Sensory Abnormality and Quantitative Autism Traits in Children With and Without Autism Spectrum Disorder in an Epidemiological Population

'We're quite good at thinking outside the box: Early autistic sensory experiences expressed by autistic adults and caregivers of autistic children

Sensory differences are well documented in autistic individuals. However, early sensory experiences have not been fully explored, particularly from the perspective of autistic people. We sought to understand early sensory experiences in autism from the perspective of autistic adults (some of whom also had autistic children) and caregivers of autistic children (some of whom also had a personal autism diagnosis). Using a qualitative descriptive design, aligned with a constructivist paradigm, focus groups were conducted with 3 autistic adults and 12 caregivers of autistic children. Data were analysed with reflexive thematic analysis. Five themes were generated accounting for early sensory experiences in autism: (1) Acknowledging the uniqueness of sensory preferences, (2) Negative impacts of different sensory experiences, (3) Feeling different and the pursuit of belonging, (4) Controlling sensory experiences to support daily function, and finally (5) Overcoming the challenges of the sensory world. The findings highlight the specific sensory needs of autistic children in early childhood and the adaptability of caregivers. This information can help young autistic people and caregivers advocate the importance of recognising the uniqueness of each autistic child's sensory preferences when seeking support.Lay AbstractSensory behaviours in early childhood can impact how autistic children experience and engage in the world. There is a lot of research about sensory differences in autistic children; however, there is very little known about experiences in early childhood. We asked 3 autistic adults and 12 caregivers of autistic children about their/their child's experiences of sensory behaviours in early childhood. In our sample, autistic adults and caregivers of autistic children shared similar experiences about the challenges they/their children face related to sensory experiences in early childhood and how they overcame these. The findings can influence how researchers and service providers view sensory preferences in early childhood by understanding that everyone's preferences are unique, and the importance of advocating for what works for each autistic person.

Comparison of abnormal sensory symptoms in children with and without autism spectrum disorder

Objective

To compare the abnormal sensory symptoms in children with and without autism spectrum disorder (ASD).

Method

This case-control study was conducted at the department of Developmental & Behavioral Pediatrics, The Children's Hospital and Institute of Child Health, Multan, Pakistan from January, 2024 to June, 2024. Inclusion criteria for cases were children of either, aged 5-12 years, diagnosed with ASD, and accompanying at least one of the parents. For controls, children visiting outpatient department of pediatrics were included. The study utilized standardized sensory assessment tools "Sensory Profile" to evaluate sensory processing abnormalities in both groups.

Results

In a total of 128 children, 85 (66.4%) were male. The mean age was 8.2±2.4 years, ranging between 5-12 years. In terms of sensory profiles, children with ASD exhibited significantly higher rates of abnormal sensory symptoms across all domains compared to non-ASD children (p<0.001). In the auditory domain, hyperresponsiveness was prevalent in 43.8% of ASD children versus 7.8% in non-ASD children (p<0.001). For tactile, visual, and proprioceptive domains, similar patterns were observed where significantly higher proportions of children with ASD were affected (p<0.001). In the visual and proprioceptive domains, ASD children consistently demonstrated significantly elevated rates of hyperresponsiveness, hyporesponsiveness, and sensory-seeking behaviors compared to non-ASD children (p<0.001).

Conclusion

The high prevalence of hyperresponsiveness, hyporesponsiveness, and sensory-seeking behaviors across sensory domains in ASD children raises the requirement for comprehensive sensory assessments and individualized interventions.

HD-tDCS effects on social impairment in autism spectrum disorder with sensory processing abnormalities: a randomized controlled trial

This study examined the effects of high-definition transcranial direct current stimulation (HD-tDCS) on social impairment in children with autism spectrum disorder (ASD), focusing on those with and without sensory processing abnormalities. A randomized double-blind sham-controlled trial involved 72 children with ASD, divided into three groups based on sensory integration status. A post-hoc analysis of 51 children aged 4-8 years who received true HD-tDCS was conducted, categorizing them into hypo-tactile, hyper-tactile, and typical tactile sensitivity groups. Therapeutic efficacy was compared across these groups. (1) The randomized cntrolled Trial: The typical sensory integration group showed significant improvements in social awareness (t = 5.032, p < 0.000) and autistic mannerisms (t = 3.085, p = 0.004) compared to the sensory integration dysfunction group. (2)The result of the post-hoc analysis: The hypo-tactile and typical tactile sensitivity groups exhibited notable improvements in social awareness, cognition, communication, autistic mannerisms, and total SRS scores. In contrast, the hyper-tactile group only had a significant reduction in social communication (t = 2.385, p = 0.022) post-intervention. HD-tDCS effectively improved social impairment symptoms in children with ASD, particularly those with typical sensory integration and either typical or hypo-tactile responsiveness.

Metacognition facilitates theory of mind through optimal weighting of trait inferences

The ability to represent and infer accurately others' mental states, known as Theory of Mind (ToM), has been theorised to be associated with metacognitive ability. Here, we considered the role of metacognition in mental state inference through the lens of a recent theoretical approach to explaining ToM, the 'Mind-space' framework. The Mind-space framework posits that trait inference, representation of the qualities of the mind giving rise to the mental state, is important in forming accurate mental state inferences. We tested a potential role for metacognition in facilitating optimal weighting of trait inferences, as well as several theoretical predictions regarding factors associated with the accuracy of trait inference and confidence in those trait inferences. Participants completed a judgement-of-confidence task in the trait inference domain alongside the Interview Task, a recently-developed task for assessing the accuracy of trait and mental state inferences. A simple relationship in which increased metacognitive sensitivity is associated with increased accuracy of mental states inferences was not found. However, when predicting trial-level performance, confidence in trait inference was shown to modulate the effect of trait inference accuracy on mental state inference accuracy. This effect was greater in magnitude with lower metacognitive sensitivity, i.e., when confidence is more likely to be misplaced. Furthermore, participants' trait inference ability was associated with the accuracy of their understanding of the average mind. In addition, the accuracy of specific trait inferences was predicted by the participant's similarity to the target, but this similarity benefit was reduced in participants whose self-perception was inaccurate. Reported confidence in a given trait inference was also predicted by participant-target similarity, such that participants showed greater overconfidence in judgements made about similar targets. This overconfidence effect was larger when self-perception was more erroneous. Results support several theoretical claims made by the Mind-space theory, and further elucidate the processes underlying accurate mental state inference.

Perinatal factors associated with sensory processing difficulties in infancy: Findings from the Etude Longitudinale Francaise depuis l'Enfance (ELFE) French national birth cohort

BACKGROUND

Sensory processing involves the nervous system receiving, modulating, and responding to sensory stimuli. Clinical samples have elevated rates of sensory processing difficulties, less is known about sensory processing at population-level. We aimed to investigate patterns of sensory processing in infancy and their association with perinatal factors.

METHODS

Data from a French prospective birth cohort of 9861 babies were used to identify latent sensory classes of 1-year-olds. Multinomial logistic regression examined whether sex, cumulative sociodemographic risk or perinatal factors, were associated with these classes.

RESULTS

Three classes, 'typical sensory' (71.2 %), 'definite sensory difficulties' (21.3 %) and a 'possible sensory difficulties' group (7.5 %) best fit the data. The 'typical' group were easy to calm, adaptable, had low anxiety with no feeding concerns. The 'definite' group were the least easy to calm, least accepting of confined spaces, least adaptable and most anxious. They exhibited more sleeping and feeding problems. The 'possible' group were similar to the 'typical' group apart from being less adaptable with increased sleep difficulties. Dose-response relationships were observed between low 1.5 (relative risk ratio (RRR) CI 1.3-1.9), moderate 2.3 (CI 1.9-2.7) and high 3.5 (CI 2.6-4.8) sociodemographic risk and increasing number of pregnancy-specific adverse experiences:1.5 (CI 1.2-1.9), 1.9 (CI 1.5-2.5), 2.1 (CI 1.6-2.9), 2.4 (CI 1.6-3.6), 3.0 (CI 1.7-5.3) with an increasing risk of sensory difficulties.

