Consideration deficit/hyperactivity dysfunction (ADHD) is probably the most broadly recognized neurodevelopmental situation, affecting as many as 5% of youngsters and adolescents (Cortese et al., 2023) and three% of the grownup inhabitants (Ayano et al., 2023).
Individuals with ADHD usually tend to expertise bodily and psychological well being comorbidities (Arrondo et al., 2022; Faraone et al., 2015), and former research counsel that folks with ADHD may expertise atypical sensory processing as effectively (Dunn et al, 2002).
The idea of sensory modulation was first described as “the interplay between the neurological threshold and self-regulation” by Winnie Dunn, in 2001. Beneath this framework (1997), individuals can fall into 4 totally different classes:
- Low Registration: they don’t detect all of the sensory info, however they don’t proactively search extra sensory enter.
- Sensory In search of: they don’t detect all of the sensory info, and they proactively search extra sensory enter.
- Sensory Delicate: they detect plenty of sensory info, however they don’t proactively attempt to cease this when it’s overwhelming.
- Avoiding: they detect plenty of sensory info and they actively attempt to keep away from additional sensory stimuli if it’s overwhelming.
Everybody has their very own manner of processing sensory info, however when these patterns develop into too excessive or arduous to handle, they’ll begin to intrude with each day life and impression cognitive capabilities and psychosocial growth (Dunn, 2001); depth and pleasure of social interplay (Cosbey et al., 2010); and regulation of feelings and a focus (DelCarmen-Wiggins et al., 2004).
This meta-analysis by Jurek et al. (2025) explores proof of variations in Sensory Modulation between individuals with ADHD and people with out; to tell the care and assist we offer for individuals with ADHD.
Sensory processing atypicalities could make strange stimuli really feel like a fireplace alarm – and make life difficult in ADHD.
Strategies
This examine was registered in PROSPERO, the worldwide systematic assessment registry. The literature search lined 3 of probably the most established databases for publications dated up till June 30 2024. Phrases associated to ADHD and SPPs had been appropriately refined to streamline the search.
The authors additionally assessed potential bias and total examine high quality utilizing a modified Newcastle–Ottawa Scale (NOS),
This systematic assessment targeted solely on research the place ADHD was formally recognized, excluding self-diagnosed or non-diagnosed individuals. Research by which individuals had greater than 20% of comorbid autism spectrum dysfunction, mental incapacity, or genetic issues had been additionally excluded (Juret et al,, 2025).
By way of the examine design, unique cohort, case-control and cross-sectional research had been included, while case research had been excluded.
The examine seemed on the following outcomes:
- Severity of sensory processing variations (measured repeatedly). Primarily based on Dunn’s 4 sensory modulation patterns (sensitivity, low registration, looking for, avoiding) and 6 sensory sorts (contact, sound, sight, style/odor, motion, physique consciousness).
- Threat of being hypersensitive or hyposensitive (measured as sure/no). Primarily based on how individuals had been rated within the research.
This systematic assessment evaluated binary and steady variations in sensory processing difficulties, for individuals formally recognized with ADHD.
Outcomes
A complete of 30 research (32 publications) had been included, with 5,374 individuals (1,656 with ADHD, 3,718 controls). Most research had been cross-sectional and targeted on youngsters, although some included adolescents and adults.
Females had been underrepresented (common 30%) and ethnicity was poorly reported. Individuals usually had common IQ, with low IQ excluded in most research. ADHD analysis was based mostly on DSM/ICD standards or scientific judgment, although diagnostic instruments diverse. Reporting of comorbidities and drugs standing was inconsistent.
Sensory processing was measured utilizing varied instruments, mostly the Sensory Profile (SP), Brief Sensory Profile (SSP), and Adolescent/Grownup Sensory Profile (AASP). Threat of bias was unclear in most research.
The next outcomes had been recognized:
- Meta-analysis of sensory sensitivity (13 research) confirmed considerably elevated scores in people with ADHD.
