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Narvekar N, Carter Leno V, Pasco G, Begum Ali J, Johnson MH, Charman T, Jones EJH. The roles of sensory hyperreactivity and hyporeactivity in understanding infant fearfulness and emerging autistic traits. J Child Psychol Psychiatry 2024; 65:1022-1036. [PMID: 38172076 DOI: 10.1111/jcpp.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Existing evidence indicates that atypical sensory reactivity is a core characteristic of autism, and has been linked to both anxiety (and its putative infant precursor of fearfulness) and repetitive behaviours. However, most work has used cross-sectional designs and not considered the differential roles of hyperreactivity and hyporeactivity to sensory inputs, and is thus limited in specificity. METHODS 161 infants with and without an elevated likelihood of developing autism and attention-deficit hyperactivity disorder (ADHD) were followed from 10 to 36 months of age. Parents rated an infant precursor of later anxiety (fearfulness) using the Infant Behaviour Questionnaire at 10 and 14 months, and the Early Childhood Behavioural Questionnaire at 24 months, and sensory hyperreactivity and hyporeactivity at 10, 14 and 24 months using the Infant Toddler Sensory Profile. Domains of autistic traits (restrictive and repetitive behaviours; RRB, and social communication interaction, SCI) were assessed using the parent-rated Social Responsiveness Scale at 36 months. Cross-lagged models tested (a) paths between fearfulness and hyperreactivity at 10-24 months, and from fearfulness and hyperreactivity to later autism traits, (b) the specificity of hyperreactivity effects by including hyporeactivity as a correlated predictor. RESULTS Hyperreactivity at 14 months was positively associated with fearfulness at 24 months, and hyperreactivity at 24 months was positively associated with SCI and RRB at 36 months. When hyporeactivity was included in the model, paths between hyperreactivity and fearfulness remained, but paths between hyperreactivity and autistic traits became nonsignificant. CONCLUSIONS Our findings indicate that alterations in early sensory reactivity may increase the likelihood of showing fearfulness in infancy, and relate to later social interactions and repetitive behaviours, particularly in individuals with a family history of autism or ADHD.
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Affiliation(s)
- Nisha Narvekar
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Virginia Carter Leno
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Greg Pasco
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck, London, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Tony Charman
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily J H Jones
- Centre for Brain and Cognitive Development, Birkbeck, London, UK
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2
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Manning C. Visual processing and decision-making in autism and dyslexia: Insights from cross-syndrome approaches. Q J Exp Psychol (Hove) 2024:17470218241264627. [PMID: 38876999 DOI: 10.1177/17470218241264627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Atypical visual processing has been reported in developmental conditions like autism and dyslexia, and some accounts propose a causal role for visual processing in the development of these conditions. However, few studies make direct comparisons between conditions, or use sufficiently sensitive methods, meaning that it is hard to say whether atypical visual processing tells us anything specific about these conditions, or whether it reflects a more general marker of atypical development. Here I review findings from two computational modelling approaches (equivalent noise and diffusion modelling) and related electroencephalography (EEG) indices which we have applied to data from autistic, dyslexic and typically developing children to reveal how the component processes involved in visual processing and decision-making are altered in autism and dyslexia. The results identify both areas of convergence and divergence in autistic and dyslexic children's visual processing and decision-making, with implications for influential theoretical accounts such as weak central coherence, increased internal noise, and dorsal-stream vulnerability. In both sets of studies, we also see considerable variability across children in all three groups. To better understand this variability, and further understand the convergence and divergence identified between conditions, future studies would benefit from studying how the component processes reviewed here relate to transdiagnostic dimensions, which will also give insights into individual differences in visual processing and decision-making more generally.
