Autism vs Sensory Processing Disorder
The short answer
Autism and sensory processing difficulties overlap significantly, as most children with autism have sensory differences. However, sensory processing difficulties can exist without autism. The key distinction is that autism involves social communication differences, while sensory processing disorder primarily affects how sensory information is processed. A child with SPD alone typically has normal social communication skills. A comprehensive evaluation can distinguish between the two.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
Sensory differences are apparent in both conditions at this age. The distinguishing feature is social communication: a child with SPD alone makes eye contact, points, engages socially, and communicates intent. A child with autism has differences in these areas.
As social demands increase, differences become clearer. A child with SPD alone plays pretend, takes turns, and engages peers despite sensory challenges. A child with autism has difficulty with these social aspects.
A comprehensive evaluation including OT for sensory assessment and psychology for social communication assessment can distinguish between the two. Many children benefit from OT support regardless of diagnosis.
Both conditions benefit from occupational therapy. Children with autism also need social communication support. Accurate diagnosis guides the most effective intervention plan.
With appropriate support, children with both conditions make progress. Understanding whether the primary challenge is sensory processing, social communication, or both guides treatment priorities.
What Should You Do?
When to take action
- Your child has some sensory preferences but communicates and socializes well
- Your child has mild sensory sensitivities common in many children
- Your child's sensory behaviors are diminishing with age
- Your child has significant sensory differences and you are unsure if autism is also present
- Your child has been told they have SPD and you have lingering concerns about social communication
- You want a comprehensive evaluation to clarify your child's needs
- Your child has severe sensory and social communication difficulties affecting daily functioning
- Your child is losing skills alongside sensory and social challenges
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Behavior Concerns
Signs of Sensory Processing Difficulties
Sensory processing differences affect how a child's brain interprets sensory information from their environment and body. Signs include over-sensitivity (avoiding sounds, textures, or lights), under-sensitivity (seeking intense sensory input), or a combination. If sensory differences significantly affect your child's daily life, eating, playing, or social participation, an occupational therapy evaluation can help.
Worried About Autism - When and How to Screen
The AAP recommends autism screening at 18 and 24 months for all children, using the M-CHAT-R/F questionnaire. If you have concerns before these ages, you can request screening earlier. Early signs of autism may include limited eye contact, no pointing by 12 months, no words by 16 months, no pretend play by 18 months, or loss of any previously acquired skills. Trust your instincts as a parent and raise concerns with your pediatrician.
Early Signs of Autism in Babies and Toddlers
Autism spectrum disorder (ASD) can sometimes be identified as early as 12-18 months, though most children are not diagnosed until age 2-3. Early signs include limited eye contact, not responding to their name, lack of pointing or showing, limited social smiling, and absence of pretend play. Having one or two of these signs does not mean your child has autism - many typically developing children share individual traits. However, a pattern of multiple social communication differences warrants evaluation. Early intervention, regardless of eventual diagnosis, consistently leads to the best outcomes.
Aggressive Play vs Normal Play
Rough-and-tumble play — wrestling, chasing, play-fighting, and superhero battles — is a normal and important part of child development, particularly for toddlers and preschoolers. It helps children develop physical coordination, social skills, self-regulation, and an understanding of boundaries. The key distinction between normal rough play and concerning aggression is whether both children are having fun, there is turn-taking in roles, and no one is intentionally trying to hurt the other.
My Toddler Is Aggressive Toward Pets
Toddlers being rough with pets is extremely common and almost never reflects true aggression or cruelty. Young children lack the motor control to be consistently gentle and do not yet understand that animals feel pain the way they do. With patient, consistent teaching about gentle touch and close supervision, most toddlers learn to interact safely with pets by age 3-4.
My Baby Doesn't Seem Attached to Anyone
By 7-9 months, most babies show clear preferences for their primary caregivers and some wariness of unfamiliar people. If your baby seems equally comfortable with everyone and shows no distress when separated from caregivers, it may simply reflect an easy-going temperament. However, if combined with other social differences, it can occasionally warrant further discussion with your pediatrician.