- Sensory avoiding was greater in ADHD, however not important in low-risk research resulting from restricted information and excessive heterogeneity.
- Low sensory registration was considerably greater in ADHD, with extra pronounced results in older individuals.
- Sensory looking for was elevated total in ADHD however not in adults, and solely important beneath sure examine situations; no publication bias was discovered.
- ADHD individuals confirmed larger problem processing tactile, visible, auditory, oral, and movement-related enter, however not physique place.
- Individuals with ADHD had been 9 instances extra more likely to be hypersensitive, even after correcting for publication bias.
- Hyposensitivity was practically 10 instances extra seemingly in ADHD, seen solely in adults, although based mostly on a restricted variety of research.
Throughout research, a wide range of instruments such because the Sensory Profile (SP), Brief Sensory Profile (SSP), and Adolescent/Grownup Sensory Profile (AASP), had been used to check sensory processing and responses.
Conclusion
This meta-analysis synthesises a medium to massive set of research into ADHD and sensory profiles and challenges, to spotlight the complexity of sensory processing patterns for individuals with ADHD.
Whereas there’s a heterogeneity throughout research’ designs and dangers of bias, rising outcomes counsel ADHD people’ sensory profiles can exhibit hypersensitivity and/or hyposensitivity, in numerous particular sensory modalities – which lends weight to theories of a number of coexistent and atypical sensory patterns throughout Dunn’s 4 sensory classes, for ADHD people, which will be strengths or challenges in distinctive situations.
Strengths and limitations
This examine is the first large-scale meta-analysis specializing in sensory processing in ADHD. Strengths embody the excessive variety of research and individuals included. The methodology was systematic, following PRISMA pointers with clear inclusion and exclusion standards. Most research used validated sensory processing questionnaires (SP, SSP, AASP), enhancing comparability. Subgroup analyses had been performed based mostly on examine inhabitants (youngsters, adults), threat of bias, evaluation software, and exclusion of autism and IQ.
The primary limitation is the excessive heterogeneity throughout research, making it arduous to inform if variations mirror true results or inconsistent strategies. One other limitation is how “sensory processing” was outlined. Totally different instruments had been used throughout research, so the authors created their very own system to group outcomes. Whereas mandatory to mix information, this will have launched bias since these classes weren’t all the time utilized persistently within the unique research, probably influencing findings in methods the authors couldn’t totally management.
Generalisability is restricted: feminine individuals had been underrepresented (common 30%) throughout research, and ethnicity was largely unreported and predominantly White the place out there. Though not formal exclusion standards, this will point out {that a} “hyperactive White boys” archetype nonetheless dominates scientific and analysis cohorts in ADHD research. Additional, remedy standing was typically lacking, so it’s unclear if the target or subjective impacts of this variable on SPPs must be managed for in future analysis.
Reporting on individuals with autism was inconsistent. 20 research excluded ASD, one included just a few, and 9 gave no particulars. Due to this, it’s unclear how having each ADHD and ASD may impression the findings. Individuals with ASD are identified to typically expertise extra pronounced sensory variations (Ben-Sasson et al., 2009), so not totally accounting for co-occurring ASD may restrict how effectively the conclusions mirror sensory processing on this group.
Lastly, indicators of publication bias had been detected for outcomes like sensory avoiding, low registration, and hypersensitivity. Statistical changes had been made, however this bias suggests reported results is perhaps considerably overestimated.
The underrepresentation of girls and ethnic minorities with ADHD in research included on this assessment, makes it obscure what sensory processing ‘fireplace alarms’ appear like for these communities.
Implications for follow
Enthusiastic about SPPs (sensory processing patterns) in layman’s phrases, we are able to consider the mind working like a fireplace alarm:
- The alarm’s sensitivity is the neurological threshold, and our response is the self-regulation.
- Totally different individuals’s fireplace alarms could also be kind of delicate to smoke, earlier than they ring.
