Sensory Processing Disorder vs. Autism Spectrum Disorder: Essential Insights and Practical Advice for Parents

Neurodevelopmental disorders are a catch-all term for conditions that affect brain function and emerge in early childhood. While each is their own condition, they frequently occur together or have overlapping symptoms [1].

Two of the conditions that frequently co-occur are sensory processing disorder (SPD) and Autism Spectrum Disorder (ASD). If you’re a parent of a child with either (or both) conditions, you’ve probably asked how they’re distinct from each other.

Here, we discuss sensory processing disorder vs. autism, with their overlaps and distinctions. We also offer practical strategies for parents to support their children with autism and SPD, along with further resources that may be helpful.

What are the Key Differences Between SPD and Autism?

SPD affects sensory processing, while autism impacts social skills, communication, and behavior.

Understanding SPD and Autism for Parents

Sensory processing disorder, or simply SPD, affects how the brain receives, processes, and interprets the sensory information coming through the senses. Besides the five basic senses, this also includes the internal senses:

• Proprioceptive system: tells us about our body’s position and movement using signals from muscles and joints.
• Vestibular system: informs us of our position in space by sensing our head’s orientation relative to gravity.
• Interoceptive system: sends signals from our internal organs to inform us about our internal body states, like hunger, the need to pee, and pain.

Learn more in our comprehensive guide on how to help a child with sensory processing disorder.

Autism spectrum disorder (ASD), often simply called autism, affects how a person behaves, interacts, learns, and communicates [2]. Symptoms of autism typically appear by age two and are four times more common in males [3].

The condition is said to be in a “spectrum” because of the wide variation in its symptoms and severity. For instance, some may need a lot of help with their daily functioning, while others require limited support.

When SPD and Autism Overlap: What Parents Need to Know

SPD and autism share common characteristics, making it a challenge even for trained professionals to differentiate the two conditions. Notably, both conditions present sensory difficulties. A 2017 study found that the early sensory regions in the gray matter of children with both conditions were more prominent, indicating that these abnormalities may be associated with the sensory issues seen in both conditions [4].

Here are some traits and challenges present in both conditions:

• Sensory issues
• Repetitive behaviors
• Social interaction
• Language and communication

Both children with ASD and SPD may react negatively to certain stimuli or crave particular sensory input, some inadvertently leading to inappropriate behaviors. Both may also do repetitive behaviors like spinning, rocking, and touching surfaces. Both conditions may show language and communication difficulties, including failure to respond to tapping or calling and struggle to maintain a back-and-forth conversation.

Currently, while many argue that SPD is a separate condition from ASD, experts consider SPD as a feature of autism, given that around 90% to 95% of children with ASD also experience sensory issues [5]. It is also frequently seen in other neurodevelopmental disorders like learning disabilities and ADHD [6].

Key Differences Between SPD and Autism Explained

Below are some key differences that can help parents distinguish SPD from autism.

Diagnostic Criteria

The diagnostic criteria of autism vs. sensory processing disorder are different between the two conditions. 

While the traits of kids with autism vary greatly, it has three core characteristics based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 TR) [1]:

• Repetitive or stereotyped behaviors and movements
• Restricted or fixated interests
• Problems with social interaction and communication

Kids with SPD have trouble processing the information they receive from their environment and bodies. This confusion leads to unusual or atypical behaviors in response to these stimulations. They may:

• Not respond or have a delayed response to sensory input
• React strongly to stimuli, such as aggression, anger, cravings, or shutdown
• Actively seek out specific input, leading to disruptive or unsafe behaviors
• Struggle with posture and coordination
• Find it challenging to distinguish one sensory input from another

Unsure if your child has SPD? Take our free sensory processing disorder test.

Non-Sensory Issues

Both conditions share sensory processing difficulties. However, kids with autism tend to have more significant non-sensory related issues. Below are some studies that reflect this:

• A 2014 study found that both children with SPD and ASD showed impairment in tracts involved in sensory perception and multisensory integration [7]. Meanwhile, only children with autism showed impairment in brain areas critical for memory and processing of facial emotions.
• While both conditions have greater sensory challenges than their peers, kids with ASD seem to have fewer sensory issues but have more pronounced difficulties with attention, based on a 2019 study [8].
• In a 2018 study, both kids with ASD and SPD have higher sensory symptoms than typically developing children [9]. Both showed high scores in sensation craving, but those with ASD had higher sensory under-responsivity (SUR) scores than those with SPD.
• One study compared the behavioral differences among preschool children with SPD and ASD. It found that while both groups show significant sensory-related behavior issues, children with ASD tend to have more severe difficulties in all areas [10].

Scope and Nature of Their Issues

Another key difference is in the scope and nature of their challenges. In SPD, the challenges center around the child’s sensory difficulties. Meanwhile, the challenges seen in autism are generally broader and affect their cognition, communication, behavior, and social and language skills. 

For instance, in the 2018 study mentioned above, those with autism were less affected by others’ feelings (empathy) but showed greater interest in systems than kids with SPD [9].