CONCLUSIONS

Using public and patient involvement to guide sensory indicator selection for latent class analyses we found that post-natal sociodemographic risk and adverse pregnancy-specific experiences were most strongly associated with sensory difficulties in infants.

Neurodevelopmental Disorders and Connective Tissue-Related Symptoms: An Exploratory Case-Control Study in Children

Background/Objectives: Autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and Tourette syndrome (TS) are neurodevelopmental disorders (NDDs) with overlapping symptoms, suggesting a partially shared genetic origin. This study investigates the prevalence of connective tissue-related conditions in individuals with ASD, ADHD, or TS. Methods: A questionnaire was administered to families of 120 individuals with ASD, ADHD, or TS, collecting sociodemographic data and examining 10 types of disorders affecting various organs and systems. Statistical analyses were performed using STATA 16.0, with the significance level set at 5%. Results: Among the 120 patients, 48 had ASD, 36 had ADHD, and 36 had TS. Flat feet were significantly more common in individuals with ASD (52.1%; OR 7.20; p < 0.001), ADHD (52.8%; OR 6.73; p = 0.001), and TS (38.9%; OR 3.70; p = 0.034) compared to controls (13.6%). Hypersensitivity was more frequent in individuals with ASD (56.3%; OR 5.90; p = 0.001), ADHD (50.0%; OR 4.11; p = 0.011), and TS (58.3%; OR 5.35; p = 0.003) compared to controls (18.2%). Myopia and ptosis were more common in ADHD (30.6%). There was a possible trend towards orthodontic device use in TS (OR 3.20; p = 0.076). Flat feet and hypersensitivity were also common in fathers (31.0% and 36.4%, respectively), mothers (31.0% and 15.2%), and patients (43.8% and 55%). Conclusions: The findings of this study highlight the significant associations between ASD, ADHD, and TS and specific physical symptoms, such as flat feet, sensory hypersensitivity, and other connective tissue-related manifestations. The familial prevalence of these symptoms suggests a potential genetic underpinning, further supporting the hypothesis of shared aetiological pathways. These insights underscore the need for interdisciplinary research to explore the mechanisms linking neurodevelopmental and connective tissue disorders, aiming to improve diagnosis and management strategies.

Speech-in-Noise and Dichotic Auditory Training Students With Autism Spectrum Disorder

PURPOSE

Individuals diagnosed with autism spectrum disorder (ASD) often exhibit auditory processing issues, including poor speech recognition in background noise and dichotic processing (integration of different stimuli presented to the two ears). Auditory training could mitigate these auditory difficulties. However, few auditory training programs have been designed to target specific listening deficits for students with ASD. The present study summarizes the development of an innovative, one-on-one, clinician-developed speech-in-noise (SIN) training program that has not been previously described and an existing dichotic auditory training program to address common auditory processing deficits in students with ASD.

METHOD

Twenty verbal students with ASD, ages 7-17 years, completed a one-on-one, clinician-developed SIN training program and a commercially available dichotic training program 2-3 times a week (30-45 min per session) for 12 weeks. Maximum and minimum training levels from the SIN and dichotic training programs were analyzed statistically to document changes in training level over the training period.

RESULTS

Analyses of the pre- and posttraining data revealed significant improvements in training level for both the SIN and dichotic training programs.

CONCLUSIONS

Overall, the proposed SIN training resulted in significant improvements in training level and may be used along with dichotic training to improve some of the most common auditory processing issues documented in verbal individuals with ASD requiring minimal support. Both types of auditory training may be implemented in one-on-one therapy in clinics and in the schools.

Impact of an Auditory Processing Training Program on Individuals With Autism Spectrum Disorder

PURPOSE

Children and young adults diagnosed with autism spectrum disorder (ASD) often report and exhibit significant auditory processing difficulties, particularly in background noise. This study extends our previous work by examining the potential benefits of a 12-week auditory processing training (APT) program designed to address the auditory processing difficulties in individuals with ASD via auditory training and the use of remote-microphone technology. Effect sizes of training benefits also were calculated, and principal component analysis (PCA) was used to consolidate performance across various tests into fewer meaningful constructs related to auditory processing in this population.

METHOD

Twenty-eight children and young adults with ASD participated in a 12-week APT program that included one-on-one speech-in-noise training, computerized dichotic training, and use of remote-microphone technology at home and at school. Before and after training, each participant completed tests of speech recognition in noise, spatial processing, binaural integration, and general auditory processing skills.

RESULTS

Significant performance improvements and medium-to-large effect sizes were found across most test measures after the participants completed the APT program and when using the remote-microphone system. PCA identified strong relationships among all test measures as well as documented the relationships between behavioral performance, training duration, and training improvements.

CONCLUSIONS

The APT program significantly improved spatial processing, binaural integration, phonological processing, auditory memory, auditory cohesion, and speech recognition in noise in individuals with ASD when the remote-microphone system was used. PCA analysis of pre- and posttraining data showed a strong relationship among all test measures, suggesting an abbreviated auditory processing test battery may be feasible for individuals with ASD. Training duration (minutes) and training improvements were associated with performance outcomes measured by the test battery.

Sensory Processing Challenges in Children with Neurodevelopmental Disorders and Genetic Conditions: An Observational Study

Sensory processing challenges are crucial yet often neglected aspects in the care of children with neurodevelopmental disorders and genetic conditions. They represent a key area of interest in neuroscience, as they significantly impact children's daily functioning and quality of life. This observational study examines these challenges in a group of 614 children, aged 3 to 14 years and 11 months, divided into three groups: 183 with neurodevelopmental disorders (autism spectrum disorder, attention deficit hyperactivity disorder, developmental delays, and learning disorders), 89 with genetic conditions (22q11.2 deletion syndrome, Williams syndrome, and pseudohypoparathyroidism), and 342 controls. Sensory processing was assessed using Sensory Profile 2 (SP2). Results indicated that children with neurodevelopmental disorders and genetic conditions exhibited significant sensory processing difficulties compared to controls. SP2 identified distinct sensory challenges across different sensory systems, varying by diagnosis. Notably, genetic conditions appeared to have a more generalised impact across multiple sensory systems, while neurodevelopmental disorders tended to affect specific systems more narrowly. These findings highlight the importance of early identification and tailored evidence-based interventions to address these specific sensory processing issues. Further research should explore the long-term impact of these interventions in these different populations and their integration into broader therapeutic programmes.

Somatosensory temporal sensitivity in adults on the autism spectrum: A high-density electrophysiological mapping study using the mismatch negativity (MMN) sensory memory paradigm

Atypical reactivity to somatosensory inputs is common in autism spectrum disorder and carries considerable impact on downstream social communication and quality of life. While behavioral and survey work have established differences in the perception of somatosensory information, little has been done to elucidate the underlying neurophysiological processes that drive these characteristics. Here, we implemented a duration-based somatosensory mismatch negativity (MMN) paradigm to examine the role of temporal sensitivity and sensory memory in the processing of vibrotactile information in autistic (n = 30) and neurotypical (n = 30) adults. To capture the variability in responses between groups across a range of duration discrepancies, we compared the electrophysiological responses to frequent standard vibrations (100 ms) and four infrequent deviant vibrations (115, 130, 145, and 160 ms). The same stimuli were used in a follow-up behavioral task to determine active detection of the infrequent vibrations. We found no differences between the two groups with regard to discrimination between standard and deviant vibrations, demonstrating comparable neurologic and behavioral temporal somatosensory perception. However, exploratory analyses yielded subtle differences in amplitude at the N1 and P220 time points. Together, these results indicate that the temporal mechanisms of somatosensory discrimination are conserved in adults on the autism spectrum, though more general somatosensory processing may be affected. We discuss these findings in the broader context of the MMN literature in autism, as well as the potential role of cortical maturity in somatosensory mechanisms.