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Affiliation(s)
- Catherine Manning
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- School of Psychology, University of Birmingham, Birmingham, UK
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3
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Keating J, Purcell C, Gerson SA, Vanderwert RE, Jones CRG. Exploring the presence and impact of sensory differences in children with Developmental Coordination Disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 148:104714. [PMID: 38484422 DOI: 10.1016/j.ridd.2024.104714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/27/2024] [Accepted: 02/27/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Children with Developmental Coordination Disorder (DCD) can experience sensory differences. There has been limited exploration of these differences and their impact on children with DCD. AIMS i) To explore the presence and impact of sensory differences in children with DCD compared to children without DCD; ii) To examine whether sensory differences are related to motor ability, attention deficit hyperactivity disorder (ADHD), or autistic traits. METHOD Parents of children (8-12 years) with (n = 23) and without (n = 33) DCD used standardised questionnaires to report on their children's sensory differences, autistic traits, and ADHD traits. Motor abilities were assessed through the Movement Assessment Battery for Children-2. Data were explored both categorically (between-groups) and dimensionally. RESULTS Children with DCD had significantly higher levels of sensory differences than children without DCD. Sensory differences also had a significantly greater impact on daily activities for children with DCD. Higher levels of ADHD and autistic traits, but not motor ability, were significant independent predictors of higher levels of sensory difference. CONCLUSION Children with DCD experience high levels of sensory differences, which impact on their daily lives. These sensory differences may be a marker for additional neurodivergence in children with DCD. Practitioners should consider the sensory needs of children with DCD. WHAT THIS PAPER ADDS This paper provides insight into the sensory features of children with DCD and the impact that sensory differences can have on daily living. Using parent-report, we found that children with DCD had increased sensory differences relative to children without DCD. These included increased hyperresponsiveness, increased hyporesponsiveness, and increased sensory interests, repetitions, and seeking behaviours (SIRS). We also found that sensory differences had a greater impact on daily living for children with DCD compared to children without DCD. Across the whole sample, autistic traits predicted hyperresponsivity and hyporesponsivity patterns; whereas traits of hyperactivity and impulsivity predicted SIRS. Motor abilities did not uniquely predict sensory differences, suggesting that other traits of neurodivergence may contribute to the sensory differences in DCD. Taken together, these findings highlight the necessity of considering sensory needs when supporting children with DCD. They also suggest that if sensory differences are identified in children with DCD, it may be due to the presence of co-occurring neurodivergent traits or conditions.
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Affiliation(s)
- Jennifer Keating
- Cardiff University Centre for Human Developmental Science (CUCHDS), School of Psychology, Cardiff University, Cardiff, UK
| | | | - Sarah A Gerson
- Cardiff University Centre for Human Developmental Science (CUCHDS), School of Psychology, Cardiff University, Cardiff, UK
| | - Ross E Vanderwert
- Cardiff University Centre for Human Developmental Science (CUCHDS), School of Psychology, Cardiff University, Cardiff, UK
| | - Catherine R G Jones
- Cardiff University Centre for Human Developmental Science (CUCHDS), School of Psychology, Cardiff University, Cardiff, UK; Wales Autism Research Centre (WARC), School of Psychology, Cardiff University, Cardiff, UK.
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Storch EA, Guzick AG, D'Souza J, Clinger J, Ayton D, Kook M, Rork C, Smith EE, Draper IA, Khalfe N, Rast CE, Murphy N, Lijfijjt M, Goodman WK, Cervin M. Family Accommodation in Children and Adolescents With Misophonia. Behav Ther 2024; 55:595-604. [PMID: 38670671 PMCID: PMC11055978 DOI: 10.1016/j.beth.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 04/28/2024]
Abstract
Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared to parents of children with anxiety disorders, parents of children with misophonia more frequently reported child distress and anger when they did not accommodate. Family accommodation was moderately to strongly associated with misophonia severity even when accounting for co-occurring internalizing and externalizing symptoms and sociodemographic factors. This first study of family accommodation in pediatric misophonia suggests accommodation may be an important clinical feature. A notable study limitation is that the measure of misophonia did not delineate between adaptive versus maladaptive accommodations. Excessive and maladaptive accommodation may be one potential candidate to target in interventions when considered within a broader treatment plan. Importantly, adaptive accommodations should also be considered in day-to-day management if they improve functioning and quality of life.
