FLORA’S KISS BLOG

Sensory Processing Disorder: A Deep Dive Into What It Is, How It Affects You, and Where to Find Diagnosis and Support

Why a scratchy tag, a fluorescent light, or a crowded room can feel like an emergency — and what science, and Australia’s health system, actually have to say about it

Picture a supermarket on a Saturday morning. Trolley wheels squeak, a checkout beeps, someone’s toddler is crying two aisles over, the fluorescent lights hum, and a stranger’s shoulder brushes yours in the cereal aisle. For most people, this registers as mildly annoying background noise. For someone whose nervous system processes sensory information differently, that same ten minutes can feel like standing too close to a fire alarm — every sound, light, and touch arriving at full volume, all at once, with no way to turn any of it down. For someone else, that exact same environment might barely register at all, leaving them seeking out more noise, more movement, more input just to feel like they’re really in the room.

This is the everyday reality behind Sensory Processing Disorder (SPD) — a term used to describe significant, persistent difficulty receiving, organising, and responding to sensory information from the body and the environment. This piece is a deep dive into SPD: where the concept came from, why it remains one of the more contested ideas in paediatric and allied health, what it actually looks like across the different senses, how it overlaps with autism and ADHD, how assessment and support work in Australia, and where to turn for real, practical help. Above all, this is written to make one thing clear: whether or not SPD ever becomes an official diagnosis in its own right, the sensory difficulty behind it is real, it is exhausting to live with unsupported, and it deserves to be taken seriously.

Where the Idea Came From

The foundational theory behind SPD was developed in the 1960s and 1970s by Dr A. Jean Ayres, an American occupational therapist and educational psychologist. Ayres proposed that the brain’s ability to organise sensory input from the body and the environment — touch, movement, body position, sound, sight — underpins everything from motor coordination to learning to emotional regulation. She called this process “sensory integration”, and argued that when it doesn’t develop typically, children can struggle with everyday tasks in ways that aren’t explained by intelligence, motivation, or discipline.

The term “Sensory Processing Disorder” itself was popularised decades later by psychologist Dr Lucy Jane Miller, who founded the SPD Foundation — now the STAR Institute for Sensory Processing — in Colorado. Miller and her colleagues built a substantial body of clinical and research work around SPD, developed assessment tools, trained clinicians internationally, and campaigned for SPD to be formally added as its own diagnosis in the DSM-5, the diagnostic manual used across much of the world. That campaign did not succeed, and understanding why matters for anyone trying to make sense of a diagnosis, a school report, or a therapy recommendation that mentions SPD.

What SPD Actually Is — and Why It Isn’t an Official Diagnosis

Sensory Processing Disorder is not a recognised diagnosis in the DSM-5, the manual used by psychiatrists and psychologists in Australia and most of the world, and it is not currently recognised as a stand-alone diagnosis here either. Raising Children Network, the Australian Government-backed parenting resource, is direct about this: sensory processing difficulties are real and well documented, but “sensory processing disorder” isn’t an official diagnosis in Australia, even though the term is widely used in everyday conversation, in some clinical reports, and by allied health professionals describing what they’re observing.

There is one partial exception worth knowing about. The DC:0-5, a diagnostic classification system developed by the organisation ZERO TO THREE specifically for infants and very young children’s mental health and developmental presentations, does include a category called “Regulation Disorder of Sensory Processing”. This gives some formal diagnostic language to sensory-based regulation difficulty in very early childhood, even though the broader SPD concept still sits outside the DSM-5 and ICD-11 for older children and adults.

The Debate, Explained Fairly

This is a genuinely active, ongoing debate within paediatric health, not a settled question, and it’s worth understanding both sides rather than picking one uncritically.

• The case for recognising SPD: Occupational therapists and sensory-focused clinicians argue that sensory difficulties are a distinct, identifiable pattern that shows up with or without another diagnosis, that sensory-based interventions genuinely help many children regulate and function better, and that a name and framework for these struggles helps families and schools take them seriously instead of dismissing them as fussiness or bad behaviour.⁴
• The case for caution: Many neuropsychologists and researchers argue there isn’t yet enough rigorous evidence to support SPD as its own separate disorder, that some proposed mechanisms haven’t been carefully tested, and — most practically — that giving a child an SPD label can sometimes delay a fuller assessment for autism, ADHD, anxiety, or another condition where sensory differences are one symptom among several, not the whole picture.⁴

The most useful, least polarised way to hold this: the sensory experiences themselves — being overwhelmed by textures, sounds, or light, or needing much more input than most people to feel calm and regulated — are well documented and real, whatever the formal diagnostic label ends up being. What’s contested is whether they add up to one distinct, stand-alone disorder, or whether they’re better understood as a feature that shows up inside several different diagnoses. For a family trying to get support today, this distinction matters less than getting an accurate, thorough assessment from the right professional — which we’ll come back to below.

