Sensory Processing Disorder vs. Autism: How They Overlap and How They Differ

Sensory processing disorder (SPD) and autism both involve unusual reactions to sound, touch and other input, but they are not the same. Sensory differences are one part of autism's diagnostic criteria, along with social communication differences and repetitive behaviors. SPD is not a separate DSM diagnosis, so clinicians usually evaluate for autism, ADHD and other conditions first.

A child covers their ears at the hand dryer, refuses socks with seams, or craves spinning until they are dizzy. Is that autism, sensory processing disorder, or something else? Parents hear both terms and often get conflicting answers. This guide explains what each term means, why they overlap, how they differ, how clinicians evaluate them and which supports can help. Sensory differences are common in autism, and our guide to sensory sensitivity in autism is a good companion read.

This article is general information, not a diagnosis or medical advice.

What Is Sensory Processing Disorder?

Sensory processing disorder (SPD) is a term for difficulty taking in, organizing and responding to sensory information such as touch, sound, light, movement and taste. A child may react more strongly than expected, less than expected, or may crave extra input.

Researchers have proposed three main types, described by Miller and colleagues in 2007:

• Sensory modulation disorder. Over-responsivity, under-responsivity or sensory craving.
• Sensory discrimination disorder. Trouble telling sensory input apart.
• Sensory-based motor disorder. Difficulty with posture or planning movement.

This is a proposed grouping, not a settled one. A 2021 paper by Mulligan and colleagues notes that other experts suggest two or four main patterns. The same paper cites estimates that 5% to 16% of children in the general population may have SPD that is not explained by another diagnosis, though estimates vary by method. A common example of over-responsivity is tactile defensiveness, where ordinary touch such as clothing tags feels intense.

Is Sensory Processing Disorder a Real Diagnosis?

The sensory difficulties are real. The label is the part that is contested. SPD is not listed as a separate diagnosis in the DSM, the manual most U.S. clinicians use. The American Academy of Pediatrics (AAP) said in a 2012 policy statement that SPD "generally should not be diagnosed" because there is no universally accepted diagnostic framework. It also noted that studies have not shown sensory integration dysfunction to be a separate disorder from conditions such as autism, ADHD, developmental coordination disorder and childhood anxiety, where sensory difficulties also appear.

Some groups do use the term. The Mulligan paper notes that SPD is recognized as its own diagnosis in DC:0-5, a classification for children from birth to age five. Many occupational therapists use "sensory processing difficulties" as a description of what a child experiences. In practice, you may hear it used as a description even when it is not an official diagnosis.

Autism and Sensory Processing Disorder: What Overlaps

Sensory differences are part of how autism is defined. One of the diagnostic criteria for autism, in the DSM-5 criteria for autism summarized by the CDC, is "hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment." Examples include apparent indifference to pain or temperature, adverse responses to specific sounds or textures, and visual fascination with lights or movement. A diagnosis needs at least two of the four kinds of restricted, repetitive behaviors, and sensory features are one of them.

Sensory differences are very common in autistic children. In a 2007 study by Tomchek and Dunn, parents of 281 children with autism aged 3 to 6 filled out the Short Sensory Profile. About 95% of the autistic children showed some difference, and 83.6% showed a "definite" difference, compared with 3.2% of 281 typically developing children. The sample was a convenience sample from one region and relied on parent report, so the exact numbers should be read with that in mind.

Many autistic people find practical ways to cope, such as wearing headphones in loud places.

What Is the Difference Between Autism and Sensory Processing Disorder?

The short version: autism is a developmental diagnosis with a defined set of criteria, and sensory differences are one part of it. SPD, as proposed by its researchers, describes a sensory difficulty on its own. This table compares autism vs. sensory processing disorder as each is usually described.

Two corrections to common claims. First, autism is not something a person develops in adulthood. The CDC notes that symptoms must be present early in development, although they may not become fully apparent until social demands exceed a person's abilities, or may be masked by learned strategies. 

Many people are diagnosed as adults, but they were autistic as children. Second, saying SPD never involves social difficulty goes further than the research. Children with strong sensory difficulties may avoid noisy groups or crowded places, and that can affect their social lives. The difference is that, in SPD as proposed, social communication differences are not the defining feature.

Mulligan and colleagues also report that, in comparison studies, autism, ADHD and sensory modulation disorder looked like distinct conditions. Children with autism showed more sensory under-reactivity than children with SPD, and children with ADHD showed more inattention. 

Those studies compared groups, so they cannot say what is going on for any one child. If you want to see where autism and its look-alikes differ more broadly, our guide to types of disorders like autism covers them.

Can a Child Have Both Autism and Sensory Processing Disorder?

Because sensory differences are part of the autism criteria, clinicians usually describe them as part of an autistic child's profile rather than adding a second label. The AAP statement takes a similar view: sensory difficulties appear across several conditions, so the first step is to evaluate for those conditions. The 2021 Mulligan study excluded children with a diagnosis of autism, so it does not tell us how often the two occur together.

ADHD is the other common overlap. Both can involve fidgeting, seeking movement and trouble with noise. One neurologist quoted by CHADD says that when a child has ADHD and sensory issues, "it's ADHD and not SPD." That is one expert's view, not a rule, but it shows why a careful evaluation matters. Our guides on ADHD versus autism stimming and on autism and ADHD together explain how the two can look alike and differ.

How Are Autism and Sensory Processing Differences Evaluated?