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Affiliation(s)
| | - Andrew G Guzick
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Baylor College of Medicine
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Camacho MC, Balser DH, Furtado EJ, Rogers CE, Schwarzlose RF, Sylvester CM, Barch DM. Higher Intersubject Variability in Neural Response to Narrative Social Stimuli Among Youth With Higher Social Anxiety. J Am Acad Child Adolesc Psychiatry 2024; 63:549-560. [PMID: 38070872 DOI: 10.1016/j.jaac.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/10/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Social anxiety is associated with alterations in socioemotional processing, but the pathophysiology remains poorly understood. Movies present an opportunity to examine more naturalistic socioemotional processing by providing narrative and sensory context to emotion cues. This study aimed to characterize associations between neural response to contextualized social cues and social anxiety symptoms in children. METHOD Data from the Healthy Brain Network (final N = 740; age range 5-15 years) were split into discovery and replication samples to maximize generalizability of findings. Associations of parent- and self-reported social anxiety (Screen for Child Anxiety-related Emotional Disorders) with mean differences and person-to-person variability in functional magnetic resonance imaging-measured activation to 2 emotionally dynamic movies were characterized. RESULTS Though no evidence was found to indicate social anxiety symptoms were associated with mean differences in neural activity to emotional content (fit Spearman rs < 0.09), children with high social anxiety symptoms had higher intersubject activation variability in the posterior cingulate, supramarginal gyrus, and inferior frontal gyrus (Bonferroni familywise error-corrected ps < .05)-regions associated with attention, alertness, and emotion cue processing. Identified regions varied by age group and informant. Across ages, these effects were enhanced for scenes containing greater sensory intensity (brighter, louder, more motion, more vibrance). CONCLUSION These results provide evidence that children with high social anxiety symptoms show high person-to-person variability in the neural processing of sensory aspects of emotional content. These data indicate that children with high social anxiety may require personalized interventions for sensory and emotional difficulties, as the underlying neurology differs from child to child. DIVERSITY & INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.
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Cervantes J, Wallace J, Helms AK, Diekroger EA, Fogler J. Complex ADHD Challenging Case: When Simple Becomes Complex: Managing Clinician Bias and Navigating Challenging Family Dynamics in a 6-Year-Old Girl with ADHD and Developmental Delays. J Dev Behav Pediatr 2024; 45:e181-e184. [PMID: 38619154 PMCID: PMC11047299 DOI: 10.1097/dbp.0000000000001265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/06/2024] [Indexed: 04/16/2024]
Abstract
CASE Layla is a 6.7-year-old girl diagnosed with attention-deficit/hyperactivity disorder (ADHD)-predominantly hyperactive/impulsive type-delayed adaptive skills, enuresis, unspecified malnutrition, and feeding difficulties. She presented to developmental-behavioral pediatrics (DBP) in January 2022 due to caregiver concerns for autism spectrum disorder (ASD).Layla lives in a polyamorous family with her biological mother and father, mother's partner whom Layla refers to as her uncle, and her 2 half-siblings. There is a maternal history of special education services, schizoaffective disorder, bipolar disorder, multiple sclerosis, Wolff-Parkinson-White syndrome, and ADHD. Layla's father is a veteran diagnosed with post-traumatic stress disorder. Layla's siblings, aged 5 and 9 years, have established diagnoses of ADHD, ASD, global developmental delays, behavioral concerns, and poor sleep. There is a history of adverse childhood experiences, including parental mental health, poverty, and involvement with child protective services. Acknowledgement and inclusion of all members of this diverse family structure, as well as consistent validation from the DBP and social worker, allowed a strong treatment alliance to form and the mother continued to contact the DBP clinic, even for those questions related to other specialties. A social worker received weekly calls from the mother sharing grievances related to feeling misunderstood and spoke about the assumptions she felt external providers made about her family, culture, and parenting styles. For example, she recalls the pediatrician commenting about their family structure being "confusing for the children" and describing their home as "chaotic," assumptions that may not have been made of nuclear family structures. Behavioral therapies were a repeated recommendation, but the mother verbalized not being interested in these options as she had participated in parent management training several years earlier and felt that the strategies taught were not applicable to her unique family structure, to which the clinician replied, "this is the standard recommendation for all children this age with disruptive behaviors." Although the mother was initially hesitant to trial medications, she eventually agreed that Layla's symptoms were negatively affecting her school performance, and the DBP initiated a stimulant medication.Layla's initial evaluation included a developmental history, behavioral observations, and standardized testing. The results from developmental testing demonstrated age equivalents between 4 and 6 years across gross motor, adaptive, visual motor, and speech-language domains.On observation, Layla was extremely active. During the visit, she walked over to her mother, made eye contact, and showed her the picture that she had drawn. She engaged in imaginary play, reciprocal conversation, and responded to social bids. The mother felt strongly that Layla had ASD and reported symptoms such as motor stereotypies (hand flapping), covering ears with certain noises/sounds, and rigidity when it came to things being a certain way or a certain color. These behaviors did not occur in the initial or subsequent clinic visits with DBP, her general pediatrician, or during other outside evaluations the mother pursued. The DBP felt strongly that Layla was mimicking her siblings' symptoms and provided ongoing education regarding ADHD symptomology.In terms of behavior management, the mother did not attempt to redirect Layla's behaviors during the initial clinic visit and in subsequent visits, and both adult men yelled loudly, clapped, and hit their hands on the table as a form of redirection. The mother continued to voice her diagnostic disagreement with the DBP and the pediatrician and insisted that Layla met the criteria for ASD. When the mother reviewed the report, a statement insinuating that Layla's behaviors were "understandable given parental inconsistency and complicated family structure" upset her.What factors would you consider when thinking about caregiver disagreement with the diagnosis and treatment plan? Does diagnostic overshadowing apply here?
