Your son’s second grade teacher calls to say she’s concerned about some of his behaviors in school:

He can’t sit still through a half-hour lesson and disrupts the class.

He often seems distracted and doesn’t pay attention to what she’s saying

He bumps into kids in the lunch line, making them angry.

He can’t hold a pencil correctly, so he struggles with handwriting.

He gets upset when asked to switch from one activity to another

He melts down during assemblies and has to leave the gym.

You had started noticing this type of behavior when your child was a toddler, but now it’s hurting his progress in school. You’ve been wondering if he might have ADHD. But his teacher tells you she thinks he may have sensory processing issues.

What are sensory processing issues?

Some kids seem to have trouble handling the information their senses take in—things like sound, touch, taste, sight, and smell. There are also two other less well-known senses that can be affected—the first is a sense of body awareness, while the second involves movement, balance, and coordination. Also, kids with sensory issues can be oversensitive to input, undersensitive to input, or both.

While sensory processing issues are not a learning disorder or official diagnosis, they can make it hard for children to succeed at school. For instance, overly sensitive kids respond easily to sensory stimulation and can find it overwhelming. They may:

Be unable to tolerate bright lights and loud noises like ambulance sirens

Refuse to wear clothing because it feels scratchy or irritating-even after cutting out all the tags and labels-or shoes because they feel “too tight.”

Be distracted by background noises that others don’t seem to hear

Be fearful of surprise touch, and avoid hugs and cuddling even with familiar adults

Be overly fearful of swings and playground equipment

Often have trouble knowing where their body is in relation to other objects or people

Bump into people and things and appear clumsy

Have trouble sensing the amount of force they’re applying; for example, they may rip the paper when erasing, pinch too hard or slam down objects.

Run off, or bolt, when they’re overwhelmed to get away from whatever is distressing them

Have extreme meltdowns when overwhelmed

Meanwhile, undersensitive kids want to seek out more sensory stimulation. They may:

Have a constant need to touch people or textures, even when it’s not socially acceptable

Not understand personal space even when kids the same age are old enough to understand it

Have an extremely high tolerance for pain

Not understand their own strength

Be very fidgety and unable to sit still

Love jumping, bumping and crashing activities

Enjoy deep pressure like tight bear hugs

Crave fast, spinning and/or intense movement

Love being tossed in the air and jumping on furniture and trampolines.

You can see that these behaviors could be confused with the grade-schoolers who are undersensitive may display “negative behaviors” including what looks like hyperactivity, when in fact they’re seeking input. And in fact many of the behaviors of kids with sensory problems overlap with symptoms of ADHD, from trouble sitting still or concentrating to melting down when they are expected to make a transition from one activity (especially one they are enjoying) to another.

This is one reason it’s important that kids not be diagnosed with ADHD after a cursory visit to the pediatrician’s office, without careful use of interviews and rating scales to get a detailed picture of his behavior. Some kids with ADHD also have sensory issues.

A 2009 study found that 1 in every 6 children has sensory issues that make it hard to learn and function in school. While sensory processing issues are often seen in autistic children, they can also be found in those with ADHD, OCD and other developmental delays—or with no other diagnosis at all.

How can you help your child with sensory processing issues do better in school?

There is no medication to treat sensory processing issues, but there are therapies, as well as practical changes you can make at school and home to help your child feel and do better.

Occupational therapists (or OTs) are the specialists who work with kids who have sensory issues. The majority of OTs work in schools, though you can also find them in private practice. They engage kids in physical activities that are designed to regulate their sensory input.

You and your child’s teacher can discuss changes you can make to help him be more comfortable, secure and able to focus in the classroom. For instance:

Make sure his chair is a good fit for him. When he’s sitting at his desk, he should be able to put his feet flat on the floor and rest his elbows on the desk.

For the child who needs to move a bit, you might try an inflated seated cushion or a pillow from home so he can both squirm and stay in his seat.

Some kids are better off if they sit close to the teacher. However, if your child is easily distracted by noise, he may end up turning around often to where the noise is coming from.

If possible, eliminate buzzing and flickering fluorescent lighting.

Make sure he’s not sitting next to distracting sources of noise.

Have the OT work with him on knowing where his body is in relation to other people and things and the idea of personal space.

Provide sensory breaks such as walking in circles, jumping on a mini-trampoline and sucking on sour candy so he gets the input he craves and doesn’t bump into others.

Allow for fidgets and chewable items, available in OT catalogues, to provide input

Have the OT work with him on both gross and fine motor skills so he’s more confident, whether he’s in gym class or taking notes

To avoid meltdowns or bolting, allow him to skip school assemblies, or sit near a door so that he can take breaks in the hallway with a teacher when he starts to feel himself getting overwhelmed.

If the cafeteria is too stimulating, see about having him and one or more lunch buddies eat in a quieter room with a teacher or aide.

Have a clear visual schedule posted with plenty of preparation for transitions.

With support and accommodations from an understanding teacher, and perhaps work with an OT, your child with sensory processing issues can be primed for success in class, on the playground and with friends.