Neurodiversity
Sensory differences are common in autism, ADHD, and in children without any diagnosis at all. Here is a plain-English guide to what sensory processing disorder actually is and what the overlap looks like.
Sensory processing disorder is one of those terms that gets used a lot and explained clearly almost never. Parents hear it from occupational therapists. They see it on checklists. They wonder whether their child has it, and whether it is the same as autism, and whether it requires a separate diagnosis, and what it means for their child's school support.
Let me try to give you a genuinely clear explanation.
What sensory processing disorder is
Sensory processing disorder, sometimes called sensory processing dysfunction, refers to difficulties in how the nervous system receives, interprets, and responds to sensory information from the environment. It is not a single thing. It encompasses over-responsiveness (sensory hypersensitivity), under-responsiveness (sensory hyposensitivity), and sensory-seeking behaviour, and these can occur for different senses in the same child.
A child who covers their ears in a cafeteria that other children find comfortable is over-responsive to auditory input. A child who does not notice they have been hurt until they see the blood is under-responsive to pain. A child who needs to touch everything, spin, or seek intense physical input is sensory seeking. All of these are sensory processing differences, and they can significantly affect daily functioning.
How it relates to autism
Sensory differences are officially recognised as part of the autism diagnostic criteria in the DSM-5. This means that if a child has autism, sensory processing differences are already understood to be part of their profile. A separate diagnosis of sensory processing disorder is not required, and in most cases, the sensory differences are addressed through the autism diagnosis and the OT support that comes with it.
Where SPD as a standalone concept becomes relevant is for children who have significant sensory processing differences but do not meet criteria for autism or ADHD. These children exist. They may have significant difficulties with sensory input that affect their participation in school, sports, social situations, and daily routines, but their profile does not meet the threshold for autism. In these cases, SPD as a clinical formulation from an OT can be a useful framework for understanding and supporting the child.
The diagnosis situation in Australia
Sensory Processing Disorder is not a recognised diagnosis in the DSM-5 or ICD-11, which are the diagnostic manuals used by Australian clinicians. This means it cannot be the basis for an NDIS access request on its own. What it can do is sit within an occupational therapy assessment that documents functional impact, how the sensory processing differences affect the child's daily life, and that documentation can support funding requests under other diagnoses or as part of a Thriving Kids referral.
Common presentations to watch for
- Over-responsive to sound: distress in loud environments, covering ears, avoiding places with unpredictable noise
- Over-responsive to touch: aversion to certain fabrics, textures, or unexpected touch, difficulty wearing shoes, socks, or tags
- Over-responsive to taste or smell: significant food avoidance, distress in environments with strong smells
- Under-responsive to pain or temperature: not noticing injuries, wearing inappropriate clothing for the weather, not responding to temperature changes
- Sensory seeking: need for intense physical input, crashing, jumping, spinning, heavy work, biting, intense touch
- Proprioceptive differences: poor body awareness, difficulty with coordination, appearing clumsy or 'all over the place'
- Vestibular differences: unusual responses to movement, either seeking it intensely or avoiding it
“In autism, sensory differences are already part of the diagnostic criteria. A separate SPD diagnosis is not required. What matters is that the functional impact is documented and that OT support addresses it.”
What to do if you think your child has sensory processing differences
The most useful first step is a referral to an occupational therapist with specific experience in sensory processing. An OT can assess the specific profile of your child's sensory system, identify which senses are over- or under-responsive, and design a sensory diet, a structured programme of sensory activities, that supports regulation across the day.
If your child has an autism diagnosis, sensory processing support through OT is likely already part of their support picture. If not, speak with your GP about a referral. Under a Mental Health Treatment Plan or through the NDIS (where applicable), OT can be funded.
Can my child have sensory processing differences without an autism diagnosis?
Yes, and this is one of the most important things parents need to understand. Significant sensory processing differences can exist without autism, without ADHD, and without any other formal diagnosis. Children can have a sensory profile that significantly affects their daily functioning and still not meet the criteria for any condition in the diagnostic manuals. This does not mean their experience is not real, or that support is unavailable. It means navigating a system that is not particularly well designed for it.
If your child has significant sensory difficulties but does not have an autism or ADHD diagnosis, here is what to know.
- An occupational therapist can assess and treat sensory processing difficulties regardless of whether a formal diagnosis exists. OT does not require a diagnostic label to begin. A GP referral is a good starting point.
- Under Medicare, some OT access is available with a GP management plan for children with chronic health conditions, though coverage is limited. For children without a diagnosis that qualifies for NDIS access, most OT will be funded privately.
- At school, you do not need a formal diagnosis to request adjustments for a child who is visibly affected by their sensory environment. Under the Disability Standards for Education, schools are required to make reasonable adjustments for students with disability, and sensory processing differences can constitute a disability in this context even without a specific diagnostic label.
- Some children with significant sensory difficulties are later diagnosed with autism, ADHD, anxiety, or other conditions as assessment is completed. If you suspect something more is happening for your child, pursue a comprehensive assessment rather than managing sensory symptoms alone.
- A sensory diet developed by an OT is one of the most practical interventions available regardless of diagnostic status. It involves structured sensory activities across the day designed to regulate the nervous system and reduce dysregulation.
Sensory differences in ADHD
Sensory processing differences are significantly more common in children with ADHD than in the neurotypical population, even though sensory differences are not part of the formal ADHD diagnostic criteria in the same way they are for autism. Research suggests that between 40 and 60 percent of children with ADHD have sensory processing difficulties that affect daily functioning.
For these children, the sensory seeking behaviour that looks like the child being disruptive or unable to sit still is often the nervous system looking for regulatory input. Understanding this as a sensory need rather than a behaviour to be managed changes the response. Movement breaks, sensory tools, and environmental modifications help with the behaviour precisely because they address what is actually driving it.
Frequently asked questions
- Can sensory processing disorder be cured? No. Sensory processing differences are neurological and do not resolve. What improves with good OT support and environmental adjustment is a child's ability to manage their sensory system, build tolerance where possible, and access compensatory strategies. The nervous system itself does not change fundamentally.
- My child covers their ears constantly. Is this a sensory issue or something else? Auditory hypersensitivity is one of the most common sensory presentations and it can occur in isolation or as part of autism, ADHD, or anxiety. The behaviour itself does not tell you what is driving it. An OT assessment, alongside a broader developmental assessment if you suspect other things are happening, is the most useful next step.
- Will my child grow out of their sensory sensitivities? Some children develop greater tolerance for sensory input over time with intervention and maturation. Others do not. Sensory seeking and avoidance patterns often shift in how they manifest rather than disappearing entirely. The goal of intervention is not elimination but management and quality of life.
- My child's sensory issues are affecting the whole family. Is that normal? Yes, and it is important to name it. A child with significant sensory needs affects family routines, social activities, holiday choices, and relationships in ways that are substantial. Families benefit from support that acknowledges this, not just strategies for the child.
Neurodiversity
A note on accuracy:While every effort has been made to ensure the information in this article is accurate at the time of writing, facts, policies and research can change. We're human, and sometimes we get things wrong. If you spot something that needs updating, we'd genuinely love to hear from you.
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Dave Harrison
ESW · Neurodiversity Advocate · Podcast Host
Dave Harrison is currently working in Australian schools as an Education Support Worker. He's the founder of THRVHUB, host of the Different Is Normal podcast, and a parent of a neurodivergent teenager, writing from both sides of the classroom.
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