1. Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterised by differences in brain structure, connectivity and neurochemistry that affect attention, behavioural regulation and impulse control. These neurological differences can impair executive functions such as attention, time management and emotional regulation, making school, work and social interactions more challenging.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies ADHD as a neurodevelopmental disorder characterised by persistent patterns of inattention, hyperactivity and/or impulsivity (Koutsoklenis & Honkasilta, 2023). It identifies three presentations: predominantly inattentive, predominantly hyperactive-impulsive and combined presentation (National Institute of Mental Health, 2024). Diagnosis requires symptoms to be present before the age of 12, persist for at least six months across two or more settings and significantly impair academic, occupational or social functioning (Prasad, Siva & Rahul Kumminimana, 2025).

Although diagnosis is based on these core symptoms, ADHD is frequently associated with a range of other physical and psychiatric disorders, such as neurodevelopmental, conduct, anxiety and mood disorders (Jurek et al., 2025). In addition to the impairment caused by the core symptoms, evidence also suggests that many individuals with ADHD experience differences in sensory processing, despite these not being included within current diagnostic criteria.

Sensory processing refers to the brain’s ability to organise and interpret information from the body and surrounding environment, influencing how individuals respond to sensory experiences (Passarello et al., 2022). Brown et al. (2019) explained sensory modulation as the neurological process of regulating sensory input, which subsequently shapes behavioural responses. Building on this definition, researchers have proposed theoretical models to explain the different ways individuals respond to sensory information. One of the most widely used frameworks for understanding these responses is Dunn’s Model of Sensory Processing (Dunn, 1997), which categorises sensory modulation into four patterns: sensory sensitivity, sensory avoiding, sensory seeking and low registration. These patterns are determined by an individual’s neurological threshold and behavioural response to sensory input.

Research suggests that children with ADHD differ significantly from their peers in sensory responsiveness, which may contribute to difficulties with learning, organisation, motor performance and social participation (Dunn & Bennett, 2002). Neuroscientific evidence has proposed that these differences may arise from reduced activation of the prefrontal cortex and frontoparietal attention network, regions responsible for executive functioning and filtering irrelevant sensory information (Cardon, 2018). Altered functional brain connectivity may further contribute to sensory overload by reducing the brain’s ability to suppress competing sensory input.

Despite growing evidence linking ADHD and atypical sensory processing, there remains limited consensus regarding how sensory differences should be assessed or addressed in clinical practice. The absence of standardised diagnostic criteria and assessment tools represents a significant gap in current research and clinical care. A greater understanding of sensory processing differences may help explain why individuals with ADHD often experience difficulties in environments such as classrooms, workplaces and busy social settings, while also informing more effective assessment, intervention and environmental accommodations. Therefore, this literature review aims to examine how sensory differences in ADHD affect daily experiences such as school, social spaces or work.

2. Psychological Aspects

2.1 Sensory differences through the concept of self-efficacy

The ability to process sensory information plays an important role in how individuals understand and interact with the world around them. For individuals with ADHD, differences in processing this information can greatly influence their experiences throughout their day. These differences may present as over-responsivity (sensory hypersensitivity) or under-responsivity. Individuals with signs of sensory over-responsivity experience intense and prolonged reactions to sensory stimuli, whereas individuals with sensory under-responsivity are characterised by reduced or delayed responses to sensory input (Ghanizadeh, 2011). Sensory processing differences are more prevalent among individuals with ADHD, with hypo- and hypersensitivity occurring more frequently than the neurotypical population. Research illustrates that the severity of sensory-related issues is positively associated with the severity of ADHD symptoms (Yulug Tas et al., 2025; Panagiotidi, Overton & Stafford, 2018). Consequently, sensory-rich environments can be particularly demanding for individuals with ADHD, as sensory sensitivity can interfere with attention management by reducing their ability to filter relevant sensory information (Ben-Sasson, Carter & Briggs-Gowan, 2009).

Further studies suggest that these sensory differences can contribute to social withdrawal, negatively affecting the development and maintenance of peer relationships (Yulug Tas et al., 2025). Sensory-related behaviours may be misinterpreted by peers as disruptive and inattentive. When combined with the stigma surrounding ADHD, this can worsen social difficulties; over time, these experiences can accumulate and lead to the development of negative self-perception and lower self-esteem (Webster, 2018). If individuals repeatedly encounter similar experiences, they may begin to doubt their ability to succeed academically, socially or professionally. 

This pattern can be understood through Albert Bandura’s concept of self-efficacy, which refers to an individual’s belief in their ability to succeed. Repeated experiences of success strengthen self-efficacy, whereas repeated perceived failures – in other words, negative self-perception – can weaken confidence in one’s abilities. These beliefs, in turn, influence how people approach challenges (Yancey, 2024). Those with high self-efficacy are more likely to take action and persevere through obstacles, whereas individuals with low self-efficacy are more prone to procrastination and avoid challenging tasks (Yancey, 2024). Recent research supports this perspective. Andreassen et al. (2026) found that university students support this perspective; students with ADHD, on average, reported lower self-esteem, academic self-efficacy and poorer relationships with their faculty and peers when compared to neurotypical students. 

