We’ve created a sensory processing disorder checklist as a tool for sensory processing needs. Having resources like this sensory processing and self-regulation checklist will support sensory needs in individuals of all ages.
Sensory processing disorder is a condition where the brain misinterprets sensory information so that the body responds in atypical ways. Sensory processing disorder can be broken down into different categories, but one thing is clear: interpretation of sensory input is “off”.
Printable Sensory Processing Disorder Checklist
Below, you will find a list of common sensory responses that might be seen with sensory processing disorder. Use this sensory processing disorder checklist to better understand responses to sensory input. It will be helpful to read this sensory processing disorder chart to get a bigger picture on this umbrella term.
I see evidence of sensory processing challenges everywhere. Though not all of them should be classified as disorders. Sometimes it is ok to be a seeker or an avoider for our safety, wellbeing, career, or comfort. A person who is sensitive does not necessarily have a disorder until it affects their daily life. I do not like a lot of textures, however, I am functioning well in my day to day life.
Here are a few other examples of sensory red flags that are not damaging:
- Certain athletes feel a drive to exercise. They must do it for their well being. Perhaps their arousal level is off, and exercise provides the modulation they need.
- Football players love crashing and bumping. Is it possible they are sensory seekers, driven to engage in this sport?
- Goldilocks had a hard time finding the right porridge, bed, and chair. Maybe she was sensitive to texture, taste and temperature. Eventually she found the right situation that suited her needs. She did not have a meltdown or shutdown in the process.
- In The Old Hat, New Hat Book Papa Berenstain had a hard time finding the right hat. Too twisty, too twirly, too beady, too bumpy. In the end he decided on his familiar hat. This might be classified as a disorder if he “needed” a new hat and could not get one. We see this often with children having to get new shoes. Change is hard.
- What professions can you see might be tactile seekers? Gardeners, artists, potters, masseuses, and chefs?
- Who is likely to be avoiding stimuli when choosing their profession? People who choose to work at home, solitary workers, librarians, a spa manager, or an accountant?
- Is it fair to say that people who choose high energy jobs are seekers or sensory integrated? Nurses, teachers, taxi drivers, OT/PTs? Maybe. Perhaps like me, they are not seekers or well integrated, but driven to help. I am exhausted mentally and physically at the end of the day. My profession is probably toxic for me, but important enough that I keep going.
When looking at all the red flags in diagnosing others, it is important to judge the impact the difficulty is having on life. This level of difficulty will determine who needs sensory processing treatment, who needs accommodations, and who is doing just fine.
The picky eater who lives on two foods and is not getting adequate nutrition is worth taking a look at. A child who is so sensitive to textures that he can not find anything to wear to school, or gets naked everyday in public, is struggling. The child whose meltdowns are so significant, they interfere with their daily life, needs some intervention.
In my career I have seen the whole spectrum of sensory processing difficulties. I have worked with children so impacted that it is a wonder they are surviving. On the other hand, I have evaluated children who are just quirky, not atypical. I remember trying to explain this to a parent. Her son was just quiet and introverted. He liked chess and robotics. He had a small social circle, but had friends and was doing well in school. Not everyone needs treatment or “fixing”. We all are not suited to be gardeners, football players, or electricians.
When looking at sensory difficulties, we need to focus our attention on the impact. This is why our goals are not often simply “improve sensory processing”. In the examples above with the picky eater and the child who will not wear clothes, the goals would focus on increasing food intake, and decreasing tactile aversion so the student can wear something to school.
Sensory Processing Disorder and Early Intervention
I talk a lot about education and early intervention. Help stem the flow of a problem before it gets too big. Educate large groups of people about a topic and treatment, so it can have a trickle down effect. One of the key factors in working with people is understanding. In my book, Seeing your Home and Community with Sensory Eyes, I spend time in each chapter helping the caregiver or recipient of the information understand what is happening with sensory struggles. I describe why your child may be screaming, kicking, refusing, or melting down in each setting. Then we look toward communication, treatment, and accommodation. It is available here on the OT Toolbox, in digital format or on Amazon (affiliate link) in print if you prefer.
