Autism or Sensory Sensitivity? Understanding the Difference

For many people—particularly women—the path to diagnosis is paved with doubt: Am I just "highly sensitive"... or autistic? The two experiences can appear similar: emotional overload, social exhaustion, heightened sensations… Yet they stem from very different neurological mechanisms.

Clarifying the distinction is crucial for tailoring support, avoiding diagnostic confusion, and understanding whether one is dealing with a sensory variation or a distinct neurotype.

Sensory Sensitivity Is Not a Formal Diagnosis

It is essential to remember that there is no international clinical consensus on the definition of sensory sensitivity. It is not formally recognised in global diagnostic manuals like the DSM-5 or ICD-11. Instead, it is often used as a subjective interpretive framework by individual practitioners based on their own clinical perspective.

This doesn’t mean that such experiences aren’t real—far from it. But terms like "highly sensitive", "emotionally gifted", or "intellectually gifted" (HSE, HPE, HPI in French) should be handled with caution, especially when they are used to explain significant daily challenges.

➡️ If your sensitivity significantly affects your social, professional, or emotional functioning, it's worth exploring further, for example through sensory profiling or neurodevelopmental assessments.

Shared Traits… but Different Origins

Both sensory sensitivity and autism (ASD) can lead to:

• strong reactions to sounds, lights, textures, or smells;

• fatigue following social interactions;

• avoidance of certain places or situations;

• intense emotional responses.

But where sensory sensitivity is an isolated sensory or emotional variation (that may not impact other cognitive domains), ASD is a neurodevelopmental condition that shapes perception, cognition, and social interaction as a whole.

Autism Is About Much More Than Sensitivity

One can be highly sensitive without being autistic. Conversely, almost all autistic people are highly sensitive—but their profile also includes:

• social inference difficulties (interpreting intentions, implicit expectations);

• a need for routines and strong resistance to unpredictability (DSM-5, 2013);

• a detail-focused cognitive style, favouring precision at the expense of broader context (Happé & Frith, 2006);

• atypical emotional regulation: not simply emotional intensity, but difficulty identifying, naming, or prioritising emotions (alexithymia is common — Bird & Cook, 2013).

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Their Relationship to the World Is Different

A highly sensitive person may feel overwhelmed by stimuli but generally understands social norms, even if they dislike them. They may have high empathy and often possess strong social intuition.

An autistic person, on the other hand, may not perceive these cues at all, or only understand them through conscious learning. They may also feel empathy, but it is often expressed differently (emotional empathy often intact, cognitive empathy more variable — Baron-Cohen, 2004).

Camouflaging Can Obscure the Diagnosis

Some autistic women, in particular, develop social camouflaging strategies from a young age. They observe, mimic, and compensate—so effectively that they may appear socially adept. This can be mistaken for emotional sensitivity, when in fact it is a massive adaptive effort, often leading to burnout (Lai et al., 2017; Hull et al., 2020).

One Questionnaire Isn’t Enough

Sensory sensitivity scales (like Elaine Aron's) can be helpful, but they do not allow for a clear differential diagnosis. A diagnosis of autism requires multidimensional assessment—developmental history, social cognition, rigidity, emotional regulation, and life trajectory.

🧠 Important: many undiagnosed autistic individuals are labelled “highly sensitive”… simply because the other aspects of their profile are overlooked.

In Summary

• Sensory sensitivity is not a disorder: it’s a variation in emotional or sensory processing.

• It has no standardised clinical definition and may mask a deeper neurodevelopmental profile.

• Autism is a neurotype, marked by differences in social cognition, perception, routines, and emotional regulation.

• You can be highly sensitive without being autistic, but if you also relate to:

  • rigid routines,

  • difficulty reading between the lines,

  • intense interests,

  • post-social shutdowns,

  …it may be worth considering an autism assessment.

  
  

📚 Further Reading

• Bird, G., & Cook, R. (2013). Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry.

• Happé, F., & Frith, U. (2006). The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders.

• Lai, M.-C., Lombardo, M. V., Ruigrok, A. N. V., et al. (2017). Quantifying and exploring camouflaging in men and women with autism. Nature Communications.

• Hull, L. et al. (2020). Development and validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders.

• Baron-Cohen, S. (2004). The empathizing–systemizing theory of sex differences and the extreme male brain theory of autism. Trends in Cognitive Sciences.

• American Psychiatric Association. (2013). DSM-5 Diagnostic and Statistical Manual of Mental Disorders.