Treatment of Sensory Hypersensitivities
For individuals with sensory hypersensitivities, occupational therapy interventions focusing on graded exposure, sensory grounding techniques, and environmental modifications should be the primary treatment approach, as these directly address the maintaining factors that limit functional participation and exacerbate disability. 1
Core Treatment Strategy
The treatment framework centers on preventing avoidant behaviors that perpetuate disability while systematically reintroducing sensory stimuli in a controlled manner. 1
Occupational Therapy Interventions
Graded exposure therapy forms the foundation of treatment, where patients progressively confront avoided sensory stimuli in manageable increments to prevent the cycle of avoidance that maintains hypersensitivity. 1
Sensory grounding techniques help patients remain present during overwhelming sensory experiences and include: 1
- Noticing environmental details (colors, textures, sounds) to anchor attention
- Cognitive distractions such as word games or counting backwards
- Physical sensory distractors like flicking a rubber band on the wrist or holding textured objects
Environmental Modifications
Practical environmental controls reduce sensory overload while patients build tolerance: 1
- Controlling lighting intensity and using softer illumination
- Reducing ambient noise levels or using noise-canceling devices
- Minimizing tactile triggers in clothing and daily materials
- Scheduling activities during lower-stimulation periods
Context-Specific Considerations
Functional Neurological Disorder (FND)
Sensory hypersensitivity in FND patients (including hypersensitivity to touch, light, sound, and movement) requires recognition that these symptoms act as maintaining factors that must be addressed to prevent progressive disability. 1 The terminology includes sensory modulation difficulties, sensory defensiveness, and sensory over-responsiveness. 1
Acquired Brain Injury
For patients with stroke, traumatic brain injury, or brain tumors, sensory hypersensitivity occurs in 76-89% of cases and affects multiple modalities (visual, auditory, tactile, multisensory). 2, 3 Treatment must address the strong association between sensory hypersensitivity and fatigue, as these symptoms compound each other. 2
Coping strategies specific to brain injury patients include: 2
- Pacing activities to prevent sensory overload
- Taking regular breaks in low-stimulation environments
- Gradually increasing exposure duration as tolerance improves
Managing Comorbid Symptoms
Anxiety Management
Since anxiety frequently coexists with and exacerbates sensory hypersensitivity, concurrent treatment includes: 1
- Education about the physiological fight-or-flight response
- Breathing techniques and progressive muscle relaxation
- Grounding strategies and visualization
- Thought reframing and mindfulness practices
- Regular cardiovascular exercise
- Graded exposure to anxiety-provoking sensory situations
Pain and Fatigue
Evidence-based pain and fatigue management strategies from other chronic conditions should be adapted for patients with sensory hypersensitivity, as these symptoms commonly co-occur and worsen functional outcomes. 1
Critical Pitfalls to Avoid
Do not allow complete sensory avoidance, as this creates a self-perpetuating cycle where hypersensitivity worsens, leading to further avoidance and progressive functional limitation. 1
Do not dismiss these symptoms as purely psychological, as sensory hypersensitivity has documented neurophysiological correlates and causes genuine distress that impacts return to work and social participation. 2, 3
Do not use a one-size-fits-all approach, as the specific sensory modalities affected (visual, auditory, tactile, olfactory, movement) vary substantially between patients and require individualized assessment. 2, 3
Referral Considerations
Patients should be referred to occupational therapists with specific training in sensory processing interventions. 1 For those with significant psychological trauma contributing to sensory hypersensitivity, additional referral to mental health specialists with appropriate training may be necessary, though this is not universally required. 1
The prognosis for sensory hypersensitivity improves significantly when treatment focuses on maintaining functional participation rather than complete symptom elimination, with the goal of preventing disability progression and supporting gradual desensitization. 1, 2