Sensory reactivity differences are a diagnostic criterion in autism spectrum conditions. Sensory hyperreactivity has been linked to intolerance of uncertainty (IU) and anxiety in autistic children. However, research is yet to explore the mediating relationships or sensory hyporeactivity, seeking, and anxiety subtypes in preschool-age autistic children. Therefore, we aimed to elucidate the relationships between sensory reactivity, IU and anxiety subtypes in a heterogeneous group of 54 preschool-age autistic children, age 3-6 years, using a range of observational and parent-report assessments. Correlational analysis found sensory hyperreactivity, IU and anxiety subtypes, including generalised anxiety, social anxiety, obsessive-compulsive symptoms, physical injury fears, and separation anxiety, were significantly intercorrelated. Neither sensory hyporeactivity or seeking were significantly related to IU or anxiety subtypes. Serial mediation analyses indicated significant full mediation between sensory hyperreactivity and anxiety through IU, and significant full mediation between sensory hyperreactivity and IU through anxiety in preschool-age autistic children.Our results therefore suggest that theoretical models of anxiety in autism should consider sensory hyperreactivity as a predictive factor for anxiety, and supports that IU is an important interrelated construct in the development and maintenance of anxiety. Our findings have important implications for understanding anxiety and related symptoms in autistic children, which can inform the development of effective interventions. However, due to limitations with the measures, our research also highlights a pressing need for objective assessments of anxiety and IU that can be used with preschool-age autistic children.
Sensory reactivity, empathizing and systemizing in autism spectrum conditions and sensory processing disorder