Sensory processing Disorder Test
Using a sensory processing disorder checklist is just one step in completing a SPD test or assessment. It’s important to start somewhere and getting information from parents, educators, and others who know and love the child or individual is a key step in moving in the right direction with a sensory processing disorder evaluation. We want to see what’s really happening and what’s impacting function so the checklist portion is really important.
A checklist for sensory issues can be part of a screening tool. This gathers so much information and can really drive the evaluation process.
Other sensory processing assessment tools include observation, questionaries, and then the standardized assessment performed by an occupational therapist. The evaluating OT will use one of several sensory processing assessments to create a clinical picture that is part of the skilled evaluation process for SPD.
Sensory Processing Evaluations
Here are some of the most common evaluations that can be used to assess sensory processing. These sensory processing disorder tests do can be used along with other sources of information to get a bigger picture of what’s going on.
Sensory Integration and Praxis Tests (SIPT)– This test is appropriate for children aged 4 months through 8 years, 11 months. It’s a very comprehensive assessment. The SIPT does require extensive training to administer.
Sensory Profile 2– This assessment is appropriate for birth-14 years, 11 months. It is a comprehensive evaluation and it has a school companion form for the child’s teacher to complete.
Sensory Processing Measure-2 (SPM-2)– This evaluation is appropriate for children aged 4 months-87 years. It is a quick assessment and it has a home and a school form that can be used for a comprehensive look at the child across environments.
Evaluation in Ayres Sensory Integration® (EASI)– This evaluation is appropriate for children aged 3 years through 12 years. It’s based on Ayres Sensory Integration® and it’s a very comprehensive eval. Examiners do need to be trained in order to do this evaluation.
Structured Observations of Sensory Integration (SOSI-M)– This assessment is appropriate for children aged 5 years to 14 years.
Here are a few other sensory processing assessments to be aware of:
Short Sensory Profile (SSP): 3–15 years
Sensory Experiences Questionnaire (SEQ 3.0): 5 months – 6 years
Sensory Rating Scale (SRS): 0–3 years
SensOR Inventory (SensOR): 3–55 years
Sensory Processing Measure (SPM): 3–10 years
Infant/Toddler Sensory Profile (ITSP): 0–36 months
Diagnostic Interview for Social and Communication Disorders (DISCO): All ages
Adolescent/Adult Sensory Profile (AASP): Adolescent and adult ages
Working in the sensory realm is difficult and confusing. There can be 1001 combinations of reasons a person is having difficulty, and just as many possible solutions. Once you find a solution, it may only work a handful of times. Broaden your OT Toolbox with treatment ideas, checklists, and resources.
Speaking of OT Toolbox, our website is packed with valuable resources. Yes you can go onto AI and get a quick answer, but it will not be full of resources, hands on activities, and fun!
With sensory processing disorder, input from each of the sensory systems can be interpreted by the brain in different ways. Kids can hyper-respond or overreact to sensory input. Or, they can hypo-respond, or under-react to sensory information.
Sensory processing disorder can be seen in children or on adults.
Sensory Processing Disorder Checklist
Putting it all together – Let’s look at all of the sensory systems in a list:
- Visual System (Sight)
- Auditory System (Sound)
- Tactile System (Touch)
- Gustatory System (Taste)
- Olfactory System (Smell)
- Proprioceptive System (Position in space)
- Vestibular System (Movement)
- Interoceptive System (Inner body)
Typically, sensory dysregulation within these three systems present in many different ways. A child with sensory difficulties may be over- or under-responsive to sensory input. They may operate on an unusually high or unusually low level of activity. They may fatigue easily during activity or may constantly be in motion. Children may fluctuate between responsiveness, activity levels, and energy levels.
Additionally, children with sensory processing differences typically present with other delays. Development of motor coordination, fine motor skills, gross motor skills, social-emotional skills, behaviors, executive functioning skills, language, and learning are all at risk as a result of impaired sensory processing.
Sensory Processing Disorder Symptoms
It can be overwhelming when you start looking into various symptoms in sensory processing disorder. But if you are wondering about specific signs of SPD in your child, it can be helpful to have a comprehensive checklist of various areas that impact learning, play and functioning.
The comprehensive list of sensory signs and symptoms listed below are helpful to spot an issue in your child, but more so can help you pinpoint a starting point with helping your child so you can support their needs.
red Flags for Tactile Dysregulation
Tactile defensiveness, or what is sometimes described as tactile differences, refers to differences in how an individual experiences and responds to touch-based sensory input. This can include avoiding certain textures or, for some, actively seeking out tactile sensory experiences.
