By Ali Kandeğer
Short Comment
Atypical sensory processing patterns (SPPs) refer to difficulties in how the brain receives, organizes, and responds to sensory input, such as sounds, textures, movements, or lights. These patterns are typically classified into four sensory modulation domains: sensitivity, avoiding, seeking, and registration, based on Dunn’s model. While often discussed in the context of autism spectrum disorder, SPPs are also relevant to ADHD. They can influence attention, emotional reactivity, behavioral regulation, and social functioning—yet they remain underrecognized in clinical ADHD practice, particularly in adults.
In this timely systematic review and meta-analysis, Lucie Jurek et al. examined the association between ADHD and atypical SPPs. A total of 30 studies with 5,374 participants were included, of which 7 studies specifically focused on adults with ADHD. The review synthesizes data across age groups to provide a comprehensive picture of sensory difficulties in ADHD. The meta-analysis revealed that individuals with ADHD exhibited significantly higher levels of atypical sensory processing across all four modulation domains—sensory sensitivity, low registration, sensory seeking, and sensory avoiding—compared to controls. These differences were observed in both children and adults. Notably, adults with ADHD showed particularly elevated sensory sensitivity and low registration, while the evidence for sensory seeking in adults was less consistent, potentially due to measurement limitations or age-related symptom changes. Additionally, adults and children with ADHD both had an increased risk of hypersensitivity and hyposensitivity, highlighting the clinical relevance of these patterns across the lifespan.
Despite these findings, current ADHD guidelines do not include sensory processing as a focus for assessment or intervention, especially in adult populations. This study underscores the need for clinicians and researchers to systematically evaluate sensory profiles as part of the diagnostic process. In adults, understanding these sensory patterns may help explain functional impairments and guide the development of more personalized interventions. Rather than labeling these differences as pathological, recognizing sensory profiles can support adaptation strategies and environmental modifications that improve everyday functioning and quality of life for adults with ADHD.
Lucie Jurek, Arnaud Duchier, Christophe Gauld, Léonie Hénault, Caroline Giroudon, Pierre Fourneret, Samuele Cortese, Mikail Nourredine
J Am Acad Child Adolesc Psychiatry. 2025 Apr 16:S0890-8567(25)00209-6.
https://doi.org/10.1016/j.jaac.2025.02.019
Abstract
Objective: To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) and atypical sensory processing patterns.
Method: For this systematic review and meta-analysis, PubMed, Embase, and Web of Science were searched from their inception until June 30, 2024. Studies examining sensory processing patterns using questionnaires in participants with a diagnosis of ADHD compared with healthy controls were included. The study risk of bias was assessed using a modified Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted using R Version 4.3.1 software, considering sensory modulation severity atypicities as the primary outcome. The risk of publication bias was explored, and sensitivity analyses were conducted to test the robustness of findings.
Results: After screening 10,750 references, 30 studies (reported in 32 publications) encompassing 5,374 participants were included, with 23 studies focusing on children and 7 focusing on adults. Patients with ADHD presented with significantly more severe sensory atypicities than the control group in multiple domains: sensory sensitivity (k = 13, SMD = 1.17, 5% CI [0.75, 1.59], I2 = 87%), sensory avoiding (k = 11, SMD = 1.15, 95% CI [0.66, 1.64], I2 = 92%), low sensory registration (k = 23, SMD = 1.22, 95% CI [0.89, 1.56], I2 = 92%), and sensory seeking (k = 15, SMD = 1.23, 95% CI [0.48, 1.97], I2 = 97%). Heterogeneity was high in all analyses. Only 9 studies were deemed at overall low risk of bias.
Conclusion: Even though available ADHD clinical guidelines do not specifically mention the need to assess sensory processing in ADHD, this meta-analysis suggests that this should be systematically explored in the evaluation of children and adults referred for ADHD.
Keywords: attention-deficit/hyperactivity disorder; meta-analysis; sensory modalities; sensory processing; systematic review.