A comparison of the performance of children with and without autism on the Sensory Profile

Keeping time in the brain: Autism spectrum disorder and audiovisual temporal processing

A growing area of interest and relevance in the study of autism spectrum disorder (ASD) focuses on the relationship between multisensory temporal function and the behavioral, perceptual, and cognitive impairments observed in ASD. Atypical sensory processing is becoming increasingly recognized as a core component of autism, with evidence of atypical processing across a number of sensory modalities. These deviations from typical processing underscore the value of interpreting ASD within a multisensory framework. Furthermore, converging evidence illustrates that these differences in audiovisual processing may be specifically related to temporal processing. This review seeks to bridge the connection between temporal processing and audiovisual perception, and to elaborate on emerging data showing differences in audiovisual temporal function in autism. We also discuss the consequence of such changes, the specific impact on the processing of different classes of audiovisual stimuli (e.g. speech vs. nonspeech, etc.), and the presumptive brain processes and networks underlying audiovisual temporal integration. Finally, possible downstream behavioral implications, and possible remediation strategies are outlined. Autism Res 2016, 9: 720-738. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Attenuated auditory event-related potentials and associations with atypical sensory response patterns in children with autism

Neurobiological underpinnings of unusual sensory features in individuals with autism are unknown. Event-related potentials elicited by task-irrelevant sounds were used to elucidate neural correlates of auditory processing and associations with three common sensory response patterns (hyperresponsiveness; hyporesponsiveness; sensory seeking). Twenty-eight children with autism and 39 typically developing children (4-12 year-olds) completed an auditory oddball paradigm. Results revealed marginally attenuated P1 and N2 to standard tones and attenuated P3a to novel sounds in autism versus controls. Exploratory analyses suggested that within the autism group, attenuated N2 and P3a amplitudes were associated with greater sensory seeking behaviors for specific ranges of P1 responses. Findings suggest that attenuated early sensory as well as later attention-orienting neural responses to stimuli may underlie selective sensory features via complex mechanisms.

Visual feedback and target size effects on reach-to-grasp tasks in children with autism

This study explores the effects of visual condition and target size during four reach-to-grasp tasks between autistic children and healthy controls. Twenty children with autism and 20 healthy controls participated in the study. Qualisys motion capture system and kinematic measures were used to record movement. Autistic group showed significantly longer movement time, larger normalized jerk score, more movement unit than controls, especially in non-visual feedback and small target blocks. Autistic group also showed significantly larger maximal grip aperture and normalized maximal grip aperture in visual feedback condition than controls. Autistic children demonstrate motor coordination problems and also depend on more visual cuing in high accuracy tasks. Autistic children develop other compensatory skills while performing tasks.

DEVELOPMENT OF A TURKISH VERSION OF THE SENSORY PROFILE: TRANSLATION, CROSS-CULTURAL ADAPTATION, AND PSYCHOMETRIC VALIDATION

The purpose of this study was to translate and culturally adapt the Sensory Profile (SP), which is used to measure sensory processing abilities of children ages of 3-10 years, and test its reliability and validity for use with Turkish children with autism. A cross-cultural adaptation process was carried out by bilingual experts, following typical guidelines. The test-retest reliability, internal consistency, and construct validity studies of the Turkish SP were done for 144 children with autism. A comparison was also made between results of children with autism and 101 healthy children to test the validity of the Turkish SP. There were significant differences between results of autistic and healthy children on all subsections of the test. The Cronbach's as ranged from .63 to .97 for all subsections except I, J, and N, which had poor internal consistency reliability. Test-retest reliability over a one-week period was excellent (ICC > .90).

Sensory processing dysfunction among Saudi children with and without autism

[Purpose] There is a dearth of studies that have examined the occurrence of sensory processing dysfunction and its components in Saudi Arabian children with autism. Therefore, this study investigated the manifestation of sensory processing dysfunction in autism and compared the functional components of sensory processing between Saudi Arabian children with and without autism. [Subjects and Methods] A convenience sample of 46 Saudi Arabian children with autism and 30 children without autism participated in this study. The sensory processing functions of both groups were assessed with the Short Sensory Profile. [Results] The overall findings indicated that 84.8% of children with autism demonstrated definite sensory processing dysfunction. The most prevalent sensory processing dysfunctions involved the under-responsive/seeks sensation (89.13%), auditory filtering (73.90%), and tactile sensitivity (60.87%) domains. Most of the children without autism (66.66%) demonstrated typical sensory function; the most prevalent sensory processing dysfunctions involved the tactile sensitivity (33.3%), under-responsive/seeks sensation (23.33%), and movement sensitivity (20%) domains. [Conclusion] Saudi Arabian children with and without autism have clinically significant sensory dysfunctions. However, the prevalence of those sensory dysfunctions in children with autism is significantly higher than in the children without autism.

Enjoyment of tactile play is associated with lower food neophobia in preschool children

Previous research has shown that parental reports of food neophobia and tactile sensitivity are associated with lower fruit and vegetable (F/V) intake in children. This study aimed to pilot a behavioral observation measure of tactile play in young children. The primary aim of the study was to see whether children's enjoyment of tactile play was associated with higher F/V consumption, as well as lower food neophobia. Seventy 2- to 5-year-old children (37 males and 33 females) and their parents were recruited through children's centers in the Leicester region of the United Kingdom during July to October 2012. Children's engagement in two tactile play tasks using sticky foods (mashed potatoes and vegetarian gelatin) was observed and rated by both the researcher and parent. Parents were asked to complete a series of questionnaires measuring F/V consumption, food neophobia, and sensory processing. It was found that lower child food neophobia was significantly related to enjoyment of tactile play, whereas child F/V consumption was associated with parental F/V consumption, but not enjoyment of tactile play. The findings strengthen the idea that tactile processing may be associated with the acceptance of food variety, but not the total amount of F/V consumed. Additional research is indicated to determine whether tactile play tasks can be used to lower child food neophobia.