When we use terms like disabilities, dysregulation, differences, or challenges, or our goal is not to label an individual as having a deficiency or to pathologize sensory differences. Sometimes you may even hear the term dysfunction. When these terms are used, the goal is to describe sensory preferences and needs that may be impacting participation in everyday activities.
It is important to recognize that sensory processing is a spectrum of diverse experiences. Some sensory responses may create barriers to functional skills, such as self-care, play, or learning, not because there is something “wrong” with the person, but because their sensory system may require additional support or accommodations. Using this lens allows us to be neuro-affirming: we are not trying to “fix” or “normalize” an individual’s sensory experiences, but to understand and support their sensory needs so they can engage meaningfully in their environment.
Tactile defensiveness refers to avoidance of certain textures or the seeking out of tactile sensory input. These indicators can mean a sensory issue with the tactile sensory system.
Consider the sensory checklist based on the tactile system:
Hyper-responsiveness of the tactile sense may present in a child as over-responsiveness or overreaction to tactile sensation. This looks like:
- Overly sensitivity to temperature including air, food, water, or objects
- Withdrawing when touched
- Refusing certain foods because of food texture issues
- Dislike of having face or hair washed
- Dislikes of hair cuts
- Dislikes of having fingernails cut
- Excessively ticklish
- Avoidance to messy play or getting one’s hands dirty
- Avoidance of finger painting, dirt, sand, bare feet on grass, etc.
- Clothing preferences and avoidances such as resisting shoes or socks
- Annoyance to clothing seams or clothing textures
- Resistance to hair brushing
- Over-reactive to unexpected touch
- Overreactions to accidental or surprising light touches from others
- Avoids affectionate touch such as hugs
- Avoids washing hands at the sink
- Difficulty with clothing fasteners like buttons, zippers, and belts
- Challenges in the shower or bathtub with soap, washcloths preferences, and soap textures
- Refuses to use glue
Hypo-responsiveness of the tactile sense may present in a child as under-responsiveness or under-reaction to tactile sensation. This may look like:
- Seeks out tactile sensory input
- Bumps into others
- High pain tolerance
- Stuffs food in mouth
- Licks items or own skin
- Not aware of being touched
- Seems unaware of light touch
- Startles easily when touched
- When getting dressed, doesn’t notice clothing that is twisted
- Tendency for self-abusiveness: biting self, rubbing self with heavy pressure, head-banging, pinching self, etc.
- Doesn’t notice a runny nose, messy face, or messy hands
- Puts items in the mouth
- Lack of personal space
- Runs into other children without noticing
- Has difficulty maintaining space in line; bumps into others without noticing
- Falls out of chair
- NEEDS to touch everything
- Uses a tight pencil grip on the pencil
- Writes with heavy pencil pressure
- Tears paper when cutting with scissors
- Unintentionally rough on siblings, other children, or pets
- Always touching others or things
- Seeks out messy play experiences
- Prefers to rub or feel certain textures
- Difficulty with fine motor tasks
- Craves touch
- Doesn’t seem to notice unexpected touch
- Constantly playing in the soap or water at the sink
red Flags for Proprioception Dysfunciton
The Proprioception Sensory System is the recognition and response to the body’s position in space with an internal feedback system using the position in space of the joints, tendons, and muscles. This sensory system allows the body to automatically react to changes in force and pressure given body movements and object manipulation. The body receives more feedback from active muscles rather than passive muscle use. Related to the proprioception system is praxis or motor planning. Individuals are able to plan and execute motor tasks given feedback from the proprioceptive system. Praxis allows us to utilize sensory input from the senses and to coordinate hat information to move appropriately.