Here is a comparison of the different manifestations of their challenges:

ASD

SPD

–       A majority have SPD or sensory processing difficulties –       Impaired communication and language delay and problems in communication are two of the core clinical features of ASD [11] –       The intellectual skills of kids with ASD may range from having an intellectual disability to being intellectually gifted  –       Repetitive behaviors in ASD, often called “stimming,” tend to be more pronounced and restrictive. Children also use stimming for various reasons. This can appear as a response to uncertainty or stress, to seek or avoid sensory stimulation, or to express themselves.

–       May or may not have co-occurring ASD or other conditions –       Communication and social interaction can be affected if the auditory system is affected, such as in those with central auditory processing disorder (CAPD) –       Kids with SPD generally have intellectual skills and abilities within the average range.  –       Repetitive behaviors in SPD are often related to sensory-seeking or sensory-avoidance behaviors

Diagnosing and Treating SPD and Autism: A Guide for Parents

For both conditions, diagnosis typically begins with screening for the need for further assessment. Children usually receive developmental screening during well-child visits. They also get screened for ASD at 18 and 24 months [12].

To receive a diagnosis of ASD, the child must meet the diagnostic criteria of ASD based on the DSM-5 TR. This is done through caregiver interviews, screenings, tests, and observations. 

While experts still do not consider SPD as a standalone condition, those trained in sensory integration, commonly occupational and physical therapists, use several checklists and assessment tools to determine if the child has SPD. They will also observe the child and conduct interviews to learn more about the particular difficulties children experience. This helps them identify the type and severity of the child’s SPD and the sensory system/s affected. 

“We don’t really diagnose SPD since it isn’t an official diagnosis. However, we say things like sensory integration difficulties or sensory processing challenges to refer to them. We use questionnaires like SPM or SP and do clinical observations to assess a child’s sensory processing abilities. At the end of the day, what’s important is that we (OTs) assess the child’s functional performance and learn more about their challenges so we can provide the right management.” – Erin, OT from Minnesota

Treatment for Sensory Processing Disorder

“When it comes to handling kids with SPD, the most important thing is to meet them where they are and work with what they have without comparing them with others.” – Meg, a trained SI therapist from Manila

Here are some of the common treatment strategies for SPD:

• Sensory integration therapy: sensory-rich activities done in a controlled environment with a trained therapist
• Sensory Diet: an individualized schedule of sensory activities done in school and at home to keep the child organized and regulated.
• Occupational therapy: Aside from providing specialized SI treatment and sensory diets to kids with SPD, occupational therapy for sensory processing disorder may also help manage other skill difficulties like gross and fine motor skill deficits
• Speech language pathology: Speech language pathologists (SLPs) or speech therapists can help improve kids with SPD’s communication and interaction skills.

Intervention Approaches for Autism

According to the U.S. Centers for Disease Control and Prevention (CDC), here are some of the most common treatments for kids with autism [13]:

• Behavioral approaches: These focus on changing undesired behaviors and encouraging desired ones. This includes applied behavioral analysis
• Developmental approaches: These focus on improving particular developmental skills. OT, SLP, and PT are included here.
• Social-relational approaches: These aim to improve social skills and include social skills training and DIR FloorTime.
• Educational treatments: These aim to help kids with autism thrive in the classroom setting through accommodations and adjustments.
• Psychological approaches: These focus on working together with the child to help them cope with mental health issues like anxiety.
• Medications: These aim to treat co-occurring symptoms such as aggression and self-harming behaviors.

Practical Tips for Parents Managing SPD and Autism

Kids with ASD and ASD face many challenges daily. Aside from interventions, parents can also help them cope with their challenges. Here are some helpful strategies to try:

• Reinforce good behaviors. Praise the child when they demonstrate good behaviors and reward them.
• Teach the child how to express their needs. Whether through gestures or verbal expression, helping them express their needs can help reduce frustration.
• Tag the child along on errands and everyday activities. This will help them get used to the world around them and expose them to new situations.
• Collaborate with the professionals. It’s important to constantly communicate with your child’s teachers and therapists to work together on the same goals and learn ways to help the child thrive in different settings.
• Ask for support. Joining support groups is an excellent way to gain more insight and guidance on how to deal with challenges commonly experienced by those with SPD and ASD and their families.

“Our goal is to educate parents, caregivers, babysitters, whomever is important to the family. We want them to have the skills to carry over interventions” – Karina, OT in Oregon

Sensory challenges can hinder a child from engaging with others and their environment. Here are some ways parents can create a supportive environment with appropriate modifications and accommodations:

• Create and follow a schedule. Following a schedule keeps things predictable for your child. This can help reduce anxiety and give a sense of stability. When diverting from your usual routine, be sure to inform the child beforehand to prepare them.
• Reduce clutter and noise. Minimize unnecessary clutter and noise in the environment for kids who are sensitive or distracted easily by these sensory stimuli.
• Use visual cues. Visual times, charts, and schedules can help remind the child about their schedules and help promote smoother transitions between tasks. On strategies for working with children with sensory processing disorders, Sarah, an OT from Washington D.C., United States, suggested visual timers. It gives kids “an ‘end’ to the activity as toddlers have difficulty with sense of time. One kiddo did this for brushing teeth. Now, he will do it as long as the timer is set.” 
• Create sensory corners. These spaces in a room provide the child with various sensory stimuli they can escape or go to when they need stimulation or a place to calm down.
• Provide sensory toys and equipment. Identify your child’s sensory needs and provide toys and equipment to help them self-soothe. These include trampolines, weighted blankets, chewable jewelry, scented markers, rainmaker toys, sensory chew toys, fidget toys, and swings.

