Written By:
MS, BCBA
Introduction
When a child becomes overwhelmed by the tag in their shirt, melts down at the hum of fluorescent lights, or refuses to step on grass barefoot, parents often wonder if something more than typical childhood preference is at play. Sensory Processing Disorder (SPD) affects how the nervous system receives and responds to sensory information, and for many families, getting a clear answer through proper assessment is the first step toward meaningful support.
This guide walks through what SPD testing actually involves, who is qualified to perform these evaluations, the most widely used assessment tools, and how SPD overlaps with, but differs from, autism spectrum disorder.
What Is Sensory Processing Disorder?
Sensory Processing Disorder describes a neurological difference in how the brain organizes and interprets information coming in through the senses, not just sight, sound, taste, smell, and touch, but also proprioception (body position awareness) and vestibular input (balance and movement).
Children with SPD may be over-responsive to sensory input (a clothing tag feels unbearable, certain food textures trigger gagging), under-responsive (they don’t notice when their face is dirty or a name is called), or sensory-seeking (constantly crashing into furniture, chewing non-food items, spinning for long periods). Some children show all three patterns across different senses.
While SPD is not currently listed as a standalone diagnosis in the DSM-5, it is widely recognized in clinical practice, particularly within occupational therapy. Sensory differences often appear alongside autism, ADHD, anxiety, and developmental delays, but they can also exist on their own.
What Does an SPD Test Actually Look Like?
There is no single test that diagnoses SPD. A thorough evaluation usually combines several approaches over one or more sessions, typically taking between 60 and 90 minutes total.
A typical assessment includes a detailed parent interview to learn about the child’s developmental history, daily routines, and specific behaviors that have raised concern. Parents are often asked when symptoms first appeared, how they affect mealtimes, sleep, school, and play. Next come standardized questionnaires completed by parents, and often by teachers or daycare providers, that measure how the child responds across different sensory systems. The clinician then conducts direct observation and clinical play tasks, watching how the child moves, responds to touch and sound, handles fine motor activities, and reacts to a structured sensory environment. Finally, performance-based measures, obstacle courses, balance challenges, or tactile discrimination tasks allow the clinician to see the child’s responses in real time.
The child is rarely “tested” in the way they might experience a school exam. Most evaluations feel like extended play sessions, which helps the clinician see authentic responses rather than performance under pressure.
Who Can Administer SPD Tests?
This is one of the most important things for parents to understand: not every professional who works with children is qualified to evaluate sensory processing.
Occupational therapists (OTs) with specialized training in sensory integration are the primary providers of SPD assessments. Many hold advanced credentials, such as the Sensory Integration and Praxis Tests (SIPT) certification, or have completed continuing education through institutions like STAR Institute or the Collaborative for Leadership in Ayres Sensory Integration (CLASI).
Developmental pediatricians and child psychologists may screen for sensory differences as part of a broader evaluation, particularly when autism, ADHD, or developmental delays are being considered. They often refer to OTs for the in-depth sensory workup.
Speech-language pathologists sometimes administer sensory-related questionnaires when oral-motor or feeding concerns are present.
ABA therapists, behavior analysts, and educators play important roles in supporting children with sensory differences, but a formal SPD diagnosis falls outside their scope of practice. At Admire ABA, our clinical team works closely with occupational therapists and developmental specialists when sensory concerns are part of a child’s profile but the diagnostic assessment itself is conducted by appropriately credentialed professionals.
Common SPD Assessments
Several standardized tools are used throughout Maryland and across the country. Understanding what they measure can help parents know what to expect.
Sensory Profile-2 (SP-2)
Developed by Dr. Winnie Dunn, the Sensory Profile-2 is one of the most widely used sensory assessments in the United States. It uses caregiver and teacher questionnaires to measure sensory patterns across four quadrants: seeking, avoiding, sensitivity, and registration. There are versions for infants, toddlers, children up to age 14, and a self-report version for older children. Results help identify where a child’s sensory responses fall compared to those of typically developing peers.
Sensory Processing Measure (SPM and SPM-2)
The SPM evaluates sensory processing across home, school, and community environments, which makes it particularly useful for understanding how a child functions in different settings. Parents and teachers fill out separate forms, and the comparison often reveals important patterns, for instance, a child who copes well at home but struggles significantly at school. The SPM-2 expanded the assessment across the full lifespan, from infancy through adulthood.
Sensory Integration and Praxis Tests (SIPT)
The SIPT is a more intensive, performance-based assessment administered directly to the child, typically by an OT with specific certification. It measures praxis (motor planning), bilateral coordination, balance, and various forms of sensory discrimination. Because of the training required and the time involved, the SIPT is less commonly used than questionnaire-based tools, but it provides detailed information when a deeper assessment is needed.
Evaluation in Ayres Sensory Integration (EASI)
A newer assessment developed to update and eventually replace the SIPT, the EASI is gaining traction among OTs trained in Ayres Sensory Integration. It is performance-based and designed to be more accessible internationally.
Infant/Toddler Sensory Profile
For very young children, including those in early intervention programs, shorter caregiver-completed questionnaires help identify sensory concerns early enough to make a real difference in development.
How SPD Differs From Autism
This is a question we hear often from families. The two conditions can look similar from the outside, and they frequently co-occur—research suggests that the majority of autistic children have sensory differences. But they are not the same.