Developmental Impacts of Early Sensory Patterns on School-Age Adaptive, Maladaptive, and Participation Outcomes in Autistic and Non-autistic Children

Early sensory differences may cascade into later social-communication difficulties in autism, yet their impacts on broader functional outcomes have remained understudied. This study aimed to conduct a comprehensive investigation into the longitudinal impacts of sensory patterns, including sensory hyperresponsiveness, hyporesponsiveness, and sensory repetitions/seeking behavior, on various school-age outcome domains among a community sample of children with autistic and non-autistic conditions. We prospectively followed 1,517 children with caregiver-reported sensory questionnaires across three timepoints from infancy to school age. A subsample (n = 389; 88 with reported autism diagnosis/concerns) was further assessed with adaptive, maladaptive and participation outcome measures at age 6-7. Structural equation modeling approaches were used to evaluate the multivariate associations between latent growth parameters (i.e., intercepts and slopes) of sensory patterns and school-age outcomes. Increasing sensory hyperresponsiveness was directly associated with poorer adaptive/maladaptive outcomes and indirectly with lower participation in activities with higher functional demands across settings at school age. Elevated sensory hyporesponsiveness was associated with lower adaptive functioning, more externalizing problems, and lower classroom participation. Trajectories of sensory patterns accounted for more unique variances in adaptive functioning and participation in daily life settings with higher functional and environmental demands among autistic children compared to their non-autistic peers.

Brief Report: Characterization of Sensory Over-Responsivity in a Broad Neurodevelopmental Concern Cohort Using the Sensory Processing Three Dimensions (SP3D) Assessment

Sensory Over-Responsivity (SOR) is an increasingly recognized challenge among children with neurodevelopmental concerns (NDC). To investigate, we characterized the incidence of auditory and tactile over-responsivity (AOR, TOR) among 82 children with NDC. We found that 70% of caregivers reported concern for their child's sensory reactions. Direct assessment further revealed that 54% of the NDC population expressed AOR, TOR, or both - which persisted regardless of autism spectrum disorder (ASD) diagnosis. These findings support the high prevalence of SOR as well as its lack of specificity to ASD. Additionally, AOR is revealed to be over twice as prevalent as TOR. These conclusions present several avenues for further exploration, including deeper analysis of the neural mechanisms and genetic contributors to sensory processing challenges.

Early-Life Digital Media Experiences and Development of Atypical Sensory Processing

Importance

Atypical sensory processing is challenging for children and families, yet there is limited understanding of its associated risk factors.

Objective

To determine the association between early-life digital media exposure and sensory processing outcomes among toddlers.

Design, Setting, and Participants

This multicenter US study used data that were analyzed from the National Children's Study (NCS), a cohort study of environmental influences on child health and development, with enrollment from 2011 to 2014. Data analysis was performed in 2023. The study included children enrolled in the NCS at birth whose caregivers completed reports of digital media exposure and sensory processing.

Exposures

Children's viewing of television or video at 12 months (yes or no), 18 months, and 24 months of age (hours per day).

Main Outcomes and measures

Sensory processing was reported at approximately 33 months of age on the Infant/Toddler Sensory Profile. Quadrant scores (low registration, sensation seeking, sensory sensitivity, and sensation avoiding) were categorized into groups representing typical, high, and low sensory-related behaviors, and multinomial regression analyses were performed.

Results

A total of 1471 children (50% male) were included. Screen exposure at 12 months of age was associated with a 2-fold increased odds of being in the high category of low registration (odds ratio [OR], 2.05; 95% CI, 1.31-3.20), while the odds of being in the low category instead of the typical category decreased for sensation seeking (OR, 0.55; 95% CI, 0.35-0.87), sensation avoiding (OR, 0.69; 95% CI, 0.50-0.94), and low registration (OR, 0.64; 95% CI, 0.44-0.92). At 18 months of age, greater screen exposure was associated with increased risk of high sensation avoiding (OR, 1.23; 95% CI, 1.03-1.46) and low registration (OR, 1.23; 95% CI, 1.04-1.44). At 24 months of age, greater screen exposure was associated with increased risk of high sensation seeking (OR, 1.20; 95% CI, 1.02-1.42), sensory sensitivity (OR, 1.25; 95% CI, 1.05-1.49), and sensation avoiding (OR, 1.21; 95% CI, 1.03-1.42).

Conclusions and Relevance

In this cohort study, early-life digital media exposure was associated with atypical sensory processing outcomes in multiple domains. These findings suggest that digital media exposure might be a potential risk factor for the development of atypical sensory profiles. Further research is needed to understand the relationship between screen time and specific sensory-related developmental and behavioral outcomes, and whether minimizing early-life exposure can improve subsequent sensory-related outcomes.

Intact Somatosensory Temporal Sensitivity in Adults on the Autism Spectrum: A High-Density Electrophysiological Mapping Study Using the Mismatch Negativity (MMN) Sensory Memory Paradigm

Atypical reactivity to somatosensory inputs is common in autism spectrum disorder and carries considerable impact on downstream social communication and quality of life. While behavioral and survey work have established differences in the perception of somatosensory information, little has been done to elucidate the underlying neurophysiological processes that drive these characteristics. Here, we implemented a duration-based somatosensory mismatch negativity paradigm to examine the role of temporal sensitivity and sensory memory in the processing of vibrotactile information in autistic (n=30) and neurotypical (n=30) adults. To capture the variability in responses between groups across a range of duration discrepancies, we compared the electrophysiological responses to frequent standard vibrations (100 ms) and four infrequent deviant vibrations (115, 130, 145, and 160 ms). The same stimuli were used in a follow-up behavioral task to determine active detection of the infrequent vibrations. We found no differences between the two groups with regard to discrimination between standard and deviant vibrations, demonstrating comparable neurologic and behavioral temporal somatosensory perception. However, exploratory analyses yielded subtle differences in amplitude at the N1 and P220 time points. Together, these results indicate that the temporal mechanisms of somatosensory discrimination are conserved in adults on the autism spectrum, though more general somatosensory processing may be affected. We discuss these findings in the broader context of the MMN literature in autism, as well as the potential role of cortical maturity in somatosensory mechanisms.

Preliminary Study on Speech in Noise Training in Children with Sensory Processing Disorder and Hyperacusis

Hyperacusis is the perception of certain everyday sounds as too loud or painful. Past research suggests that some individuals with Sensory Processing Disorder (SPD) may also have a comorbid hyperacusis. The aim of this preliminary study was to explore if hyperacusis symptoms in children with SPD change following Speech in noise training (SPINT). This was a retrospective cross-sectional study. Data were included for 28 children with SPD and sound intolerance (12/28 were female, mean age was 8.7 ± 1.9 years old). Patients were assessed using the Persian Buffalo Model Questionnaire-Revised version (P-BMQ-R) that measures various behavioural aspects of auditory processing disorder and word in noise test (WINT) before and after SPINT. After SPINT the subscales of DEC, TFM with its Noi, and Mem, subcategories, APD, ΣCAP, and Gen of P-BMQ-R questionnaire significantly improved (P < 0.05), however, the changes in subscales of Var, INT and ORG were not statistically significant (P > 0.05). In addition, SPINT led to better performance in WINT in both ears (P < 0.05). This preliminary study showed promising result for the effect of SPINT on improving behavioural indicators of APD (as measured via P-BMQ-R and WINT) and decreasing hyperacusis symptoms (as measured via Noi).