The Three Recognised Patterns of Sensory Processing Difference

Even without a single DSM entry, the clinical framework built up around SPD — largely through the STAR Institute’s research — describes three broad patterns. A person can show features of more than one pattern at the same time, and can be affected differently across different senses.

1. Sensory Modulation Differences

This is about how intensely the nervous system registers and reacts to sensory input, and it has three recognised presentations:

• Sensory over-responsivity (SOR): The nervous system registers sensation more easily and more intensely than most. Ordinary input — a tag in a shirt, a hand dryer, a hug — can trigger a genuine stress response, and the person often works hard to avoid or minimise these sensations.
• Sensory under-responsivity (SUR): The nervous system needs much more intensity or repetition before it registers input at all. This can look like not noticing pain, temperature, a full bladder, or someone calling their name, and can be mistaken for inattention or disinterest.
• Sensory craving or seeking: The person actively seeks out intense sensory experiences — spinning, crashing into things, loud noise, strong flavours — because their system needs a higher level of input to feel regulated, alert, or calm.

2. Sensory Discrimination Differences

This is about accurately telling sensory qualities apart — not how intensely something is felt, but how clearly it’s interpreted — and it can affect any of the body’s eight recognised sensory systems, including the three that are less commonly discussed:

• Auditory: distinguishing similar sounds, following speech in background noise
• Visual: distinguishing similar shapes, letters, or objects, or tracking visual detail
• Tactile: identifying what’s being touched, or where, without looking
• Vestibular: interpreting movement, balance, and the body’s position relative to gravity
• Proprioceptive: sensing where the body’s own joints and muscles are in space
• Gustatory: distinguishing tastes
• Olfactory: distinguishing smells
• Interoception: reading the body’s internal signals — hunger, thirst, needing the toilet, a racing heart, rising emotion — a system increasingly recognised as central to emotional regulation, and not just physical sensation.

3. Sensory-Based Motor Differences

This pattern affects movement and physical coordination as a downstream result of how sensory information is processed:

• Postural disorder: difficulty stabilising the body, whether at rest or during movement — this can look like poor balance, low muscle tone, or tiring quickly from tasks that require sustained posture, like sitting at a desk.
• Dyspraxia: difficulty planning and carrying out new or unfamiliar physical movements — forming an idea for a movement, sequencing the steps, and executing them smoothly — which can affect anything from handwriting to riding a bike to using cutlery.

What It Looks Like, Sense by Sense

Sensory differences rarely follow a tidy pattern. It’s genuinely common for the same person to be over-responsive in one sensory system and under-responsive in another — overwhelmed by fluorescent light while also craving deep pressure or intense movement — which is one reason a generic checklist can only ever be a starting point, not a diagnosis.

How Common Is It — and How Confident Can We Be in the Numbers?

Because SPD isn’t a formally diagnosed condition, there’s no single agreed prevalence figure, and the numbers most often cited come from advocacy and clinical organisations rather than large-scale population studies, so they’re worth holding with appropriate caution. The STAR Institute cites an early study suggesting at least 1 in 20 children’s daily life is affected by sensory processing difficulty, and separately references research suggesting as many as 1 in 6 children experience sensory differences significant enough to affect everyday functioning. Both figures describe a spectrum from mild to significant difficulty, not a single fixed rate of “disorder”.

Sensory differences are understood to affect a large majority of autistic people specifically — commonly cited research puts sensory abnormalities at over 90% of autistic children assessed — and there’s a growing, though still developing, research base on overlap with ADHD, where sensory over-responsivity and sensory seeking are increasingly studied as a genuine feature of the condition rather than an unrelated coincidence.

A 2013 UC San Francisco brain-imaging study using diffusion tensor imaging found measurable differences in the white matter structure of boys with sensory processing difficulties compared with typically developing boys and with autistic boys, offering early biological evidence that sensory processing differences may have a distinct neurological signature — though as with much of this field, this is one study, not a settled finding, and larger replications are still needed before firm conclusions can be drawn.

