Dressing: Sensory Sensitivities or Something Else?

As someone with my own sensory preferences when it comes to clothing, I know just how overwhelming and uncomfortable getting dressed can be. For some people, putting on clothes is a quick part of the morning routine. For others, it can be one of the most challenging parts of the day.

While clothing sensitivities are common in children with sensory processing differences, dressing difficulties aren't always caused by sensory processing alone. Understanding why dressing is difficult is the first step towards finding strategies that can help.

What do sensory sensitivities with clothing look like?

Sensory sensitivities with clothing can result in:

• Refusing certain clothes or fabrics.

• Complaints that clothes feel "itchy," "scratchy," "too tight," or "wrong."

• Difficulty tolerating seams, tags, socks, waistbands, or certain textures.

• Frequent changing of clothes throughout the day.

• Distress, meltdowns, or avoidance around getting dressed.

• A preference for a very limited range of clothing that feels comfortable and predictable.

However, there can be other factors that influence a child's experience with dressing. Determining whether difficulties with dressing stem from sensory sensitivities or something else can help your therapist support your child in the most effective way.

When is it sensory sensitivity?

Children with sensory sensitivities are typically responding to how clothing feels on their body. Certain textures, temperatures, pressure, or movement of clothing may genuinely feel uncomfortable or even painful. These children often have "safe" clothing that they consistently choose because it feels predictable and comfortable.

Most of us have clothes we change into as soon as we get home because they simply feel better. Children with sensory sensitivities often have these "safe clothes" too. They may wear the same jumper, favourite leggings or well-worn T-shirt whenever possible because those items feel familiar and comfortable.

How can Occupational Therapy help?

When dressing difficulties are related to sensory processing, our goal isn't to force children to tolerate uncomfortable clothing. Instead, we work alongside the child and their family to understand what their sensory system is communicating and find practical ways to make dressing less stressful.

Strategies may include:

• Identifying clothing features that are more comfortable, such as seamless socks, tagless shirts, soft fabrics or looser-fitting clothing.

• Developing a collection of "safe clothes" that can be mixed and matched while still meeting school or family expectations.

• Involving children in choosing or shopping for clothing so they have greater control over what they wear.

• Washing new clothes several times before wearing them or removing tags where possible.

• Gradually introducing new clothing in a low-pressure way, allowing children to explore and build familiarity over time rather than expecting immediate wear.

• Using sensory regulation strategies before getting dressed, such as movement, heavy work activities or deep pressure, if these help the child feel more regulated.

• Reducing the stress of busy mornings by preparing outfits the night before or offering a choice between two suitable options.

• Supporting children to recognise and communicate their sensory preferences so they can advocate for their own needs as they grow.

Sometimes the challenge isn't just the clothing itself—it's that getting dressed happens during one of the busiest parts of the day. If a child is already tired, hungry, rushed or dysregulated, clothing discomfort may feel much more intense. Occupational therapists look at the whole routine, not just the clothing, to identify ways to support regulation before dressing begins.

There is no one-size-fits-all approach. What feels calming and comfortable for one child may be overwhelming for another, which is why an individualised approach is so important.

When might it be something else?

A child who is experiencing sensory discomfort is usually trying to avoid an unpleasant sensation. Once they have found clothing that feels comfortable, they are often happy to wear it. If a child doesn't seem to have any clothing that feels "safe," or they continue to experience significant distress regardless of what they wear, it may be worth exploring whether other factors are contributing.

Children experiencing anxiety or OCD may also avoid getting dressed, but the reasons are different. In these situations, the distress is often driven by anxious thoughts or compulsions rather than the physical sensation of the clothing itself.

Anxiety

For some children, dressing difficulties are linked to anxiety rather than sensory processing alone.

They may worry about making the "wrong" choice, how others will perceive them, whether their clothes are appropriate for the weather or occasion, or they may seek repeated reassurance before leaving the house. In these situations, the distress is often driven by anxious thoughts rather than the physical sensation of the clothing.

OCD

Children experiencing obsessive-compulsive disorder (OCD) may also experience challenges with dressing, but for different reasons.

For example, they may feel compelled to change clothes repeatedly until they feel "just right," avoid certain clothes due to fears of contamination, or follow rigid dressing rituals that must be completed in a specific order. While these behaviours may appear similar to sensory sensitivities, they are typically driven by obsessive thoughts and compulsions rather than discomfort from the clothing itself.

Why does it matter?

Many children experience a combination of sensory differences, anxiety, and emotional regulation challenges, so the answer isn't always straightforward. Understanding the "why" behind dressing difficulties allows us to choose the most appropriate strategies and supports.

As occupational therapists, we can help children understand their sensory preferences, develop regulation strategies, build independence with dressing, and identify clothing adaptations that improve comfort. However, if a child's dressing difficulties appear to be driven by anxiety, OCD, or other mental health concerns, collaborating with a psychologist or other mental health professionals can ensure the child receives the most appropriate support.

As both an occupational therapist and someone with my own sensory preferences, I know that clothing discomfort is real. I also know that understanding why getting dressed is difficult is what allows us to provide meaningful support.

Looking beyond the behaviour to understand what is driving the challenge is often the first step toward making dressing a little easier. Ultimately, the goal isn't simply getting dressed—it is helping children feel comfortable, confident, and successful in their everyday lives.

References

Bart, O., Bar-Shalita, T., Mansour, H., & Dar, R. (2017). Relationships among Sensory Responsiveness, Anxiety, and Ritual Behaviors in Children with and without Atypical Sensory Responsiveness. Physical & Occupational Therapy In Pediatrics, 37(3), 322–331. https://doi.org/10.1080/01942638.2016.1185504

Brezinka, V., Mailänder, V., & Walitza, S. (2020). Obsessive compulsive disorder in very young children - a case series from a specialized outpatient clinic. BMC psychiatry, 20(1), 366. https://doi.org/10.1186/s12888-020-02780-0

Houghton, D. C., Stein, D. J., & Cortese, B. M. (2020). Review: Exteroceptive Sensory Abnormalities in Childhood and Adolescent Anxiety and Obsessive-Compulsive Disorder: A Critical Review. Journal of the American Academy of Child and Adolescent Psychiatry, 59(1), 78–87. https://doi.org/10.1016/j.jaac.2019.06.007

Unwin, K., Wales, K., Johnson, T., Leonard, C., Dixon, G., English, L., & Lane, A. (2024). Evidence Synthesis and Clinical Recommendations for Supporting School Students With Sensory Processing Challenges: A Rapid Review. The American journal of occupational therapy: official publication of the American Occupational Therapy Association, 78(6). https://doi.org/10.5014/ajot.2024.050766