Overall, these findings suggest that ADHD-related sensory differences affect daily experiences by making environments more demanding to navigate while simultaneously shaping one’s confidence in their ability to overcome these challenges. Through the lens of Bandura’s concept of self-efficacy, these experiences can explain why individuals with ADHD might become less likely to engage with challenging academic or social situations (Webster, 2018). Repeated sensory and social difficulties can gradually erode an individual’s belief in their capacity for success. As self-efficacy deteriorates, individuals may become more likely to avoid demanding tasks (Yancey, 2024). This avoidance limits opportunities to develop successful experiences that would otherwise strengthen one’s self-efficacy, creating a negative feedback loop where reduced participation further reinforces feelings of negative self-perception and feelings of incompetence, subsequently weakening self-efficacy and increasing withdrawal.

2.2 Sensory overresponsivity and links with anxiety in children

Children with ADHD may exhibit a wide range of sensory processing abnormalities. An example of which may be sensory modulation disorders (SMDs). SMDs describe the inability to correctly respond to environmental stimuli in a way that aligns with the demands of said stimulus (Lane, 2019). Subtypes of SMDs include sensory overresponsivity (SOR), in which responses to sensory stimuli are more intense or for a longer duration than typical sensory responsivity, and sensory underresponsivity (SUR), in which sensory stimuli are ignored or disregarded, where the child seems to lack awareness of the environment and appears to be lacking in motivation (Miller et al., 2007).

Moreover, comorbid anxiety disorder was found to be a diagnostic moderator for ADHD in a large multimodal treatment study among symptom severity and child intellectual level. It acts as a variable that impacts the expression and predicts the outcomes of childhood ADHD (March et al., 2000). Findings have shown that sensory responsivity varies among children with ADHD, and there is increasing evidence for a relationship between ADHD and SOR (Lane & Reynolds, 2019).

Most research conducted on specific symptoms associated with ADHD in the early 21st century were done in isolation, and therefore, there is not much known on how these symptoms interact with each other in individuals with ADHD. However, the Kathryn Lawrence Dragas Sensory Processing and Stress Evaluation (SPASE) lab used a more dimensional approach to study how constructs such as sensation, anxiety and stress responses interact with each other and their possible relationship in individuals with ADHD (Lane & Reynolds, 2019). In this lab, children with ADHD were split into two sub-groups, those with ADHD and SOR were labelled “ADHDs” and those with only ADHD but no SOR were labelled “ADHDt”. Findings showed that children with ADHDs were more likely to exhibit higher anxiety levels than children with ADHDt (Reynolds & Lane, 2009).

Furthermore, a study that investigated SOR, in children with ADHD, as a moderating variable for electrophysiological measurement was conducted. This study demonstrated that children with ADHD as well as a specific version of SOR, known as tactile overresponsivity or tactile defensiveness, show different central processing of somatosensory input compared to children who have ADHD but no tactile overresponsivity. This shows a need for more research to be conducted on SOR in children with ADHD (Parush et al., 2007).

The primary SOR model states that general anxiety can result because of SOR. The idea behind this model is that overresponsivity to certain stimuli becomes associated with specific objects or events around said stimuli. Furthermore, this association becomes perceived by the individual as unpredictable and uncontrollable which could lead to the formation of phobias and thus to general anxiety (Green & Ben-Sasson, 2010). This model was supported by a study that showed that SOR may be a cause of anxiety in children with and without ADHD (Lane et al., 2012).

3. Neurological Aspects

3.1 Hyperactive ADHD

The hyperactive type of ADHD displays characteristics such as impulsive, excessive or situationally inappropriate motor activity (Halperin et al., 1992), as well as a lack of inhibitory control of responses (Barkley, 1997; Chelune et al., 1986; Nigg, 2000). Studies show that sensory seeking behaviour and sensory sensitivity are significantly more common in individuals with ADHD compared to control populations (Jurek et al., 2025). ADHD is typically associated with a weaker prefrontal cortex (PFC) – an area integral in regulating behaviour, emotion and attention. In particular, the right hemisphere is crucial for behavioural inhibition. To maintain its correct function, the prefrontal cortex relies heavily on its neurochemical environmental conditions, requiring noradrenergic stimulation of alpha-2A adrenoceptors and dopaminergic stimulation of D1 receptors. Both of these chemicals need to be present at the right levels for the PFC to function properly (Arnsten, 2009). It has been shown that by dosing animals with stimulant medications, levels of norepinephrine increase in the prefrontal cortex, causing locomotor activity to decrease (Arnsten, 2006).  While deficits in the prefrontal cortex explain difficulties with behavioural inhibition, impaired sensory gating offers an additional explanation for why individuals with ADHD might exhibit poorer cognitive performance and difficulty maintaining focus on relevant information due to the overwhelming environmental stimuli (Holstein et al., 2013)