An odor identification approach based on event-related pupil dilation and gaze focus

Olfactory disorders constitute a potential marker of many diseases and are considered valuable clues to the diagnosis and evaluation of progression for many disorders. The most commonly used test for the evaluation of impairments of olfactory identification requires the active participation of the subject, who must select the correct name of the perceived odor from a list. An alternative method is required because speech may be impaired or not yet learned in many patients. As odor identification is known to be facilitated by searching for visual clues, we aimed to develop an objective, vision-based approach for the evaluation of odor identification. We used an eye tracking method to quantify pupillary and ocular responses during the simultaneous presentation of olfactory and visual stimuli, in 39 healthy participants aged from 19 to 77years. Odor presentation triggered an increase in pupil dilation and gaze focus on the picture corresponding to the odor presented. These results suggest that odorant stimuli increase recruitment of the sympathetic system (as demonstrated by the reactivity of the pupil) and draw attention to the visual clue. These results validate the objectivity of this method.

Early Intervention with a Parent-Delivered Massage Protocol Directed at Tactile Abnormalities Decreases Severity of Autism and Improves Child-to-Parent Interactions: A Replication Study

Tactile abnormalities are severe and universal in preschool children with autism. They respond well to treatment with a daily massage protocol directed at tactile abnormalities (QST massage for autism). Treatment is based on a model for autism proposing that tactile impairment poses a barrier to development. Two previous randomized controlled trials evaluating five months of massage treatment reported improvement of behavior, social/communication skills, and tactile and other sensory symptoms. This is the first report from a two-year replication study evaluating the protocol in 103 preschool children with autism. Parents gave daily treatment; trained staff gave weekly treatment and parent support. Five-month outcomes replicated earlier studies and showed normalization of receptive language (18%, P = .03), autistic behavior (32%, P = .006), total sensory abnormalities (38%, P = .0000005), tactile abnormalities (49%, P = .0002), and decreased autism severity (medium to large effect size, P = .008). In addition, parents reported improved child-to-parent interactions, bonding, and decreased parenting stress (44%, P = .00008). Early childhood special education programs are tasked with addressing sensory abnormalities and engaging parents in effective home programs. Until now, they have lacked research-based methods to do so. This program fulfills the need. It is recommended to parents and ECSE programs (ages 3–5) at autism diagnosis.

A comparative study of sensory processing in children with and without Autism Spectrum Disorder in the home and classroom environments

Sensory processing and higher integrative functions impairments are highly prevalent in children with ASD. Context should be considered in analyzing the sensory profile and higher integrative functions. The main objective of this study is to compare sensory processing, social participation and praxis in a group of 79 children (65 males and 14 females) from 5 to 8 years of age (M=6.09) divided into two groups: ASD Group (n=41) and Comparison Group (n=38). The Sensory Processing Measure (SPM) was used to evaluate the sensory profile of the children: parents reported information about their children's characteristics in the home environment, and teachers reported information about the same characteristics in the classroom environment. The ASD Group obtained scores that indicate higher levels of dysfunction on all the assessed measures in both environments, with the greatest differences obtained on the social participation and praxis variables. The most affected sensory modalities in the ASD Group were hearing and touch. Only in the ASD Group were significant differences found between the information reported by parents and what was reported by teachers: specifically, the teachers reported greater dysfunction than the parents in social participation (p=.000), touch (p=.003) and praxis (p=.010). These results suggest that the context-specific qualities found in children with ASD point out the need to receive information from both parents and teachers during the sensory profile assessment process, and use context-specific assessments.

Looking Backward, Thinking Forward

As autism spectrum disorders become more prevalent and comprise a growing percentage of occupational therapists’ caseloads, it is important to examine trends in the literature. The purpose of this scoping review is to provide a historical analysis to illuminate changes and gaps in the occupational therapy literature related to autism spectrum disorders to inform the direction of research and practice. A total of 115 articles published in five occupational therapy journals in the United States from 1980 to 2013 were reviewed. Publications were coded by article type, with intervention studies coded in detail. Results indicated a consistent increase in number of publications as years progressed. Analysis by decade highlighted a shift from a biomedical focus to an occupation focus. Suggestions for future research include building a stronger evidence base, developing occupation-based assessments and interventions, and addressing needs of individuals with autism spectrum disorders and their families across the life span.

Association between pupillary light reflex and sensory behaviors in children with autism spectrum disorders

Atypical pupillary light reflexes (PLR) has been observed in children with autism spectrum disorders (ASD), which suggests potential autonomic nervous system (ANS) dysfunction in ASD. ANS is also involved in modulating sensory processing and sensory dysfunction has been widely reported in children with ASD. However, the potential association between physiological measurements of PLR and behavioral observations (e.g. sensory behaviors) has not been examined extensively in literature. In this study, we investigated the potential correlation between PLR and frequently observed sensory behaviors in children with ASD. We found a significant association between PLR constriction amplitude and a set of sensory behaviors in the ASD group but not in typically developing children. Children with ASD who showed more atypical sensory behaviors also had smaller PLR constriction amplitudes. A smaller PLR constriction amplitude suggests lower parasympathetic modulation. This observation implies that some atypical sensory behaviors in children with ASD could be associated with decreased parasympathetic modulation.