Hyper-responsiveness of the proprioception sense may present in a child as over-responsiveness or overreaction to proprioceptive sensation. This may include postural insecurity. This may look like:
- Uses too little pressure when writing or coloring
- Prefers soft or pureed foods
- Appears lethargic
- Bumps into people or objects
- Poor posture, slumps in their seat
- Poor handwriting
- Inability to sit upright when writing or completing desk work; Rests with head down on arms while working
- Poor awareness of position-in-space
- Frequent falling
- Clumsiness
- Poor balance
- Poor body awareness
- Poor attention
- Poor motor planning
- Uses extreme force during tasks
- Challenged by clothing fasteners ( how much force to use with fastening buttons, zippers, and belts, or snaps)
Hypo-responsiveness of the proprioceptive sense may present in a child as under-responsiveness or underreaction to proprioceptive sensation. This looks like:
- Uses excessive pressure when writing or coloring
- “Jumper and crasher”- seeks out sensory input
- Can’t sleep without being hugged or held
- Bumps into people or objects
- Seems aggressive
- Grinds teeth
- Walks on toes
- Chews on pencils, shirt, sleeve, toys, etc.
- Prefers crunchy or chewy foods
- Cracks knuckles
- Breaks pencils or crayons when writing or coloring
- Pinches, bites, kicks, or headbutts others
- Difficulty with fine motor skills
- Poor handwriting
- Poor awareness of position-in-space
- Stomps their feet on the ground when walking
- Kicks their chair or their neighbors chair in the classroom
- Frequent falling
- Clumsiness
- Poor balance
- Constantly moving and fidgeting
- Poor attention
- Uses extreme force
- Has unexpected bruises
- Seeks out wrestling games
red Flags for Vestibular Differences
Vestibular dysregulation refers to differences in how an individual perceives and responds to movement, balance, and spatial orientation. This may look like avoidance of certain types of movement (such as swinging or climbing), or an increased need to seek out movement experiences (like constant spinning or jumping). When describing vestibular needs or sensitivities, it is important to approach this language with care. When we see red flags related to vestibular challenges, we can acknowledge that these sensory differences may affect a person’s comfort, safety, and ability to participate in daily activities.
Recognizing vestibular differences through this lens allows us to support each individual’s unique sensory profile without the goal of “correcting” or changing who they are. Instead, we aim to create environments, strategies, and opportunities that honor sensory needs and promote functional engagement. A neuro-affirming approach respects that sensory processing differences are part of human diversity, and that with the right supports, individuals can thrive in their own way.
The Vestibular Sensory System is the sense of movement and balance, and uses the receptors in the inner ear and allows the body to orient to position in space. The vestibular system is closely related to eye movements and coordination. Vestibular sensory input is a powerful tool in helping children with sensory needs. Adding a few vestibular activities to the day allows for long-lasting effects. Every individual requires vestibular sensory input in natural development. In fact, as infants we are exposed to vestibular input that promotes a natural and healthy development and integration of all systems.
Vestibular dysregulation and problems with the Vestibular Processing System can present as different ways:
- Poor visual processing
- Poor spatial awareness
- Poor balance
- Difficulty with bilateral integration
- Sequencing deficits
- Poor visual-motor skills
- Poor constructional abilities
- Poor discrimination of body position
- Poor discrimination of movement
- Poor equilibrium
- Subtle difficulties discerning the orientation of head
- Trouble negotiating action sequences
Hyper-responsiveness of the vestibular sense may present in a child as over-responsiveness or overreaction to vestibular sensation. This look may look like:
- Experiences gravitational insecurity
- Overly dizzy with motions
- Resistant to moving activities such as swings, slides, elevators, or escalators
- Fear of unstable surfaces
- Unable to tolerate backward motions
- Unable to tolerate side to side motions
- Illness in moving vehicles
- Avoids swings or slides
- Gets motion sick easily
- Appears “clingy”
- Refuses to move from the ground (i.e. jumping or hopping activities)
- Difficulty/fear of balance activities
- Refusal to participate in gym class
- Refusal to try playground equipment
- Fearful on bleachers or on risers
- Fear or dislike of riding in elevators or escalators
- Fearful of movement
- Dislike of spinning motions
- Avoids chasing games
- Overly fearful of heights
- Nauseous when watching spinning objects
- Poor posture
- Easily fatigued
- Poor coordination
- Low muscle tone
- Poor motor planning
- Fearful when a teacher approaches or pushes in the child’s chair
- Clumsiness
- Poor attention
- Difficulty or fearful on stairs
- Fearful during situations of constant motion
- Struggles or fearful on ladders
- An extreme dislike of high places
- Refuses to sit on or try a bike
Hypo-responsiveness of the vestibular sense may present in a child as under-responsiveness or underreaction to vestibular sensation. This may look like:
- Constant movement including jumping, spinning, rocking, climbing
- Craves movement at fast intervals
- Craves spinning, rocking, or rotary motions
- Poor balance on uneven surfaces
- Constantly fidgeting
- Increased visual attention to spinning objects or overhead fans
- Bolts or runs away in community or group settings, or when outdoors or in large open areas such as shopping malls
- Difficulty maintaining sustained attention
- Impulsive movement
- Constantly getting up and down from desk in the classroom
- Walks around when not supposed to (in the classroom, during meals, etc.)