Individuals with ADHD experience a higher input of sensory stimuli, causing a lesser ability to process information (Biederman, 2005; Faraone et al., 2000). Irrelevant and excessive environmental stimuli lead to poorer attention (Holstein et al., 2013). Sensory gating is the brain’s ability to automatically filter out intrusive sensory information – an elementary form of pre-attentive information processing (Braff & Geyer, 1990). This process can be measured using the P50 brain-wave response (a neurological measure of sensory gating), which measures P50 suppression: the brain’s ability to filter out or ignore unimportant, repeated sounds. Using an electroencephalogram (EEG), brain waves are monitored after two identical sound clicks are played through headphones with 500 milliseconds between them. In a healthy brain, the P50 wave response decreases in size when the sound is presented a second time, reflecting the successful filtering of excessive sensory information (Holstein et al., 2013). Holstein et al. (2013) compared 26 adults with ADHD to 26 healthy controls to measure P50 suppression. They noticed a significant suppression impairment in those with ADHD compared to the healthy individuals,  and the ADHD group also had an overall worse cognitive performance. This can explain some of the common experiences in ADHD, such as being easily overwhelmed by background noise or being unable to filter out distractions.

It is important to note that patients who experienced difficulties with P50 performed normally on another measure of sensorimotor gating: pre-pulse inhibition (PPI), which is the brain’s automatic ability to filter unnecessary sensory input. It is assessed by measuring to what extent a weak, non-startling warning stimulus reduces the body’s startle reaction to a subsequent loud and sudden noise (Gómez-Nieto et al., 2020). This suggests that the deficit is specific to sensory filtering and is not an overall impairment in inhibitory processing (Holstein et al., 2013).

3.2 Tactile sensitivity

A previous study by Ben-Sasson et al. (2014) suggests that one in six children with ADHD have sensory impairments which have a negative impact on daily functioning. As previously mentioned, sensory processing differences in ADHD may be in the form of over-responsivity, under-responsivity or sensory-seeking. Among the three types, over-responsivity is also referred to as sensory hypersensitivity. This is when individuals respond to sensory stimuli in a way that is more intense than what is expected (Ghanizadeh, 2011). The types of sensory hypersensitivity include auditory, visual and tactile. In this particular section, we will focus on tactile hypersensitivity.

Among the senses, the tactile sense is the earliest to develop and plays a crucial role in learning about our surroundings, as well as our own bodies. Somatosensory responses can be detected in utero as early as eight weeks gestational age (Montagu, 1986). Due to the importance of touch in our development and learning processes, alterations in tactile processing can result in long-lasting effects.

A previous study by Parush et al. (1997) found that somatosensory evoked potential (SEP), which measures the size of the electrical voltage generated by the nervous system in response to a sensory stimulus, is higher in boys with ADHD than typically-developing boys at the cortical, but not the cervical, level, indicating there is no altered higher-order processing at the spinal cord level. In a follow-up study, it was found that although children without the co-occurrence of ADHD and tactile defensiveness had a lower cortical SEP amplitude compared to those who did, they still had higher amplitudes than typically-developing children.

The brain areas associated with sensory processing are suggested to be functionally altered in people with ADHD, and a study by Cortese et al. (2012) seems to support this statement. The study used functional magnetic resonance imaging (fMRI) to find increased activation in the somatosensory cortex (the main area of the brain that processes body sensations, specifically touch, pain, temperature and body position) to social touch, in addition to self-reported social aversion.

3.3 Impact on daily life

ADHD affects the structure, function and communication of several brain regions responsible for attention, behaviour and self-regulation. Research has identified the prefrontal cortex, basal ganglia and default mode network (DMN) as key areas involved in ADHD. Additionally, neurotransmitters also play a critical role. Dopamine, which regulates rewards, motivation and attention, and norepinephrine, which helps regulate alertness and focus, are often altered in people with ADHD (Change et al., 2023).

