What is Sensory Sensitivity in Childhood?
Sensory sensitivity in childhood is increased awareness, compared to other people, of information gained from the five senses.
Sensory overload refers to a sense of overwhelm and painful discomfort caused by sensory stimulation. When a child has sensory sensitivity, they are prone to be overloaded with sensory information. It is really uncomfortable for them to eat something of that texture, tolerate certain smells, manage loud noises, or function in certain lighting.
Parents often notice sensory sensitivities at a young age. Some children refuse almost all foods based on smell or texture. Some children cannot be in noisy places or avoid messy activities that other children seem to love.
Every child is different. Some children are pickier eaters than others. Some children prefer to stay neat and clean rather than being willing to try messy foods. Some children love noise, activity, new sights, and smells, while others find them overwhelming.
Sensory sensitivities become an issue when day-to-day life is significantly impacted. If you can make a simple adaptation, these sensory problems may not require support from a professional.
Examples of Sensory Overload from Common Triggers
Here are some examples of what sensory triggers can be and how an overloaded child might act in response. It is not unusual for a child to have some mild sensory sensitivities to certain sensations. For example, some kids are distressed at a young age by certain noises or types of clothing. The examples here are cases where the sensory issue is actually interfering with day-to-day functioning and are worthy of a closer look.
- Clothes: Johnny refuses to wear clothes. He gets very distressed after being dressed and disrobes constantly
- Auto toilets and driers: Sam is afraid of hand driers and autoflush toilets. He will not go into a public bathroom without a lot of comforting from an adult
- Loud unexpected noises: Fire drills terrify Janell. She tries to avoid the school cafeteria because she is afraid.
- Tags, seams, fabrics: Joey will only wear clothes that are void of tags, zippers, collars, or waistbands. Instead, he insists on wearing sweatpants and t-shirts every day
- Food texture: Sally will only eat yogurt or cheese. This tendency is so significant that she becomes constipated or refuses to take in certain nutrients she needs to be healthy
- Loud places: Madison hates noisy restaurants. The people and music irritate her so much she is unable to eat or enjoy herself
- Grass, water, sand on the skin: Drew will not walk barefoot on the ground. He screams if you try to get him to touch the ground and may run around in circles or walk on his toes all the time out of fear of encountering an unpleasant feeling on his feet
Parents generally bring these concerns to the pediatrician and are often met with a “wait and see” suggestion or referral to an Occupational Therapist.
Indeed when it comes to sensory sensitivities, it is important not to jump to a hasty conclusion that there is a significant problem.
On the other hand, if sensory differences impact your child’s life, it can be helpful to take a careful look at your child’s growth and development across all areas. You’d want to be sure as a parent that you are not going extremely far out of your way to accommodate your child’s sensory needs. It is totally okay to cut out scratchy tags or to allow your child to wear sweatpants to dinner. However, you will want to be sure that your child can generally engage in the social environment without significant distress over minor sensory input.
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Symptoms of Sensory Sensitivity in Children
- Sensitive: Showing sensitivity to sight, smell, sound, taste, touch, or texture
- Avoiding lights: Complaining about bright lights, headaches, or squinting eyes to mute out the light
- Resisting clothes: Refusing to wear certain textures, like jeans or socks with seams
- Finding fabric aversive: Having trouble with certain fabrics, like velvet or satin
- Avoiding places: Attempting to stay away from loud and busy places, like the school cafeteria or the auditorium
- Covering ears: Getting so distressed over loud noises that your child covers ears or runs away from the sound
- Afraid of loud noises: Seeming so afraid of auto-flush toilets or fire alarms as to avoid events or situations that may include such loud sounds
- Refusing certain foods: Demonstrating sensitivity (i.e., gagging, refusals, protests) to texture, smell, and presentation of food
- Won’t walk barefoot: Refusing to walk on grass, to play in the sand, or to touch Play-Doh
- Dislikes water: Saying water hurts their skin
- Irritated by busy sights: Seeming annoyed by patterned wallpaper or elaborate art, murals, or intricate landscapes
Causes of Sensory Sensitivity
Well-known developmental psychologist Jean Piaget said that infants build knowledge of the world through motor-sensory trial and error. They learn as they assimilate information and accommodate their developing schemas, which means children learn and expand on knowledge. For example, they start by categorizing things they see, hear, touch, taste, and feel. Children use their motor and sensory systems to explore the world from this young age, and this process of discovery aids young brains in development.
As you may imagine, differences in your sensory processing can significantly impact day-to-day life. Certain stimuli may not be well tolerated or may not be noticed. However, these psychologists do not see sensory differences as a stand-alone disorder.