- Loves to be upside down
- Head banging
- Hypermobile or all over playground equipment
- Leans chair back when seated at a desk
- Loves spinning
- Rocks self-back and forth when seated
- Poor posture
- Poor coordination
- Poor motor planning
- A deep need to keep moving in order to function
- Frequent falling
- Clumsiness
- Poor balance
- Poor attention
- Always in constant motion
- Prefers being in high places
Red Flags for Visual SYSTEM Dysregulation
Visual dysregulation refers to differences in how an individual processes and responds to visual input, such as light, movement, patterns, or cluttered environments. Some individuals may be more sensitive to bright lights, busy visuals, or fast-moving scenes, while others may seek out visual stimulation through watching spinning objects or moving their eyes in specific ways. When we use the term dysregulation to describe these sensory experiences, it is not to imply a problem or deficit, but to acknowledge that visual processing differences may influence an individual’s comfort, attention, and participation in everyday tasks.
Taking a neuro-affirming perspective, we recognize that sensory differences, including those in the visual system, are a natural part of human variation. Our goal is not to “normalize” visual responses but to support individuals by adapting environments, offering accommodations, and providing strategies that help them engage meaningfully in their world. By understanding and respecting visual sensory needs, we can better empower individuals to navigate their surroundings in ways that feel safe and supportive.
Eighty percent of the information we receive from our environment is visual. When perception of this information is not processed correctly, it can create an altered state that influences many areas: eye-hand coordination, postural reflexes, and vestibular processing are all influenced and reliant upon the visual system.
The visual system is the sensory system that most individuals rely upon most heavily for daily tasks. Visual information is perceived by cells in the back of the eye. These cells (rods and cones) relay and transfer light information into information that is transferred to the central nervous system. These photoreceptors are able to perceive day time vision and night time vision, with adjustments to sensitivity of light intensity. They are able to respond to different spectrum of color and differentiate color information. The rod and cone cells, along with the retina, process a great deal of visual information in the neural structure of the eye before transmitting information to the central nervous system.
The relay of information from the eyes to the central nervous system are made up of three pathways. Pathways project to different areas of the brain and allow for:
- Processing and recognition of faces/shapes/motion (the “what” and “where” of objects)
- Integration of information in order to coordinate posture and eye movements
- Oculomotor adaptation.
Hyper-responsiveness of the visual sense may present in a child as over-responsiveness or overreaction to visual sensation. This may look like:
- Complains of lights being too bright
- Unable to tolerate certain lighting such as fluorescent overhead lights
- Struggles with sudden changes in lighting
- Challenged by bright or flashing lights
- Colorful lights “hurt” the eyes
- Complains of headaches in bright light
- Complains of the “glow” of unnatural lighting
- Distressed by light sources
- Sensitive to light
- Sensitive to certain colors
- Distracted by cluttered spaces
- Avoids eye contact
- Trouble with puzzles
- Frustration at the movies
- Difficulty reading
- Difficulty finding objects in a busy drawer
Hypo-responsiveness of the visual sense may present in a child as under-responsiveness or underreaction to visual sensation. This looks like:
- Attracted to spinning objects
- Difficulty with visual perception
- Difficulty with eye-hand coordination
- Difficulty with reading and writing
- Holds or presses hands on eyelids in order to see flashing lights
- Squints or presses eyelids shut
- Flaps hands or objects in front of eyes
- Holds eyes at the movies
red Flags for Auditory SYSTEM Dysregulation
Auditory dysregulation refers to differences in how an individual perceives and responds to sounds in their environment. This may include heightened sensitivity to certain noises, difficulty filtering out background sounds, or a strong preference for certain auditory experiences. Some individuals may cover their ears, avoid noisy environments, or become overwhelmed in spaces with unpredictable sounds, while others may seek out calming or repetitive auditory input. When we use the term dysregulation in this context, it is not to suggest that there is something wrong with the person, but rather to acknowledge that their auditory processing needs may impact comfort and participation in daily life.