- One individual’s alarm may solely go off when the whole constructing is on fireplace (excessive neurological threshold), another person’s may go off on the puff of a vape (low neurological threshold).
- Some individuals won’t reply to the alarm being triggered and simply anticipate it to cease (passive responders), some may open the home windows to let the smoke out or disable the alarm all collectively (lively responders), and others may get overwhelmed.
Whereas widespread characterisations of individuals with ADHD is usually a hyperactivity related to perpetual stimulus looking for, this assessment identifies that there will be a wide range of sensory processing patterns in ADHD people, which look like broadly distributed throughout Dunn’s sensory domains.
Individuals with ADHD will be normally hypersensitive to a wide range of bodily stimuli, however a cohort of people who find themselves hyposensitive relative to undiagnosed populations shouldn’t be excluded from therapeutic design issues.
Though not explicitly acknowledged on this examine’s evaluation – given the heterogeneity of obtainable information for assessment, the variations recognized between ‘low registration’ SPP prevalence in older individuals and ‘sensory looking for’ SPP earlier than maturity may additionally open an avenue for additional analysis on ADHD and any traits in sensory processing patterns throughout the lifespan.
Studying about sensory processing profiles, can affect extra inclusive therapies and assist design, for individuals with ADHD throughout the lifespan — leaving nobody behind when their alarm bells ring.
Assertion of pursuits
None to declare
Hyperlinks
Main paper
Jurek L, Duchier A, Gauld C, Hénault L, Giroudon C, Fourneret P, Cortese S, Nourredine M. Sensory Processing in People With Consideration-Deficit/Hyperactivity Dysfunction In contrast With Management Populations: A Systematic Overview and Meta-analysis. J Am Acad Youngster Adolesc Psychiatry. 2025 Apr 16:S0890-8567(25)00209-6. doi: 10.1016/j.jaac.2025.02.019. Epub forward of print. PMID: 40250555.
Different references
S. Cortese, M. Tune, L.C. Farhat, et al. Incidence, prevalence, and world burden of ADHD from 1990 to 2019 throughout 204 nations: information, with vital re-analysis, from the International Burden of Illness examine. Mol Psychiatry, 28 (11) (2023), pp. 4823-4830, 10.1038/s41380-023-02228-3
G. Ayano, L. Tsegay, Y. Gizachew, et al. Prevalence of consideration deficit hyperactivity dysfunction in adults: umbrella assessment of proof generated throughout the globe. Psychiatry Res, 328 (2023), Article 115449, 10.1016/j.psychres.2023.115449
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S.V. Faraone, P. Asherson, T. Banaschewski, et al. Consideration-deficit/hyperactivity dysfunction. Nat Rev Dis Primers, 1 (1) (2015), Article 15020, 10.1038/nrdp.2015.20
Dunn, W. (2001) The sensations of on a regular basis life: empirical, theoretical, and pragmatic issues, American Journal of Occupational Remedy, 55(6), pp. 608–620.
Dunn W, Bennett D. Patterns of sensory processing in youngsters with consideration deficit hyperactivity dysfunction. Occupational Remedy Journal of Analysis. 2002;22(1):4-15. https://doi.org/10.1177/153944920202200102
Dunn, W. (1997). The impression of sensory processing skills on the each day lives of younger youngsters and their households: A conceptual mannequin. Infants & Younger Kids, 9(4), pp.23–35. https://doi.org/10.1097/00001163-199704000-00005
J. Cosbey, S.S. Johnston, M.L. Dunn Sensory processing issues and social participation. Am J Occup Ther, 64 (3) (2010), pp. 462-473, 10.5014/ajot.2010.09076
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Ben‑Sasson, A., Hen, L., Fluss, R., Cermak, S. A., Engel‑Yeger, B. & Gal, E. (2009) A meta‑evaluation of sensory modulation signs in people with autism spectrum issues. Journal of Autism and Developmental Problems, 39(1), pp. 1–11.
