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Home » Sensory Solutions »

Sensory Processing Disorder vs.

Autism: Understanding the
Differences

By Sharon Longo, BA

July 9, 2023

Sensory processing disorder (SPD) is often

confused with autism spectrum disorder (ASD)
due to the similarities and connections that exist.
While the two have many similarities, SPD is often
a comorbid symptom of ASD, but not all children
with sensory processing disorder have autism.

What is autism?
Autism is a developmental disorder which,
according to the Diagnostic and Statistical Manual
of Mental Disorders, 5th Edition (DSM-5), has
certain criteria for the diagnosis. Human
development occurs in stages with milestones that
are met or exceeded over time. During the early
stages of a child’s development, children begin to
communicate and socialize, beginning with their
parents, while reacting to and showing emotions.
Deficiencies that persist in these areas could be a
problem. A child may repeat certain behaviors or
have restrictive mannerisms or interests. Some
children may show stimming behavior, such as
hand flapping and repetitive noises, while others
may need a toy to be placed in exactly the same
spot each time, with a dislike for any disruption or
change.

Autism can cause a child to learn, react, and

attend to details differently. If an intellectual
disability or an intellectual developmental disorder
is not the sole cause of these deficiencies, with a
child’s socialization and communication being
below what is typical for their level of
development, this could be a sign of autism.
Because there is no medical test to diagnose, a
doctor would need to look at the developmental
milestones and the child’s behavior, while taking
into account any parental input about the child.

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Autism spectrum disorder (ASD) is named due to

the spectrum of disorders within the category.
These would include autistic disorder, asperger’s
syndrome, and pervasive developmental disorder
not otherwise specified (PDD-NOS).

The causes for autism are not known, however

some factors may be biological (possibly related to
having older parents) or genetic (in which
chromosomal conditions create a greater chance
of having ASD, and having a sibling with the
condition leading to a higher risk.) Environmental
factors have also been considered, and the
prescription drugs, valproic acid or thalidomide,
while used in pregnancy, have been associated
with a higher risk.

While there is no cure for autism, early treatment

is better for development, with therapy aiding in
speech delays, walking, and social interaction.
The Individuals with Disabilities Education Act
(IDEA) states that a child under the age of 36
months who may have a developmental delay
could possibly qualify for services within their local
district.

What is sensory processing

disorder?
Sensory processing is the way a person’s brain
perceives sensory information and how that
person responds to that information. A person with
sensory processing disorder (SPD) has an
impairment in the way their brain processes the
sensory information that is used to regulate
behavior and motor function/performance such as
balance, walking, and coordination. They may
react to sensory stimuli in a socially or emotionally
negative way, and this could affect their behavior
or the way other people respond to them.

Originally called “sensory integration dysfunction,”

it is said to affect approximately 5-16% of school-
aged children in general. Many children with SPD
may be extremely sensitive to the way certain
things feel, look, or sound; they may be distracted
more easily; and their fine motor skills may be
lacking.

Sensory processing involves eight components:

the five senses – taste, smell, hearing, seeing and
touch; as well as three other components.
Vestibular function and proprioception are
sometimes referred to as the “sixth and seventh
sense.”

Proprioception is a sense of one’s own body

movement or position, so that if a child lifts their
hand, they are aware that they are doing that
action. Vestibular function is the inner ear and
brain working together to help control movement
of the eyes, body balance, and one’s awareness
of their own body in relation to other objects
around them.

The final component, interoception, is the

awareness of what is happening within one’s own
body. For example, a person can feel how hot or
cold an object is through their skin or know when
they are thirsty or hungry. Being aware of one’s
own heart rate is another example, as well as the
link between emotions and the body’s reaction to
those feelings.

In regard to sensory issues, most information

refers to two types:

1. Hyper sensitivity
Hyper sensitivity is when a child is easily
stimulated by sensory stimuli. The child may have
a low tolerance for pain, some coordination
issues, and/or they could be sensitive to certain
sights or sounds such as bright lights or noisy
appliances. A child with this may also be a finicky
eater.

2. Hypo sensitivity
Hypo sensitivity is when a child does not have
enough sensory stimulation. The child may have a
high pain tolerance, may bump into surrounding
walls or objects, and may have a need to touch or
mouth items.

One study showed that children who were more

fearful or had anxiety, as well as premature babies
or those with birth complications, might present
with more sensory issues.

Some diagnostic classification guides include

sensory processing disorder, however, it is not
listed as an “official” disorder in the Diagnostic and
Statistical Manual of Mental Disorders – Fifth
Edition (DSM-5).

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Connections between sensory

processing disorder and autism
spectrum disorder
Some experts have found that over 80% of
children with autism also have sensory processing
disorder, and the DSM-5 includes “hyper or hypo
reactivity to sensory input,” listing this as one of
the behaviors associated with ASD.

