TL;DR

The scale: Sensory processing differences show up in the vast majority of autistic adults, and for many, they intensify with age rather than fading.

The gap: Almost all sensory processing research and intervention was built for autistic children. Adults, especially those diagnosed later in life, are left with no equivalent scaffolding for building regulation skills.

The hidden cost: Without that early support, autistic adults spend years reinventing coping strategies by trial and error, often not realizing their experiences were “issues” at all until a late diagnosis finally names them.

The real problem: Sensory differences are still treated in a lot of clinical training as something to correct through exposure or desensitization, rather than a dimension of how a nervous system relates to the world.

What works: Individualized, adult-appropriate support, in the therapy room and in the workplace, built around control, predictability, and recovery, not around “getting used to it.”

Sensory differences are not a footnote to autism; for most autistic adults they are the daily texture of it. In one survey of autistic adults, 94% identified as sensory hyperreactive, and nearly a quarter reported experiencing hyperreactivity, hyporeactivity, and sensory seeking all at once, sometimes to the same input in different moments (MacLennan et al., 2022). This is not a childhood phase that autistic people age out of. A recent study following autistic adults from their forties into their nineties found that sensory processing differences and their associated anxiety and depression symptoms were more pronounced in older participants than younger ones, with older autistic adults reporting a declining ability to cope with sensory input as they aged (Chen et al., 2026). That finding runs opposite to what most of us assume about adaptation over a lifetime. It is worth sitting with.

The OT gap late-diagnosed adults are living with

Here’s what I keep coming back to with my late-diagnosed clients: occupational therapy for sensory processing was built around a developmental window many autistic adults never had access to. If you weren’t identified as autistic in childhood, whether your presentation didn’t fit the diagnostic picture clinicians were trained to recognize, or you learned to camouflage early and effectively, you likely never had a sensory diet, never had an OT teach you to recognize your own thresholds before they were breached, never had a name for what was happening to you.

In the study by Chen et al., (2026), several autistic adults described exactly this. Before diagnosis, they assumed their sensory experiences were universal, or that they were simply “being fussy.” After diagnosis, often received well into midlife, participants described a marked shift: they finally had language for their triggers and limits, and their capacity to manage their sensory environment improved. That is not a small thing. It means the skill-building that should have happened in childhood is instead happening decades later, informally, often without any clinical support at all.

What autistic adults build instead, absent that early scaffolding, is a self-taught toolkit assembled through years of trial and error: noise-cancelling headphones, learned avoidance, understanding which fabrics and foods are tolerable (MacLennan et al., 2022). These strategies work. But they are reactive, individually assembled, and hard-won, rather than something a clinician helped a person develop with intention. The research on sensory integration therapy, meanwhile, remains almost entirely concentrated in childhood populations; a recent systematic review covering a decade of studies found the evidence base for sensory integration interventions is built almost exclusively on clinical work with children, with authors explicitly calling for research into how these approaches translate to the home, school, and adult environments where people actually live their lives (Camino-Alarcón et al., 2024). Adults are, in a real sense, an evidence gap.

What this looks like at work

Sensory differences do not stay home when an autistic adult goes to work, and the workplace is rarely built with them in mind. Research into how autistic adults experience public and shared spaces has identified recurring features that make an environment disabling rather than merely uncomfortable: an unrelenting sensory burden with no way to reduce or escape it, a lack of any control over lighting or sound, unpredictability in layout or routine, and no space to recover once someone becomes overwhelmed (MacLennan et al., 2023). Every one of those features shows up in a typical office or open-plan workplace: fluorescent lighting nobody can dim, background chatter nobody can mute, a floor plan that changes without warning, and no quiet room to retreat to when it all becomes too much.