Early developmental profiles of sensory features and links to school-age adaptive and maladaptive outcomes: A birth cohort investigation

Sensory-based subtypes among autistic children have been well documented, but little is known about longitudinal sensory subtypes beyond autistic populations. This prospective study aimed to identify subtypes based on trajectories of parent-reported sensory features measured at 6-19 months, 3-4, and 6-7 years of age among a community-based birth cohort (N = 1,517), and to examine their associations with school-age clinical and adaptive/maladaptive outcomes on a subset sample (N = 389). Latent class growth analysis revealed five trajectory subtypes varying in intensity and change rates across three sensory domains. In contrast to an Adaptive-All Improving subtype (35%) with very low sensory features and overall better school-age outcomes, an Elevated-All Worsening subtype (3%), comprised of more boys and children of parents with less education, was associated with most elevated autistic traits and poorest adaptive/maladaptive outcomes. Three other subtypes (62% in total) were generally characterized by stable or improving patterns of sensory features at mild to moderate levels, and challenges in certain outcome domains. Our findings indicate that characterizing children based on early sensory trajectories may contribute to earlier detection of subgroups of children with sensory challenges who are more likely to experience developmental challenges by school age, followed by early targeted interventions for improved long-term outcomes.

Sensory Integration Approaches for Children and Youth in Occupational Therapy Practice

This AOTA Position Statement describes the role of occupational therapy practitioners in providing services to children and youth with a variety of sensory processing patterns and sensory integrative dysfunction. It also serves as a resource for policymakers, funding and reimbursement sources, and caregivers.

Modality-specific associations between sensory differences and autistic traits

LAY ABSTRACT

Sensory symptoms are a major source of distress for many autistic people, causing anxiety, stress, and avoidance. Sensory problems are thought to be passed on genetically together with other autistic characteristics, such as social preferences. This means that people who report cognitive rigidity and autistic-like social function are more likely to suffer from sensory issues. We do not know what role the individual senses, such as vision, hearing, smell, or touch, play in this relationship, because sensory processing is generally measured with questionnaires that target general, multisensory issues. This study aimed to investigate the individual importance of the different senses (vision, hearing, touch, smell, taste, balance, and proprioception) in the correlation with autistic traits. To ensure the results were replicable, we repeated the experiment in two large groups of adults. The first group contained 40% autistic participants, whereas the second group resembled the general population. We found that problems with auditory processing were more strongly predictive of general autistic characteristics than were problems with the other senses. Problems with touch were specifically related to differences in social interaction, such as avoiding social settings. We also found a specific relationship between proprioceptive differences and autistic-like communication preferences. The sensory questionnaire had limited reliability, so our results may underestimate the contribution of some senses. With that reservation in mind, we conclude that auditory differences are dominant over other modalities in predicting genetically based autistic traits and may therefore be of special interest for further genetic and neurobiological studies.

Integrated gene expression profiling and functional enrichment analyses to discover biomarkers and pathways associated with Guillain-Barré syndrome and autism spectrum disorder to identify new therapeutic targets

Guillain-Barré syndrome (GBS) is one of the most prominent and acute immune-mediated peripheral neuropathy, while autism spectrum disorders (ASD) are a group of heterogeneous neurodevelopmental disorders. The complete mechanism regarding the neuropathophysiology of these disorders is still ambiguous. Even after recent breakthroughs in molecular biology, the link between GBS and ASD remains a mystery. Therefore, we have implemented well-established bioinformatic techniques to identify potential biomarkers and drug candidates for GBS and ASD. 17 common differentially expressed genes (DEGs) were identified for these two disorders, which later guided the rest of the research. Common genes identified the protein-protein interaction (PPI) network and pathways associated with both disorders. Based on the PPI network, the constructed hub gene and module analysis network determined two common DEGs, namely CXCL9 and CXCL10, which are vital in predicting the top drug candidates. Furthermore, coregulatory networks of TF-gene and TF-miRNA were built to detect the regulatory biomolecules. Among drug candidates, imatinib had the highest docking and MM-GBSA score with the well-known chemokine receptor CXCR3 and remained stable during the 100 ns molecular dynamics simulation validated by the principal component analysis and the dynamic cross-correlation map. This study predicted the gene-based disease network for GBS and ASD and suggested prospective drug candidates. However, more in-depth research is required for clinical validation.Communicated by Ramaswamy H. Sarma.

Nutrient intake and adequacy in children with autism spectrum disorder: EPINED epidemiological study

LAY ABSTRACT

Children with autism spectrum disorder (ASD) have a fivefold elevated risk of developing eating problems, which predisposes them to nutritional deficiencies. This study assesses nutritional intake and adequacy in children with ASD, subdiagnostic autistic symptoms and typically developing (TD) children. Preschool children with ASD and subdiagnostic symptoms had slightly lower intake of monounsaturated fatty acids (MUFA), vitamin D and vitamin B12. Primary school children with ASD and subdiagnostic symptoms had slightly higher intake of protein, cholesterol, thiamine and niacin, and a higher percentage of obesity than children with TD. All children had a high intake in sugars, fats and saturated fatty acids; a very highly inadequate intake of vitamins (vitamins D and E), fibre, b-carotene, calcium and magnesium; and a moderately inadequate intake of vitamin C, folate and iron. However, although all children need nutrition advice, children with ASD and subdiagnostic autistic symptoms had a poorer quality diet than those with TD.

Auditory symptoms and autistic spectrum disorder: A scoping review and recommendations for future research

Introduction

Auditory symptoms in individuals with Autistic Spectrum Disorder (ASD) are well described within the neurodevelopmental literature, yet there is minimal mention of ASD in Otolaryngology literature. This is surprising considering the potential clinical and diagnostic implications of this link, and the potential for ASD to present to Otolaryngologists in the form of unexplained auditory symptoms. The aims of this literature review were to explore the intersection of auditory symptoms and ASD from the perspective of clinical Otolaryngology, and to outline a clinically focused research agenda based on emerging themes relevant to Otolaryngology.

Methods

We searched Pubmed, Embase, Ovid and Cochrane library for studies until November 2021. Four authors independently reviewed 227 publications identified. 39 were filtered into the final analysis. The PRISMA 2020 guidelines were followed. The heterogeneity of literature meant that a Systematic Review was not feasible. Included studies were therefore classified thematically, forming the basis of the scoping review.

Results

Diagnostic theories for auditory symptoms in ASD include the entire auditory pathway and brain. There is a growing body of literature on auditory symptoms in ASD, suggesting that a primary diagnosis of ASD should be considered in patients presenting with otherwise unexplained auditory symptoms, and indicating a learning need for Otolaryngologists and audiologists, to whom these patients may present.

Conclusion

We recommend a research agenda focusing on multidisciplinary collaboration, stakeholder engagement, responsible clinical screening, and clarification of pathophysiological mechanisms and terminology.

Sensory Features of Young Children From a Large Community Sample: Latent Factor Structures of the Sensory Experiences Questionnaire (Version 2.1, Short Form)

IMPORTANCE

Although three sensory factors (hyperresponsiveness [HYPO]; hyporesponsiveness [HYPER]; and sensory interests, repetitions, and seeking behaviors [SIRS]) have been demonstrated among a wide age range of clinical populations, they have not been well validated in the general population, especially with a large community sample of young children.