Sleep problems in children with autism spectrum disorder: examining the contributions of sensory over-responsivity and anxiety

OBJECTIVES

Children with autism spectrum disorder (ASD) are at high risk for sleep problems. Previous research suggests that sensory problems and anxiety may be related to the development and maintenance of sleep problems in children with ASD. However, the relationships among these co-occurring conditions have not been previously studied. The current study examined the interrelations of these symptoms in a large well-characterized sample of children and adolescents with ASD.

METHODS

The current study examined the relationships among sleep problems, sensory over-responsivity, and anxiety in 1347 children enrolled in the Autism Speaks Autism Treatment Network. The primary measures included the Children's Sleep Habits Questionnaire, the Child Behavior Checklist, and the Short Sensory Profile.

RESULTS

In bivariate correlations and multivariate path analyses, anxiety was associated with all types of sleep problems (ie, bedtime resistance, sleep-onset delay, sleep duration, sleep anxiety, and night wakings; p < 0.01 to p < 0.001; small to medium effect sizes). Sensory over-responsivity (SOR) was correlated with all sleep problems in bivariate analyses (p < 0.01 to p < 0.001; small effect sizes). In multivariate path models, SOR remained significantly associated with all sleep problems except night awakenings for older children, while SOR was no longer significantly associated with bedtime resistance or sleep anxiety for younger children.

CONCLUSIONS

Children with ASD who have anxiety and SOR may be particularly predisposed to sleep problems. These findings suggest that some children with ASD and sleep disturbance may have difficulties with hyperarousal. Future research using physiological measures of arousal and objective measures of sleep are needed.

Emotion dysregulation and the core features of autism spectrum disorder

The aim of this study was to examine the relationship between emotion dysregulation and the core features of Autism Spectrum Disorder (ASD), which include social/communication deficits, restricted/repetitive behaviors, and sensory abnormalities. An 18-item Emotion Dysregulation Index was developed on the basis of expert ratings of the Child Behavior Checklist. Compared to typically developing controls, children and adolescents with ASD showed more emotion dysregulation and had significantly greater symptom severity on all scales. Within ASD participants, emotion dysregulation was related to all core features of the disorder, but the strongest association was with repetitive behaviors. These findings may facilitate the development of more effective therapeutic strategies targeting emotion dysregulation in order to optimize long-term outcomes for individuals with ASD.

Relationship between Sympathetic Skin Responses and Auditory Hypersensitivity to Different Auditory Stimuli

[Purpose] Auditory hypersensitivity has been widely reported in patients with autism spectrum disorders. However, the neurological background of auditory hypersensitivity is currently not clear. The present study examined the relationship between sympathetic nervous system responses and auditory hypersensitivity induced by different types of auditory stimuli. [Methods] We exposed 20 healthy young adults to six different types of auditory stimuli. The amounts of palmar sweating resulting from the auditory stimuli were compared between groups with (hypersensitive) and without (non-hypersensitive) auditory hypersensitivity. [Results] Although no group × type of stimulus × first stimulus interaction was observed for the extent of reaction, significant type of stimulus × first stimulus interaction was noted for the extent of reaction. For an 80 dB-6,000 Hz stimulus, the trends for palmar sweating differed between the groups. For the first stimulus, the variance became larger in the hypersensitive group than in the non-hypersensitive group. [Conclusion] Subjects who regularly felt excessive reactions to auditory stimuli tended to have excessive sympathetic responses to repeated loud noises compared with subjects who did not feel excessive reactions. People with auditory hypersensitivity may be classified into several subtypes depending on their reaction patterns to auditory stimuli.

A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children

Parents of children with autism spectrum disorder (ASD) frequently report child food refusal based on characteristics of food. Our study sought to determine whether parent report of food refusal based on the characteristics of food was greater in children with ASD than in typically developing children, associated with a greater percentage of foods refused of those offered, and associated with fruit and vegetable intake. A modified food frequency questionnaire was used to determine overall food refusal as well as fruit and vegetable intake. Parent-reported food refusal related to characteristics of food (eg, texture/consistency, temperature, brand, color, shape, taste/smell, foods mixed together, or foods touching other foods) was compared between 53 children with ASD and 58 typically developing children aged 3 to 11 years in the Children's Activity and Meal Patterns Study (2007-2008). Children with ASD were significantly more likely to refuse foods based on texture/consistency (77.4% vs 36.2%), taste/smell (49.1% vs 5.2%), mixtures (45.3% vs 25.9%), brand (15.1% vs 1.7%), and shape (11.3% vs 1.7%). No differences between groups were found for food refusal based on temperature, foods touching other foods, or color. Irrespective of ASD status, the percentage of foods refused of those offered was associated with parent reports of food refusal based on all characteristics examined, except temperature. Food refusal based on color was inversely associated with vegetable consumption in both groups. Routine screening for food refusal among children with ASD is warranted to prevent dietary inadequacies that may be associated with selective eating habits. Future research is needed to develop effective and practical feeding approaches for children with ASD.