The fix is not complicated, even if it is under-implemented. Autistic professionals and researchers designing workplaces with sensory needs in mind have proposed concrete, low-cost adjustment: giving employees control over their own sensory input (something as simple as being able to turn off a voice prompt, or dim a desk light, matters more than it sounds), building in low-stimulus spaces for recovery, and increasing predictability by communicating changes to layout or routine in advance (Hillman, 2024; MacLennan et al., 2023). None of this requires an organization to become a specialist autism service provider. It requires treating sensory accommodation as a design question rather than a personal problem for the employee to solve on their own.

What clinicians get wrong

This is where I want to push back on how sensory differences are still framed in a lot of clinical training: as a deficit to correct through exposure, desensitization, or normalization. The research does not actually support that framing. A narrative review of sensory-based interventions in autism found that while approaches like sensory integration therapy show promise for some individuals, there is no consensus among professionals about the evidence base, and outcomes vary enormously from person to person (Patil & Kaple, 2023). Sensory reactivity is not a single problem with a single fix; it is a dimension of how a nervous system relates to the world, and research on sensory processing sensitivity in the general adult population confirms that this dimension exists on a spectrum well beyond autism, with meaningful associations to stress across many different populations (Harrold et al., 2024). Autistic adults are not broken versions of a sensory system that works correctly in everyone else. They are living at a different point on a spectrum that all of us occupy somewhere.

When I work with autistic adults on sensory regulation, the goal is never to make someone tolerate more than their nervous system can hold. It is to help them understand their own patterns clearly enough to build a toolkit with intention, rather than by accident and years too late, and to have real conversations about what control, predictability, and recovery look like in their actual daily environments, including the workplace. That is a very different starting point than “how do we get you used to it.” And for the adults who spent decades without anyone ever asking that question, it changes what’s possible.

Stacy Finch, PsyD(c), RCC, CCC, is a registered clinical counsellor, neurodivergent workplace consultant, and speaker originally from the Washington, DC metropolitan area and now based in British Columbia, Canada. She partners with neurodivergent individuals and organizations worldwide to translate research into practical, neurodivergent-affirming therapeutic and workplace practices. Her doctoral research focuses on autism and therapy.

References

Camino-Alarcón, J., Robles-Bello, M. A., Valencia-Naranjo, N., & Sarhani-Robles, A. (2024). A systematic review of treatment for children with autism spectrum disorder: The sensory processing and sensory integration approach. Children, 11(10). https://doi.org/10.3390/children11101222 

Chen, Y., Jenkins, C. A., Charlton, R. A., Happé, F., Mandy, W., & Stewart, G. R. (2026). “Utterly Overwhelming” – A mixed-methods exploration of sensory processing differences and mental health experiences in middle-aged and older autistic adults. Autism in Adulthood, 8(2). https://doi.org/10.1089/aut.2024.0031 

Harrold, A., Keating, K., Larkin, F., & Setti, A. (2024). The association between sensory processing and stress in the adult population: A systematic review. Applied Psychology: Health and Well-Being, 16(4), 2536-2566. https://doi.org/10.1111/aphw.12554 

Hillman, H. (January 10, 2024). Designing a sensory-friendly workplace for autistic adults. Autism Spectrum Now. https://autismspectrumnews.org/designing-a-sensory-friendly-workplace-for-autistic-adults/

MacLennan, K., O’Brien, S., & Tavassoli, T. (2022). In our own words: The complex sensory experiences of autistic adults. Journal of Autism and Developmental Disorders, 52, 3061-3075. https://doi.org/10.1007/s10803-021-05186-3 

MacLennan, K., Woolley, C., Andsensory, E., Heasman, B., Starns, J., George, B., & Manning, C. (2023). “It is a big spider web of things:” Sensory experiences of autistic adults in public spaces. Autism in Adulthood, 5(4). https://doi.org/10.1089/aut.2022.0024 

Patil, O., & Kaple, M. (2023). Sensory processing differences in individuals with autism spectrum disorder: A narrative review of underlying mechanisms and sensory-based interventions. Cureus, 15(10). https://doi.org/10.7759/cureus.48020