Sensory issues in children: signs, causes and how to help

We take in information from the world through our senses all day: touch, movement, body position, sight, sound, smell and taste. The Alder Hey leaflet describes sensory processing as taking in that information, making sense of it and using it to act and respond appropriately. The York and Scarborough leaflet says the brain uses what is needed to function and remain appropriately calm and alert.

In children with sensory processing differences this system works differently. The York leaflet explains that the brain may place too much or too little importance on the information, so the child receives too much or too little of a sensation. The Alder Hey leaflet gives examples: being overly responsive to touch, sights or sounds, being under-responsive to movement, sights or touch, and having difficulty organising and carrying out everyday activities.

Both leaflets are careful to say that some sensory quirks are normal. The York leaflet gives examples such as not liking certain food textures, cutting labels out of clothes, a heightened sense of smell or not liking busy, noisy places, and says it is the level of these problems and their impact on essential everyday tasks that makes a sensory processing difficulty.

Sensory differences show up in daily routines. The NHS autism guidance, which covers sensory differences in autistic children, lists reacting very strongly, or not at all, to lights, sounds, smells, tastes or textures; not liking brightly lit or noisy rooms; not liking to wear certain clothes or materials; only being able to eat certain foods or in a certain way; not liking foods with certain textures; and not liking foods mixed or touching. It also lists finding it hard to describe feelings such as hunger, pain, being upset or angry, and actively looking for calming sensations such as movement, pressure, sounds and textures.

Because the pattern differs between children, the picture can look contradictory: one child may cover their ears at hand dryers and seek crashing or squeezing games, another may seem not to notice pain. Noting what triggers distress, what calms the child and when problems are worst is more useful than a label.

• Distress at everyday sounds, such as hand dryers, vacuum cleaners or crowded places.

• Refusing certain clothes, labels, socks or hair brushing.

• A very narrow range of foods, or strong reactions to texture and smell.

• Constant movement, seeking pressure or crashing into things, or very little reaction to bumps or pain.

• Difficulty with dressing, mealtimes, toileting or classroom routines because of sensory demands.

There is no single cause identified in the sources read for this page. The NHS says autism is a difference in how the brain develops, and sensory differences are among its recognised signs in children. Sensory difficulties also occur in children without an autism diagnosis, and in children with other developmental conditions. The West Suffolk NHS children's occupational therapy page lists autistic spectrum disorder and sensory processing differences, among other conditions, as reasons why pre-school children may be seen by its service.

A sensory difficulty does not automatically mean autism. If you are concerned about your child's development, a health visitor, GP or school SENCO is a sensible first contact; the West Suffolk page lists these professionals among those who can refer. A developmental assessment looks at the whole picture of communication, play, behaviour and sensory responses, rather than sensory issues alone.

Children's occupational therapy services lead on sensory processing in most areas. The York leaflet says the occupational therapy team accepts referrals that detail barriers to function and the impact this has on physically completing everyday tasks, that the therapist will discuss the difficulties at the assessment appointment and that the service offers advice and recommendations to manage difficulties within home and school, working as a team with parents, the child and school staff. It adds that the therapist will provide a report of strategies and information, and that in many cases only one appointment is needed.

The Alder Hey leaflet describes a community occupational therapy service that offers parent and carer sensory workshops, lasting approximately 2.5 hours, with a workbook of strategies, and describes itself as an advice and strategies service that does not work directly with the child. Workshops are accessed by a parent or carer completing a referral form, and may be offered virtually or as a recorded webinar. The West Suffolk page says a paediatric occupational therapy team sees children from birth to 19 years, works with schools and other services and aims to carry out initial assessment within 18 weeks of an accepted referral, accepting referrals from professionals such as GPs, health visitors, paediatricians and school SENCOs.

Services differ by area in who can be referred, the age range and what is offered, so ask your GP, health visitor or school SENCO how to access your local service.

The strategies offered by NHS services are practical. The sources read for this page do not list a single set of techniques, but the principle in the York leaflet is to manage difficulties within home and school environments through advice tailored to the child. In practice that can mean adjusting the environment (for example quieter spaces, softer lighting or different clothing), building predictable routines, giving the child ways to take sensory breaks and ways of getting the sensory input they seek, and introducing new foods or textures gradually without pressure.

Share observations with school staff, because many sensory difficulties are most disabling in noisy, busy classrooms, assemblies and dining halls. A short written profile of what overwhelms your child and what helps them can make adjustments easier to put in place.

Seek medical advice promptly if there is a loss of skills your child previously had, severe restriction of eating that affects growth or health, or distress that seems out of proportion and is affecting sleep, attendance or wellbeing, which are worth discussing with your GP or health visitor.

NHS children's occupational therapy, paediatric and community child health teams, and school services provide most support, and thresholds and waiting times vary by area. Private occupational therapists, some with additional sensory integration training, also work with families in the UK. Whichever route you use, it is reasonable to check the therapist's professional registration and what the approach involves.