OBJECTIVE

To validate the factor structure of the Sensory Experiences Questionnaire (Version 2.1, Short Form; SEQv2.1) in a community sample and to confirm the factor structure's existence in this sample.

DESIGN

Caregivers completed the SEQv2.1, a parent-reported questionnaire designed to capture children's everyday sensory experiences. The latent factors of the SEQv2.1 were examined using confirmatory factor analysis.

SETTING

North Carolina.

PARTICIPANTS

Caregivers of 2,195 children age 3 yr were initially recruited through state birth records and were eligible to participate if the child did not have a history of serious medical problems and English was the family's primary language.

OUTCOMES AND MEASURES

SEQv2.1.

RESULTS

The SEQv2.1 showed validity in the community sample. Similar to previous research with clinical populations, the three broad patterns of sensory responsiveness were also confirmed in this large community sample of young children, but associations among the factors differed.

CONCLUSIONS AND RELEVANCE

Validation of the three-sensory-factor structure in the general population suggests that these constructs are similar to those found with samples of participants with autism spectrum disorder and developmental disabilities. This finding underscores the importance of understanding the normative development of sensory features across a wider age range to better delineate qualitative differences underlying sensory features between clinical and general populations. What This Article Adds: Occupational therapists seeking to assess children's sensory features can use the SEQv2.1 not only with clinical samples but also with children in the general population.

Sensory features in autism: Findings from a large population-based surveillance system

Sensory features (i.e., atypical responses to sensory stimuli) are included in the current diagnostic criteria for autism spectrum disorder. Yet, large population-based studies have not examined these features. This study aimed to determine the prevalence of sensory features among autistic children, and examine associations between sensory features, demographics, and co-occurring problems in other areas. Analysis for this study included a sample comprised of 25,627 four- or eight-year-old autistic children identified through the multistate Autism and Developmental Disabilities Monitoring Network (2006-2014). We calculated the prevalence of sensory features and applied multilevel logistic regression modeling. The majority (74%; 95% confidence interval: 73.5%-74.5%) of the children studied had documented sensory features. In a multivariable model, children who were male and those whose mothers had more years of education had higher odds of documented sensory features. Children from several racial and ethnic minority groups had lower odds of documented sensory features than White, non-Hispanic children. Cognitive problems were not significantly related to sensory features. Problems related to adaptive behavior, emotional states, aggression, attention, fear, motor development, eating, and sleeping were associated with higher odds of having documented sensory features. Results from a large, population-based sample indicate a high prevalence of sensory features in autistic children, as well as relationships between sensory features and co-occurring problems. This study also pointed to potential disparities in the identification of sensory features, which should be examined in future research. Disparities should also be considered clinically to avoid reduced access to supports for sensory features and related functional problems. LAY SUMMARY: In a large, population-based sample of 25,627 autistic children, 74% had documented differences in how they respond to sensation. We also identified significant associations of sensory features with adaptive behavior and problems in other domains. Sensory features were less common among girls, children of color, and children of mothers with fewer years of education, suggesting potential disparities in identification.

Understanding Foot Loading and Balance Behavior of Children with Motor Sensory Processing Disorder

Sensory processing disorder (SPD) could influence the neuromuscular response and adjustment to external sensory discrimination and lead to disruptions in daily locomotion. The objective of the current study was to compare plantar loadings and foot balance during walking, running and turning activities in SPD children in order to reveal the behavioral strategy of movement and balance control. Six SPD children and six age-match healthy controls participated in the test using a FootScan plantar pressure plate. The time-varying parameters of forces, center of pressure and foot balance index were analyzed using an open-source one-dimensional Statistical Parametric Mapping (SPM1d) package. No difference was found in foot balance and plantar loadings during walking, while limited supination–pronation motion was observed in the SPD children during running and turning. The plantar forces were mainly located in the midfoot region while less toe activity was found as well. Findings should be noted that SPD children had limited supination–pronation movement for shock attenuation in the foot complex and reduced ankle pronation to assist push-off and toe gripping movements. Understanding the behavior of plantar loading strategy and balance control during walking, running and turning activities may provide clinical implications for the rehabilitation and training of daily tasks.

Developmental trajectories of sensory patterns from infancy to school age in a community sample and associations with autistic traits

This prospective study examined the latent growth trajectories of sensory patterns among a North Carolina birth cohort (N = 1517; 49% boys, 87% White) across infancy (6-19 months), preschool (3-4 years), and school years (6-7 years). Change rates of sensory hyper- and hyporesponsiveness better differentiated children with an autism diagnosis or elevated autistic traits from those with other developmental conditions, including non-autistic children with sensory differences. More sensory hyper- and hyporesponsiveness at infancy followed by steeper increases differentially predicted more autistic traits at school age. Further, children of parents with higher education tended to show stable or improving trajectories. These findings highlight the importance of tracking sensory patterns from infancy for facilitating early identification of associated challenges and tailored support for families.

Characterizing Social Functioning in School-Age Children with Sensory Processing Abnormalities

Children with sensory abnormalities (SAs) have a variety of social problems resulting in poorer social functioning than children with typical development (TD). We describe the relationship between SAs and social functioning in school-age children with SAs, children with TD and a clinical comparison sample of children with autism spectrum disorder (ASD). Children with SAs demonstrated impaired social functioning on standardized measures. Children with SAs demonstrated worse social functioning than children with TD and equivalent social functioning to children with ASD. Increased SAs were associated with poorer social functioning across all groups. The results suggest that children with SAs experience clinically significant problems with social functioning and future research is needed to develop interventions to support social functioning in this population.

The Impact of the Presence of Intellectual Disabilities on Sensory Processing and Behavioral Outcomes Among Individuals with Autism Spectrum Disorders: a Systematic Review

Background

Autism spectrum disorder and intellectual disability (ID) are linked to atypical sensory processing, but consensus lacks on the impact of their co-occurrence. We studied the impact of the presence of ID in autistic individuals on (1) sensory processing and (2) the relation between sensory processing and behavioral outcomes.

Methods

A systematic review was performed on English-language peer-reviewed studies.

Results

Eleven papers were included. Papers based on overall and sensory subscales reported no impact of the presence of ID. Papers based on subtypes reported hyporesponsiveness and sensory seeking related to the presence of ID; hyporesponsiveness showed the poorest behavioral outcomes.

Conclusions

Findings regarding the impact of the presence of ID are contradictory. More research regarding sensory subtypes is needed to investigate the needs of autistic individuals with ID.

Cognitive assessment using ERP in child and adolescent psychiatry: Difficulties and opportunities

Event related potentials (ERPs) represent powerful tools to investigate cognitive functioning in child and adolescent psychiatry. So far, the available body of research has largely focused on advancements in analysis methods, with little attention given to the perspective of assessment. The aim of this brief report is to provide recommendations for cognitive ERPs assessment that can be applied across diagnostic categories in child and adolescent psychiatry research. First, we discuss major issues for ERPs testing using examples from common psychiatric disorders. We conclude by summing up our recommendations for methodological standards and highlighting the potential role of ERPs in the field.