Overlap With Other Conditions

Sensory processing difficulty very rarely exists entirely on its own, which is a large part of why a thorough assessment matters more than a quick label:

• Autism spectrum disorder: Sensory reactivity has been part of the official DSM-5 autism diagnostic criteria since 2013 — it is not a separate, optional add-on, but one of the recognised features clinicians look for directly.⁷
• ADHD: A meaningful and growing body of research links ADHD with sensory over-responsivity and sensory seeking, though the exact relationship — whether shared neurology, overlapping symptoms, or something else — is still being actively researched.⁹
• Anxiety: Chronic sensory overwhelm is exhausting and unpredictable, and can contribute meaningfully to anxiety — while pre-existing anxiety can also heighten a person’s sensitivity to sensory input, making the two difficult to fully untangle.
• Developmental coordination disorder (DCD/dyspraxia): Sensory-based motor differences and DCD overlap significantly in how they present day to day, particularly around coordination and motor planning.
• Genetic and developmental conditions: Sensory processing differences are also commonly reported in Fragile X syndrome and in children born prematurely or at low birth weight, among other developmental profiles.⁶

None of this means sensory difficulty is “actually” always one of these other conditions in disguise — plenty of children and adults have significant sensory processing differences without meeting criteria for any of the above. It means a proper assessment, rather than a single checklist, gives the clearest and most useful picture.

Getting an Assessment in Australia: Who’s Involved, and What to Expect

Because SPD isn’t a stand-alone Australian diagnosis, there’s no single Medicare item number or referral pathway that says “SPD assessment” on the label. In practice, sensory processing difficulty is assessed and supported through occupational therapy, usually alongside — or as part of the picture that leads to — assessment for autism, ADHD, anxiety, or a developmental delay. Here’s how that typically unfolds.

A typical assessment brings together caregiver and, where appropriate, teacher questionnaires, structured clinical observation of the person engaging in different sensory-based tasks, and a detailed history of how sensory reactions show up across home, school, and community settings — because a pattern that only appears in one environment tells a very different story from one that shows up everywhere.

If your child or you already hold an NDIS plan — most often because of an autism, ADHD, or developmental delay diagnosis — occupational therapy addressing sensory needs can typically be funded as a “capacity building” support, worth raising directly with your planner or support coordinator. If there’s no NDIS plan in place, private paediatric OT assessment and therapy is available Australia-wide, with partial Medicare rebates available through a GP-issued care plan, and some costs may be offset through private health insurance extras cover.

Support and Treatment That Actually Helps

The best-known therapeutic approach is Ayres Sensory Integration (ASI) — structured, play-based occupational therapy delivered in a sensory-equipped clinic space, following specific fidelity principles originally set out by Jean Ayres and refined since. It’s worth being candid about where the evidence currently sits, because families deserve an honest picture rather than a marketing one.

A 2026 systematic review published in the Journal of Autism and Developmental Disorders examined studies that adhered to the revised ASI fidelity measure in children under ten. It found the evidence base remains limited: only a handful of the reviewed studies met a low risk-of-bias standard, and even among those, results were mixed rather than consistently positive. The review’s authors recommend combining sensory-informed strategies with approaches that have stronger, higher-quality evidence behind them, and highlight environmental modification — changing the sensory demands of a space rather than only trying to change the child’s response to it — as a well-supported complementary strategy in its own right.

In practice, most Australian OTs draw on a combination of the following, tailored to the individual rather than applied as a fixed program:

• Sensory diets: an individualised, scheduled plan of sensory activities — movement breaks, deep pressure, chewy snacks, quiet time — built to help a person’s nervous system stay within a regulated, functional range across the day, rather than swinging between overwhelm and shutdown.
• Environmental modification: practical changes to reduce unnecessary sensory demand — noise-reducing headphones, dimmer lighting, seating away from high-traffic areas, tag-free clothing, and predictable routines — often the single most immediately useful intervention available.
• Graded exposure and desensitisation: slow, consent-based, child-led introduction to challenging sensory experiences, paired with regulation strategies, rather than forced exposure.
• Interoception and emotional regulation coaching: increasingly used, particularly where sensory overwhelm and emotional dysregulation are closely linked — helping a person build a clearer internal map of their own body’s signals.
• Collaboration with school: consistent sensory strategies between home and the classroom — a quiet corner, movement breaks, flexible seating, advance warning of fire drills or assemblies — tend to make the biggest practical difference to a child’s day.