A neuro-affirming approach recognizes auditory processing as a diverse experience, not a flaw to be corrected. Our role is to honor and support each individual’s auditory needs by offering accommodations, adapting environments, and providing tools that help them engage in ways that feel safe and manageable. By understanding these sensory differences, we can foster inclusion and respect for all sensory profiles.
Receptors for the auditory system are located in the inner ear and are responsible for receiving vibration from sound waves and changing them to fluid movement energy. Information is projected to the central nervous system and transmits sound frequency as well as timing and intensity of sound input. The auditory system is integrated with somatosensory input in order to play a role in controlling orientation of the eyes, head, and body to sound.
Hyper-responsiveness of the auditory sense may present in a child as over-responsiveness or overreaction to auditory sensation. This may look like:
- Startles easily to unexpected sounds
- Dislikes noisy places
- Overly sensitive to speakers on radios
- Fearful of smoke detectors, overhead speakers
- Shushes others or asks others to stop talking
- Holds hands over ears
- Sensitive to certain sounds such as lawnmowers or the hum of the refrigerator
- Easily distracted by sounds and background noise
- Hums to block out background noise
Hypo-responsiveness of the auditory sense may present in a child as under-responsiveness or underreaction to auditory sensation. This looks like:
- Seems to be unaware of sounds
- Holds radio speakers up against ears
- Doesn’t respond to alarms
- Makes silly sounds at inappropriate times or frequently
- Mimics sounds of others
- Talks to self
- Difficulty locating sounds, especially when in a noisy environment
- Hums in order to hear the sound of humming
red Flags for Gustatory System Dysregulation
Gustatory dysregulation refers to differences in how an individual experiences and responds to taste and oral sensory input. This can include strong preferences or aversions to certain flavors, temperatures, or textures of foods and drinks. Some individuals may seek out intense flavors like spicy or sour foods, while others may avoid specific textures or have a very limited range of preferred foods. When we use the term dysregulation in this context, it is not intended to pathologize sensory preferences, but to describe how these differences may influence eating habits, nutritional intake, and participation in mealtime routines.
Viewing gustatory processing through a neuro-affirming lens allows us to respect individual sensory needs and preferences without the goal of “fixing” them. Instead, the focus is on understanding how these sensory differences impact daily life and finding supportive strategies to promote positive mealtime experiences. This might include offering a variety of sensory-friendly food options, gradually expanding food exploration in a safe and supportive way, and working collaboratively with families to honor each child’s unique sensory profile.
The gustatory system perceives input through the tongue. Taste cells in the mouth perceive five sensations: salty, sweet, bitter, sour, and savory. The gustatory system is closely related to the sense of smell and proprioception. How we perceive taste is deeply influenced by the sense of smell.
While many children with sensory needs have a tendency to chew on their shirt collars or pencils as a sensory strategy in order to seek proprioception needs, the behavior may occur as a result or as a reaction to under-responding to oral input. Other children may seek out intense taste sensations and in that case put non-edible items into their mouth to satisfy that sensory need. Still other children may over-respond or under-respond to certain flavors or taste sensations. For those children, it is common to experience food refusal related to texture or taste.
Hypersensitivity to oral sensory input may present in a child as over-responsiveness or overreaction to gustatory sensation. This looks like:
- Dislike of mixed textures (cereal in milk or chunky soup)
- Resistant to trying new foods
- Avoids certain textures
- Avoids straws
- Avoidance of specific food or drink temperatures
- Picky eating
- Preference for bland foods
- Avoids temperature extremes (unable to tolerate hot or cold foods)
- Prefers foods that do not touch or mix on their plate
- Use of only a specific spoon or fork or no utensil at all
- Intolerance to teeth brushing.
