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Key points
- Sensory processing issues are common in neurodevelopmental disorders such as ADHD and autism.
- The overstimulation of one or all five senses can trigger sensory overload.
- Learning what triggers sensory overload and making accommodations using sensory-friendly items can help alleviate a meltdown.
Virtually anyone can have a sensory processing issue; however, more often than not, sensory processing challenges affect the neurodiverse. More specifically, they're commonly seen in neurodevelopmental disorders such as ADHD and autism.
A 2015 review found that children with ADHD had substantially more sensory processing issues than neurotypical children. It is so prevalent that in 2019, researchers even called for sensory over-responsivity to be added to diagnostic criteria for ADHD.
These “hypersensitivities” are best characterized as having an extreme or heightened reaction to sensory stimuli such as sight, sound, taste, touch, smell. This emotional reaction is sometimes referred to as “sensory overload,” characterized by difficulty regulating emotional responses to sensations. In short, the brain is overwhelmed with more sensory information than it can process, often resulting in feelings of anxiety, anger, and fear.
Although “sensory issues” may sound trivial, they can significantly interfere with everyday functioning and are beginning to be taken more seriously by the mental health community. Individuals more susceptible to these hypersensitivities experience sensations more intensely and for more extended periods than neurotypicals. Consequently, it’s not uncommon for these individuals to demonstrate “fight or flight” behaviors such as agitation, panic, and a general feeling of being "unsafe."
Because all senses can be affected by sensory modulation difficulties, all aspects of life can be affected as well. The sensory processing literature is replete with evidence that sensory issues are associated with negative affect, aggressive behaviors, emotional reactivity, decreased overall well-being, social participation, and anxiety.
One study even found that more sensory issues in ADHD predict higher levels of aggression and delinquency. These unfortunate—and, more importantly, preventable—consequences speak to the importance of early detection and intervention.
Symptoms of Sensory Overload
Sensory overload can be triggered by overstimulation of one or all five senses, and the emotional and physical reactions can be mild, moderate, or severe.
In children, it often looks like a complete meltdown. It’s not unusual for children to:
- Cry
- Whine
- Run away
- Avoid specific people, places, and situations
- Close their eyes
- Cover their nose
- Cover their ears
- Gag at different smells, tastes, and textures
- Complain of nausea
- Perseverate on a specific sensation—i.e., a tag, seam, or certain type of fabric
In teens and adults, symptoms include:
- Inability to ignore loud sounds, strong smells, or other types of sensory input
- Anxiety and fear
- Extreme sensitivity to clothing or different textures
- Feeling overwhelmed or agitated
- Irritability
- Difficulty focusing
- Restlessness
- Stress
- Insomnia
Types of Sensory Triggers in ADHD and How to Handle Them
1. Touch-Tactile Sensitivities
Triggers: Hugs, unwanted personal contact, hair brushing, brushing teeth, touching sticky things, clothing that’s too tight or itchy, holding a pencil, clothing tags, sock seams, certain fabrics.
How to accommodate:
Luckily, many brands now create sensory-friendly clothing for children and adults. A simple internet search will yield thousands of hits. There are even unique detangling hairbrushes available on the market for those who struggle with hair-brushing.
2. Sound-Auditory Sensitivities
Triggers: Loud noises, fireworks, music, barking, chewing, crunching, tongue clicking, tapping, slurping, swallowing, nail filing, chirping, whistling, and movie theaters. These triggers could indicate that the individual is struggling with a condition called misophonia, which is Greek for “hatred of sound.” These sounds elicit extreme emotional reactions such as anger, rage, and disgust.
How to accommodate:
Earplugs, ear pods, and noise-canceling headphones are all valuable tools. Special headsets for the hearing impaired are also offered at certain movie theaters, which allow you to control the volume of the movie. Call ahead to see if your local movie theater carries the device.
Parents may also need to be understanding of their child wearing earplugs at the dinner table if it means eating together as a family. If that’s not a viable option, allow for background music to muffle out the chewing sounds at dinner.
3. Sight-Visual Sensitivities
Triggers: Bright lights, flashing lights, video games, TV shows
How to accommodate:
Sunglasses, hats, dimming lights, and getting rid of fluorescent lightbulbs are all helpful solutions. Spending less time on screens can also reduce the likelihood of being triggered.
4. Smell-Olfactory Sensitivities
Trigger: Perfumes, colognes, aftershaves, cigarette smoke, gases, and food can cause individuals to become nauseous, gag, or even throw up. Many people report feeling distracted, “wound up,” overwhelmed, and agitated by scents that others would have difficulty even noticing.
How to accommodate:
An excellent place to start is identifying triggers. Cooking with your family is a great way to understand which foods or scents elicit adverse emotional reactions. Making your environment as fragrance-free as possible is also helpful. Finally, keeping rooms well ventilated may be the best option. Keep a set of Kleenex with you at all times, just in case you need to cover your nose.
5. Taste and Texture-Gustatory Sensitivities
Triggers: Brushing teeth, hot food, cold food, specific textures—i.e., smooth, crunchy, or pureed food—particular flavors of food (i.e., food that is too sugary, too sweet, too salty)
How to accommodate:
Multiple sensory-sensitive toothbrushes are designed with soft bristles to reduce tooth and gum pain. As for food and eating issues, please note a significant difference between a “picky eater” and someone with a sensory processing issue. Picky eaters typically do not exhibit the extreme reactions seen during sensory overload. For example, a picky eater will not gag, panic, or cry when trying new foods. An individual with gustatory sensory issues might.
Occupational therapy for children is beneficial and essential as nutritional deficiencies are associated with this sensory issue.
To find a therapist, visit the Psychology Today Therapy Directory.
