ADHD, Sensory Processing & the Brain

Sensory processing difficulties can affect how adults with ADHD experience and respond to their everyday environment. Although ADHD is commonly associated with attention, impulsivity and executive functioning, some adults also experience heightened sensitivity to sound, light, touch, smells or busy visual environments.

For example, a crowded supermarket, a brightly lit office or a workplace with constant background noise may require considerable mental effort. Some individuals find certain clothing textures uncomfortable, struggle with multiple conversations happening simultaneously or become overwhelmed in environments that others seem to manage comfortably. Others may actively seek sensory stimulation to maintain alertness and engagement.

These experiences can interact with attention, emotional regulation, fatigue and executive functioning. An environment that places excessive demands on sensory processing may make it harder to concentrate, plan, complete tasks or manage competing responsibilities.

Sensory experiences vary considerably between individuals, and not every adult with ADHD experiences sensory sensitivities. Similar difficulties can also occur in other neurodevelopmental conditions or independently of ADHD.

My doctoral research investigated auditory processing and spatial listening in adults with ADHD, giving me a particular scientific interest in how sensory environments influence everyday functioning. In my coaching practice, I take a broader perspective, exploring how environmental demands, individual sensory preferences and executive functioning challenges may interact.

Coaching may involve identifying sensory triggers, recognising patterns of overload and developing practical environmental adjustments or strategies that support concentration, comfort and everyday functioning.

Yes. Some adults with ADHD report difficulty following conversations in restaurants, meetings, classrooms or other environments where several sounds compete for attention.

These experiences do not necessarily indicate hearing loss. Understanding speech in noise involves auditory processing, selective attention, working memory and other cognitive processes that help listeners identify and follow relevant information.

My doctoral research examined auditory processing and spatial listening in adults with ADHD using behavioural assessments, self-report measures and electrophysiological recordings. One important area of interest is understanding why listening difficulties reported in everyday life may not always be reflected in conventional laboratory measures.

Auditory processing refers to the nervous system's handling and interpretation of sound information. It supports abilities such as distinguishing sounds, using spatial information and understanding speech in complex listening environments.

ADHD is primarily recognised as a neurodevelopmental condition involving difficulties with attention regulation and related functions, but these processes can interact with listening demands. For example, following a conversation in a noisy setting requires both processing incoming auditory information and maintaining attention on the relevant speaker.

Researchers continue to investigate the relative contributions of auditory, attentional and cognitive mechanisms to listening difficulties in adults with ADHD.

Normal hearing sensitivity does not guarantee effortless listening in every environment.

A conventional hearing test primarily measures the ability to detect sounds at different frequencies. Everyday listening often involves additional demands, such as separating competing voices, maintaining attention, remembering spoken information and interpreting speech in challenging acoustic conditions.

Difficulties in these areas can arise for different reasons, including hearing-related, auditory processing and cognitive factors. Where listening problems are persistent, an appropriate hearing and clinical assessment can help clarify potential causes.

For a closer examination of why adults may experience listening difficulties despite normal hearing test results, read my article When the hearing test is normal but listening is still difficult, which discusses current research on auditory processing assessment and its limitations.

Following a conversation in a noisy environment requires the brain to identify relevant speech, separate it from competing sounds and maintain attention on the intended speaker. This process involves both auditory processing and cognitive functions, including selective attention and working memory.

Some adults with ADHD report particular difficulties in restaurants, meetings and social gatherings where several people speak simultaneously. They may hear the conversation clearly but struggle to follow it consistently, particularly when background sounds compete for attention.

These experiences do not necessarily indicate an impairment in basic hearing sensitivity. They may reflect the interaction between auditory information, attentional demands and the complexity of the listening environment.

My doctoral research at Macquarie University investigated auditory processing and spatial listening in adults with ADHD, including the relationship between physiological measurements and self-reported listening difficulties.

An important question in this area is why people may report significant difficulties in everyday listening situations even when controlled laboratory measures do not reveal corresponding group differences.

Spatial hearing allows us to use information about the location of sounds in our environment. It contributes to identifying where sounds originate, separating competing sound sources and orienting attention towards relevant auditory information.

One important mechanism involves detecting very small differences in the timing of sounds arriving at the two ears, known as interaural time differences (ITDs). The auditory system uses these differences as part of the process of determining sound location.

Spatial hearing is particularly relevant in environments containing multiple sound sources, such as restaurants, classrooms, workplaces and public spaces.

In my doctoral research, I investigated neural responses associated with processing interaural time differences in adults with ADHD using an electrophysiological measure known as the interaural time modulation following response (ITM-FR).

The study did not identify a statistically significant overall difference between the ADHD and control groups in this measure. This finding highlights the importance of distinguishing between specific laboratory measurements and the broader demands of everyday listening.

Some adults with ADHD describe difficulties understanding speech, maintaining attention during conversations or following spoken information despite having hearing thresholds within the normal range.

