When doing assessments, we often find that children are diagnosed with ADHD when in fact it is a sensory processing issue. Have a look at the article below to learn more about sensory processing issues and ADHD and how to distinguish between the two.
By Peg Rosen
Constantly fidgeting and squirming. Invading personal space. Melting down in public. These can be signs of both ADHD and sensory processing issues. While they’re different issues, they have some overlap and can occur together. This table breaks down some of the key differences between ADHD and sensory processing issues.
|ADHD||Sensory Processing Issues|
|What is it?||A biological condition that makes it hard for many children to concentrate and sit still.||An over- or undersensitivity to sensory input such as sights, sounds, flavors, smells and textures.|
|Signs you may notice||· Seems daydreamy or confused
· Appears not to listen
· Is prone to tantrums and meltdowns due to lack of impulse control
· Struggles with organization and completing tasks
· Gets easily bored unless an activity is very enjoyable
· Struggles to sit still during quiet activities
· Is impatient and has trouble waiting his turn
· Is constantly moving
· Fidgets and needs to pick up and fiddle with everything
· Interrupts people and blurts things out inappropriately
· Doesn’t understand the consequences of his actions
· Plays roughly and takes physical risks
· Has trouble focusing; can’t filter out distractions
· Dislikes being touched
· Notices sounds and smells that others don’t
· Has meltdowns, flees or becomes upset in noisy, crowded places
· Fears for his safety even when there’s no real danger
· Has difficulty with new routines, new places and other change
· Shifts and moves around because he can’t get comfortable
· Is very sensitive to the way clothing feels
· Constantly needs to touch people or things
· Has trouble gauging others’ personal space
· Seem clumsy or uncoordinated
· Shows a high tolerance for pain
· Plays roughly and takes physical risks
|Possible emotional and social impact||Trouble following social rules can make it hard to make and keep friends. Frequent negative feedback for acting out or not paying attention can impact self-esteem and motivation, making a child feel he’s “bad” or “no good.”||Feeling anxious in or avoiding crowded and noisy places can make it hard to socialize. Peers may avoid or exclude an undersensitive child because he plays too roughly or doesn’t respect their personal space.|
|Professionals who can help||· Pediatricians, developmental behavior pediatricians, nurse practitioners, child psychiatrists: Diagnose ADHD and prescribe ADHD medication. Psychiatrists will look for other issues like anxiety.
· Clinical child psychologists: Provide behavior therapy to teach kids skills to manage their actions and interactions. Provide cognitive behavioral therapy to help with emotional issues related to their ADHD. Diagnose ADHD and mental health issues that may co-occur, such as anxiety. May also evaluate for learning issues.
· Pediatric neuropsychologists: Diagnose ADHD and common mental health issues that may co-occur, such as anxiety. May also evaluate for learning issues.
|· Occupational therapists: Help kids learn coping skills for challenging situations. Provide sensory integration therapy that helps kids respond to sensory input in an appropriate way.
· Clinical child psychologists: Provide behavior therapy to teach kids skills to manage their actions and interactions. Provide cognitive behavioral therapy to help with emotional issues related to their sensory processing issues. Diagnose ADHD and mental health issues that may co-occur with sensory processing issues. May also evaluate for learning issues.
· Developmental behavioral pediatricians: Prescribe medication for anxiety to relieve panic responses.
|What the school may provide||Accommodations under a 504 plan or an IEP. Child might be eligible for an IEP under the category of “other health impairment.” Examples might include:
· Extended time on tests, including standardized tests
· A seat close to the teacher and away from distractions
· A larger, more private work space to get work accomplished
· A signal, nonverbal cue or picture card to get the child’s attention
· Long assignments broken into smaller chunks
· Worksheets with fewer questions
· Written or picture schedules for daily activities
· Movement breaks
|Accommodations and/or occupational therapy, under a 504 plan or an IEP. Child might be eligible for an IEP under the category of “other health impairment,” especially if he also has ADHD. Examples of accommodations might include:
· A seat away from distracting sources of noise
· Sensory breaks
· Physical activity to help regulate emotions, behavior and need for movement
· Noise-canceling headphones or ear buds to reduce stimulation in busy places like assemblies
· A chair that is a good fit for him so he can put his feet flat on the floor and rest his elbows on the desk
· An inflated cushion or pillow so he can both squirm and stay in his seat
|What you can do at home||· Set rules and stick to them to help your child think before acting.
· Create daily routines and rituals to provide structure.
· Break tasks into smaller chunks.
· Use visual prompts like checklists, visual schedules and sticky notes to help your child focus, stay organized and get things done.
· Allow for breaks during homework and study time.
· Create an organized homework and study area.
· Help organize his backpack and check that it’s cleaned out regularly.
· Give advance warning about changes in the schedule and explain what he can expect in new situations.
|· Track your child’s behavior patterns so you can anticipate tough situations for him.
· Prepare your child for social gatherings or new situations so he knows what to expect.
· Keep earplugs or ear buds handy.
· Find outlets for your child’s energy such as exercise routines, sports or music.
· Teach your child about dangerous situations he may not be sensitive to, such as bitter cold and burning heat.
· Buy divided plates if he’s bothered when different foods touch.
· Install and use dimmer switches or colored bulbs to modify lighting.
· Shop with your child so he can pick out clothes that are comfortable for him.
· Look for tagless, seamless clothes in super-soft fabrics.