Sensory Processing Disorder Checklist: Signs by Sensory System
This checklist is not a diagnosis. It is a way to notice patterns — which sensory systems seem most affected, whether your child is seeking or avoiding input, and whether the signs are consistent enough to warrant a professional assessment.
Written byMaya Ellison
Medically reviewed byDana Whitfield, OTR/LLast reviewed August 5, 2026 · every clinical claim checked by a licensed pediatric OT
The short version
Sensory processing differences are not rare. Up to 16% of children have measurable sensory processing differences, and many more have mild versions that affect daily life without meeting clinical thresholds. This checklist helps you notice whether your child's sensory responses are consistent enough to warrant further investigation.
Go through each section and tick the signs you have observed consistently over at least two weeks and across at least two settings (home, school, public places). A cluster of ticks in one system, or ticks across multiple systems, is a signal to talk to your pediatrician about an occupational therapy referral.
Professional resources: The American Occupational Therapy Association (AOTA) provides information on sensory processing and occupational therapy. The NIH has published research on sensory processing differences.
The checklist by sensory system
Tactile system (touch)
| Over-responsive (avoiding) | Under-responsive (seeking) | What it looks like at home |
|---|---|---|
| Hates tags, seams, and certain fabrics | Touches everything, puts objects in mouth | Morning clothing battles, or constantly touching walls and surfaces |
| Dislikes being touched unexpectedly | Does not notice when face or hands are dirty | Startles at unexpected touch, or does not respond to a light tap |
| Refuses certain food textures | Prefers very spicy or very crunchy foods | Limited diet based on texture, or seeks intense flavours |
| Hates hair washing or brushing | Does not notice when hair is messy or wet | Bath time battles, or walks around with food in hair |
| Dislikes walking barefoot on grass or sand | Walks barefoot everywhere, seeks barefoot contact | Shoes on in summer, or refuses shoes in winter |
Proprioceptive system (body awareness)
| Over-responsive (avoiding) | Under-responsive (seeking) | What it looks like at home |
|---|---|---|
| Avoids physical activities | Crashes into furniture and people | Refuses playground equipment, or is constantly bumping into things |
| Moves cautiously, seems afraid of falling | Jumps, climbs, and hangs from everything | Overly cautious on stairs, or never stops moving |
| Uses too little force (drops things) | Uses too much force (breaks toys, writes too hard) | Frequent dropping of objects, or torn paper and broken crayons |
| Slumps in chairs, poor posture | Leans on everything, rests head on table | Cannot sit upright at the table, or is always leaning on you |
Vestibular system (balance and movement)
| Over-responsive (avoiding) | Under-responsive (seeking) | What it looks like at home |
|---|---|---|
| Gets carsick easily | Loves spinning and does not get dizzy | Refuses swings and slides, or spins for hours without stopping |
| Afraid of feet leaving the ground | Seeks heights and fast movement | Refuses to climb, or climbs to the top of everything |
| Dislikes uneven surfaces | Seeks uneven surfaces, walks on edges | Refuses to walk on grass, or is always balancing on curbs |
| Prefers sitting still | Cannot sit still, rocks or sways constantly | Sits quietly for long periods, or is always in motion |
Oral system
| Over-responsive (avoiding) | Under-responsive (seeking) | What it looks like at home |
|---|---|---|
| Gags easily on certain textures | Chews everything — clothing, pencils, toys | Limited diet, or constant chewing on non-food items |
| Refuses lumpier foods as they get older | Prefers very spicy, sour, or crunchy foods | Still eating only purees at 2, or seeks extreme flavours |
| Does not like tooth brushing | Chews on toothbrush, bites it | Bath time tooth-brushing battles, or destroys toothbrushes |
| Drools more than expected for age | Drools less, mouth seems dry | Wets bibs past toddler age, or rarely drinks |
Auditory system (sound)
| Over-responsive (avoiding) | Under-responsive (seeking) | What it looks like at home |
|---|---|---|
| Covers ears at loud sounds | Does not respond when called | Meltdowns at hand dryers, or seems not to hear you |
| Distressed by background noise | Makes noise constantly — humming, tapping, singing | Cannot focus in a busy room, or needs constant background sound |
| Startles easily at sudden sounds | Does not startle at loud, sudden sounds | Cries at unexpected noises, or sleeps through alarms |
| Prefers quiet environments | Turns up volume very loud | Needs a quiet room to function, or TV at maximum volume |
Visual system (sight)
| Over-responsive (avoiding) | Under-responsive (seeking) | What it looks like at home |
|---|---|---|
| Squints or shields eyes in bright light | Stares at lights, fans, and spinning objects | Wears sunglasses indoors, or is fascinated by ceiling fans |
| Overwhelmed by busy visual environments | Notices small details others miss | Meltdowns in busy shops, or spots a tiny toy across the room |
| Prefers dim lighting | Prefers bright lighting, even at bedtime | Needs a dark room to sleep, or needs a nightlight |
| Avoids eye contact | Makes intense eye contact | Looks away when spoken to, or stares without blinking |
What the signs mean
A single sign in one system does not mean your child has SPD. Every child has sensory preferences and aversions. What matters is consistency and impact. If your child shows three or more signs in a single system, and those signs are affecting daily life — mealtimes, sleep, school, social situations — then it is worth investigating further.
The difference between a sensory preference and a sensory processing difference is intensity and persistence. A child who does not like tags but wears the shirt anyway has a preference. A child who cannot attend school because of tags has a processing difference that needs support.
Read more about the difference between seeking and avoiding in our sensory seeking vs avoiding guide.
