Sensory Processing Issues in ADHD: Hyper- and Hyposensitivity
Children with ADHD (Attention-Deficit/Hyperactivity Disorder) often experience co-occurring conditions, including sensory processing issues. These issues arise when the brain struggles to process and respond to sensory information, significantly impacting a child's interaction with their environment, including their response to sounds, lights, touch, and tastes. Dr. Danish and his team at Philadelphia Integrative Psychiatry frequently encounter these challenges and are dedicated to providing comprehensive care tailored to each child's unique needs.
Sensory Processing in ADHD
Sensory processing issues in ADHD can manifest as either hyper- or hyposensitivity to stimuli. In some cases, children may exhibit both types of sensitivity depending on the sensory system involved. For example, a child might be hypersensitive to auditory stimuli but hyposensitive to tactile (touch) input. This dual nature of sensory processing issues can lead to a variety of comorbid conditions often seen in ADHD.
Research Findings
A research article titled "Atypical sensory processing in adolescents with Attention Deficit Hyperactivity Disorder: A comparative study" investigates the sensory processing differences between adolescents with ADHD and their typically developing peers. The study found that adolescents with ADHD scored significantly higher across all four components of the Adolescent Sensory Profile (ASP): Low Registration, Sensation Seeking, Sensory Sensitivity, and Sensation Avoiding. Significant differences were observed in sensory processing across various modalities, including taste/smell, movement, visual, touch, activity level, and auditory processing. These findings support the Cumulative and Emergent Automatic Deficit (CEAD) model, which posits that altered sensory processing in ADHD impairs the ability to automate behaviors and process information efficiently, leading to increased cognitive load and impairments in controlled processes such as attention, memory, and impulse control.
Another study titled "Sensory processing abilities and their impact on disease severity in children with attention-deficit hyperactivity disorder" found that children with ADHD had significantly lower scores on most sensory processing factors compared to controls. Notably, children with ADHD-Hyperactive-Impulsive (ADHD-HI) and ADHD-Combined (ADHD-C) subtypes exhibited higher sensory processing scores, indicating hyperresponsiveness, while the ADHD-Inattentive (ADHD-I) subtype tended to be hyporesponsive. There was a moderate negative correlation between hyperactivity/impulsivity and auditory processing scores, suggesting that higher hyperactivity/impulsivity is associated with more auditory processing problems. Additionally, weak correlations were found between visual processing scores and learning problems, and between the severity of conduct disorder, oppositional defiant disorder, anxiety, and sensory processing scores.
Impact on Daily Life
The sensory processing issues in ADHD can lead to various comorbid conditions; just a few common examples include:
Increased Touch and Avoidance of Touch: Children may seek out physical touch to help regulate their sensory input or avoid it due to hypersensitivity.
Hyperactivity: Sensory seeking behaviors can manifest as hyperactivity, where children may move a lot or invade personal space.
Restricted Food Interests: Children with ADHD often exhibit more restricted dietary preferences and/or a reduced appetite, and Avoidant/Restrictive Food Intake Disorder (ARFID) can play a significant role in this; read Dr. Danish’s comprehensive blog here on ARFID.
Enuresis: Hyposensitivity to sensory input can lead to issues like enuresis, where children may not feel a full bladder.
Attention and Distraction: Children may struggle with attention, either not hearing a teacher due to hyposensitivity and/or being easily distracted by peers due to hypersensitivity.
Sensory Seeking Behavior
Children with ADHD who also have sensory processing challenges may be "sensory seekers." They often crave specific types of sensory input to help them regulate their responses and physical state. Physical touch can be a significant source of this needed sensory input. Other examples include more risky behaviors such as climbing on furniture, or eating dopamine elevating foods such as sugary snacks.
Self-Regulation, Grounding, and Sensory Regulation
Touch can be a crucial tool for self-regulation, especially for children with ADHD. Deep pressure touch, such as firm hugs or being wrapped in a heavy blanket, can help children calm down when they are feeling stressed, anxious, or overstimulated. This type of touch can be soothing and may stimulate the release of serotonin, a neurotransmitter that aids in mood regulation and fosters feelings of calm. Additionally, physical touch acts as a grounding technique, helping children feel more connected to their bodies and surroundings. This is particularly beneficial for children with ADHD who might feel scattered or unfocused. Touch can also serve as a distraction from sensory overload or intense emotions, helping to redirect attention away from distressing thoughts or feelings.
Incorporating various types of touch and other sensory activities can be highly beneficial for children with ADHD. For those who are sensory seekers, using weighted blankets or vests, fidget toys, or engaging in physical activities that involve 'heavy work' (like carrying or pushing heavy objects) can help them feel more alert and focused. Allowing children to be fidgety or to doodle can also aid in maintaining their attention and managing their energy levels. Sensory fidgets, such as stress balls or koosh balls, provide an outlet for the brain and body’s need for movement, helping children remain focused. Additionally, activities like yoga, deep breathing exercises, and meditation can help children learn to calm their nerves and manage strong emotions. Creating a sensory box with familiar items or setting up a quiet space for self-regulation can also provide a safe environment for children to manage their emotions effectively.
Comprehensive Care at Philadelphia Integrative Psychiatry
At Philadelphia Integrative Psychiatry, we specialize in diagnosing and treating ADHD and sensory processing issues. Our holistic and integrative approach ensures that we consider all aspects of our patients' well-being in developing personalized treatment plans. If you or a loved one are seeking support for ADHD or similar conditions, please text or call 610-999-6414 to learn how we can help.
For more on this topic and related subjects, check out these blogs:
Here is a list of blogs by Dr. Danish on various on- and off-label medications for ADHD.