Autistic traits and abnormal sensory experiences in adults

Sensory processing abnormalities are common in autism spectrum disorders (ASD), and now form part of the Diagnostic and Statistical Manual 5th Edition (DSM-5) diagnostic criteria, but it is unclear whether they characterize the 'broader phenotype' of the disorder. We recruited adults (n = 772) with and without an ASD and administered the Autism Quotient (AQ) along with the Adult/Adolescent Sensory Profile (AASP), the Cardiff Anomalous Perceptions Scale (CAPS), and the Glasgow Sensory Questionnaire (GSQ), all questionnaire measures of abnormal sensory responsivity. Autism traits were significantly correlated with scores on all three sensory scales (AQ/GSQ r = 0.478; AQ/AASP r = 0.344; AQ/CAPS r = 0.333; all p < 0.001). This relationship was linear across the whole range of AQ scores and was true both in those with, and without, an ASD diagnosis. It survived correction for anxiety trait scores, and other potential confounds such as mental illness and migraine.

The Sensory Perception Quotient (SPQ): development and validation of a new sensory questionnaire for adults with and without autism

BACKGROUND

Questionnaire-based studies suggest atypical sensory perception in over 90% of individuals with autism spectrum conditions (ASC). Sensory questionnaire-based studies in ASC mainly record parental reports of their child's sensory experience; less is known about sensory reactivity in adults with ASC. Given the DSM-5 criteria for ASC now include sensory reactivity, there is a need for an adult questionnaire investigating basic sensory functioning. We aimed to develop and validate the Sensory Perception Quotient (SPQ), which assesses basic sensory hyper- and hyposensitivity across all five modalities.

METHODS

A total of 359 adults with (n = 196) and without (n = 163) ASC were asked to fill in the SPQ, the Sensory Over-Responsivity Inventory (SensOR) and the Autism-Spectrum Quotient (AQ) online.

RESULTS

Adults with ASC reported more sensory hypersensitivity on the SPQ compared to controls (P < .001). SPQ scores were correlated with AQ scores both across groups (r = .-38) and within the ASC (r = -.18) and control groups (r = -.15). Principal component analyses conducted separately in both groups indicated that one factor comprising 35 items consistently assesses sensory hypersensitivity. The SPQ showed high internal consistency for both the total SPQ (Cronbach's alpha = .92) and the reduced 35-item version (alpha = .93). The SPQ was significantly correlated with the SensOR across groups (r = -.46) and within the ASC (r = -.49) and control group (r = -.21).

CONCLUSIONS

The SPQ shows good internal consistency and concurrent validity and differentiates between adults with and without ASC. Adults with ASC report more sensitivity to sensory stimuli on the SPQ. Finally, greater sensory sensitivity is associated with more autistic traits. The SPQ provides a new tool to measure individual differences on this dimension.

De novo SCN2A splice site mutation in a boy with Autism spectrum disorder

BACKGROUND

SCN2A is a gene that codes for the alpha subunit of voltage-gated, type II sodium channels, and is highly expressed in the brain. Sodium channel disruptions, such as mutations in SCN2A, may play an important role in psychiatric disorders. Recently, de novo SCN2A mutations in autism spectrum disorder (ASD) have been identified. The current study characterizes a de novo splice site mutation in SCN2A that alters mRNA and protein products.

CASE PRESENTATION

We describe results from clinical and genetic characterizations of a seven-year-old boy with ASD. Psychiatric interview and gold standard autism diagnostic instruments (ADOS and ADI-R) were used to confirm ASD diagnosis, in addition to performing standardized cognitive and adaptive functioning assessments (Leiter-R and Vineland Adaptive Behavior Scale), and sensory reactivity assessments (Sensory Profile and Sensory Processing Scales). Genetic testing by whole exome sequencing revealed four de novo events, including a splice site mutation c.476 + 1G > A in SCN2A, a missense mutation (c.2263G > A) causing a p.V755I change in the TLE1 gene, and two synonymous mutations (c.2943A > G in the BUB1 gene, and c.1254 T > A in C10orf68 gene). The de novo SCN2A splice site mutation produced a stop codon 10 amino acids downstream, possibly resulting in a truncated protein and/or a nonsense-mediated mRNA decay. The participant met new DSM-5 criteria for ASD, presenting with social and communication impairment, repetitive behaviors, and sensory reactivity issues. The participant's adaptive and cognitive skills fell in the low range of functioning.

CONCLUSION

This report indicates that a splice site mutation in SCN2A might be contributing to the risk of ASD. Describing the specific phenotype associated with SCN2A mutations might help to reduce heterogeneity seen in ASD.

Sensory symptoms in autism spectrum disorders

The aim of this review is to summarize the recent literature regarding abnormalities in sensory functioning in individuals with autism spectrum disorder (ASD), including evidence regarding the neurobiological basis of these symptoms, their clinical correlates, and their treatment. Abnormalities in responses to sensory stimuli are highly prevalent in individuals with ASD. The underlying neurobiology of these symptoms is unclear, but several theories have been proposed linking possible etiologies of sensory dysfunction with known abnormalities in brain structure and function that are associated with ASD. In addition to the distress that sensory symptoms can cause patients and caregivers, these phenomena have been correlated with several other problematic symptoms and behaviors associated with ASD, including restrictive and repetitive behavior, self-injurious behavior, anxiety, inattention, and gastrointestinal complaints. It is unclear whether these correlations are causative in nature or whether they are due to shared underlying pathophysiology. The best-known treatments for sensory symptoms in ASD involve a program of occupational therapy that is specifically tailored to the needs of the individual and that may include sensory integration therapy, a sensory diet, and environmental modifications. While some empirical evidence supports these treatments, more research is needed to evaluate their efficacy, and other means of alleviating these symptoms, including possible psychopharmacological interventions, need to be explored. Additional research into the sensory symptoms associated with ASD has the potential to shed more light on the nature and pathophysiology of these disorders and to open new avenues of effective treatments.