Conventional hearing assessments provide important information about hearing sensitivity, but they do not capture every process involved in understanding complex auditory information.

Everyday listening also depends on how auditory information is processed and how cognitive systems support attention, working memory and interpretation.

Research has investigated several auditory and electrophysiological measures in ADHD, but findings are not consistent across all studies or experimental approaches.

It is therefore important to avoid assuming that all listening difficulties in ADHD originate from an underlying auditory processing impairment. Attentional factors, cognitive demands, hearing-related conditions and environmental characteristics may all contribute.

A comprehensive assessment can help distinguish between possible explanations when listening difficulties are persistent or significantly affect everyday functioning.

Sensory overload is a term commonly used to describe situations in which sensory input becomes difficult to manage or tolerate. People may experience discomfort, fatigue, irritability or difficulty concentrating when exposed to competing sounds, bright lights, movement or other environmental stimuli.

Some adults with ADHD report heightened sensitivity to particular sensory environments, although sensory experiences vary considerably between individuals.

A busy supermarket, crowded office or noisy restaurant may require continuous processing of multiple sources of information. In addition to sensory demands, individuals may need to navigate social interactions, make decisions, remember tasks and regulate attention.

These combined demands can create substantial cognitive load, even when none of the individual tasks appears particularly difficult.

Understanding sensory overload therefore requires considering not only the intensity of sensory input but also the cognitive and environmental demands occurring simultaneously.

Practical approaches may include reducing unnecessary stimulation, planning quieter periods, using appropriate environmental adjustments and allowing opportunities for recovery.

Electroencephalography (EEG) measures electrical activity generated by populations of neurons. In auditory neuroscience, electrophysiological methods can help researchers investigate how the nervous system responds to sound at different stages of processing.

Auditory brainstem responses (ABRs), for example, provide information about neural activity associated with the early auditory pathway. Auditory steady-state responses (ASSRs) can be used to examine neural responses to regularly modulated sounds.

These measures are valuable research tools because they allow investigators to study aspects of auditory processing that cannot be understood through behavioural performance alone.

My doctoral research included ABR, ASSR and ITM-FR recordings to investigate different aspects of auditory neural processing in adults with ADHD.

The results did not demonstrate consistent statistically significant differences between groups across these electrophysiological measures. This is important because subjective listening difficulties should not automatically be assumed to correspond to measurable differences in every auditory neural response.

Although EEG contributes to understanding neurophysiological mechanisms, these auditory measures are not established standalone diagnostic tests for ADHD.

For a closer look at how EEG can reveal differences in automatic auditory processing and later attentional responses in ADHD, read my article ADHD and auditory processing: where does the difference actually begin?

Laboratory assessments are designed to investigate specific mechanisms under controlled conditions. Everyday listening, however, involves many cognitive and environmental demands operating simultaneously.

During a laboratory experiment, participants may listen to carefully controlled sounds while distractions are minimised. In everyday situations, they may need to follow conversations, ignore background noise, remember information and respond to changing social demands.

These conditions are not equivalent.

In my doctoral research, adults with ADHD reported greater everyday listening difficulties than control participants on the Speech, Spatial and Qualities of Hearing Scale (SSQ-12). However, the electrophysiological measures examined did not reveal corresponding statistically significant overall group differences.

This contrast raises questions about how auditory processing, attention, cognitive demands and environmental complexity interact in everyday life.

It also highlights the importance of ecological validity: the extent to which experimental findings reflect people's experiences outside the laboratory.

The absence of a statistically significant difference in a particular laboratory measure does not establish that the groups are identical in all aspects of auditory functioning.

For a discussion of why carefully controlled laboratory findings may not fully reflect the complexity of everyday listening, read my article Neuroscience loves quiet rooms. Real life is rarely quiet.

My doctoral research at Macquarie University investigated auditory processing and spatial listening in adults with ADHD through electrophysiological, behavioural and subjective perspectives.

The study involved 40 adults, including 20 participants with ADHD and 20 control participants. All participants met the study's criteria for normal hearing sensitivity.

I examined several aspects of auditory functioning, including auditory brainstem responses (ABRs), the interaural time modulation following response (ITM-FR), auditory steady-state responses (ASSRs) and self-reported everyday listening experiences.

One of the most important findings was that adults with ADHD reported greater difficulties with everyday listening on the SSQ-12 questionnaire. However, the electrophysiological measures investigated did not show statistically significant overall differences between the ADHD and control groups.

These findings suggest that difficulties experienced in everyday listening environments may not be fully captured by the specific neural measures used in controlled laboratory settings.

The research does not establish that adults with ADHD have a universal auditory processing deficit. Instead, it contributes to a broader discussion about the relationship between auditory mechanisms, cognitive functioning and real-world listening demands.

For me, one of the most important implications is the need to investigate listening difficulties using multiple complementary approaches rather than assuming that one measurement can explain the complexity of everyday experience.