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Sensory Processing in Individuals With Attention-Deficit/Hyperactivity Disorder Compared With Control Populations: A Systematic Review and Meta-Analysis - 29/09/25

Doi : 10.1016/j.jaac.2025.02.019 
Lucie Jurek, MD, PhD a, b, c, , Arnaud Duchier, MD d, Christophe Gauld, MD, PhD e, Léonie Hénault, MSc a, Caroline Giroudon, MSc f, Pierre Fourneret, MD, PhD f, Samuele Cortese, MD, PhD c, g, h, i, Mikail Nourredine, MD, MSc b, c, f
a Centre Hospitalier Le Vinatier, Bron, France 
b Université de Lyon 1, Lyon, France 
c University of Southampton, Southampton, United Kingdom 
d Hôpital Charles Perrens, Bordeaux, France 
e Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France 
f Hospices Civils de Lyon, Lyon, France 
g Solent NHS Trust, Southampton, United Kingdom 
h New York University Child Study Center, New York City, New York 
i University of Bari Aldo Moro, Bari, Italy 

Correspondence to Lucie Jurek, MD, PhD, CETESLA, bat 504, CH Le Vinatier, 69500 Bron, FranceCETESLA, bat 504CH Le VinatierBron69500France

Abstract

Objective

To evaluate the association between attention-deficit/hyperactivity disorder (ADHD) and atypical sensory processing patterns.

Method

For this systematic review and meta-analysis, PubMed, Embase, and Web of Science were searched from their inception until June 30, 2024. Studies examining sensory processing patterns using questionnaires in participants with a diagnosis of ADHD compared with healthy controls were included. The study risk of bias was assessed using a modified Newcastle-Ottawa Scale. A random-effects meta-analysis was conducted using R Version 4.3.1 software, considering sensory modulation severity atypicities as the primary outcome. The risk of publication bias was explored, and sensitivity analyses were conducted to test the robustness of findings.

Results

After screening 10,750 references, 30 studies (reported in 32 publications) encompassing 5,374 participants were included, with 23 studies focusing on children and 7 focusing on adults. Patients with ADHD presented with significantly more severe sensory atypicities than the control group in multiple domains: sensory sensitivity (k = 13, SMD = 1.17, 5% CI [0.75, 1.59], I2 = 87%), sensory avoiding (k = 11, SMD = 1.15, 95% CI [0.66, 1.64], I2 = 92%), low sensory registration (k = 23, SMD = 1.22, 95% CI [0.89, 1.56], I2 = 92%), and sensory seeking (k = 15, SMD = 1.23, 95% CI [0.48, 1.97], I2 = 97%). Heterogeneity was high in all analyses. Only 9 studies were deemed at overall low risk of bias.

Conclusion

Even though available ADHD clinical guidelines do not specifically mention the need to assess sensory processing in ADHD, this meta-analysis suggests that this should be systematically explored in the evaluation of children and adults referred for ADHD.

Plain language summary

This systematic review and meta-analysis examined 30 studies including over 5,000 participants to assess the link between attention-deficit/hyperactivity disorder (ADHD) and atypical sensory processing. Findings show that individuals with ADHD experience significantly higher sensory sensitivity, sensory avoidance, sensory seeking, and low sensory registration compared to controls. Given their impact on daily functioning, assessing sensory processing could improve clinical evaluations for both children and adults with ADHD.

Study registration information

Association between ADHD and sensory processing disorder: A systematic review and meta-analysis; CRD42022325271.

Diversity & Inclusion Statement

We actively worked to promote sex and gender balance in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science.

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Key words : attention-deficit/hyperactivity disorder, meta-analysis, sensory modalities, sensory processing, systematic review


Plan


 The authors have reported no funding for this work.
 Data Sharing: Data and code are available upon request to the corresponding author.
 Disclosure: Lucie Jurek has received a research mobility grant from the Planiol Foundation. The Planiol Foundation was not involved in any part of this work. Pierre Fourneret has received honoraria from HAC Pharma. Samuele Cortese, National Institute for Health and Care Research (NIHR) Research Professor (NIHR303122), is funded by the NIHR for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, National Health Service (NHS), or the UK Department of Health and Social Care. He is also supported by NIHR grants NIHR203684, NIHR203035, NIHR130077, NIHR128472, and RP-PG-0618-20003 and by grant 101095568-HORIZONHLTH-2022-DISEASE-07-03 from the European Research Executive Agency. He has declared reimbursement for travel and accommodation expenses from the Association for Child and Adolescent Mental Health (ACAMH) in relation to lectures delivered for ACAMH, the Canadian ADHD Alliance Resource, the British Association of Psychopharmacology, and Healthcare Convention for educational activity on ADHD, and has received honoraria from Medice. Arnaud Duchier, Christophe Gauld, Léonie Hénault, Caroline Giroudon, and Mikail Nourredine have reported no biomedical financial interests or potential conflicts of interest.


© 2025  American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
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