Associations Between Chronic Irritability and Sensory Processing Difficulties in Children and Adolescents

Irritability is one of the most common reasons for which children and adolescents are referred for psychiatric evaluation and care. However, clinical irritability is difficult to define; thus, its prevalence varies widely. Chronic irritability may be associated with sensory processing difficulties (SPD), but little is known about the relationship between these two factors in clinical populations. In this study, we examined the prevalence of chronic irritability and its association with SPD in 166 children aged 5-16 years who were referred to the psychiatric outpatient clinic of the Osaka City University Hospital. Chronic irritability and parent-reported scores for the Short Sensory Profile, Infant Behavior Checklist-Revised, Child Behavior Checklist, and Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (Present and Lifetime version) questionnaires were used for assessment. A total of 22 children (13.2%) presented with chronic irritability (i.e., the irritability group) and were more likely to have oppositional defiant disorder, externalizing problems, and attention issues than those without chronic irritability (i.e., the control group). SPD were reported in eight (36%) patients in the irritability group and in 21 (15%) in the control group (p = 0.029). Moreover, compared to the control group, the irritability group showed a significant difference in almost all items of the Short Sensory Profile. Chronic irritability was associated with more severe overall SPD, even after adjusting for possible confounding factors (internalizing and externalizing problems, age, sex, and low income). We provide evidence to support our hypothesis that chronic irritability is associated with SPD in children and adolescents. Therefore, SPD should be assessed to provide appropriate interventions in children and adolescents with chronic irritability.

Prevalence of Decreased Sound Tolerance (Hyperacusis) in Individuals With Autism Spectrum Disorder: A Meta-Analysis

OBJECTIVES

Hyperacusis, defined as decreased tolerance to sound at levels that would not trouble most individuals, is frequently observed in individuals with autism spectrum disorder (ASD). Despite the functional impairment attributable to hyperacusis, little is known about its prevalence or natural history in the ASD population. The objective of this study was to conduct a systematic review and meta-analysis estimating the current and lifetime prevalence of hyperacusis in children, adolescents, and adults with ASD. By precisely estimating the burden of hyperacusis in the ASD population, the present study aims to enhance recognition of this particular symptom of ASD and highlight the need for additional research into the causes, prevention, and treatment of hyperacusis in persons on the spectrum.

DESIGN

We searched PubMed and ProQuest to identify peer-reviewed articles published in English after January 1993. We additionally performed targeted searches of Google Scholar and the gray literature, including studies published through May 2020. Eligible studies included at least 20 individuals with diagnosed ASD of any age and reported data from which the proportion of ASD individuals with current and/or lifetime hyperacusis could be derived. To account for multiple prevalence estimates derived from the same samples, we utilized three-level Bayesian random-effects meta-analyses to estimate the current and lifetime prevalence of hyperacusis. Bayesian meta-regression was used to assess potential moderators of current hyperacusis prevalence. To reduce heterogeneity due to varying definitions of hyperacusis, we performed a sensitivity analysis on the subset of studies that ascertained hyperacusis status using the Autism Diagnostic Interview-Revised (ADI-R), a structured parent interview.

RESULTS

A total of 7783 nonduplicate articles were screened, of which 67 were included in the review and synthesis. Hyperacusis status was ascertained in multiple ways across studies, with 60 articles employing interviews or questionnaires and seven using behavioral observations or objective measures. The mean (range) age of samples in the included studies was 7.88 years (1.00 to 34.89 years). The meta-analysis of interview/questionnaire measures (k(3) = 103, nASD = 13,093) estimated the current and lifetime prevalence of hyperacusis in ASD to be 41.42% (95% CrI, 37.23 to 45.84%) and 60.58% (50.37 to 69.76%), respectively. A sensitivity analysis restricted to prevalence estimates derived from the ADI-R (k(3) = 25, nASD = 5028) produced similar values. The estimate of current hyperacusis prevalence using objective/observational measures (k(3) = 8, nASD = 488) was 27.30% (14.92 to 46.31%). Heterogeneity in the full sample of interview/questionnaire measures was substantial but not significantly explained by any tested moderator. However, prevalence increased sharply with increasing age in studies using the ADI-R (BF10 = 93.10, R2Het = 0.692).

CONCLUSIONS

In this meta-analysis, we found a high prevalence of current and lifetime hyperacusis in individuals with ASD, with a majority of individuals on the autism spectrum experiencing hyperacusis at some point in their lives. The high prevalence of hyperacusis in individuals with ASD across the lifespan highlights the need for further research on sound tolerance in this population and the development of services and/or interventions to reduce the burden of this common symptom.

Prevalence and severity-based classification of sensory processing issues. An exploratory study with neuropsychological implications

Sensory processing issues, mainly known as sensory processing disorder or SPD, are frequent in children with neurodevelopmental disorders and are associated with learning and behavioral difficulties. However, previous studies suggest that these disturbances might also be present in typically developing children, reaching prevalence rates of 10-20%. Nevertheless, published studies have been primary been conducted in non-European countries. Therefore, we aim, as first objective, to explore the frequency of sensory processing difficulties in a random sample of school-age children from Spain to contribute to the study of its prevalence. The Sensory Profile-2 (SP2) assessment tool was administered to 369 participants to study their sensory processing patterns, the absence or presence of sensory processing issues, the affected sensory systems, as well as their socioemotional, attentional, and behavioral impact. Furthermore, as second objective, we have developed a novel strategy to classify SPD by severity ranges using SP2 yielded results; accordingly, the sample was classified as follows: no alteration, mild, moderate, and severe sensory processing alteration. The results show prevalence rates consistent with previous findings: 15.9% of participants met the severe alteration criteria and 10.5%, 11.1% and 62.5% were classified as moderate, mild and no alteration, respectively. Finally, we hypothesize about SPD and underlying neuropsychological processes that might be associated with this condition. Our results highlight the necessity of further research efforts to establish whether high-frequency and severity rates of sensory processing alterations are linked to neuropsychological variables. The provided classification system might be useful to determine such associations.

Exploring sensory phenotypes in autism spectrum disorder

BACKGROUND

Atypical reactions to the sensory environment are often reported in autistic individuals, with a high degree of variability across the sensory modalities. These sensory differences have been shown to promote challenging behaviours and distress in autistic individuals and are predictive of other functions including motor, social, and cognitive abilities. Preliminary research suggests that specific sensory differences may cluster together within individuals creating discrete sensory phenotypes. However, the manner in which these sensory differences cluster, and whether the resulting phenotypes are associated with specific cognitive and social challenges is unclear.

METHODS

Short sensory profile data from 599 autistic children and adults between the ages of 1 and 21 years were subjected to a K-means cluster analysis. Analysis of variances compared age, adaptive behaviour, and traits associated with autism, attention-deficit and hyperactivity disorder, and obsessive and compulsive disorder across the resultant clusters.

RESULTS

A five-cluster model was found to minimize error variance and produce five sensory phenotypes: (1) sensory adaptive, (2) generalized sensory differences, (3) taste and smell sensitivity, (4) under-responsive and sensation seeking, and (5) movement difficulties with low energy. Age, adaptive behaviour, and traits associated with autism, attention-deficit and hyperactivity disorder, and obsessive and compulsive disorder were found to differ significantly across the five phenotypes.

LIMITATIONS

The results were based on parent-report measures of sensory processing, adaptive behaviour, traits associated with autism, attention-deficit and hyperactivity disorder, and obsessive and compulsive disorder, which may limit the generalizability of the findings. Further, not all measures are standardized, or psychometrically validated with an autism population. Autistic individuals with an intellectual disability were underrepresented in this sample. Further, as these data were obtained from established records from a large provincial database, not all measures were completed for all individuals.

CONCLUSIONS

These findings suggest that sensory difficulties in autistic individuals can be clustered into sensory phenotypes, and that these phenotypes are associated with behavioural differences. Given the large degree of heterogeneity in sensory difficulties seen in the autistic population, these sensory phenotypes represent an effective way to parse that heterogeneity and create phenotypes that may aid in the development of effective treatments and interventions for sensory difficulties.

