Marion Wilm

Many young children are referred to occupational therapy due to concerns with sensory issues such as:  Easily distracted or upset by sounds, not enjoying touching wet textures, being bothered by clothing, not able to sit still, lacking self-control, very active and does not follow directions.  It is often my job as an occupational therapist to diagnose whether the child has sensory processing issues or whether something else is contributing to the child's unusual behaviors.  Often the answer is more complex and the child may have several issues contributing to their difficulties. 
Especially in young children, it is important to treat the sensory issues first since the primary way of learning in children under the age of 5 is through sensory exploration.  If the sensory information is confusing to the child then appropriate behavior, self-control (including adequate attention), and learning will not occur.  However, many young children with immature sensory processing abilities may also have an underlying attention deficit disorder.  How can you tell the difference?

If the child's main difficulty is sensory processing dysfunction then sensory input will quickly change the immediate behavior but if ADHD is the main dysfunction, then sensory input alone will not make a difference.  Here are some additional contrasts between sensory dysfunction vs. ADHD behaviors.  For more information, please refer to the book Sensational Kids by Lucy Jane Miller, PhD, OTR or contact an occupational therapist at Child & Family Development in Charlotte.

Impulsivity: 
Sensory--will stop impulsive behavior with sufficient sensory input.
ADHD--cannot stop impulsive behavior with sensory input.
High Activity Level: 
Sensory--craves activity that is related to sensation (deep touch or movement that changes the head position)
ADHD--seeks novelty
Lacks self control: 
Sensory--seeks a lot of touch by pushing, poking others.
ADHD--tends to talk all the time; interrupts; not able to wait turn.
Doesn't finish tasks: 
Sensory--avoids starting the task, but able to finish when prompted.
ADHD--Can start tasks, but not stick with them.
Difficulty focusing: 
Sensory--not interested enough to focus on the material/task.
ADHD--Gets started but focus gets diverted easily and makes mistakes.
Does not follow directions: 
Sensory--poor awareness of directions given, poor motor planning so can't follow directions.
ADHD--no motor component issues that prevent child from following the directions; can't remember long list of verbal directions.