The perceived casual relations between sensory reactivity differences and anxiety symptoms in autistic adults

Rates of anxiety are inordinately high in autistic adults. Sensory reactivity differences, such as hyperreactivity (e.g., strong reactions to sound), hyporeactivity (e.g., no, or slower reactions to pain), and seeking (e.g., fascination with spinning objects) are a diagnostic criterion of autism and have been linked with anxiety. Understanding how individuals perceive these to be causally related can impact assessment and treatment of anxiety. Therefore, we examined the perceived causal relations between sensory reactivity differences and anxiety in autistic adults.246 autistic adults aged 18 – 76 years took part in an online study. They completed self-report assessments of sensory reactivity differences, and anxiety, followed by the perceived causal relations scale; indicating if they perceived their sensory reactivity differences to be more of a cause or an effect of their anxiety symptoms.Sensory reactivity differences were found to be significantly related to anxiety. Furthermore, total sensory hyperreactivity and visual, auditory, and olfactory hyperreactivity was perceived to be more of a cause of anxiety, whilst total sensory seeking and tactile and vestibular seeking was perceived to be more of an effect of anxiety. Therefore, sensory hyperreactivity and sensory seeking may be important to consider in anxiety treatments for autistic individuals.

The sensory-reactivity PROM set: identification of a parent reported outcome measure set for autism spectrum disorder

Background Most children with autism spectrum disorder (ASD) suffer from aberrant responses to sensory stimuli that significantly impact the quality of life. To develop sensory interventions, individually tailored outcome measures are crucially needed for the domain of sensory reactivity problems. Here, we describe the identification of relevant sensory themes according to caregivers of children with ASD according to the guidelines for developing a (parent proxy) patient-reported outcome measure set. Subsequently, we identify parallels between these themes and a well-validated and supported PROMIS® portal to facilitate implementation. Interviews with clinicians and focus groups and interviews with parents of children with ASD were used in the initial phase for concept elicitation. Codes and themes were generated by qualitative thematic data analysis on the transcripts and cognitive interviews with different parents were used for revisions. The resulting themes were compared to existing generic PROMIS-item banks and other existing questionnaires. Results A total of 11 parent-reported outcomes were identified that could be either classified as directly or indirectly related to sensory reactivity. Directly related themes comprised of: (1) sensory stimulation tolerance and (2) sensitivity to sensory stimuli. Indirectly related themes were: (3) irritable behavior (4) anxiety problems (5) mood problems (6) sleep problems (7) fatigue (8) physical complaints (9) daily functioning and participation (10) routines, structure and dealing with change and (11) problems in social interaction and communication. Seven out of 11 themes could be measured with generic PROMIS item banks. The four remaining outcomes (sensory stimulation tolerance; irritable behaviour; routines, structure and dealing with change; and sensitivity to sensory stimuli) were found suitable to be inventoried by existing PROMs. Conclusion The majority of parent-reported problems seemed related to indirect consequences of sensory reactivity, which are suitable to be measured with generic item banks. In sum, we identified a sensory-reactivity PROM (parent-proxy) set consisting of PROMIS® item banks and additional domains that together form a comprehensive and readily available outcome set for sensory reactivity problems in children with ASD.

Sonic bombardment, noise hypersensitivity and ethics: A response to Fodstad and colleagues: ‘Assessment and treatment of noise hypersensitivity in a teenager with autism Spectrum Disorder’

This commentary – provided by a group of Autistic researchers – reflects on a case study trialling a ‘modified Cognitive Behavioural Therapy intervention’ to address the ‘noise hypersensitivity’ and associated behaviours of an Autistic teenager, ‘Aaron’. We identify serious flaws in the evidence base behind the ‘therapy’: including failing to account for divergent Autistic sensory reactivity, aiming to remove ‘stimming’ behaviours and promoting masking. We challenge the lack of informed consent reported as given by either Aaron or a proxy and the absence of any reported ethical approval for this case study. We also strongly condemn the methods of sonic bombardment delivered upon Aaron under the guise of ‘therapy’. We conclude with three questions around the processes that led to the original article’s publication. All authors are joint first authors. The essay was published by Participatory Autism Research Collective: https://participatoryautismresearch.wordpress.com/2021/10/27/sonic-bombardment-noise-hypersensitivity-and-ethics-a-response-to-fodstad-and-colleagues/

Relationships Between Sensory Processing Behaviors, Executive Function, and Temperament Characteristics for Effortful Control in School-Age Children

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. A descriptive correlation study examined relationships between temperament, effortful control, executive function, and sensory processing behavior. Outcomes from three standardized questionnaires in children between 7.0 and 10.11 years old indicated that statistically significant associations between typical sensory responses were related to abilities for executive function and effortful control, whereas sensory reactivity was related to decreased abilities for executive function and effortful control. Primary Author and Speaker: Rachel Diamant

The predictive relationship between sensory reactivity and depressive symptoms in young autistic children with few to no words

Depression, much like other mental health conditions, is common in autism, with autistic individuals much more likely to be diagnosed than their non-autistic peers. Sensory reactivity differences are also commonly experienced by autistic individuals and have been associated with depressive symptoms. However, there is little understanding of the predictive relationship between sensory reactivity and depressive symptoms, or the nature of this relationship in autistic children who speak few to no words. This study set out to explore the longitudinal relationship between sensory reactivity and depressive symptoms in 33 young autistic children who speak few to no words over two timepoints. We found positive correlations between depressive symptoms and hyper-reactivity and sensory seeking at both timepoints. We further found a bidirectional predictive relationship between depressive symptoms and sensory seeking. These results implicate sensory seeking in the development of depressive symptoms in young autistic children who use few to no words. Our findings have important implications for preventative mental health interventions, especially for those with a developmental language delay.Key words: autism; sensory reactivity; depression; children; language delay