The STAR Institute for Sensory Processing in

Colorado has conducted studies finding that “at
least three quarters of children with autistic
spectrum disorders have significant symptoms of
sensory processing disorder, and probably more
depending on how significant symptoms are
defined.” Yet, many studies show that the
reciprocal of this discovery is not a fact. Most
children who have SPD do not have ASD.

Roya Ostovar, PhD, is the Director of McLean

Hospital’s Pathways Academy in Belmont,
Massachusetts and an Assistant Professor of
Psychology, Department of Psychiatry at Harvard
Medical School. Dr. Ostovar noted that people
with SPD don’t show the traits of someone with
autism, such as difficulties with social and
communication skills or stimming behaviors such
as repetitive sounds or movement.

Differences between autism and

sensory processing disorder
Studies have been conducted to show the
differences between children with autism spectrum
disorder and sensory processing disorder. In one
study, 210 participants were included with 68
having autism spectrum disorder, 79 having
sensory processing disorder, and 63 with typical
development (TD). Any child who had ASD with
SPD was not included in the study.

Children were scored for Sensory Over-Reactivity

(SOR), where sensory items bother a child;
Sensory Under-Reactivity (SUR), where sensory
items were not noticed by the child; and Sensory
Craving (SC), where the child needed certain
sensory stimulation. They were also scored for
their Empathy Quotient (EQ), or how easily or
strongly they reacted to or were able to gauge
another person’s feelings. Finally, the children
were scored for their Systemizing Quotient (SQ),
or how interested the child was in understanding
how the internal components of a machine
worked.

They found that for Sensory Under-Reactivity, the

ASD group scored higher than the SPD group,
which scored higher than the TD group. For
Sensory Over- Reactivity, the ASD and SPD
groups were relatively the same, but much higher
than the TD group. For Sensory Craving, the ASD
and SPD groups were about the same as each
other, but with higher scores than the TD group. In
the category of Systemizing Quotient, children
with ASD scored higher than both the SPD and
TD groups.

Finally, in regard to Empathy Quotient, ASD

children scored lower than SPD and TD, although
children with SPD scored lower than TD children
in this area. The Empathy Quotient scores were
also affected by gender, with girls scoring higher
than boys. The ASD group showed difficulties in
empathy, with higher scores in systemizing as
compared to both of these areas in the SPD and
TD groups, both of whom scored in the average
range. Using empathy and systemizing as a factor
to help differentiate between autism spectrum
disorder and sensory processing disorder will help
to improve the diagnostic criteria being used.

At the University of California – San Francisco

(UCSF) Benioff Children’s Hospital, a study
looking at the structural connections of the
sensory area of the brain were conducted on
children with ASD, SPD, and typically developing
boys. With an advanced type of Magnetic
Resonance Imaging (MRI) called Diffusion Tensor
Imaging (DTI), a measurement was taken to
gather information about the white matter tracts of
the three groups’ brains. The white matter
contains the connections that link together
different areas of the brain that help a person with
cognition, perception and movement so that they
can see something, contemplate it, and act upon
it. Through the imaging, researchers were able to
see the course of the white matter “wires” as well
as the cohesion.

The study was conducted on males in the age

range of 8 to 12, 16 of whom had Sensory
Processing Disorder, 15 with autism, and 23 who
were typically developing. Elysa Marco, MD, a
cognitive and behavioral pediatric neurologist
specializing in children with sensory processing
disorder, autism and other neurodevelopmental
conditions led the study which revealed that only
the ASD group had impairments in the part of the
brain which helps with recognizing facial emotion,
memory, and social processing. Children with SPD
showed more brain disconnection in some of the
tracts dealing with sensory issues than the
subjects with autism. These abnormal white
matter tracts at the back of the brain are where the
systems for sensory processing are located.

Senior author of the study and Professor of

Radiology and Biomedical Imaging and
Bioengineering at UCSF, Pratik Mukherjee, MD,
PhD determined that because of the location of
the abnormalities, this could indicate SPD as
being distinguishable from other
neurodevelopmental disorders. He believes that it
is important to find the neurological reasons
behind ASD and SPD and pinpoint areas of
overlap and distinction. He also feels that findings
from their research could provide a biological root
for SPD which could then be measured and used
for future diagnoses.

A previous study done in 2006 with twins showed

that if one child was hypersensitive to light or
sound, the other would also have that sensitivity,
revealing the possible genetic element.

SPD or ASD: finding the right

diagnosis
It is important for parents to find a professional
who can provide the correct diagnosis, as early as
possible, so children can receive the appropriate
treatment. Many doctors will try to help alleviate
the sensory issues while treating the autism
spectrum disorder, if that diagnosis applies.