Auditory processing and sensory behaviours in children with autism spectrum disorders as revealed by mismatch negativity

Sensory dysfunctions may underlie key characteristics in children with Autism Spectrum Disorders (ASD). The current study aimed to investigate auditory change detection in children with ASD in order to determine event-related potentials to meaningless and meaningful speech stimuli. 11 high functioning boys with a diagnosis of autism spectrum disorders (mean age=13.0; SD=1.08) and 11 typically developing boys (mean age=13.7; SD=1.5) participated in a mismatch negativity (MMN) paradigm. Results revealed that compared to TD controls, the children with ASD showed significantly reduced MMN responses to both words and pseudowords in the frontal regions of the brain and also a significant reduction in their activation for words in the Central Parietal regions. In order to test the relationship between sensory processing and auditory processing, children completed the Adult and Adolescent Sensory Profile. As predicted, the children with ASD showed more extreme sensory behaviours and were significantly higher than their typically developing controls across three of the sensory quadrants (sensory sensitivity, low registration and sensory avoidance). Importantly, only auditory sensory sensitivity was able to account for the differences displayed for words in the frontal and central parietal regions when controlling for the effect of group, revealing an inverse relationship of the higher sensory sensitivity scores the less activation in response for words. We discuss how the expression of sensory behaviours in ASD may result in deficient neurophysiological mechanisms underlying automatic language processing.

The effect of bumetanide treatment on the sensory behaviours of a young girl with Asperger syndrome

Sensory behaviours were not considered as core features of autism spectrum disorders until recently. However, they constitute an important part of the observed symptoms that result in social maladjustment and are currently quite difficult to treat. One promising strategy for the treatment of these behaviours is the use of bumetanide, which was previously shown to reduce the severity of autism spectrum disorders. In this study, we proposed to evaluate sensory behaviours using Dunn's Sensory Profile after 18 months of bumetanide treatment in a 10-year-old girl with Asperger syndrome. Reported improvements covered a large range of sensory behaviours, including auditory, vestibular, tactile, multisensory and oral sensory processing. Although our results were limited to a single case report, we believe that our clinical observations warrant clinical trials to test the long-term efficacy of bumetanide to manage the sensory behaviours of people with autism spectrum disorders.

Emotional responses to odors in children with high-functioning autism: autonomic arousal, facial behavior and self-report

Although emotional functioning is impaired in children with autism, it is unclear if this impairment is due to difficulties with facial expression, autonomic responsiveness, or the verbal description of emotional states. To shed light on this issue, we examined responses to pleasant and unpleasant odors in eight children (8-14 years) with high-functioning autism and 8 age-matched typically developing controls. Despite subtle differences in the facial actions of the children with autism, children in both groups had similar facial and autonomic emotional responses to the odors. However, children with autism were less likely than controls to report an emotional reaction to the odors that matched their facial expression, suggesting difficulties in the self report of emotional states.

Sensory over-responsivity in adults with autism spectrum conditions

Anecdotal reports and empirical evidence suggest that sensory processing issues are a key feature of autism spectrum conditions. This study set out to investigate whether adults with autism spectrum conditions report more sensory over-responsivity than adults without autism spectrum conditions. Another goal of the study was to identify whether autistic traits in adults with and without autism spectrum conditions were associated with sensory over-responsivity. Adults with (n = 221) and without (n = 181) autism spectrum conditions participated in an online survey. The Autism Spectrum Quotient, the Raven Matrices and the Sensory Processing Scale were used to characterize the sample. Adults with autism spectrum conditions reported more sensory over-responsivity than control participants across various sensory domains (visual, auditory, tactile, olfactory, gustatory and proprioceptive). Sensory over-responsivity correlated positively with autistic traits (Autism Spectrum Quotient) at a significant level across groups and within groups. Adults with autism spectrum conditions experience sensory over-responsivity to daily sensory stimuli to a high degree. A positive relationship exists between sensory over-responsivity and autistic traits. Understanding sensory over-responsivity and ways of measuring it in adults with autism spectrum conditions has implications for research and clinical settings.

Sensory Processing Difficulties, Behavioral Problems, and Parental Stress in a Clinical Population of Young Children

This study examined the relationship between sensory processing difficulties, parental stress, and behavioral problems in a clinical sample of young children with developmental and behavioral difficulties. We hypothesized that a high rate of sensory processing difficulties would be found, that there would be a high rate of comorbidity between sensory processing difficulties and behavioral problems, and that children's sensory processing difficulties and parental stress would be highly correlated. Parents of 59 children ages two to five who attended an out-patient clinic in a low income, urban community completed the Child Behavior Checklist, Parental Stress Inventory-Short Form and the Short Sensory Profile. Children in this clinical population showed a high prevalence (55.9%) of sensory processing difficulties, a significantly higher rate than previously reported. Sensory processing deficits were correlated with behavioral difficulties and parental stress levels-suggesting that as sensory processing difficulties increase, so do behavioral difficulties and parental stress. Parents of children with sensory processing deficits had significantly higher levels of parental stress than parents of children without sensory deficits. Parenting stress levels were also clinically elevated for the cohort of children in which sensory processing difficulties and behavioral concerns co-existed. These findings suggest that treatment outcomes might improve and parental stress could be reduced if mental health clinicians were trained to identify and address sensory problems. This could result in more children being screened and treated for sensory processing difficulties and an eventual reduction in the rates of parental stress.