Repeated Sessions of Transcranial Direct Current Stimulation on Adolescents With Autism Spectrum Disorder: Study Protocol for a Randomized, Double-Blind, and Sham-Controlled Clinical Trial

Background: Social-emotional difficulties are a core symptom of autism spectrum disorder (ASD). Accordingly, individuals with ASD have problems with social cognition such as recognizing emotions from other peoples' faces. Various results from functional magnetic resonance imaging and electroencephalography studies as well as eye-tracking data reveal a neurophysiological basis of these deficits by linking them to abnormal brain activity. Thus, an intervention targeting the neural origin of ASD impairments seems warranted. A safe method able to influence neural activity is transcranial direct current stimulation (tDCS). This non-invasive brain stimulation method has already demonstrated promising results in several neuropsychiatric disorders in adults and children. The aim of this project is to investigate the effects of tDCS on ASD symptoms and their neural correlates in children and adolescents with ASD. Method: This study is designed as a double-blind, randomized, and sham-controlled trial with a target sample size of 20 male participants (aged 12-17 years) diagnosed with ASD. Before randomization, the participants will be stratified into comorbid depression, comorbid ADHS/conduct disorder, or no-comorbidity groups. The intervention phase comprises 10 sessions of anodal or sham tDCS applied over the left prefrontal cortex within 2 consecutive weeks. To engage the targeted brain regions, participants will perform a social cognition training during the stimulation. TDCS-induced effects on ASD symptoms and involved neural circuits will be investigated through psychological, neurophysiological, imaging, and behavioral data at pre- and post-measurements. Tolerability will be evaluated using a standardized questionnaire. Follow-up assessments 1 and 6 months after the intervention will examine long-lasting effects. Discussion: The results of this study will provide insights into the changeability of social impairments in ASD by investigating social and emotional abilities on different modalities following repeated sessions of anodal tDCS with an intra-simulation training. Furthermore, this trial will elucidate the tolerability and the potential of tDCS as a new treatment approach for ASD in adolescents. Clinical Trial Registration: The study is ongoing and has been registered in the German Registry of Clinical Trials (DRKS00017505) on 02/07/2019.

The Potential Effect of Na v 1.8 in Autism Spectrum Disorder: Evidence From a Congenital Case With Compound Heterozygous SCN10A Mutations

Apart from the most prominent symptoms in Autism spectrum disorder (ASD), namely deficits in social interaction, communication and repetitive behavior, patients often show abnormal sensory reactivity to environmental stimuli. Especially potentially painful stimuli are reported to be experienced in a different way compared to healthy persons. In our present study, we identified an ASD patient carrying compound heterozygous mutations in the voltage-gated sodium channel (VGSC) Na v 1.8, which is preferentially expressed in sensory neurons. We expressed both mutations, p.I1511M and p.R512∗, in a heterologous expression system and investigated their biophysical properties using patch-clamp recordings. The results of these experiments reveal that the p.R512∗ mutation renders the channel non-functional, while the p.I1511M mutation showed only minor effects on the channel's function. Behavioral experiments in a Na v 1.8 loss-of-function mouse model additionally revealed that Na v 1.8 may play a role in autism-like symptomatology. Our results present Na v 1.8 as a protein potentially involved in ASD pathophysiology and may therefore offer new insights into the genetic basis of this disease.

Co-activation pattern alterations in autism spectrum disorder-A volume-wise hierarchical clustering fMRI study

INTRODUCTION

There has been a growing effort to characterize the time-varying functional connectivity of resting state (RS) fMRI brain networks (RSNs). Although voxel-wise connectivity studies have examined different sliding window lengths, nonsequential volume-wise approaches have been less common.

METHODS

Inspired by earlier co-activation pattern (CAP) studies, we applied hierarchical clustering (HC) to classify the image volumes of the RS-fMRI data on 28 adolescents with autism spectrum disorder (ASD) and their 27 typically developing (TD) controls. We compared the distribution of the ASD and TD groups' volumes in CAPs as well as their voxel-wise means. For simplification purposes, we conducted a group independent component analysis to extract 14 major RSNs. The RSNs' average z-scores enabled us to meaningfully regroup the RSNs and estimate the percentage of voxels within each RSN for which there was a significant group difference. These results were jointly interpreted to find global group-specific patterns.

RESULTS

We found similar brain state proportions in 58 CAPs (clustering interval from 2 to 30). However, in many CAPs, the voxel-wise means differed significantly within a matrix of 14 RSNs. The rest-activated default mode-positive and default mode-negative brain state properties vary considerably in both groups over time. This division was seen clearly when the volumes were partitioned into two CAPs and then further examined along the HC dendrogram of the diversifying brain CAPs. The ASD group network activations followed a more heterogeneous distribution and some networks maintained higher baselines; throughout the brain deactivation state, the ASD participants had reduced deactivation in 12/14 networks. During default mode-negative CAPs, the ASD group showed simultaneous visual network and either dorsal attention or default mode network overactivation.

CONCLUSION

Nonsequential volume gathering into CAPs and the comparison of voxel-wise signal changes provide a complementary perspective to connectivity and an alternative to sliding window analysis.

Characteristics of Idiopathic Sensory Processing Disorder in Young Children

This study described the developmental and behavioral characteristics of children identified with idiopathic sensory processing disorder (SPD) as well as the relations among specific types of SPD as proposed by the nosology presented by Miller et al. (2007), adaptive behavior profiles, and behaviors associated with mental functioning. A retrospective, non-experimental design applying descriptive and correlational analyses was used. Data were obtained from clinic medical records of 78 children ages 2 to 7 years who were identified with sensory processing problems affecting daily life, but who did not meet criteria for any other neurodevelopmental or mental disorders following a comprehensive diagnostic evaluation. Results revealed that all SPD types as described by current typologies were well represented with the most common being the over-responsivity sensory modulation subtype. Within the sample, 53% of the children displayed more than one SPD type. Atypical externalizing and internalizing behavior scores associated with various mental disorders as measured by the child behavior checklist (CBCL) fell in the borderline dysfunctional range. Adaptive behavior for all developmental domains was below average, and the severity of SPD symptoms moderately and positively correlated with behaviors associated with mental disorders, and with lower adaptive behavior performance. It was concluded that symptoms characteristic of the various types of idiopathic SPD overlap substantially suggesting that current typologies may include more types/subtypes than are necessary or clinically useful. Children with SPD share similar, but often less severe pathological behaviors associated with other mental or related neurodevelopmental disorders. Psychometrically sound measures of SPD are needed, and further study of the neural mechanisms involved in sensory processing deficits is vital for validating idiopathic SPD as its own diagnostic entity.

Relationship between Sensory Alterations and Repetitive Behaviours in Children with Autism Spectrum Disorders: A Parents' Questionnaire Based Study

The relationship between sensory profile and repetitive behaviours in autism spectrum disorder (ASD) has long been known. However, there is no consensus on the type of relationship that exists between them. This monocentric retrospective-prospective observational study aimed (a) to detect a clinical correlation between the severity of repetitive behaviours and the alterations of sensory profile in a sample of 50 children diagnosed with ASD; (b) to evaluate how different patterns of stereotypies and sensory alterations correlate with each other and with the main clinical-instrumental variables in the same sample. We enrolled 29 children in the retrospective phase of the study and 21 in the prospective phase. The Repetitive Behaviour Scale-Revised (RBS-R) and the Short Sensory Profile (SSP) were administered to the caregivers, and clinical-instrumental data were collected. SSP and RBS-R total scores directly correlated with a high significance rate. Among the subscales, the strongest correlations involved "Visual/Auditory Sensitivity", related to "Stereotyped Behaviour" and "Sameness Behaviour". "Under-Responsive/Seeks Sensation" related to "Stereotyped Behaviour". Sex and intellectual disability significantly influenced both the stereotypies and the sensory alterations of the examined population. In conclusion, this study provides new insights into the relationship between sensory alterations and repetitive behaviours in ASD children by using direct medical observation and parent observation.