Sensory Processing Disorder (SPD): The American Academy of Pediatrics and the American Medical Association encourage parents and practitioners to be cautious with such terms as SPD. They are cautious because medical research suggests that sensory processing challenges may be symptoms of several different recognized medical conditions. There is insufficient evidence in the research to suggest that sensory processing challenges occur alone as a “disorder.” For this reason, the medical community urges the treatment of sensory sensitivities to be a part of a comprehensive treatment plan for a child. Even though SPD is not a stand-alone diagnosis, your child may still benefit from treatment for sensory symptoms.
An Occupational Therapy evaluation, for example, may determine whether or not your child needs help with sensory processing.
What a specific OT evaluation will not do, though, is tell you whether or not these sensory issues are related to challenges with attention, behavior, social skills, or anxiety. It is important to be clear about your child’s evaluation. If you have a referral from your pediatrician for an evaluation, it is important to understand what kind of evaluation you need. If you have concerns that go beyond sensory needs and into areas like social skills, learning, or attention, you need a licensed psychologist in addition to potentially an OT or Speech Language Pathologist. Generally a multidisciplinary team assesses is best to determine if the sensory sensitivity is related to any issues with behavior, emotions, attention, or cognitive processing.
Many parents believe they had a comprehensive assessment for their child at a young age only to discover that sensory development was the only area assessed.
Attention Deficit Hyperactivity Disorder (ADHD): Children with ADHD often have sensory processing differences. ADHD kiddos are likely to be sensory seekers, looking for contact, sensory input, rough play, climbing sports, etc. They could also be more sensitive to sensory input like sound, taste, or touch. If your child has sensory differences and attention challenges, ADHD may be important to rule in or out. Children with ADHD may also struggle with concepts like personal space and body awareness, which may relate to their sensory perception.
Childhood Anxiety: Children who have anxiety may also have sensory sensitivities. They may react to tastes and textures, such as the feeling of sand or water on their skin. Sometimes, children with anxiety have pretty marked and unusual reactions to specific sensory experiences. An example is extreme emotional overwhelm at the feeling of water touching their skin. This reaction is not common but good to be aware of if you have an anxious child with sensory sensitivities.
Autism Spectrum Disorder: Children who have a developmental delay or have been diagnosed with autism are very likely to have sensory differences, including sensitivities. Sensory symptoms fall in the restricted interest/ repetitive behavior category of the autism diagnosis. Children on the Spectrum generally feel sensory experiences very uniquely. Knowing this, parents can approach these special needs with care.
Developmental Coordination Disorder: Children with motor coordination disorders and challenges with gross and fine motor skills may also have sensory processing differences. This disorder is another diagnosis with which you may find sensory symptoms co-occurring.
What to Do about Sensory Sensitivity
Home Suggestions For the Very Sensitive Child
- Introduce new foods a little at a time. Be consistent and be patient. The most common method occupational therapists use to teach children to tolerate foods is the Sequential Oral Sensory Approach (SOS).
“The program allows a child to interact with food in a playful, non-stressful way, beginning with the ability to tolerate the food in the room and in front of him/her; then moving on to touching, kissing, and eventually tasting and eating foods” .
Introduction of foods follows the following hierarchy:
- tolerates food
- interacts with food
- smells food
- touches food
- tastes food
- eats food
- You might first simply require the child to tolerate the food on their plate and then interact with it several times before actually eating it. Many children need to try a new food 12-20 times before deciding they like it. Don’t give up.
- When introducing new foods, the SOS model encourages playing with your food and doesn’t view this play as a bad thing. This approach never forces children to eat food.
- The SOS model also encourages fun activities before a feeding session
- Gross motor movement (swinging, obstacle course)
- Oral motor activity (blowing bubbles or using whistles)
- When dressing your child who is sensitive to collars and waistbands, make sure you offer some give and take. Let’s say you are working with your daughter to wear some formal clothing. Maybe this time, your daughter will be willing to wear some dress shoes but refuses to wear a skirt. Next time, though, perhaps she will wear a skirt as long as it has an elastic waistband. Progressively and patiently, adding sensory inputs can help your child develop tolerance. Allowing for these concessions can go a long way in developing flexibility in your child and avoiding conflict.
- Some sensitive kiddos feel like wearing a tighter shirt (e.g., Spandex) under long-sleeved shirts or coats helps them tolerate clothing.
- If your child cannot stand scratchy tags, cut them out. Some sensory issues are simply not worth fighting. Try some simple strategies like removing tags before pursuing expensive treatments.
