Abstract

Atypical sensory processing is common in Attention Deficit Hyperactivity Disorder (ADHD). Despite growing evidence that ADHD symptoms persist into adolescence, the sensory processing of individuals with ADHD in this age group is limited. The aim of this study was to assess differences in self-reported sensory experiences between adolescents with and without ADHD. One hundred thirty-eight Italian adolescents aged between 14 and 18 years (M=16.20; SD= ± ۱٫۹۰) participated in the study. Sixty-nine participants with ADHD were matched by gender, age, and IQ to 69 typically developing individuals. The sensory processing of all participants was assessed using the Adolescent Sensory Profile (ASP) on the components: low registration, sensation seeking, sensory sensitivity, and sensation avoiding. Moreover, the modalities of ASP were measured: movement, vision, touch, activity level, hearing, and taste/smell. Results show that the ADHD group consistently displayed higher scores across all four components of the sensory profile compared to the control group. The subjects with ADHD also reported higher scores than the control group in all the modalities of ASP. These results confirming the presence of atypical sensory processing in adolescents with ADHD were discussed considering the Cumulative and Emergent Automatic Deficit model (CEAD).

Introduction

Through the senses, individuals are able to perceive and process a significant amount of information from the external world (Marshall et al., 2022). The process by which the nervous system receives, modulates, integrates, organizes, and responds to stimuli is known as sensory processing (Miller and Lane, 2000, Miller et al., 2007). Sensory processing is crucial for adaptive behavior, as it enables individuals to produce appropriate responses to specific situations (Dellapiazza et al., 2020) and influences their overall functioning and psychophysical well-being (Kojovic et al., 2019).

Dunn’s model (1999) explains how reactivity to sensory processing can vary based on the neurological threshold and individual behavioral self-regulation responses, both of which exist on a continuum. At the extremes of the neurological threshold continuum, two types of atypical sensory processing can be observed: hypo-reactivity to sensory stimulation associated with a low neurological threshold, and hyper-reactivity characterized by a high neurological threshold. Similarly, the extremes of the behavioral response continuum encompass passive self-regulation strategies, which involve allowing sensory stimuli to occur without interference, and active self-regulation strategies that entail engaging in behaviors to manage sensory input. The interplay between these continua gives rise to four components of sensory processing: sensation seeking, sensory avoidance, sensory sensitivity, and low registration (Rogers et al., 2011). Each component pertains to specific sensory modalities, including taste/smell, movement, vision, touch, activity level, and auditory processing. While the prevalence of atypical sensory processing in typically developing children is reported to be 12% (Adams et al., 2015), several studies have focused on investigating sensory processing in clinical populations and examining how it differs from that of the general population (Balasco et al., 2020, MacLean et al., 2022, Griffin et al., 2022, Isralowitz et al., 2023; Mohammadhsani et al., 2020).

Conclusion

In summary, this study provides substantial evidence of the association between ADHD and atypical sensory processing in adolescents. These findings lend support to the theoretical perspectives of CEAD and Johnson, highlighting the significant role of sensory experiences in the development and manifestation of ADHD symptoms. This is important because sensory processing influences daily functioning and participation in academic environments, leisure activities, and social interactions (Harrison et al., 2019, Fabio et al., 2020, Kerley et al., 2023). These findings also have significant implications in the educational field. Atypical sensory processing contributes to explaining the discrepancies between intellectual abilities and academic performance in students with ADHD. Understanding strengths and weaknesses in sensory processing and attention is necessary to design better classroom environments and develop more effective accommodations and interventions to support optimal success (Wood, 2020, Panagiotidi et al., 2020). Understanding the interplay between sensory processing, automatization, and ADHD symptoms can inform the development of targeted interventions and therapeutic strategies. By addressing sensory processing difficulties and promoting automatization of basic knowledge, it may be possible to alleviate cognitive load and improve cognitive functioning in individuals with ADHD, ultimately enhancing their daily functioning and quality of life.