Detecting Feeding Problems in Young Children with Autism Spectrum Disorder

Feeding problems are prevalent in children with ASD. We investigated whether the Montreal Children’s Hospital Feeding Scale (MCH-FS, Ramsay et al. in Pediatrics and Child Health 16:147–151, 2011) can be used for young children with ASD. Participants (1–6 years) were selected from a clinical ASD sample (n = 80) and a general population sample (n = 1389). Internal consistency was good in both samples. In general, parents of children with ASD reported more feeding problems than those from the population sample. The response patterns on the individual items was highly similar. There was a slight increase in symptoms with age in the population sample, but not in the ASD sample. These results suggest that the MCH-FS can be used in populations that include children with ASD.

Stress and emotional wellbeing of parents due to change in routine for children with Autism Spectrum Disorder (ASD) at home during COVID-19 pandemic in Saudi Arabia

BACKGROUND

Parents of children with Autism Spectrum Disorder (ASD) experience considerable amounts of stress and impaired emotional well-being. Consequently, it is likely that these have been adversely impacted by COVID-19 outbreak due to disruptions to the schedules of children with ASD.

AIM

This study investigated the stress and emotional well-being of parents of children with ASD in Saudi Arabia during the COVID-19 pandemic.

METHOD

The study obtained quantitative data from 150 parents of children with ASD from different regions in Saudi Arabia using an online survey. The data collected included demographic data of the parents, ASD status of the family, ASD support during COVID-19 pandemic, severity of ASD behaviours in comparison to the pre- COVID-19 status eating behaviour of the child with ASD, Parental Stress, and emotional well-being. The PSI-short form (PSI-SF) (Abidin, 1995) scale was utilised to obtain data related to parental stress and the General Health Questionnaire (GHQ-12) (Goldberg, 1992) scale was utilised to obtain data related to parents' emotional well-being.

RESULTS

The study found that family ASD status (in particular, age and gender of child with ASD, and severity of his/her symptoms) had a significant impact on parental stress and emotional well-being. Moreover, parental stress and emotional well-being were negatively impacted by the frequency and usefulness of ASD support received during COVID-19 pandemic. These were also adversely impacted by the change in severity of ASD behaviours of the children with ASD. Finally, parental stress was found to have a negative impact on the emotional well-being of parents. Overall, the study found that the parental stress and emotional well-being of parents of children with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic.

CONCLUSIONS

Overall, the study found that the parental stress and emotional well-being of parents with ASD in Saudi Arabia had been unfavourably impacted by COVID-19 pandemic. This study recommends the involvement of the Saudi Ministry of Health to establish and extend support services to support parents of children with ASD. Moreover, the provision of training programs to help parents deal with the characteristic behaviour of their children with ASD such as, the ability to maintain routines, aggressive or repetitive behaviour, is also recommended.

Behavioral Auditory Processing in Children and Young Adults with Autism Spectrum Disorder

BACKGROUND

Auditory-processing deficits are common in children and adults who are diagnosed with autism spectrum disorder (ASD). These deficits are evident across multiple domains as exhibited by the results from subjective questionnaires from parents, teachers, and individuals with ASD and from behavioral auditory-processing testing.

PURPOSE

Few studies compare subjective and behavioral performance of adults and children diagnosed with ASD using commercially available tests of auditory processing. The primary goal of the present study is to compare the performance of adults and children with ASD to age-matched, neurotypical peers. The secondary goal is to examine the effect of age on auditory-processing performance in individuals with ASD relative to age-matched peers.

RESEARCH DESIGN

A four-group, quasi-experimental design with repeated measures was used in this study.

STUDY SAMPLE

Forty-two adults and children were separated into four groups of participants: (1) 10 children with ASD ages 14 years or younger; (2) 10 age-matched, neurotypical children; (3) 11 adolescents and young adults with ASD ages 16 years and older; and (4) 11 age-matched, neurotypical adolescents or young adults.

DATA COLLECTION AND ANALYSIS

Data from each participant were collected in one test session. Data were analyzed with analysis of variance (ANOVA), repeated measures ANOVA, or nonparametric analyses. Effect sizes were calculated to compare performance between those with ASD and those who were neurotypical within each age group.

RESULTS

Across all the questionnaires and the majority of the behavioral test measures, participants with ASD had significantly poorer ratings or auditory-processing performance than age-matched, neurotypical peers. Adults had more favorable performance than children on several of the test measures. Medium to large effect sizes corroborated the significant results.

CONCLUSION

Overall, the questionnaires and behavioral tests used in this study were sensitive to detecting auditory-processing differences between individuals diagnosed with ASD and those who are considered neurotypical. On most test measures, children performed more poorly than adults. The findings in this study support that both children and adults with ASD exhibit auditory-processing difficulties. Appropriate school and work accommodations will be necessary to ensure appropriate access to speech in challenging environments.

Correlations Between Audiovisual Temporal Processing and Sensory Responsiveness in Adolescents with Autistic Traits

Atypical sensory processing has recently gained much research interest as a key domain of autistic symptoms. Individuals with autism spectrum disorder (ASD) exhibit difficulties in processing the temporal aspects of sensory inputs, and show altered behavioural responses to sensory stimuli (i.e., sensory responsiveness). The present study examined the relation between sensory responsiveness (assessed by the Adult/Adolescent Sensory Profile) and audiovisual temporal integration (measured by unisensory temporal order judgement (TOJ) tasks and audiovisual simultaneity judgement (SJ) tasks) in typically-developing adolescents (n = 94). We found that adolescents with higher levels of autistic traits exhibited more difficulties in separating visual stimuli in time (i.e., larger visual TOJ threshold) and showed a stronger bias to perceive sound-leading audiovisual pairings as simultaneous. Regarding the associations between different measures of sensory function, reduced visual temporal acuity, but not auditory or multisensory temporal processing, was significantly correlated with more atypical patterns of sensory responsiveness. Furthermore, the positive correlation between visual TOJ thresholds and sensory avoidance was only found in adolescents with relatively high levels of autistic traits, but not in those with relatively low levels of autistic traits. These findings suggest that reduced visual temporal acuity may contribute to altered sensory experiences and may be linked to broader behavioural characteristics of ASD.

Sensory Processing and Attention Profiles Among Children With Sensory Processing Disorders and Autism Spectrum Disorders

This study explores the differences in the profile of relationships between sensory processing and attention abilities among children with sensory processing disorder (SPD), autism spectrum disorder (ASD), and typically developing (TD) children. The Test of Everyday Attention for Children (TEA-Ch), a performance-based measure of attention, was administered to 69 children (TD: n = 24; SPD: n = 21; ASD: n = 24), ages 6-10 years. All participants' parents completed the Short Sensory Profile (SSP), a standardized parent-report measure of sensory-related behaviors. Discriminant analyses using the TEA-Ch and the SSP domains revealed two classification functions; the first revealed that both clinical groups significantly differed from the TD group with greater sensory processing challenges in the categories of auditory filtering, under-responsive/seeks sensation, low energy/weak, and taste/smell sensitivity subscales of the SSP. The second function discriminated between the two clinical groups, indicating that children with ASD had significantly greater control and sustained attention deficits and less sensory issues than did children with SPD. Together, the two functions correctly classified 76.8% of the participants as to their group membership. The different profiles of sensory processing and attention abilities in children with SPD and ASD may provide guidance in identifying appropriate individualized therapeutic strategies for these children.