People with ADHD often experience difficulty in planning, prioritising, starting tasks and more; these challenges are neurological rather than a lack of intelligence or effort (Norman et al., 2024). Similarly, people with ADHD can experience time blindness in their daily lives, a distortion of the perception of time when a person is unable to understand how much time has passed or how much time is expected to pass between events. Schools rely heavily on this type of executive functioning (i.e., the brain’s “management system”); similarly, many adults with ADHD face comparable issues in the workplace. Depending on the work environment, some challenges for people with ADHD include missing deadlines, difficulty prioritising multiple tasks, trouble sitting through long meetings and becoming overwhelmed by paperwork (CDC, 2026). Predominantly inattentive people may become easily distracted, daydream, experience forgetfulness, lose items and have difficulty maintaining focus. Meanwhile, predominantly hyperactive-impulsive people may exhibit fidgeting, talking frequently, acting before thinking, restlessness and difficulty waiting turns. Additionally, the sleep-wake cycle is often affected in people with ADHD, resulting in some form of irregular sleep pattern. ADHD can delay the brain’s ability to release melatonin, the sleep hormone, by approximately one hour, resulting in worsened mood, attention and executive skills the following day (Roggli, 2026). 

Scientists have made significant progress in understanding the neuroscience of ADHD using MRI and fMRI. Studies have identified a delayed maturation of the prefrontal cortex, reduced activity in executive-control networks, altered dopamine and norepinephrine signalling, and differences in communication between attention networks and the default mode network (Norman et al., 2023).

4. Discussion

Overall, the evidence presented throughout this research suggests that the neurological differences associated with ADHD extend beyond attention deficits, with impairment in executive functioning and atypical sensory processing affecting many aspects of daily life. These differences can make it more difficult for individuals to maintain certain executive functioning skills such as organisation, attention, time management and impulse control.

These difficulties are often experienced in daily activities, which can complicate school work, such as completing assignments, meeting deadlines and maintaining structured daily routines (Pacific Neuropsychiatric Specialists, 2025). Students with ADHD usually lack focus during lessons and have difficulty remembering assignments, staying organised, effectively following multi-step instructions and managing study time. They may also find it difficult to get into the habit of taking notes while listening, transitioning between different subjects or remaining attentively focused during long periods of instruction, which can ultimately contribute to poorer academic performance (Pacific Neuropsychiatric Specialists, 2025). For instance, in 2024, a systematic review of 15 studies reported that university students with ADHD consistently achieved lower performance when completing academic tasks than their peers, due to their inattention and executive functioning difficulties. Thus, they were identified to be the strongest predictors for poorer results (Pagespetit et al., 2024). Similar challenges are experienced in workplaces, including procrastination, distractibility, forgetfulness and difficulty completing tasks on time, which reduces productivity and increases stress levels. This is supported by the World Health Organisation’s World Mental Health Survey which found that employed adults with ADHD lost an average of 22.1 additional work-performance days per year, in comparison with workers without ADHD, highlighting the significant impact of ADHD on occupational functioning (de Graaf et al., 2008).

Beyond its effect on academic and occupational functioning, ADHD also influences social relationships and emotional well-being. Research suggests that misunderstandings and miscommunications between friends, family members and colleagues are often led by impulsivity, forgetfulness and challenges interpreting social cues (de Graaf et al., 2008).

ADHD symptoms can be managed through practical strategies and professional support. Establishing routines, breaking tasks into smaller steps and using reminders or planners can enhance daily functioning. Certain treatments such as ADHD coaching, medication and cognitive behavioural therapy can also improve coping skills, emotional regulation and overall quality of life.

In addition to executive functioning complications, individuals with ADHD often experience atypical sensory processing which can significantly affect their way of living. A systematic review and meta-analysis in 2025 found that individuals with ADHD were significantly more likely to experience sensory avoidance, sensory sensitivity, low sensory registration and sensory-seeking behaviours than neurotypical individuals (Jurek et al., 2025). These patterns of atypical sensory processing can make it more difficult to properly regulate and filter environmental stimuli such as bright lights, background noise, crowded classrooms in school or busy workplaces (Jurek et al., 2025). Consequently, sensory distractions make it more difficult for students to sustain attention during lessons and complete academic tasks efficiently. In workplace settings, sensory overload can also increase stress and make communication, participation and emotional regulation more difficult. While the meta-analysis demonstrated a strong association between ADHD and atypical sensory processing, these functional impacts are supported by broader research from psychology and neuroscience.

5. Conclusion

Sensory processing in neurodivergence often differs from that of neurotypicals, explained by terms such as sensory gating and sensory thresholds. The differences in sensory processing may have a negative impact on the majority of neurodivergent people living with ADHD. However, these challenges are not due to flaws or malfunctions, but rather the result of a mismatch between their processing styles and a world built primarily according to neurotypical standards. Educational systems, societal environments, workplace standards and daily expectations are designed for the average sensory thresholds, which may suit the neurotypical majority but fail to accommodate the minority of neurodivergent people. If these difficulties and the need for systemic changes could be recognised and worked upon, society may accommodate a wider, fuller spectrum of the human race and the vast spectrum of differences in sensory processing. Awareness of the effects of sensory processing difficulties promotes early intervention and management in people with ADHD. As neuroscience and psychology reveal new findings every year, a deeper understanding of sensory processing will enable people with ADHD to function better rather than struggle with their conditions.

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