out to doctors, therapists, and teachers, and don’t hesitate to join support groups for advice and sharing experiences.
- Find a support system: Join support groups and seek resources that provide strategies and emotional support from other parents who understand your challenges.
Summary: Sensory Processing Disorder and ADHD in Children
SPD and ADHD are two common childhood disorders that are often confused with each other. While they share similar and sometimes overlapping traits, they also have distinct differences. A proper diagnosis can help you provide the best treatment, develop coping strategies, and better advocate for your child’s needs to help them thrive in things that matter most to them.
As a next step, discover more about how to help a child with sensory processing disorder.
FAQs
Can you have ADHD and Sensory Processing Disorder?
Yes. It is possible to have both conditions. At the same time, one condition may appear like the other or show symptoms similar to the other.
Can a child with Sensory Processing Disorder lead a normal life?
Yes. With proper management and sufficient support from their families and community, children with SPD can learn skills and coping strategies to lead full, productive lives.
References
- Centers for Disease Control and Prevention (CDC). (2024). Data and statistics on ADHD. https://www.cdc.gov/adhd/data/index.html
- Miller, L. J., Schoen, S. A., Mulligan, S., & Sullivan, J. (2017). Identification of Sensory Processing and Integration Symptom Clusters: A Preliminary Study. Occupational Therapy International, 2017, 2876080. https://doi.org/10.1155/2017/2876080
- Crasta, J. E., Salzinger, E., Lin, M. H., Gavin, W. J., & Davies, P. L. (2020). Sensory Processing and Attention Profiles Among Children With Sensory Processing Disorders and Autism Spectrum Disorders. Frontiers in integrative neuroscience, 14, 22. https://doi.org/10.3389/fnint.2020.00022
- Fabio, R. A., Orsino, C., Lecciso, F., Levante, A., & Suriano, R. (2024). Atypical sensory processing in adolescents with Attention Deficit Hyperactivity Disorder: A comparative study. Research in Developmental Disabilities, 146, 104674. https://doi.org/10.1016/j.ridd.2024.104674
- Lane, S. J., & Reynolds, S. (2019). Sensory Over-Responsivity as an added dimension in ADHD. Frontiers in Integrative Neuroscience, 13. https://doi.org/10.3389/fnint.2019.00040
- Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007). Concept evolution in sensory integration: a proposed nosology for diagnosis. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 61(2), 135–140. https://doi.org/10.5014/ajot.61.2.135
- Delgado-Lobete, L., Pértega-Díaz, S., Santos-Del-Riego, S., & Montes-Montes, R. (2020). Sensory processing patterns in developmental coordination disorder, attention deficit hyperactivity disorder and typical development. Research in Developmental Disabilities, 100, 103608. https://doi.org/10.1016/j.ridd.2020.103608
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- National Health Service (NHS). (2024). Treatment: Attention deficit hyperactivity disorder. https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/treatment/
Rachel Ann Melegrito
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