Sensory over responsivity (SOR) as a transdiagnostic marker of neurodevelopmental risk. An epidemiological birth cohort study.

This study looked at 4,424 eight-year-old children to understand how sensory sensitivity relates to different developmental conditions. They found that children who are oversensitive to things like sounds, textures, or lights are nearly 5 times more likely to have developmental challenges. This sensitivity was most common in autistic children, but also appeared across ADHD, motor problems, learning difficulties, and other conditions. The research suggests that sensory sensitivity could be an early warning sign that helps identify children who might need extra support.

This large epidemiological study of 4,424 eight-year-old Finnish children examined sensory over-responsivity (SOR) as a transdiagnostic marker across neurodevelopmental conditions. SOR was found in 6.4% of children and was 4.7 times more likely in those with any developmental difficulty. Autism showed the strongest association with SOR, followed by ADHD traits, motor difficulties, intellectual disability, Tourette's/tics, and learning difficulties. Factor analysis identified three underlying dimensions of neurodevelopmental symptoms, all significantly associated with SOR: Social Communication & Language, Learning & Cognitive Processing, and Attention & Motor Regulation.

The findings support conceptualizing SOR as a transdiagnostic feature within the neurodevelopmental spectrum.

SOR may serve as an early transdiagnostic screening tool for identifying children at risk for various neurodevelopmental conditions. Clinicians should consider sensory assessments as part of comprehensive evaluations. The findings support developing sensory-informed interventions that address underlying sensory processing difficulties across diagnostic categories rather than condition-specific approaches.

The study relied on parent-reported questionnaire data which may introduce reporting bias. Cross-sectional design prevents determination of causality between SOR and neurodevelopmental difficulties. The study was conducted in a specific Finnish population which may limit generalizability to other cultural contexts.

While previous research has linked heightened sensitivity to sensory input to individual diagnoses such as autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD), no large-scale, population-based studies have examined its transdiagnostic associations across a broad spectrum of neurodevelopmental difficulties. This study utilized a population-based cohort of 4 424 eight-year-old children from the Northern Ostrobothnia Hospital District in Finland. Parent-reported data on sensory over responsivity (SOR) and neurodevelopmental difficulties were collectedquestionnaires. Logistic regression models were used to examine bidirectional associations between SOR and individual developmental difficulties, while exploratory factor analysis was conducted to identify underlying dimensions of neurodevelopmental symptoms.

SOR was reported in 6.4% of children and was significantly more common among those with developmental challenges. Children with any developmental difficulty were 4.7 times more likely to exhibit SOR than those without. ASD showed the strongest association, followed by ADHD related traits, motor difficulties, intellectual disability, Tourette's/tics, and learning difficulties. Factor analysis identified three latent dimensions: (1) Social Communication & Language, (2) Learning & Cognitive Processing, and (3) Attention & Motor Regulation - each of which was statistically significantly associated with SOR.

SOR is a prevalent and clinically significant transdiagnostic feature that cuts across multiple neurodevelopmental domains. Our findings support the conceptualization of SOR as a modality-specific liability factor nested within the proposed neurodevelopmental spectrum of the Hierarchical Taxonomy of Psychopathology (HiTOP) framework. Recognizing SOR as a transdiagnostic marker may improve early identification and guide more tailored interventions for children with diverse developmental profiles.