- Anxiety or gagging when presented with new foods
- Drooling
Hypo-responsiveness of the gustatory sense may present in a child as under-responsiveness or underreaction to gustatory sensation. This may look like:
- Licking objects
- Bites others
- Chews on clothing
- Hums all the time
- Prefers a vibrating toothbrush
- Prefers spicy foods
- Stuffs food into cheeks
- Prefers food very hot or very cold temperature
red Flags for Olfactory System Dysregulation
Olfactory dysregulation refers to differences in how an individual perceives and responds to smells in their environment. Some individuals may be highly sensitive to certain scents and may become overwhelmed, nauseous, or distressed by everyday smells such as perfumes, cleaning products, or certain foods. Others may seek out strong or specific scents as a way to self-regulate. Using the term dysregulation here is not meant to label these sensory responses as a problem, but to acknowledge that olfactory processing differences can affect comfort, attention, and participation in daily routines.
A neuro-affirming perspective recognizes that variations in how we experience smells are part of natural sensory diversity. The goal is not to eliminate these differences, but to provide support that respects individual needs. This might include adapting environments to minimize triggering scents, offering preferred calming smells, and helping individuals develop strategies to navigate scent-rich settings more comfortably. By understanding and honoring olfactory sensory needs, we can foster more inclusive and supportive environments.
The olfactory system, or the system that enables the sense of smell, has receptors in the tissue of the nose that are connected by pathways to the brain. Connections occur via two pathways, one being a direct route to neurons in the brains and the second being a path that passes near the roof of the mouth. This channel is connected to the taste of foods.
There is some evidence indicating that the sense of smell is more associated with memory than the sense of vision or the other senses. The connection of the olfactory sense to the emotional part of the brain and previous experiences, as well as hypersensitivity or hyposensitivity to smells can cause anxiety or sensory related breakdowns in children with sensory processing difficulties.
Hyper-responsiveness of the olfactory sense may present in a child as over-responsiveness or overreaction to olfactory sensation. This may look like:
- Overly sensitive to smells
- Notices smells others don’t
- Anxious around certain smells
- Holds nose in response to certain scents
- Challenged in the shower or bathtub, with overwhelming preferences and disliking certain scents
Hypo-responsiveness of the olfactory sense may present in a child as under-responsiveness or underreaction to olfactory sensation. This may look like:
- Smells unusual items like paper or certain materials
- Prefers strong scents
Red Flags for Interoceptive System Dysregulation
Interoceptive dysregulation refers to differences in how an individual perceives and interprets internal body signals, such as hunger, thirst, fatigue, pain, temperature, or the need to use the bathroom. Some individuals may have difficulty recognizing or responding to these signals, while others may experience them as overwhelming or confusing. When we describe interoceptive dysregulation, it is not to suggest a deficit or problem within the individual, but to acknowledge that these sensory differences can impact self-awareness, self-care, emotional regulation, and participation in everyday routines.
A neuro-affirming approach respects that interoceptive experiences vary widely among individuals and are a natural part of sensory diversity. Rather than aiming to “correct” these differences, the goal is to provide support and tools that help individuals better understand and respond to their internal cues in a way that feels right for them. This may include using visual supports, developing body awareness activities, or building self-advocacy skills. By honoring interoceptive needs, we can help foster greater comfort, autonomy, and engagement in daily life.
The interoceptive sensory system is an area that most people are not as familiar with. This system is connected to amygdala, the emotional system, the limbic system, our emotional awareness, our feelings, and subconscious arousal. Receptors for the interoceptive system are in our organs and skin. The receptors relay information regarding feelings such as hunger, thirst, heart rate, and digestion to the brain. This is the foundation to sensations such as mood, responding to the moods and emotions of others (co-regulation), emotions, aggression, excitement, and fear and in turn, promotes the physical response of our bodies.
Physical responses include functions such as hunger, thirst, feelings, digestion, heart rate, and body temperature.
