Pediatric Down Sensory Processing Disorder

Physical signs

Children with Sensory Processing Disorder (SPD) may experience physical challenges that affect movement, coordination, posture, and participation in daily activities.

Common physical symptoms include:

• Poor balance or frequent falls
• Clumsiness or appearing “accident-prone”
• Difficulty coordinating both sides of the body
• Poor posture or slouching
• Low muscle tone (appearing “floppy”)
• Weak core strength
• Delayed gross motor milestones
• Difficulty running, jumping, hopping, or climbing
• Trouble learning to ride a bike or scooter
• Difficulty catching, throwing, or kicking a ball
• Poor endurance or tiring easily during physical activity
• Walking on toes
• Frequent bumping into people, walls, or furniture
• Difficulty judging personal space
• Poor body awareness (proprioception)
• Difficulty using playground equipment
• Motion sickness or fear of movement
• Constantly seeking movement by spinning, swinging, jumping, or crashing into objects
• Avoiding swings, slides, climbing structures, or uneven surfaces
• Difficulty with handwriting due to poor postural control and hand strength
• Trouble using scissors, utensils, or manipulating small objects
• Sensitivity to pain or, conversely, seeming unaware of injuries
• Difficulty sleeping because of sensory discomfort

Developmental & Cognitive Symptoms:

Sensory processing differences can also impact how children learn, think, organize information, and participate in school and everyday routines.

Attention & Focus

• Difficulty paying attention in busy environments
• Easily distracted by sounds, lights, or movement
• Difficulty remaining seated during class or meals
• Frequently appears “zoned out”
• Trouble following multi-step directions

Learning Challenges

• Difficulty learning new motor skills
• Needs repeated demonstrations before mastering tasks
• Slower processing of verbal information
• Difficulty transitioning between activities
• Trouble completing assignments independently
• Inconsistent performance from day to day

Executive Functioning

• Difficulty planning and organizing tasks
• Poor time management
• Difficulty starting or finishing activities
• Trouble adapting to changes in routine
• Challenges with problem-solving
• Difficulty remembering multiple-step instructions

Motor Planning (Praxis)

Children may know what they want to do but struggle to coordinate the movements needed to complete the task.

Examples include:

• Difficulty dressing independently
• Trouble learning new playground skills
• Difficulty copying movements
• Challenges participating in sports
• Trouble sequencing movements for everyday tasks
• Difficulty imitating actions during play

Developmental & Cognitive Regulation

• Becomes overwhelmed easily
• Difficulty calming after becoming upset
• Low frustration tolerance
• Anxiety in unfamiliar environments
• Emotional outbursts when overstimulated
• Difficulty coping with changes in routine
• Avoidance of new experiences
• Difficulty recognizing internal body signals such as hunger, thirst, or the need to use the restroom (interoception)

School-Related Signs

Children may:

• Have difficulty sitting still during lessons
• Become overwhelmed by classroom noise
• Avoid art, music, PE, or recess
• Have messy handwriting
• Need frequent movement breaks
• Struggle with group work because of sensory overload
• Have difficulty participating in assemblies, cafeterias, or other crowded settings
• Require additional support to stay organized and complete schoolwork

These physical and developmental symptoms can vary widely from child to child. Some children may primarily seek sensory input, while others avoid it, and many experience a combination of both. A comprehensive evaluation by experienced pediatric therapists can help identify your child’s unique sensory profile and determine the most effective treatment strategies.