Sensitivity to Light and Sound
- Be aware of situations that just won’t work for your child. If you have a sensory-sensitive child, you may avoid certain places. For example, a sensory-sensitive kid may not be able to handle a movie theater, luau, or concert. As a parent, it can be difficult at times to steer clear of these activities, but it may be worth it to avoid the meltdowns, throwing up, or intense anxiety these may cause your child. If this activity is very important to your family, consider introducing these activities in small steps.
When to Seek Help For Sensory Sensitivity
If your child has significant sensory challenges, a disability may be present.
Consider a comprehensive evaluation. Competent specialists recommend a neuropsychological evaluation to determine the best course of treatment. Make sure your evaluator is either a psychologist or includes team members from psychology, psychiatry, developmental pediatrics, occupational therapy, speech therapy, learning, and physical therapy. For example, you will not get a comprehensive evaluation from a speech therapist alone.
Pursue only evidence-based treatments. A comprehensive treatment plan may include some combination of occupational therapy, physical therapy, behavioral therapy, play therapy, language therapy, tutoring, school-based supports, social groups, or other therapies. Understanding your child’s profile in its entirety can help you prioritize treatment and look for research-based support. Many treatments that others may suggest to you might not have evidence to support their use in treating children.
For Autism Spectrum Disorder, more than any other diagnosis, many treatments are suggested that may not have merit. You can use a trusted website to check out a treatment and see whether it has met the standard set for research-based, effective treatment. See the Association for Science in Autism Treatment for more information on evidence-based treatments for autism. http://www.asatonline.org
Further Resources on Sensory Sensitivity
- Psychotherapist or play therapist: to treat anxiety or emotional symptoms and provide social skills training as needed. Cognitive Behavioral Therapy could help an older child, and play therapy or ABA therapy may be best for the younger age group.
- Psychologist or neuropsychologist: to consider a full assessment, look at symptoms in a mental health context, and determine diagnoses and recommendations.
- Occupational therapist: to help your child reduce sensory sensitivities and to address motor integration challenges
- Applied behavior analyst (ABA) therapist: to teach adaptive skills from a behavioral perspective, improve compliance and reduce problem behaviors, and work to meet sensory needs while also addressing behavior.
- Pediatrician or child psychiatrist: to manage medications that may treat ADHD or anxiety or symptoms like sleep problems that co-occur with Autism
Similar Conditions to Sensory Sensitivity
- Social deficits: a child’s difficulty interacting with peers and trouble reading others emotions or social cues can be related to sensory sensitivity problems
- Rigid behavior or insistence on sameness: a child’s need for predictability and the desire to have things just so can be related to sensory sensitivity problems
- Meltdowns or tantrums: a child’s screaming, hitting, refusing, could occur when the lights are too bright or the classroom is loud
- Toilet training or toileting accidents: a child’s under or oversensitivity to stimuli leading to a lack of awareness of toileting needs
- Disordered eating: a child’s under or oversensitivity to stimuli leading to a lack of awareness of hunger or to being sensitive to specific textures or tastes
- Anxiety or mood concerns: a child’s excessive worry, sadness, negative self-statements, and panic may sometimes come from extreme sensory sensitivities
- Attachment or trauma symptoms: a child’s reaction to unstable environmental situations may present with unusual sensitivities, hoarding food, breaking toys, and clinging to caregivers
Resources For Sensory Sensitivity In Childhood
 American Academy of Pediatrics (2012). Sensory Integration Therapies for Children With Developmental and Behavioral Disorders
SECTION ON COMPLEMENTARY AND INTEGRATIVE MEDICINE, COUNCIL ON CHILDREN WITH DISABILITIES. Pediatrics; 129: 1186-1189. http://pediatrics.aappublications.org/content/pediatrics/129/6/1186.full.pdf
 Association for Science in Autism Treatment:
 Toomey, Kay (Retrieved 2017). Sequential Oral Sensory approach to feeding.
And scholarly article can be found: http://sosapproach-conferences.com/resources/articles/
 Wong, Connie, et al (2015). Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder: A Comprehensive Review.
Journal of Autism and Developmental Disorders. http://fpg.unc.edu/sites/fpg.unc.edu/files/resources/reports-and-policy-briefs/2014-EBP-Report.pdf
For Sensory Processing Related Eating Challenges
 Children’s Hospital of Colorado- Swallowing
Sensory Processing Supports-
 Star Institute Occupational Therapy, Denver
 Kay A. Toomey PhD
Individual Practitioner, Feeding Specialist
 This parenting blog has many resources, including the feeding hierarchy: http://singingthroughtherain.net