There is no single test for SPD. The AAP advises pediatricians not to use SPD as a diagnosis, and to look for autism, ADHD, developmental coordination disorder and anxiety, often by referral. A reasonable path is:

1. Talk to your pediatrician. Describe what you see and when. Sensory differences can show up early, as in these unusual sensory responses in infancy.
2. Ask about an autism evaluation if you also see differences in communication, play or social connection. Read when autism is diagnosed to know what to expect.
3. Ask about an OT evaluation to describe how sensory reactions affect eating, dressing, sleep, school and play.
4. Know who can help. Our guide to who can diagnose autism explains which professionals evaluate for it.

What Helps: Occupational Therapy and Sensory Supports

Occupational therapy is the field that most often addresses sensory needs. Our overview of occupational therapy for autism explains what OTs do. One approach is sensory integration therapy, covered in our sensory integration therapy guide.

The evidence for that approach is limited, and it helps to know this up front. The AAP called the research on sensory integration therapies "limited and inconclusive." A 2018 systematic review by Schaaf and colleagues looked at five studies of Ayres Sensory Integration for autistic children and found insufficient evidence for improvements in play, sensory-motor, perceptual, cognitive and language outcomes. Reviews are limited by the number and quality of the studies available. They do not mean a child cannot benefit, but they do mean it makes sense to set clear goals.

The AAP suggests families and clinicians do the following:

• Set explicit, specific goals for therapy.
• Track progress with a behavior diary or before-and-after rating scales.
• Schedule a time to review whether the therapy is working.
• Prioritize treatment according to how much sensory problems affect daily functioning.

Everyday Supports at Home and School

You do not have to wait for a diagnosis to make a day easier. Changing the environment is something families and teachers can start right away, and the American Occupational Therapy Association encourages OTs to modify environments and reduce noise and distractions, according to CHADD.

• At home, a quiet corner can help a child reset. See these calming sensory room ideas.
• At school, loud, crowded spaces are often the hardest. Our guide to cafeteria and lunchroom sensory challenges shows what can help.
• When a child refuses a sensory experience, pushing harder rarely works. These tips on addressing sensory aversion take a gradual approach.

Where ABA Therapy Fits

ABA therapy does not treat sensory processing, and it does not replace an occupational therapist. What a BCBA can do is help a child manage life with sensory differences: tolerate a haircut in small steps, ask for a break, use headphones, or move through a loud hallway. A good ABA team coordinates with the child's OT, so everyone is working toward the same goals. At Apex ABA, that planning starts with what your child needs now.

Frequently Asked Questions

Q: Is sensory processing disorder a mild form of autism?

A: No. They are different concepts. Sensory differences are one part of autism, but autism also includes differences in social communication and repetitive behaviors. SPD is not a milder version of it.

Q: Can an adult develop autism or SPD later in life?

A: Autism is present from early development, so an adult does not develop it, but an adult can be recognized as autistic for the first time. Sensory difficulties can also be noticed or change over time. If you are an adult with lifelong sensory struggles, ask a clinician about an evaluation.

Q: Which professional should I see first?

A: Start with your child's pediatrician. They can screen for autism, ADHD and other conditions, and refer you to a developmental specialist or an occupational therapist.

Q: What should I ask my child's school?

A: Ask for an evaluation of how sensory needs affect learning, and about accommodations such as a quiet break space. Our guide to 504 plans and IEPs explains the options.

Ready to Talk About ABA Therapy?

If your child has sensory differences along with other needs, our team can help you plan. Read what an ABA session involves, visit Apex ABA, contact us or call 888-690-0663.

Sources

1. CDC, "Clinical Testing and Diagnosis for Autism Spectrum Disorder" (DSM-5 criteria summary): https://www.cdc.gov/autism/hcp/diagnosis/index.html
2. Zimmer, M., Desch, L., et al. (2012). Sensory Integration Therapies for Children With Developmental and Behavioral Disorders. American Academy of Pediatrics policy statement. Pediatrics, 129(6), 1186-1189 (copy hosted by the Brazilian Society of Pediatrics): https://www.sbp.com.br/fileadmin/user_upload/pdfs/POLICY_STATEMENT-Sensory_Integration-Therapies_Children_With_Developmental-Behavioral_DisordesAAP2012.pdf
3. Mulligan, S., Douglas, S., & Armstrong, C. (2021). Characteristics of Idiopathic Sensory Processing Disorder in Young Children. Frontiers in Integrative Neuroscience: https://www.frontiersin.org/journals/integrative-neuroscience/articles/10.3389/fnint.2021.647928/pdf
4. Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: a comparative study using the Short Sensory Profile. American Journal of Occupational Therapy, 61(2), 190-200 (publisher PDF copy): https://sensoryhealth.org/sites/default/files/publications/10SensoryProcessingInChildren.pdf
5. Schaaf, R. C., et al. (2018). Efficacy of Occupational Therapy Using Ayres Sensory Integration: A Systematic Review. American Journal of Occupational Therapy, 72(1) (ASHA Evidence Map summary): https://apps.asha.org/EvidenceMaps/Articles/ArticleSummary/1a87a5ac-75c5-438e-ac7a-a3f794c57ad9
6. CHADD, "Sensory processing disorder & ADHD: What to know" (ADHD Weekly, 2016): https://chadd.org/adhd-weekly/sensory-processing-disorder-adhd-what-to-know/