How a child with ADHD perceives the world.

Sensory processing.

In our daily lives, experiencing stimuli most often stays in the background. The hum of conversations in a restaurant, a label at the collar, the lighting in a shopping centre — they are present, but do not dominate our attention. The nervous system automatically organises them, filters them and assigns them appropriate meaning.

In some children, this mechanism works differently. Stimuli do not come together into a coherent whole — they become intense, difficult to ignore, or conversely, as if insufficiently noticeable. What for some people is a neutral background becomes for others an experience that requires regulation.

In recent years, this area has gained particular significance in ADHD research. A growing number of studies indicate that the way sensory stimuli are processed is not merely an add-on to the clinical picture, but an important part of it.

Sensory processing as a starting point for understanding the child

In a child's daily functioning, sensory processing remains invisible — until it begins to affect their behaviour. For a parent, this means situations that are hard to explain clearly: sudden overload in noise, a strong reaction to touch, difficulty concentrating in a particular environment.

The authors of the study describe this mechanism in fundamental terms:

From this perspective, the child's behaviour is no longer the starting point. It becomes a consequence of how their nervous system interprets reality.

A consistent pattern of responses rather than random behaviours

For a caregiver, a child's behaviours can seem inconsistent — hypersensitivity one day, a need for intense movement or stimulus-seeking the next. In everyday life it is difficult to connect these reactions into a whole, because they appear in different contexts and are often interpreted as separate difficulties: emotional, behavioural or related to concentration.

In research, however, this picture turns out to be ordered and repeatable. What looks from the outside like variability may in fact be the result of a single mechanism — the way the nervous system regulates its level of arousal in response to stimuli.

The authors of the study point to a clear pattern:

In practice, this means a child may simultaneously experience two apparently contradictory states: overload and insufficient stimulation. In a stimulus-rich environment — such as a classroom, shopping centre or playground — their nervous system may react excessively, leading to withdrawal, irritability or loss of concentration. In low-stimulation situations, on the other hand, a need for intense movement, impulsivity or active stimulus-seeking may emerge.

It is precisely this context-dependence that makes a child's functioning difficult to predict. At the same time, the research shows that this is not random variability, but a predictable pattern of responses arising from differences in sensory processing.

With this knowledge, an observant parent or teacher can more precisely observe not only how a child behaves, but in what conditions a given behaviour appears. This in turn opens the way to real influence — through modifying the environment, the structure of the day or the way demands are made — rather than focusing solely on controlling behaviour.

Everyday situations in the light of research

In practice, the greatest tension arises in moments that are hard to anticipate — the child's reaction seems disproportionate to the situation. For a teacher, this may be a lack of response to an instruction; for a parent, a sudden emotional reaction in an apparently neutral context.

The study shows that these reactions share a common basis:

This means a child may simultaneously experience the world as both too intense and insufficiently stimulating — depending on the situation.

Implications for diagnosis and planning support

From a diagnostic perspective, taking sensory processing into account allows for a better understanding of where observed difficulties originate. What is visible as a concentration problem may have its source in sensory overload or in a need for additional stimulation.

The authors of the study emphasise the importance of this approach:

Contemporary diagnostic approaches increasingly include analysis of the sensory profile, emotional regulation and the child's functioning across different environments. This allows not only for more accurate diagnosis, but also for better-matched forms of support and psychoeducation for parents and families.

Conclusions for the child's everyday functioning

In a child's daily life, knowledge about sensory processing changes the way many situations are interpreted. It makes it possible to see that the difficulty does not always concern behaviour as such, but the way the world is perceived. For a parent or teacher, this means shifting attention from the question "why does the child behave this way" to "what is happening at the level of their nervous system in this situation".

The authors summarise their conclusions clearly:

Extending these conclusions to practice, this means that many of a child's everyday difficulties — such as overload in the school environment, difficulty maintaining attention in noise, strong emotional reactions or a need for intense movement — may stem from disrupted filtering and modulation of stimuli, rather than solely from deficits in attention or impulse control.

The study indicates that the co-occurrence of hypersensitivity and stimulus-seeking leads to variable, context-dependent responses — which explains why a child's functioning can differ so much depending on the situation.

For a caregiver, this means a need for more careful observation of the conditions in which difficulties arise — the level of noise, the number of stimuli, the structure of the environment and the cognitive demands being made.

For the therapeutic process, it means the need to incorporate strategies that support sensory regulation, rather than focusing solely on behaviour. This approach allows not only for a reduction in symptom severity, but above all for an increase in the child's comfort in functioning within their everyday environment.

From this perspective, the focus shifts — from controlling behaviour to understanding its causes and the conditions in which the child can function more stably and in line with their own capacities.

Scientific source

This article was prepared on the basis of the following publication:

Engel-Yeger B., Saadon-Grosman N., Miodownik C. et al. Sensory Processing in Individuals With Attention-Deficit/Hyperactivity Disorder Compared With Control Populations: A Systematic Review and Meta-Analysis Journal of the American Academy of Child & Adolescent Psychiatry, 2025.

Full text: https://www.jaacap.org/article/S0890-8567(25)00209-6/fulltext

References

[1] Engel-Yeger B., Saadon-Grosman N., Miodownik C. et al. (2025). Sensory Processing in Individuals With ADHD Compared With Control Populations . JAACAP..