Sensory and motor secondary symptoms as indicators of brain vulnerability

In addition to the primary symptoms that distinguish one disorder from the next, clinicians have identified, yet largely overlooked, another set of symptoms that appear across many disorders, termed secondary symptoms. In the emerging era of systems neuroscience, which highlights that many disorders share common deficits in global network features, the nonspecific nature of secondary symptoms should attract attention. Herein we provide a scholarly review of the literature on a subset of secondary symptoms––sensory and motor. We demonstrate that their pattern of appearance––across a wide range of psychopathologies, much before the full-blown disorder appears, and in healthy individuals who display a variety of negative symptoms––resembles the pattern of appearance of network abnormalities. We propose that sensory and motor secondary symptoms can be important indicators of underlying network aberrations and thus of vulnerable brain states putting individuals at risk for psychopathology following extreme circumstances.

Child and family characteristics influencing intervention choices in autism spectrum disorders

A myriad of treatment options are available for children with autism, yet little is understood regarding characteristics of parents (e.g., education) and children (e.g., severity of autism symptoms) that influence types and amounts of therapy utilization. Interviews from 70 families were analyzed to determine potential influences on utilization (e.g., start of first services, use of traditional services). Descriptive findings regarding therapy types were similar to national studies. However, only three of the variables predicted utilization of specific therapies: severity of sensory processing problems was associated with earlier initiation of services in general, and higher maternal and paternal education was associated with the use of dietary and/or vitamin therapy as well as with more types of services. No other variables had predictive value; thus, the amount and type of therapies received may be more related to diagnostic practices and/or to the affordances/constraints of service delivery and reimbursement systems at particular ages.

Sensory processing and motor skill performance in elementary school children with autism spectrum disorder

Research to examine both sensory processing and motor skill performance in children with autism spectrum disorder (ASD) is limited. This study assessed whether children with ASD would show sensory and motor delays compared to typically developing children and examined the relationship between sensory processing and motor performance. 32 children diagnosed with ASD were assessed using the Short Sensory Profile (SSP) and the Movement ABC-2 (MABC-2). The SSP measures children's sensory processing in daily life and the MABC-2 measures children's fine and gross motor skill performance. Overall, the samples' scores on the SSP indicated atypical sensory processing and scores on the MABC-2 showed poorer fine and gross motor performance as compared to age-matched norms. Furthermore, the samples' scores for sensory processing were positively correlated with their motor performance. The results suggest that fine and gross motor difficulties of children with ASD may be related to their delayed sensory processing to visual, auditory, tactile, and movement stimuli, and that this hypothesis needs to be tested in future research.

Sensory Response Patterns in Nonverbal Children with ASD

We sought to examine concurrent and longitudinal associations between sensory response patterns (i.e., hyperresponsiveness, hyporesponsiveness, and sensory seeking) and verbal status of young children with autism spectrum disorder (ASD) as a potential factor influencing the development of verbal communication. Seventy-nine children with ASD (verbal, n = 29; nonverbal, n = 50) were assessed using cross-sectional analyses (Study 1), and 14 children with ASD (verbal, n = 6; nonverbal, n = 8) were assessed using prospective longitudinal analyses (Study 2). Data were collected regarding sensory response patterns and verbal ability. Hyporesponsiveness and sensory seeking behaviors were associated with verbal status in both cross-sectional and longitudinal analyses; nonverbal children were more likely to demonstrate higher hyporesponsive and sensory seeking patterns. Hyperresponsiveness did not significantly differ between verbal and nonverbal groups in either design. Sensory hyporesponsiveness and seeking behaviors may be important factors hindering the development of functional verbal communication in children with ASD. Unusual sensory responsiveness can often be observed before the onset of speech and may yield important prognostic capabilities as well as inform early interventions targeting verbal communication or alternative communication options in young children with ASD.

The development of multisensory integration in high-functioning autism: high-density electrical mapping and psychophysical measures reveal impairments in the processing of audiovisual inputs

Successful integration of auditory and visual inputs is crucial for both basic perceptual functions and for higher-order processes related to social cognition. Autism spectrum disorders (ASD) are characterized by impairments in social cognition and are associated with abnormalities in sensory and perceptual processes. Several groups have reported that individuals with ASD are impaired in their ability to integrate socially relevant audiovisual (AV) information, and it has been suggested that this contributes to the higher-order social and cognitive deficits observed in ASD. However, successful integration of auditory and visual inputs also influences detection and perception of nonsocial stimuli, and integration deficits may impair earlier stages of information processing, with cascading downstream effects. To assess the integrity of basic AV integration, we recorded high-density electrophysiology from a cohort of high-functioning children with ASD (7-16 years) while they performed a simple AV reaction time task. Children with ASD showed considerably less behavioral facilitation to multisensory inputs, deficits that were paralleled by less effective neural integration. Evidence for processing differences relative to typically developing children was seen as early as 100 ms poststimulation, and topographic analysis suggested that children with ASD relied on different cortical networks during this early multisensory processing stage.