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Affiliation(s)
- Jennifer Cervantes
- Department of Pediatrics, Baylor College of Medicine & Texas Children's Hospital, Houston, TX
| | | | - Annie Kennelly Helms
- Department of Developmental Pediatrics, Children's Hospital Colorado & University of Colorado, Aurora, CO
| | - Elizabeth A. Diekroger
- Division of Developmental-Behavioral Pediatrics and Psychology, UH Rainbow Babies and Children's Hospital & Case Western Reserve University School of Medicine, Cleveland, OH; and
| | - Jason Fogler
- Division of Developmental Medicine, Boston Children's Hospital & Harvard Medical School, Brookline, MA
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Davis-Cheshire R, Bennington S, Hartsek A, Kelly T, Marinelli J, Perez A. The Impact of Weighted Blanket Use on Adults with Sensory Sensitivity and Insomnia. Occup Ther Int 2023; 2023:3109388. [PMID: 38152339 PMCID: PMC10752672 DOI: 10.1155/2023/3109388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose This study's purpose was to determine the impact of weighted blanket use on moderate to severe insomnia in adults with sensory sensitivity greater than the average population. Methods For this study, a four-week, single-case, multiple-participant ABA study design was used. Through convenience sampling, four participants scoring 15 or greater on the Insomnia Severity Index (ISI), which categorizes them as having moderate to severe insomnia, and much more than most people in sensory sensitivity on the Adolescent/Adult Sensory Profile were recruited. First, seven-day baseline sleep data was gathered, followed by two weeks of weighted blanket use, concluding with a seven-day withdrawal phase. Additional outcome measures included: Tuck and Snooze Survey, Consensus Sleep Diary Morning, and Additional Sleep Diary Questions. Data analysis included visual analysis, mean comparisons, Tau-U calculations, and pre- to post-ISI category comparisons. Results All participants' ISI scores were categorized as one level less severe postintervention. All participants demonstrated increased sleep quality, and three participants showed an increase in sleep duration based on individual mean comparisons between baseline and intervention phases. Conclusion Weighted blankets appear beneficial in reducing insomnia severity in adults with much more than the average population sensory sensitivity. In addition, those with self-reported anxiety may have increased benefit from this intervention.
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Affiliation(s)
| | | | - Allison Hartsek
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
| | - Teresa Kelly
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
| | | | - Amanda Perez
- Kettering College, 3737 Southern Blvd, Kettering, OH 45429, USA
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MacLennan K, Woolley C, @21andsensory E, Heasman B, Starns J, George B, Manning C. "It Is a Big Spider Web of Things": Sensory Experiences of Autistic Adults in Public Spaces. AUTISM IN ADULTHOOD 2023; 5:411-422. [PMID: 38116051 PMCID: PMC10726197 DOI: 10.1089/aut.2022.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background Sensory processing differences are commonly experienced by autistic individuals, and some sensory experiences can greatly impact the mental health and quality of life of individuals. Previous research suggests that adapting the sensory nature of environments may improve individual experiences and engagement with these spaces. However, knowledge about which public places are particularly disabling is limited, especially from the perspective of autistic individuals. Little is also known about what in the sensory environment makes them particularly disabling. Methods In this participatory research study, we investigated the sensory experiences of autistic adults in public spaces. We used an online focus group method, recruiting 24 autistic adults across 7 focus groups. We applied content analysis, reflexive thematic analysis, and case study analysis. Results The results of the content analysis showed that supermarkets, eateries (i.e., restaurants, cafés, pubs), highstreets and city/town centers, public transport, health care settings (i.e., doctor's surgeries and hospitals), and retail shops and shopping centers are experienced to be commonly disabling sensory environments for autistic adults. However, outdoor spaces, retail shops, museums, concert venues/clubs, cinemas/theaters, and stadiums are identified to be commonly less disabling sensory environments. In addition, through reflexive thematic analysis we identified 6 key principles that underlie how disabling or enabling sensory environments are: Sensoryscape (sensory environment), Space, Predictability, Understanding, Adjustments, and Recovery. We represented these principles as a web to emphasize the interconnected, dimensional spectrum of the different themes. Lastly, we used case study analysis to evidence these principles in the commonly disabling sensory environments for richer detail and context and to provide credibility for the principles. Conclusions Our findings have important implications for businesses, policy, and built environment designers to reduce the sensory impact of public places to make them more enabling for autistic people. By making public spaces more enabling, we may be able to improve quality of life for autistic individuals.
