Understanding Sensory Processing and Down Syndrome: Insights from Dr. Katie Frank

When we think about how our children experience the world, we often focus on what they see, hear, touch, or taste. But there’s an entire system working behind the scenes that helps their brains make sense of all that information, and when that system doesn’t quite work as expected, it can have a big impact on everyday life.

Dr. Katie Frank, an occupational therapist with decades of experience supporting individuals with Down syndrome, compares the sensory system to electrical wiring. “When there is a kink in a wire,” she explains, “it may cause lights to flicker.” The same can happen in our sensory systems and when something’s off, it sends mixed messages to the brain. And for individuals with Down syndrome, these sensory "flickers" are not uncommon.

What Is Sensory Processing?

Simply put, sensory processing is how the brain receives and responds to information from the senses like touch, movement, sound, or even hunger. None of us have a “perfect” sensory system, and we all have preferences. Some of us hate scratchy tags in our shirts; others can’t stand loud noises. But for some people, especially those with Down syndrome, the way sensory information is processed can significantly affect learning, movement, behaviour, and interactions with others.

How Sensory Challenges Might Show Up

Dr. Frank notes that sensory processing challenges can look very different from person to person. Some individuals are extra sensitive to touch, while others may crave deep pressure or movement. For example, she points out that many people with Down syndrome might struggle with activities like bathing or haircuts due to tactile sensitivity or find it hard to wear certain types of clothing. Others may avoid water touching their face or dislike having lotion applied, even if their skin is dry.

In the realm of food and eating, sensory issues can contribute to picky eating or unsafe habits like stuffing the mouth with food. Dr. Frank explains this may stem from proprioceptive differences (how the body senses pressure and movement), or from the lesser known interoceptive system, which helps us feel things like thirst and fullness.

Hearing and vision also play a role. Many people with Down syndrome experience hearing loss or build-up of wax, which can make sounds seem muffled. Combine that with auditory processing difficulties, and things can get overwhelming quickly. Loud, unexpected noises might be too much, but music at full volume? Totally fine. Visual support and clear, simple language are often more helpful than complex verbal instructions.

Why Movement Matters

Another key sensory system that often gets overlooked is proprioception—input to the muscles and joints that helps us understand where our body is in space. Because individuals with Down syndrome often have low muscle tone, Dr. Frank explains that their bodies may struggle to interpret this input, which can affect how they move and how much force they use. Think about squeezing a tube of toothpaste too hard, or not hard enough to get anything out. That’s proprioception in action.

So What Can Help?

The good news is that with the right support, children and adults with Down syndrome can learn to manage sensory challenges in a way that helps them thrive. One of the most effective tools, according to Dr. Frank, is something called a sensory diet. But don’t worry, it’s not about food! A sensory diet is a personalized plan of sensory activities built into a daily routine to help keep the nervous system regulated. It’s more like choosing from a menu than following a strict recipe, says Dr. Frank.

These activities, like jumping; swinging; deep pressure; or quiet time—can help prepare someone for transitions, calm them down after becoming overwhelmed, or support focus and attention throughout the day. Sensory diets work best when they’re consistent and used proactively, not as a reward or punishment. Dr. Frank cautions that once the body gets used to a certain type of sensory input (like wearing a weighted vest), it stops noticing it after a while—just like we stop noticing our earrings after a few minutes. That’s why sensory breaks should be short and varied throughout the day.

Every Person Is Unique

One of the most important takeaways from Dr. Frank’s work is that there’s no one-size-fits-all approach. Sensory needs are highly individual—even among people with Down syndrome. Just because one child avoids touch doesn’t mean another will. And while sensory difficulties often overlap with autism, Dr. Frank reminds us that sensory challenges can exist on their own, without another diagnosis.

At the end of the day, helping a child (or adult) feel more comfortable in their body can make a world of difference. As Dr. Frank explains, when a person’s sensory system is regulated, “they are better able to pay attention, follow directions, and perform at an optimal level.” That’s true for all of us—whether or not we have a diagnosis.

For more resources & videos on Down Syndrome, visit the Adult Down Syndrome Center's Website where Dr. Frank works.

 And if you're concerned about your child’s sensory processing or want to explore sensory strategies at home, consider speaking with an occupational therapist who understands the unique needs of individuals with Down syndrome. Check out our Professionals Map to find a therapist in your area!