Hyporesponsiveness to social and nonsocial sensory stimuli in children with autism, children with developmental delays, and typically developing children

This cross-sectional study seeks to (a) describe developmental correlates of sensory hyporesponsiveness to social and nonsocial stimuli, (b) determine whether hyporesponsiveness is generalized across contexts in children with autism relative to controls, and (c) test the associations between hyporesponsiveness and social communication outcomes. Three groups of children ages 11-105 months (N = 178; autism = 63, developmental delay = 47, typical development = 68) are given developmental and sensory measures including a behavioral orienting task (the Sensory Processing Assessment). Lab measures are significantly correlated with parental reports of sensory hyporesponsiveness. Censored regression models show that hyporesponsiveness decreased across groups with increasing mental age (MA). Group differences are significant but depend upon two-way interactions with MA and context (social and nonsocial). At a very young MA (e.g., 6 months), the autism group demonstrates more hyporesponsiveness to social and nonsocial stimuli (with larger effects for social) than developmental delay and typically developing groups, but at an older MA (e.g., 60 months) there are no significant differences. Hyporesponsiveness to social and nonsocial stimuli predicts lower levels of joint attention and language in children with autism. Generalized processes in attention disengagement and behavioral orienting may have relevance for identifying early risk factors of autism and for facilitating learning across contexts to support the development of joint attention and language.

Temperament and sensory features of children with autism

This study sought to characterize temperament traits in a sample of children with autism spectrum disorder (ASD), ages 3-7 years old, and to determine the potential association between temperament and sensory features in ASD. Individual differences in sensory processing may form the basis for aspects of temperament and personality, and aberrations in sensory processing may inform why some temperamental traits are characteristic of specific clinical populations. Nine dimensions of temperament from the Behavioral Style Questionnaire (McDevitt and Carey in Manual for the behavioral style questionnaire, Behavioral-Developmental Initiatives, Scottsdale, AZ, 1996) were compared among groups of children with ASD (n = 54), developmentally delayed (DD; n = 33), and the original normative sample of typically developing children (McDevitt and Carey in J Child Psychol Psychiatr 19(3):245-253, 1978; n = 350) using an ANOVA to determine the extent to which groups differed in their temperament profiles. The hypothesized overlap between three sensory constructs (hyperresponsiveness, hyporesponsiveness, and seeking) and the nine dimensions of temperament was analyzed in children with ASD using regression analyses. The ASD group displayed temperament scores distinct from norms for typically developing children on most dimensions of temperament (activity, rhythmicity, adaptability, approach, distractibility, intensity, persistence, and threshold) but differed from the DD group on only two dimensions (approach and distractibility). Analyses of associations between sensory constructs and temperament dimensions found that sensory hyporesponsiveness was associated with slowness to adapt, low reactivity, and low distractibility; a combination of increased sensory features (across all three patterns) was associated with increased withdrawal and more negative mood. Although most dimensions of temperament distinguished children with ASD as a group, not all dimensions appear equally associated with sensory response patterns. Shared mechanisms underlying sensory responsiveness, temperament, and social withdrawal may be fruitful to explore in future studies.

Odor identification testing in children and young adults using the smell wheel

OBJECTIVE

Olfaction is important for nutrition, safety, and quality of life. Detecting smell loss in young children can be difficult, since many children with olfactory deficits do not recognize their problem and may even pretend to smell. The short attention span of some young children precludes testing with longer standardized olfactory tests. Currently there is a dearth of pediatric smell tests. In this study we evaluated the performance of 152 children and young adults on a game-like rotating "Smell Wheel" odor identification test. This forced-choice test, which can be self-administered, was designed to capture the child's imagination and to provide a standardized test measure with odors known to young children using a minimum number of trials.

METHOD

Thirty 4-5-year olds (10 female), 62 6-7-year olds (17 female), 30 10-11-year olds (18 female) and 30 18-19-year olds (15 female) were tested. Analysis of variance was used to assess the influences of sex and age on the test scores.

RESULTS

All participants completed the simple and rapid test protocol. Test performance and age-related changes analogous to those obtained using longer tests were observed. Test scores of participants who self-administered the test were equivalent to those for whom the test was administered by the experimenter.

CONCLUSION

Good compliance and olfactory test findings congruent with literature results were obtained using the Smell Wheel, suggesting that this test may be useful in assessing olfactory function in pediatric settings where attentional demands are compromised and test time is limited.

Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders

Children with autism spectrum disorders (ASD) experience high rates of anxiety, sensory processing problems, and gastrointestinal (GI) problems; however, the associations among these symptoms in children with ASD have not been previously examined. The current study examined bivariate and multivariate relations among anxiety, sensory over-responsivity, and chronic GI problems in a sample of 2,973 children with ASD enrolled in the Autism Treatment Network (ages 2-17 years, 81.6 % male). Twenty-four percent of the sample experienced at least one type of chronic GI problem (constipation, abdominal pain, bloating, diarrhea, and/or nausea lasting three or more months). Children with each type of GI problem had significantly higher rates of both anxiety and sensory over-responsivity. Sensory over-responsivity and anxiety were highly associated, and each provided unique contributions to the prediction of chronic GI problems in logistic regression analyses. The results indicate that anxiety, sensory over-responsivity and GI problems are possibly interrelated phenomenon for children with ASD, and may have common underlying mechanisms.

