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Key points
- Sensory sensitivities can lead a child to over- or under-react to certain sensations or experiences.
- Sensory sensitivities often co-occur with disorders like autism or ADHD.
- Parents can help by accommodating where necessary and responding to meltdowns without judgment or criticism.
Only the softest of clothing will do!
By the time one of my children was 18 months old, I couldn’t buy her clothing until she touch-tested it herself—it had to be a certain kind of soft, or she would not wear it. Her sensitivity has lessened, but even as an adult, soft clothes are a priority for her. Many of my patients have similar challenges—such as being super sensitive to tags in their clothes, loud noises, or sand on their feet—and sensory-triggered tantrums can be epic.
If your child has sensory sensitivities, you know how disruptive they can be. They can interfere with every step of every day—from getting dressed in the morning to touching glue at school to brushing teeth at night. Things as basic as eating can be affected by sensory sensitivities in the mouth—and washing hands might be a nightmare if your child hates the feeling of water on their hands. A child may have mild responses such as fussing or crying, but sometimes they may explode, shut down, or try to run when exposed to a triggering sensation.
Sound, sight, touch, taste, and/or smell can be involved, and tactile reactions can be associated with many features including texture, temperature, and levels of pressure. Children may have heightened responses to some sensations—or they may experience low sensitivity, which can lead them to seek sensory input.
Beyond the external five senses, there are internal senses including proprioception and the vestibular sense that send signals to the brain to coordinate movement and balance. Low or high sensitivity to these senses can profoundly affect how a child moves through space.
Pain is another internal sensation; it starts anywhere and moves through complex pathways in the nervous system. Children can have high low or high pain sensitivity as well. Low sensitivity to pain input can be dangerous, especially in younger children. Your child may not start tugging at their ear until their ear infection has become severe, which can complicate treatment and can lead to hearing loss that further exacerbates communication difficulties.
Do Sensory Sensitivities Mean My Child Has Autism?
Sensory sensitivities often co-occur with other disorders, including autism. Importantly, however, sensory sensitivities are not the same thing as autism. While it's common to associate sensory sensitivity with autism, these types of reactions occur with other conditions as well, including (but not limited to) anxiety, OCD, ADHD, and intellectual disability.
In autism, sensory sensitivities—atypically high or atypically low responses to some types of sensory input—are included in the diagnostic criteria. Since children with autism also tend to have challenges in communicating their experiences and needs, it can be uniquely challenging for you to identify and navigate these experiences.
Anxiety disorders commonly co-occur with sensory sensitivities. Often, a child with anxiety will experience hypersensitivity to touch, smell, or sound. Alternatively, you may notice that your child with anxiety craves deep muscle massage—which may be related to the high levels of muscle tension that they experience.
Obsessive-compulsive disorder (OCD) is also commonly associated with sensory sensitivities. They can be part of an obsessive thought, such as a spot on the playground being contaminated and a compulsion not to touch the ground in that spot—or it might be more of a general sense of disgust or hypersensitivity to touching dirt.
ADHD is another diagnosis that often occurs along with sensory sensitivities. ADHD can lead to challenges in filtering sensory input—which can cause hypersensitive reactions. If your child has ADHD, you know they can become overstimulated in high sensory situations (for me and my kids Chuck E. Cheese was a common culprit) which can lead to meltdowns, shutting down, or even trying to run away.
Global developmental delay or intellectual disability (without associated autism) are other diagnoses that are commonly associated with sensory sensitivities. As with children with autism spectrum disorder, communication difficulties can make it difficult for parents and caregivers to fully understand the sensory responses and to navigate and manage them.
If your child has sensory sensitivities but doesn’t have another identified developmental or psychiatric diagnosis, they may be described as having sensory processing disorder. This is not a formal medical or psychiatric diagnosis, but it can be helpful in identifying needs and developing interventions. However, if your child is presenting with sensory sensitivities, you should consider developmental and/or psychiatric evaluations to determine if another condition is present.
Behavior Plans Don't Work, But These Tips Can Help
Identifying underlying or associated syndromes or diagnoses is critical so that your child can receive the appropriate support and interventions for those problems. Even with appropriate care, though, the sensory sensitivities will likely continue as their own challenges. Fortunately, there are some key points to keep in mind when responding to your child:
- These experiences are real. They are not simply behavioral problems that can be “fixed” with sticker charts or other behavioral management interventions. Respect your child’s sensory responses. Embrace who they are and how they respond to the world—they don’t have to be like everyone else.
- Modify and accommodate when reasonable and safe. Cutting tags out of clothing, keeping volumes down, or having manageable snacks available if your child can’t tolerate the family dinner are examples of changes you can make to reduce their experience of “nails on a chalkboard” every day.
- Seek help when necessary. If sensory sensitivities are urgent—such as not being able to eat enough to maintain growth—your pediatrician should be able to refer you to appropriate treatment, such as feeding or occupational therapy.
- Educate your school team. It’s appropriate to ask for reasonable accommodations based on sensory sensitivities at school, such as permitting your child to bypass assemblies or the cafeteria if loud, crowded situations predictably trigger outbursts.
- Address other developmental needs as they arise. Your child who struggles with noisy places may hesitate to go to a friend’s house if that family is a big boisterous one. Working with an occupational therapist can help children manage sensitivities and increase tolerance.
- Practice empathy and patience. Most importantly, if your child has an emotional meltdown or shutdown over an unavoidable sensory exposure, parents should help them re-regulate without criticism, judgment, shame, or punishment. Keeping your cool helps them re-equilibrate.