Hyper-responsiveness of the interoceptive sense may present in a child as over-responsiveness or overreaction to interoceptive sensation. This may look like:
- High pain tolerance
- Distracted and overwhelmed by feelings of stress
- Distracted or overly sensitive to sensations of stomach digestion
- Distracted or overly sensitive to sensation of heart beat
- Always hungry or thirsty
- Eat more and more often to avoid feelings of hunger
- Unable to sense the feeling of being full; overeats or overdrinks
- Overwhelmed by feelings of sadness, anger, happiness, etc. and unable to respond appropriately
- High urine output
- Use the bathroom more often than necessary to avoid feelings of a full bladder or bowel
- Distracted by changes in body temperature
- Distracted and overly sensitive to sweating
- Overly sensitive to feeling ticklish or itchy
- Overly sensitive to cold or heat
- Overly sensitive to signs of illness
- Fearful of vomiting
Hypo-responsiveness of the interoceptive sense may present in a child as under-responsiveness or underreaction to interoceptive sensation. This may look like:
- Low pain tolerance
- Poor or low response to interoceptive stimuli
- Doesn’t know when to go to the bathroom
- Never says they are hungry or thirsty
- Does not drink or eat enough
- Difficult to toilet train
- Never complains of being cold or hot (always wears shorts in the winter or pants in the summer)
- Never complains of sickness
- Difficulty falling asleep
- Unable to identify feelings of stress
- Unable to identify specific feelings and appropriate responses
Sensory Checklists, explained
There is a lot to think about here, right? Taking a giant list of common sensory processing disorder lists and knowing what to do with that list is complicated. What if you had strategies to address each sensory system’s over-responsiveness or under-responsiveness so you could come up with a sensory diet that helps kids function?
In The Sensory Lifestyle Handbook, I do just that.
Sensory processing is broken down by sensory system so you can understand what you are seeing in the sensory responses listed above. Then, you can use the lists of sensory activities to help the child complete functional tasks while they get the sensory input they need to focus, organize themselves, and function.
The sensory activities are presented as meaningful and motivating tasks that are based on the child’s interests, making them motivating and meaningful.
You can get the Sensory Lifestyle Handbook and start building a sensory diet that becomes an integrated part of each day’s daily tasks, like getting dressed, completing household chores, school work, community interaction, and more.
Get your copy of The Sensory Lifestyle Handbook here.
Sensory checklists in early intervention
In young children, sensory issues can present leading to the early intervention process. Having a sensory processing disorder checklist on hand can help relieve some of the questions parents have about development and whether a behavior or action is typical or not.
Characteristics of sensory issues show up during these young years. You may see frustration or meltdowns due to unexpected touch.
You may identify tactile defensiveness even in the infant years when babies pull away from heavy input of a cuddle or wrapped blanket. You may notice sensory preferences in the way of seeking out a pacifier for comfort (long beyond the typical pacifier stage). You may even identify distress with certain aspects of sensory input as listed in the sensory processing checklists above.
A few helpful resources are listed below:
Meltdowns– This blog post covers temper tantrums verses sensory meltdowns.
This blog post on early intervention strategies for sensory differences covers important information for sensory needs during the infant to 5 years range.
Sensory integration at the playground – Exploring different sensory input areas at the playground can help identify sensory challenges in young children.
A Final Note on Examples of Sensory Processing Dysregulation
This extensive list of sensory red flags is meant to act as an educational tool for parents, educators of children.
As occupational therapists, we strive to support children and their “team” of parents, caregivers, family, and educators with resources and information that will serve the individual child so that they can function in everyday life tasks.
The purpose of this sensory processing disorder checklist is to help parents and professionals who interact with children become educated about particular signs of sensory processing differences.
A checklist is not to be used as the absolute diagnostic criteria for labeling children with sensory processing disorder. It is simply a resource to be used as a starting point when identifying distress symptoms to explore further.
If you have difficulty understanding your child’s sensory preferences, sensory avoidances, use this sensory processing disorder checklist as a starting point and reach out to a pediatrician and pediatric occupational therapist.
- More information on sensory processing can be found in this resource on Ayres Sensory Integration.
- Grab this printable sensory processing information PDF for advocacy.
- Get a copy of our short Sensory Processing Information Booklet.
- For a comprehensive look at sensory processing throughout every day activities, try our Sensory Lifestyle Handbook.
Colleen Beck, OTR/L has been an occupational therapist since 2000, working in school-based, hand therapy, outpatient peds, EI, and SNF. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. Read her story about going from an OT making $3/hour (after paying for kids’ childcare) to a full-time OT resource creator for millions of readers. Want to collaborate? Send an email to contact@theottoolbox.com.