When to seek professional assessment
Sensory differences are common and do not always require intervention. Seek a professional assessment if:
- Your child's sensory responses are escalating rather than stabilising despite consistent support
- Sensory avoidance is preventing participation in everyday activities — school, family outings, self-care
- Your child is unable to communicate what they need, even with supports
- You are seeing regression in skills your child previously had
- Sensory seeking behaviours are putting your child or others at risk
- You have ticks across multiple sensory systems on this checklist
Next steps after identifying signs
If this checklist has helped you identify patterns, here is what to do next.
- Document the patterns. Write down which systems seem most affected, whether your child is seeking or avoiding, and in which settings the signs appear. Take this checklist with you to the appointment.
- Talk to your pediatrician. Share your observations and ask for a referral to a pediatric occupational therapist. If your pediatrician is not familiar with SPD, consider a developmental pediatrician or a pediatric neurologist.
- Start matching tools to systems. While waiting for an assessment, you can start supporting your child at home. Ear defenders for auditory avoidance, chew tools for oral seeking, a sensory swing for vestibular seeking. One tool at a time, used consistently for two weeks.
- Build a sensory diet. A sensory diet is a schedule of input that meets your child's nervous system needs throughout the day. Use our free sensory diet template to get started.
- Communicate with school. If your child has an IEP or 504 plan, add sensory accommodations: movement breaks, preferential seating, noise-reducing headphones. Read our guide to sensory breaks for school.
Frequently asked questions
What is sensory processing disorder?
Sensory processing disorder (SPD) is a condition in which the brain has difficulty receiving and responding to information that comes in through the senses. A child with SPD may be over-responsive to sensory input (avoiding it), under-responsive (seeking it), or have difficulty discriminating between different types of input. SPD can affect one or more sensory systems.
Is sensory processing disorder the same as autism?
No. Sensory processing differences are a feature of autism, but SPD can exist on its own. A child can have SPD without being autistic, and an autistic child may or may not have significant sensory processing differences. The two conditions overlap but are not the same diagnosis.
At what age can sensory processing disorder be diagnosed?
A formal diagnosis of SPD can be made by a pediatric occupational therapist from around age 3, though many signs are visible earlier. If you are seeing consistent sensory differences before age 3, you can still consult an OT for guidance even if a formal diagnosis is not yet possible.
Can a child outgrow sensory processing disorder?
Sensory profiles change as children grow, and many children learn to manage their sensory differences with the right support. However, SPD does not simply disappear. Adults who had SPD as children often still have sensory preferences and aversions — they have just learned to navigate them.
What should I do if my child shows signs of SPD?
Start by observing which sensory systems seem most affected and whether your child is seeking or avoiding input. Use this checklist to identify patterns, then consult a pediatric occupational therapist who specialises in sensory integration. In the meantime, match tools to the system involved — ear defenders for auditory avoidance, chew tools for oral seeking, and so on.
Does insurance cover sensory processing disorder assessment?
Coverage varies by provider and plan. Many insurance plans cover occupational therapy assessment and treatment when it is deemed medically necessary. Check with your provider about coverage for OT evaluation with a sensory integration focus. Some plans require a referral from a pediatrician.
Can sensory processing disorder affect speech and language?
Yes. Auditory processing differences can make it difficult to filter background noise and focus on speech. Oral motor difficulties can affect articulation. Some children with SPD have delayed speech because they are overwhelmed by the sensory experience of communication. An OT and a speech-language pathologist often work together on these cases.
Where to go next
For a broader understanding of sensory systems, start with the sensory tools by system guide. To understand whether your child is seeking or avoiding, read sensory seeking vs sensory avoiding. For practical tools, see our guides to sensory toys, chewelry, and noise-cancelling headphones.
Where this fits in the sensory guide
Not sure whether your child is seeking or avoiding input? Start with the pillar guide: sensory seeking vs sensory avoiding. It tells you which of the tools below to reach for first.
- MixedCalm down corner
- All systemsSeeking vs avoiding
- MixedInteroception guide
- ProprioceptiveHeavy work activities
- All systemsSensory toys
- MixedSensory fidget toys
- DevelopmentalBest toy options for special needs
- AuditoryNoise cancelling headphones
- TactileSensory bin ideas
- TactileSeamless socks for kids
- All systemsSensory toys for 2 year olds
- TactileSensory friendly clothing
- OralChew necklaces for kids
- MixedStimming toys
- VestibularSensory swings for kids
- ProprioceptiveSensory diet
- CommunicationCommunication cards
- All systemsSensory-friendly gifts
- ProprioceptiveWeighted blankets for kids
- MixedSensory breaks for school
- MixedClassroom accommodations
- All systemsToddler sensory milestones
- MixedDIY sensory tools
- MixedAutism and sleep
- ProprioceptiveWeighted blanket chart
- OralChewelry chart
Keep reading
Start with the sensory tools by sensory system guide, then go deeper:
- All systemsSeeking vs avoidingA side-by-side checklist for each sensory system, and which tool to reach for first.
- All systemsSensory toysThe full map of sensory toys by the system they feed — tactile, proprioceptive, vestibular, oral, auditory, and visual.
- All systemsSensory toys for 2 year oldsToddler-safe picks by sensory system, setup and session lengths, and the under-three safety rules.
- All systemsSensory-friendly giftsGift ideas matched to each sensory system, organised by age and budget, with the overstimulating toys to skip.
- All systemsToddler sensory milestonesA pattern-based guide to sensory development, observation, play, and when to ask a qualified professional for help.
- MixedCalm down cornerWhere to put it, what goes in it by age, and the script that teaches a child to use it.