Sensory Processing Disorder

Sensory Under-Responsivity: Signs, Causes, and Support for Children and Adults

Authored by: The DrSensory Editorial Team

Reviewed by: 🛡️ DrSensory Clinical Review Board

Last updated: June 2025

All medical content on this page has been reviewed and approved by licensed Doctors on the DrSensory Clinical Review Board. Our reviewers follow strict editorial standards and ensure alignment with current APTA guidelines, evidence-based practice, and orthopedic rehabilitation protocols.

What Is Sensory Under-Responsivity (SUR)?
Signs and Symptoms of Sensory Under-Responsivity
Causes and Risk Factors of SUR

14 min read

How Sensory Under-Responsivity Affects Learning and Daily Life
Diagnosis: How Is Sensory Under-Responsivity Identified?
Therapy and Treatment for Sensory Under-Responsivity
At-Home Support and Strategies for SUR
What’s the difference between sensory under-responsivity and laziness?
Can someone have both over- and under-responsivity?
Do kids grow out of sensory under-responsivity?
Is sensory under-responsivity related to autism or ADHD?
What does a sensory diet for under-responsivity look like?

What Is Sensory Under-Responsivity (SUR)?

Sensory Under-Responsivity (SUR) is one of the three primary subtypes of Sensory Modulation Disorder, itself a form of Sensory Processing Disorder (SPD). Individuals with SUR respond less intensely or more slowly to sensory input than others. Their nervous systems may require stronger, more frequent stimulation to register and process sensory information.

This under-responsiveness may affect all senses—including touch, sound, sight, smell, taste, movement, and proprioception (body awareness). People with SUR may appear disengaged, unaware of stimuli, or under-reactive to pain and emotions.

Signs and Symptoms of Sensory Under-Responsivity

Children and adults with SUR often show the following behaviors:

Delayed responses to name calling, sounds, or movement
Lack of reaction to pain, heat, or cold
Clumsiness or poor body awareness
Low energy or difficulty “getting going”
Seeks constant motion like spinning or jumping but doesn’t seem satisfied
May not notice messy face, dirty hands, or wet clothes

These individuals often seem passive, slow, or unmotivated, but the root issue is neurological—not behavioral.

Causes and Risk Factors of Sensory Under-Responsivity

SUR is thought to result from neurological differences in how the brain processes and integrates sensory input. Instead of filtering and reacting to information efficiently, the brain may not register sensory signals clearly or quickly.

Potential causes and risk factors include:

Genetic factors or family history of SPD, autism, or ADHD
Premature birth or low birth weight
Neurological immaturity or atypical development
Early environmental deprivation (e.g., lack of stimulation or neglect)
Prenatal exposure to stress, alcohol, or toxins

SUR may occur independently or alongside conditions like autism spectrum disorder, developmental delays, or ADHD.

How Sensory Under-Responsivity Affects Learning and Daily Life

SUR can impact multiple areas of functioning, especially in childhood:

In school: Children may be labeled “lazy” or inattentive when they actually need more sensory input to focus
In social settings: May seem disinterested or disengaged from peers
In physical development: May have poor posture, delayed motor skills, or avoid gross motor play
At home: May not notice hunger, temperature changes, or pain

SUR is often misunderstood, which is why a proper evaluation and sensory support are essential.

Diagnosis: How Is Sensory Under-Responsivity Identified?

Diagnosis is typically made by a licensed occupational therapist (OT) with expertise in sensory integration therapy. The diagnostic process includes:

Parent and teacher questionnaires (e.g., Sensory Profile, Sensory Processing Measure)
Clinical observations of sensory response patterns
Standardized testing when needed (e.g., SIPT – Sensory Integration and Praxis Tests)
Ruling out other conditions (e.g., hearing issues, developmental delays)

An individualized sensory profile is created to guide treatment goals and interventions.

Therapy and Treatment for Sensory Under-Responsivity

Occupational therapy (OT) using Sensory Integration (SI) techniques is the most effective treatment for SUR. Goals include:

Increasing the nervous system’s responsiveness to input
Improving body awareness and coordination
Helping individuals stay alert, focused, and engaged

Therapy often includes:

Proprioceptive activities (e.g., climbing, pushing, pulling)
Vestibular input (e.g., swinging, spinning, jumping)
Tactile stimulation (e.g., textured toys, sensory bins)
Sensory diets tailored for home and school environments

Sessions are usually held 1–2 times per week and may continue for several months depending on progress.

At-Home Support and Strategies for SUR

Parents and caregivers can support children with SUR by creating a sensory-rich environment and following a consistent sensory diet designed by an OT. Strategies include:

Heavy work: chores like vacuuming, carrying laundry
Jumping and crashing games
Chewy or crunchy snacks
Obstacle courses and movement breaks
Bright lights and alerting music to help with waking up or focusing

The key is consistent sensory input throughout the day to help regulate the nervous system.

What’s the difference between sensory under-responsivity and laziness?

Sensory under-responsivity is a neurological condition, not a character flaw. Children with SUR may appear “lazy” because they move slowly or don’t react to stimuli—but their brains are simply not registering input effectively. With therapy and support, their energy and engagement levels often improve dramatically.

Can someone have both over- and under-responsivity?

Yes. Many individuals with Sensory Modulation Disorder show a mixed sensory profile, meaning they may be over-responsive in some sensory systems and under-responsive in others. For example, a child may hate loud noises (auditory over-responsivity) but seek deep pressure (proprioceptive under-responsivity).

Do kids grow out of sensory under-responsivity?

Some children improve as their nervous systems mature, especially with early occupational therapy. However, without support, SUR may continue into adolescence or adulthood. The good news is that many people with SPD develop effective strategies and lead successful, independent lives.

Is sensory under-responsivity related to autism or ADHD?

It can be. Many children with autism spectrum disorder (ASD) or ADHD also exhibit sensory under-responsivity, but SUR can occur independently as well. A full evaluation by an OT and developmental specialist is the best way to determine the root cause of the symptoms.

What does a sensory diet for under-responsivity look like?

A sensory diet for SUR includes high-intensity, purposeful activities that stimulate the senses and activate the nervous system, such as:

Bouncing on a therapy ball
Climbing jungle gyms
Chewing crunchy foods
Brushing skin with sensory brushes
Playing fast-paced games with lights and music

These activities are designed to keep the brain alert and improve sensory registration over time.

This page provides general educational content and is not a substitute for professional medical advice. Always consult a licensed provider for diagnosis and treatment.

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