Conduct Disorder vs Sensory Processing Disorder | Cadabam’s CDC
As a parent, watching your child struggle with intense outbursts, defiance, or sensory quirks can feel overwhelming. Two common names you’ll hear are Conduct Disorder vs Sensory Processing Disorder—and the two can look alike at first glance. This guide from Cadabams CDC breaks down the essentials, so you can spot the differences, understand next steps, and find the right support.
1. Quick Snapshot: Conduct Disorder vs Sensory Processing Disorder
| Conduct Disorder (CD) | Sensory Processing Disorder (SPD) |
|---|---|
| Persistent rule-breaking and aggression toward people or animals | Unusual reactions to everyday sensory input (touch, sound, movement) |
| Driven by intent to violate rights or social norms | Driven by sensory discomfort, not deliberate harm |
| Begins in childhood or adolescence | Symptoms present from toddler years |
| Diagnosed by psychiatrist or psychologist | Diagnosed by occupational therapist + psychologist |
| Therapy, parent training, sometimes medication | Sensory integration therapy, environmental changes |
2. What Is Conduct Disorder?
Core Symptoms and Diagnostic Criteria (DSM-5)
According to the DSM-5, a child with Conduct Disorder shows three or more of these in the past 12 months, with at least one in the past 6 months:
- Aggression to people and animals
- Destruction of property
- Deceitfulness or theft
- Serious violations of rules (e.g., truancy before age 13)
- Pattern causes significant impairment at home, school, or with peers
Common Causes and Risk Factors
- Genetic predisposition to impulsivity and aggression
- Neurobiological differences in brain areas that regulate emotion
- Harsh or inconsistent parenting
- Trauma or chronic stress
- Peer rejection or association with delinquent friends
3. What Is Sensory Processing Disorder?
Types of SPD (Sensory Seeking vs Sensory Avoiding)
- Sensory Seeking – Craves intense movement, noise, or touch (spinning, crashing, loud music).
- Sensory Avoiding – Withdraws from typical stimuli (tags in clothes, cafeteria smells).
- Sensory Under-Responsive – Appears sluggish or unaware of pain/temperature.
- Sensory Over-Responsive – Reacts strongly to everyday sensations.
Red Flags Parents Often Miss
- Covering ears at the sound of a hand-dryer but not fireworks
- Refusing certain food textures yet chewing on shirt collars
- Constant motion during circle time but exhaustion after swings
- Meltdowns in bright supermarkets but calm in dimly lit rooms
4. Overlapping Behaviors: Why Parents Get Confused
Aggression vs Sensory Overload
- Aggression in CD is calculated—e.g., bullying for personal gain.
- Aggression in SPD is reactive—e.g., hitting when overwhelmed by noise.
Oppositional Moments: Tantrum or Meltdown?
- Tantrum (CD) stops once goal achieved; child can re-engage socially.
- Meltdown (SPD) continues even after goal met; child needs sensory reset.
5. Key Differences at a Glance
| Area | Conduct Disorder | Sensory Processing Disorder |
|---|---|---|
| Trigger | Desire to break rules | Sensory overload/seeking |
| Intent | Deliberate harm or defiance | Unintentional dysregulation |
| Response to Reward | Improves with behavior charts | Minimal change |
| Sensory Preferences | Neutral | Extreme like/dislike of textures, sounds |
| Eye Contact | May use threatening gaze | May avoid due to discomfort |
6. Dual Diagnosis: Can a Child Have Both CD and SPD?
Yes. Research shows 10–20% of children with Conduct Disorder also meet criteria for Sensory Processing Disorder. When both are present:
- Sensory overload can fuel aggressive outbursts.
- Impulsivity from CD can worsen sensory-seeking crashes.
- Treatment must address both pathways: sensory regulation + behavior change.
7. Assessment Pathway
Cadabams CDC follows a child-first, family-centred process:
Step-by-Step Diagnostic Process
- Intake Call – Discuss concerns and developmental history.
- Standardised Rating Scales – e.g., Conners-4, Sensory Profile-2.
- Clinical Interviews – With parents, teachers, and child.
- Observations – At home, school, or in-clinic sensory gym.
- Multi-disciplinary Meeting – Psychologist + Occupational Therapist review findings.
- Feedback Session – Clear diagnosis, next-step plan.
Tools We Use
- Conners-4: Screens for disruptive behavior disorders.
- Sensory Profile-2: Maps sensory patterns across home & school.
- ADOS-2: Rules out autism spectrum overlap.
- Parent & Teacher Questionnaires: Capture real-world functioning.
8. Treatment & Intervention Options
Evidence-Based Therapies for Conduct Disorder
- Parent Management Training (PMT) – Teaches consistent consequences and positive reinforcement.
- Cognitive-Behavioural Therapy (CBT) – Builds problem-solving and anger-control skills.
- Family Therapy – Repairs communication patterns.
- Medication – Atypical antipsychotics or mood stabilisers when aggression is severe.
Sensory Integration & Occupational Therapy for SPD
- Sensory Diet – Personalised schedule of sensory activities.
- Wilbarger Brushing Protocol – Reduces tactile defensiveness.
- Therapeutic Listening – Uses modulated music to regulate arousal.
- Environmental Modifications – Noise-cancelling headphones, fidget tools, dim lighting.
Parent Management Training & Family Therapy
- Unified Protocol: Combines PMT for CD with sensory coaching for SPD.
- Sibling Support Groups: Reduce household conflict and increase empathy.
9. Practical Tips for Parents & Educators
Creating Sensory-Safe Spaces at Home
- Quiet Corner: Beanbags, weighted blanket, low light.
- Visual Schedules: Reduce anxiety about transitions.
- Sensory Basket: Chewable jewelry, stress balls, textured fidgets.
- Label Zones: “High-energy play” vs “Calm-down zone.”
Behavioral Strategies to Reduce Conflict
- First-Then Language: “First brush teeth, then 5 minutes of iPad.”
- Choice Boards: Offer two acceptable options to prevent power struggles.
- Catch Them Being Good: 5:1 ratio of praise to correction.
- Planned Ignoring: Withhold attention for minor non-dangerous misbehavior.