Various skills that a child learns to do at different

age levels is called a developmental milestone,
and according to the Centers for Disease Control
and Prevention (CDC), “

The American Academy of Pediatrics

recommends that children be screened for general
development using standardized, validated tools
at 9, 18, and 30 months and for autism at 18 and
24 months or whenever a parent or provider has a
concern.” The CDC website has a list of the
milestones by months and years, which parents
can check to compare their child’s progress and
discuss with the pediatrician if there is a concern.
Once it has been determined that the child is
falling behind on any of the milestones, and if
there is a concern of autism spectrum disorder, a
recommendation should be made for the child to
be examined by a specialist. This could be a
developmental pediatrician, a pediatric
neurologist, or possibly a child psychologist or
psychiatrist.

Also, a qualified Occupational Therapist (OT) with

training in the area of sensory integration can do
an evaluation to determine if a child has sensory
processing disorder. Since there are no formal
diagnostic criteria, a child’s behavior and their
interactions would be observed to see if any
sensory issues were present.

Additionally, a qualified and trained therapist can

perform an assessment called a Sensory
Integration and Praxis Test (SIPT) or a Sensory
Processing Measure (SPM). The SIPT measures
sensory processing or sensory perception of
children aged four years to eight years, 11 months
as it relates to the developing language skills,
social interactions and educational performance.
The SPM measures sensory processing, planning
or ideas (praxis), and social engagement in the
home, school and other social realms.

Is there a treatment for sensory

processing disorder?
At this time there is no treatment for SPD, but
there are ways to help manage the sensory
issues. A highly trained Occupational Therapist
(OT) can focus on each child’s individual
sensitivities, providing them with the appropriate
amount of activities based on their needs. A swing
can provide necessary movement for a child who
needs stimulation, while the use of a soft-bristled
sensory brush may be used for a child who has an
aversion to touch or certain sensations against
their skin. Sensory Integration therapy exposes a
child to a variety of accommodations, activities,
and treatments.

Because sensory processing is not listed as an

actual disorder, many experts hesitate to use
treatments that are not backed by a lot of research
showing the effectiveness in helping to change
these behaviors. The American Academy of
Pediatrics warns that “parents should be informed
that the amount of research regarding the
effectiveness of sensory integration therapy is
limited and inconclusive.”

Download your FREE guide on

Sensory Processing Disorder

The Ultimate Guide

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Guide

Dr. Marco believes that measuring and observing

brain connectivity will help to see which
interventions are successful for the various
neurodevelopmental issues. With more research,
determination can be made to find out what the
genetic links are for the varied sensory processing
issues. They will also be able to determine what
risks, if any, there may be for SPD, and whether
the interventions being used at the current time
are useful in the change and adaptation of the
brain. Finally, researchers may be able to develop
new therapies based on any up-to-date findings.

Dr. Ostovar feels that children with sensory

processing disorder will not outgrow this.
However, the disorder can be managed in a way
that helps them adapt and still behave in a socially
conventional manner.

Final thoughts on sensory

processing disorder and autism
A child with autism spectrum disorder may have
sensory processing issues, however a child with
sensory processing disorder does not have
autism.

If a parent believes their child has any

issues regarding a developmental delay,
they should contact their pediatrician for
an evaluation
If a child shows any signs of a low
tolerance to any sensory stimuli; has an
excessive need for stimulation, such as
needing to mouth certain objects; or is
showing any coordination issues or
bumping into walls or objects, the
pediatrician should be made aware
With regard to any child who has already
been diagnosed with autism and has
sensory issues or is found to have
sensory processing disorder, a parent
should do their research to provide the
best help possible for their little one. Talk
to the pediatrician and other trusted
 professionals for recommendations, and
search the internet for websites and
groups for more information and guidance

The earlier a child with autism and/or sensory

processing disorder receives early intervention
and help, the better.

References:

https://www.cdc.gov/ncbddd/autism/facts.html

https://www.cdc.gov/ncbddd/actearly/milestones/in
dex.html https://doi.org/10.1016/j.dcn.2017.05.005

https://images.pearsonclinical.com/images/assets/
basc-
3/basc3resources/DSM5_DiagnosticCriteria_Autis
mSpectrumDisorder.pdf

https://www.mayoclinic.org/diseases-
conditions/autism-spectrum-disorder/diagnosis-
treatment/drc-
20352934#:~:text=If%20your%20child%20shows
%20any,
developmental%20pediatrician%2C%20for%20an
%20evaluation

http://middletown.ttl-stage.com/best-practice-
sensory/wp-
content/uploads/sites/3/2015/07/CASE-SMITH-
2014.pdf

https://www.pearsonclinical.co.uk/AlliedHealth/Pae
diatricAssessments/Sensory/SPM/sensory-
processing-measure.aspx

https://pediatrics.aappublications.org/content/129/
6/1186
https://www.researchgate.net/publication/2416974
63

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