Medication doesn’t treat sensory processing differences directly, but may be used by a psychiatrist or paediatrician to manage a co-occurring condition — anxiety or ADHD, for example — where that’s contributing to overall distress.

Advice for Parents and Carers

• Trust what you’re seeing. If a checklist doesn’t quite fit but your instinct says something real is going on, that’s worth a professional assessment — you know the gap between your child at home and your child elsewhere better than anyone.
• Look for a paediatric occupational therapist with specific experience in sensory processing, and ask directly about their assessment approach before booking — general paediatric OT training doesn’t always include deep sensory integration expertise.
• Hold two things at once: sensory support can genuinely help day to day, and if a broader diagnosis like autism or ADHD hasn’t been explored yet, it’s worth asking your OT or GP whether that assessment should happen alongside, not instead of, sensory-specific support.
• Build predictability into transitions and new environments wherever you can — advance warning, visual schedules, and the option to leave or take a break go a long way for an overwhelmed nervous system.
• Look after your own capacity too. Supporting a child through sensory overwhelm, meltdowns, or shutdowns is genuinely tiring, and you deserve support as much as your child does.

Advice for Teachers and Educators

• Treat sensory-seeking or sensory-avoidant behaviour as communication, not defiance — a child leaving their seat, covering their ears, or refusing an activity is very often telling you something true about their environment.
• Offer, rather than mandate, sensory tools and options — a fidget, noise-reducing headphones, a standing option, a quiet corner — and normalise their use for the whole class so no one child is singled out.
• Give advance warning before loud, bright, or crowded events — assemblies, fire drills, sport carnivals — where possible, and have an agreed exit plan ready.
• Loop in the school’s wellbeing leader, counsellor, or learning support team early, and ask the family who else is involved in the child’s care, so strategies stay consistent across home and school.

Resources — Where to Turn Next

Closing Thoughts

SPD sits in an unusual, slightly uncomfortable place in health care right now: widely recognised by families and clinicians as something real, genuinely felt, and worth taking seriously, while still not carrying the formal diagnostic weight of a DSM-5 entry. That gap can be frustrating, especially when it affects funding, school accommodations, or simply being believed. But it doesn’t change the substance of the experience underneath it — a nervous system working overtime to manage a world that, for some people, arrives too loud, too bright, too fast, or not clearly enough at all.

If you recognise your child, your student, or yourself in this piece, that recognition is worth trusting. A proper assessment — thorough, individualised, and delivered by someone experienced in this specific area — is the surest way to move from a checklist to a genuine, workable plan.

You are not alone, and neither is anyone in your care. There is a whole community of families, educators, and clinicians walking this path — you don’t have to figure it out by yourself.

Sources

1. STAR Institute, “Founder Dr. Lucy Jane Miller” and “About Us” (sensoryhealth.org); NCBI StatPearls, “Sensory Integration.”
2. Raising Children Network, “Sensory processing disorder & difficulties” (raisingchildren.net.au).
3. ZERO TO THREE, “DC:0–5 Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood” — crosswalk to DSM-5 and ICD-10 (zerotothree.org).
4. Child Mind Institute, “Is Sensory Processing Disorder a Real Diagnosis?” (childmind.org).
5. STAR Institute, “Patterns or Subtypes of Differences in Sensory Integration & Processing” (sensoryhealth.org).
6. STAR Institute, “About SPD” (sensoryhealth.org), citing Ahn, R.R., Miller, L.J. et al. (2004) on prevalence.
7. Leekam, S. et al. (2007), summarised via Autism Parenting Magazine, “Hyposensitivity Among Autistic Individuals”; American Psychiatric Association, DSM-5-TR, Criterion B4 (sensory reactivity in autism, added 2013).
8. CHADD, “New Research in Sensory Processing Dysfunction” (chadd.org).
9. University of California, San Francisco, “Breakthrough Study Reveals Biological Basis for Sensory Processing Disorders in Kids” (2013, ucsf.edu).
10. Journal of Autism and Developmental Disorders (2026), “Efficacy of Interventions Adhering to the Revised Ayres Sensory Integration® Fidelity Measure: A Systematic Review,” Springer.
11. Pearson Clinical Assessment AU&NZ, “Sensory Processing Assessments for Occupational Therapists” (pearsonclinical.com.au) — Sensory Profile 2 and Sensory Integration and Praxis Tests (SIPT).