sensory processing

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”. Here, 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.

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, dysfunction 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 dysfunctions 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 Dysfunction

Tactile defensiveness, or tactile dysfunction 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 Dysfunction

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 dysfunction 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 Dysfunction

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:

1. Processing and recognition of faces/shapes/motion (the “what” and “where” of objects)
2. Integration of information in order to coordinate posture and eye movements
3. 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 Dysfunction

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 Dysfunction

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 Dysfunction

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 Dysfunction

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. 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 Dysfunction

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 dysfunction.

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.