Autism Spectrum Disorder is a neurodevelopmental condition defined by differences in social communication and the presence of restricted or repetitive behaviors. Sensory differences are now included in the diagnostic criteria for autism, but they are one piece of a broader picture that includes how a child relates to others, uses language, plays, and processes the social world.
Sensory Processing Disorder, when it occurs without autism, involves the same sensory challenges but without the social-communication differences that define autism. A child with SPD alone may make eye contact, engage in back-and-forth conversation, share imaginative play, and form typical friendships, while still struggling profoundly with everyday sensory input.
In our diagnostic work with families across Maryland, we’ve seen children who were initially thought to have autism turn out to have isolated sensory differences, and others whose sensory struggles were the most visible symptom of an underlying autism profile that needed comprehensive support. This is exactly why a careful, multidisciplinary evaluation matters so much. A child’s behaviors don’t always tell the full story, and the right intervention plan depends on understanding what’s actually happening.
For families exploring formal evaluation, our diagnostic services team can help with autism-specific assessment and will refer to trusted occupational therapy partners when sensory processing is the central concern.
Where ABA Therapy Fits In
While ABA therapy does not diagnose or treat SPD as a standalone condition, it plays a meaningful supporting role for children whose sensory profile affects learning, communication, daily routines, or behavior.
In our sessions, we’ve worked with children whose sensory thresholds shape every part of their day, the child who can’t tolerate the texture of toothpaste, the toddler who screams when shoes go on, the school-age client whose meltdowns at the grocery store left her family avoiding outings entirely. ABA approaches in these cases focus on building tolerance gradually, teaching functional communication so the child can request breaks or accommodations, and collaborating with the family’s OT so that behavioral and sensory strategies reinforce each other.
A particularly memorable example: one family we worked with on the Eastern Shore came to us concerned about their five-year-old’s aggressive behavior at preschool. Through coordinated work with the child’s occupational therapist, we identified that most outbursts followed specific sensory triggers in the classroom—the morning circle with loud singing, the cafeteria at lunchtime. By teaching the child to request a quieter space and pairing that with the OT’s sensory diet recommendations, his classroom outbursts dropped substantially within a few months. Neither discipline alone would have produced the same result.
What to Do If You Suspect SPD
If your child’s sensory responses are interfering with daily life, mealtimes, sleep, school participation, family outings, the most useful first step is a conversation with your pediatrician about a referral to a qualified occupational therapist. Bringing specific examples, video clips if helpful, and notes about when and where difficulties show up will make that initial appointment far more productive.
If autism is also a consideration, a comprehensive developmental evaluation can clarify whether sensory differences exist alone or as part of a broader profile. Maryland families have access to evaluations through hospital developmental clinics, private practice psychologists, and provider organizations like ours.
Conclusion
Sensory Processing Disorder testing is a thoughtful, layered process, not a single test, but a combination of parent interviews, standardized questionnaires like the Sensory Profile-2 and the SPM, performance-based measures like the SIPT, and direct observation by an appropriately trained professional, usually an occupational therapist. While SPD and autism share some features and often co-occur, they are distinct conditions, and getting the right evaluation makes a real difference in the support a child receives.
If you’ve been wondering whether your child’s sensory responses warrant a closer look, you’re already taking the most important step: paying attention. From there, the path forward involves connecting with the right professionals and building a support team around your child’s specific profile.
Get in Touch With Admire ABA
Admire ABA provides ABA therapy services to families across Maryland, including in Salisbury, Baltimore, and Bowie. While sensory processing diagnostics are conducted by occupational therapists, our team supports children whose sensory profiles affect learning and behavior, coordinates with OT partners, and provides autism-specific diagnostic services when needed. If you’d like to talk through your child’s situation, we’re happy to help you understand whether ABA is a fit and connect you with the right professionals for any additional assessment needs.
Reach out through our contact page to schedule a consultation.
Frequently Asked Questions
At what age can a child be tested for Sensory Processing Disorder?
Sensory profiles can be screened from infancy onward. The Sensory Profile-2 has versions starting at birth, and caregiver questionnaires for infants and toddlers are commonly used in early intervention programs. More intensive performance-based testing, such as the SIPT, typically begins around age four, when children can follow structured instructions. Earlier identification, especially when sensory concerns are interfering with feeding, sleep, or development, gives families more time to build supports during critical developmental windows.
Does insurance cover SPD testing?
Coverage varies significantly. Because SPD is not a standalone diagnosis in the DSM-5, reimbursement for sensory-specific evaluations depends on the provider’s documentation, the child’s other diagnoses, and the specific insurance plan. Many families have evaluations covered when they are part of a broader occupational therapy assessment tied to a covered condition. In Maryland, Medicaid and most major commercial plans cover occupational therapy evaluations, though prior authorization is often required. Calling the insurance company before scheduling and asking the evaluating provider what diagnostic codes they typically use can prevent surprises.
Can a child have both autism and SPD?
Yes, and this is very common. Research suggests that the large majority of autistic children experience sensory processing differences, and sensory symptoms are now part of the diagnostic criteria for autism. A child can be diagnosed with autism and also receive occupational therapy services aimed specifically at sensory needs. Understanding both pieces of the profile usually leads to a more complete and effective support plan than treating either in isolation.
SOURCES:
- https://my.clevelandclinic.org/health/diseases/sensory-processing-disorder-spd
- https://familydoctor.org/condition/sensory-processing-disorder-spd/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9688399/
- https://en.wikipedia.org/wiki/Sensory_processing_disorder
- https://www.webmd.com/children/sensory-processing-disorder