Parents who want to know more about the conditions can check organizations and support groups online for further reading and support. Here are some of them:

For autism

• Autism Speaks
• US Autism Association Inc.
• Autism Parents Support Group (Public Facebook Group)
• Autism Society of America

For SPD

• SPD Foundation
• SPIRAL Foundation
• Sensory Processing Disorder Parent Support Community
• Sensory Processing Disorder (SPD) Support (Private Facebook Group)

Summary: Sensory Processing Disorder vs. Autism

Both Sensory Processing Disorder (SPD) and Autism Spectrum Disorder (ASD) involve significant sensory-related behavioral symptoms, though children with ASD tend to have more severe difficulties across various areas. Knowing the similarities they share and how they differ can help parents provide better support for their children.

FAQs 

How to tell the difference between autism and sensory processing disorder?

ASD and SPD can be difficult to tell apart because of their overlapping symptoms and challenges. However, the challenges of kids with SPD typically center around sensory processing difficulties. Meanwhile, kids with ASD have broader and sometimes more severe challenges, such as in the areas of language, communication, and behavior.

Can a child have sensory processing disorder and not be autistic?

Yes. A child can have SPD but not have autism. While the two frequently co-occur, SPD can be a standalone condition.

References 

1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
2. National Institute of Mental Health. (2024). Autism spectrum disorder. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd
3. Napolitano, A., Schiavi, S., La Rosa, P., Rossi-Espagnet, M. C., Petrillo, S., Bottino, F., Tagliente, E., Longo, D., Lupi, E., Casula, L., Valeri, G., Piemonte, F., Trezza, V., & Vicari, S. (2022). Sex Differences in Autism Spectrum Disorder: Diagnostic, Neurobiological, and Behavioral Features. Frontiers in psychiatry, 13, 889636. https://doi.org/10.3389/fpsyt.2022.889636
4. Yoshimura, S., Sato, W., Kochiyama, T., Uono, S., Sawada, R., Kubota, Y., & Toichi, M. (2017). Gray matter volumes of early sensory regions are associated with individual differences in sensory processing. Human brain mapping, 38(12), 6206–6217. https://doi.org/10.1002/hbm.23822
5. Guardado KE, Sergent SR. (2023). Sensory Integration.StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559155/
6. Galiana-Simal, A., Vela-Romero, M., Romero-Vela, V. M., Oliver-Tercero, N., García-Olmo, V., Benito-Castellanos, P. J., … Schumacher, U. (2020). Sensory processing disorder: Key points of a frequent alteration in neurodevelopmental disorders. Cogent Medicine, 7(1). https://doi.org/10.1080/2331205X.2020.1736829
7. Chang, Y., Owen, J. P., Desai, S. S., Hill, S. S., Arnett, A. B., Harris, J., Marco, E. J., & Mukherjee, P. (2014). Autism and sensory processing disorders: shared white matter disruption in sensory pathways but divergent connectivity in Social-Emotional pathways. PloS One, 9(7), e103038. https://doi.org/10.1371/journal.pone.0103038
8. Crasta, J. E., Salzinger, E., Lin, M., 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. https://doi.org/10.3389/fnint.2020.00022
9. Tavassoli, T., Miller, L. J., Schoen, S. A., Brout, J. J., Sullivan, J., & Baron-Cohen, S. (2018). Sensory reactivity, empathizing and systemizing in autism spectrum conditions and sensory processing disorder. Developmental Cognitive Neuroscience, 29, 72–77. https://doi.org/10.1016/j.dcn.2017.05.005
10. Purpura, G., Cerroni, F., Carotenuto, M., Nacinovich, R., & Tagliabue, L. (2022). Behavioural Differences in Sensorimotor Profiles: A Comparison of Preschool-Aged Children with Sensory Processing Disorder and Autism Spectrum Disorders. Children, 9(3), 408. https://doi.org/10.3390/children9030408
11. Sauer AK, Stanton JE, Hans S, et al. Autism Spectrum Disorders: Etiology and Pathology. In: Grabrucker AM, editor. Autism Spectrum Disorders [Internet]. Brisbane (AU): Exon Publications; 2021 Aug 20. Chapter 1. Available from: https://www.ncbi.nlm.nih.gov/books/NBK573613/ doi: 10.36255/exonpublications.autismspectrumdisorders.2021.etiology
12. U.S. Centers for Disease Control and Prevention. (2024). Developmental monitoring and screening. https://www.cdc.gov/ncbddd/actearly/screening.html
13. U.S. Centers for Disease Control and Prevention. (n.d.).Treatment and intervention for autism spectrum disorder. https://www.cdc.gov/autism/treatment/index.html