The Relationship between Sensory Reactivity Differences and Mental Health Symptoms in Children with Neurodevelopmental Conditions and Their Neurotypical Peers

Children with neurodevelopmental conditions (NDC) often have sensory reactivity differences, such as being overwhelmed by sounds, which can elicit distress in their everyday life. Furthermore, children with an NDC often present with a greater frequency of mental health symptoms compared to their typically developing peers. However little research has examined the relationship of these sensory reactivity differences on broader mental health. This study set out to explore the relationship between sensory reactivity and mental health symptoms. Data from parent-reported measures of sensory reactivity and mental health symptoms were collected for 49 children presenting with a neurodevelopmental condition and 42 typically developing (TD) controls. Partial correlational analyses, controlling for IQ, were used to elucidate the relationship between sensory reactivity and mental health symptoms. Children with an NDC were significantly more likely to present with a sensory reactivity difference or mental health symptom. Sensory seeking was found to be the sensory subtype most related to mental health symptoms, especially in externalising conditions. There was evidence also found for a relationship between depression, sensory seeking and sensory hypo-reactivity, and GAD and hyper-reactivity. Findings suggest a relationship between sensory reactivity and mental health symptoms in children with a neurodevelopmental condition. There is also preliminary evidence of unique sensory-based profiles of mental health. Assessment of sensory difficulties as part of more rigorous mental health assessments within mental health services will support more accurate diagnoses and intervention.

The Potential Effect of Nav1.8 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) Nav1.8, 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 Nav1.8 loss-of-function mouse model additionally revealed that Nav1.8 may play a role in autism-like symptomatology. Our results present Nav1.8 as a protein potentially involved in ASD pathophysiology and may therefore offer new insights into the genetic basis of this disease.

In Our Own Words: The Complex Sensory Experiences of Autistic Adults

Autistic adults commonly experience sensory reactivity differences. Sensory hyperreactivity is frequently researched, whilst hyporeactivity and seeking, and experiences across domains, e.g., vision, are often neglected. Therefore, we aimed to understand more about the sensory experiences of autistic adults. We conducted a mixed-methods study, co-produced with stakeholders; recruiting 49 autistic adults who completed an online survey. Firstly, quantitative results and content analysis enhanced our understanding of sensory input/contexts associated with sensory hyperreactivity, hyporeactivity, and seeking across modalities. Secondly, thematic analysis developed themes relating to ‘Outcomes’, ‘Control’, ‘Tolerance and management’, and ‘The role of other people’, informing a theoretical model of sensory reactivity differences in autistic adults. These findings have implications for support services and improving quality of life for autistic adults.

Sleep Duration and Quality and Sensory Reactivity in School-Aged Children: The Spanish Cross-Sectional InProS Study

Background: The relationship between children's sleep and health has been widely examined; however, research focused on the link between sleep and sensory reactivity in children without medical conditions is relatively new and based on studies with small samples. Hence, we aimed at exploring the association between sleep duration and quality and prevalence of sensory reactivity in a population-based sample of children aged 3–7.Methods: We examined data on 579 school-age children from the InProS project, a cross-sectional population-based study. Children's sleep duration was classified as <10 vs. ≥10 h/day, and sleep quality was measured using the Pediatric Sleep Questionnaire, defining poor quality sleep as a score of ≥0.33. The Short Sensory Profile (SSP) was used to classify children with or without sensory reactivity using the cut-off points proposed by W. Dunn for SSP total score and each SSP subscale. Prevalence ratios (PR) using Poisson multiple regression models with robust variance were estimated to examine main associations.Results: Around a third (32.6%; n = 189) slept <10 h/day and 10.4% presented poor sleep quality. The prevalence of sensory reactivity was 29.5% for total SSP (<155), 11.4% for tactile sensitivity (<30), 15% for taste/smell sensitivity (<15), 22.5% for movement sensitivity (<13), 49.1% for under-responsive/seeks sensation (<27), 44.4% for auditory filtering (<23), 12.4% for low energy/weak (<26), and 25.4% for visual/auditory sensitivity (<19). Main findings indicated that poor sleep quality was significantly associated with a greater prevalence of sensory reactivity for SSP total score (PR = 1.27; IC 95%: 1.18; 1.38), tactile sensitivity (PR = 1.09, IC95%: 1.00–1.19), taste/smell sensitivity (PR = 1.18, IC95%: 1.08–1.30), under-responsive/seeks sensation (PR = 1.28, IC95%: 1.20–1.37), auditory filtering (PR = 1.31, IC95%: 1.23–1.39), low energy/weak (PR = 1.14, IC95%: 1.04–1.25) and audiovisual sensitivity (PR = 1.15, IC95%: 1.05–1.26) scores after adjusting for potential confounders.Conclusions: In this study, we observed that poor sleep quality was statistically significantly associated with a higher prevalence of sensory reactivity as measured by the total SSP and almost all SSP subscales. To our knowledge, this is the first time that this association has been explored and reported. Further research from prospective studies is required to confirm these findings.