The neural basis of aberrant speech and audition in autism spectrum disorders

Autism spectrum disorders (ASD) are characterized by deficits in communication and social behavior and by narrow interests. Individuals belonging to this spectrum have abnormalities in various aspects of language, ranging from semantic-pragmatic deficits to the absence of speech. They also have aberrant perception, especially in the auditory domain, with both hypo- and hypersensitive features. Neurophysiological approaches with high temporal resolution have given novel insight into the processes underlying perception and language in ASD. Neurophysiological recordings, which are feasible for investigating infants and individuals with no speech, have shown that the representation of and attention to language has an abnormal developmental path in ASD. Even the basic mechanisms for fluent speech perception are degraded at a low level of neural speech analysis. Furthermore, neural correlates of perception and some traits typical of subgroups of individuals on this spectrum have helped in understanding the diversity on this spectrum.

Cross-cultural comparison of sensory behaviors in children with autism

Parents of children with autism frequently report that their children exhibit unusual responses to sensory experiences. Little research is available, however, describing how parents' and children's culture and environment might influence parents' reports of their children's behaviors. This study compared the frequency of parent-reported responses to sensory experiences in children from two countries-Israel and the United States. We administered the Short Sensory Profile to primary caregivers of children with autism spectrum disorders (ASD) and typically developing peers. Results indicate that Israeli parents reported unusual responses to sensory experiences less frequently than U.S. parents for both ASD and typically developing children. U.S. children with ASD demonstrated significantly greater difficulty in the Auditory Filtering and Visual/Auditory Sensitivity domains than Israeli children with ASD. These findings indicate a need to further explore the influence of culture and environment on caregiver perceptions of the responses to sensory experiences of children with ASD.

Olfactory detection thresholds and adaptation in adults with autism spectrum condition

Sensory issues have been widely reported in Autism Spectrum Conditions (ASC). Since olfaction is one of the least investigated senses in ASC, the current studies explore olfactory detection thresholds and adaptation to olfactory stimuli in adults with ASC. 80 participants took part, 38 (18 females, 20 males) with ASC and 42 control participants (20 males, 22 females). A subgroup of participants (N = 19 in each group) also conducted an adaptation task. Standardized "Sniffin' Sticks" were used to measure olfactory detection levels and adaptation. Adults with and without ASC showed similar olfactory detection thresholds, and similar adaptation to an olfactory stimulus. Since diminished adaptation in ASC has been previously suggested, future research needs to examine adaptation in other modalities as well.

Valence scaling of dynamic facial expressions is altered in high-functioning subjects with autism spectrum disorders: an fMRI study

FMRI was performed with the dynamic facial expressions fear and happiness. This was done to detect differences in valence processing between 25 subjects with autism spectrum disorders (ASDs) and 27 typically developing controls. Valence scaling was abnormal in ASDs. Positive valence induces lower deactivation and abnormally strong activity in ASD in multiple regions. Negative valence increased deactivation in visual areas in subjects with ASDs. The most marked differences between valences focus on fronto-insular and temporal regions. This supports the idea that subjects with ASDs may have difficulty in passive processing of the salience and mirroring of expressions. When the valence scaling of brain activity fails, in contrast to controls, these areas activate and/or deactivate inappropriately during facial stimuli presented dynamically.

Impact of a Contextual Intervention on Child Participation and Parent Competence Among Children With Autism Spectrum Disorders: A Pretest–Posttest Repeated-Measures Design

OBJECTIVE. We tested an occupational therapy contextual intervention for improving participation in children with autism spectrum disorders and for developing parental competence.

METHOD. Using a repeated-measures pretest–posttest design, we evaluated the effectiveness of a contextually relevant reflective guidance occupational therapy intervention involving three components: authentic activity settings, family’s daily routines, and the child’s sensory processing patterns (Sensory Profile). We used these components to coach 20 parents in strategies to support their child’s participation. Intervention sessions involved reflective discussion with parents to support them in identifying strategies to meet their goals and make joint plans for the coming week. We measured child participation (Canadian Occupational Performance Measure, Goal Attainment Scaling) and parent competence (Parenting Sense of Competence, Parenting Stress Index).

RESULTS. Results indicated that parents felt more competent and children significantly increased participation in everyday life, suggesting that this approach is an effective occupational therapy intervention.

Sensory Processing, Problem Behavior, Adaptive Behavior, and Cognition in Preschool Children With Autism Spectrum Disorders

OBJECTIVE. This retrospective study explored sensory processing characteristics in preschool-age children with autism spectrum disorders (ASD); the relationships between sensory processing and problem behavior, adaptive behavior, and cognitive function; and the differences in sensory processing between two subgroups (autism and pervasive developmental disorder–not otherwise specified).

METHOD. Study measures included the Short Sensory Profile (SSP), Aberrant Behavior Checklist–Community, Vineland Adaptive Behavior Scales, and Mullen Scales of Early Learning.

RESULTS. Most of the children with ASD had sensory processing challenges, and a significant relationship was found between SSP total scores and problem behavior scores; however, no significant relationships were found between SSP total scores and adaptive behavior and cognitive functioning. Although all the children had low Vineland scores, approximately one-quarter of the children had typical SSP scores. No significant differences in SSP scores were found between the subgroups.

CONCLUSION. The findings highlight the importance of comprehensive evaluations for children with ASD.

Adenosine and autism: a spectrum of opportunities

In rodents, insufficient adenosine produces behavioral and physiological symptoms consistent with several comorbidities of autism. In rodents and humans, stimuli postulated to increase adenosine can ameliorate these comorbidities. Because adenosine is a broad homeostatic regulator of cell function and nervous system activity, increasing adenosine's influence might be a new therapeutic target for autism with multiple beneficial effects. This article is part of the Special Issue entitled 'Neurodevelopmental Disorders'.