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Affiliation(s)
- Keren MacLennan
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Catherine Woolley
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Emily @21andsensory
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Brett Heasman
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Jess Starns
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Becky George
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Catherine Manning
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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Powell HJ, He JL, Khalil N, Wodka EL, DeRonda A, Edden RAE, Vasa RA, Mostofsky SH, Puts NA. Perceptual alterations in the relationship between sensory reactivity, intolerance of uncertainty, and anxiety in autistic children with and without ADHD. Dev Psychopathol 2023:1-13. [PMID: 37990408 DOI: 10.1017/s0954579423001360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Sensory differences and anxiety disorders are highly prevalent in autistic individuals with and without ADHD. Studies have shown that sensory differences and anxiety are associated and that intolerance of uncertainty (IU) plays an important role in this relationship. However, it is unclear as to how different levels of the sensory processing pathway (i.e., perceptual, affective, or behavioral) contribute. Here, we used psychophysics to assess how alterations in tactile perception contribute to questionnaire measures of sensory reactivity, IU, and anxiety. Thirty-eight autistic children (aged 8-12 years; 27 with co-occurring ADHD) were included. Consistent with previous findings, mediation analyses showed that child-reported IU fully mediated an association between parent-reported sensory reactivity and parent-reported anxiety and that anxiety partially mediated an association between sensory reactivity and IU. Of the vibrotactile thresholds, only simultaneous frequency discrimination (SFD) thresholds correlated with sensory reactivity. Interestingly, we found that sensory reactivity fully mediated an association between SFD threshold and anxiety, and between SFD threshold and IU. Taken together, those findings suggest a mechanistic pathway whereby tactile perceptual alterations contribute to sensory reactivity at the affective level, leading in turn to increased IU and anxiety. This stepwise association can inform potential interventions for IU and anxiety in autism.
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Affiliation(s)
- Helen J Powell
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Nermin Khalil
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Ericka L Wodka
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioural Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alyssa DeRonda
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Richard A E Edden
- Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Roma A Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioural Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stewart H Mostofsky
- Department of Psychiatry and Behavioural Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicolaas A Puts
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
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Leal ASM, Alba LA, Cummings KK, Jung J, Waizman YH, Moreira JFG, Saragosa-Harris NM, Ninova E, Waterman JM, Langley AK, Tottenham N, Silvers JA, Green SA. Sensory processing challenges as a novel link between early caregiving experiences and mental health. Dev Psychopathol 2023; 35:1968-1981. [PMID: 36523255 PMCID: PMC10734795 DOI: 10.1017/s0954579422000633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Early caregiving adversity (ECA) is associated with elevated psychological symptomatology. While neurobehavioral ECA research has focused on socioemotional and cognitive development, ECA may also increase risk for "low-level" sensory processing challenges. However, no prior work has compared how diverse ECA exposures differentially relate to sensory processing, or, critically, how this might influence psychological outcomes. We examined sensory processing challenges in 183 8-17-year-old youth with and without histories of institutional (orphanage) or foster caregiving, with a particular focus on sensory over-responsivity (SOR), a pattern of intensified responses to sensory stimuli that may negatively impact mental health. We further tested whether sensory processing challenges are linked to elevated internalizing and externalizing symptoms common in ECA-exposed youth. Relative to nonadopted comparison youth, both groups of ECA-exposed youth had elevated sensory processing challenges, including SOR, and also had heightened internalizing and externalizing symptoms. Additionally, we found significant indirect effects of ECA on internalizing and externalizing symptoms through both general sensory processing challenges and SOR, covarying for age and sex assigned at birth. These findings suggest multiple forms of ECA confer risk for sensory processing challenges that may contribute to mental health outcomes, and motivate continuing examination of these symptoms, with possible long-term implications for screening and treatment following ECA.
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Affiliation(s)
| | - Laura A. Alba
- Graduate School of Education, University of California, Riverside, Riverside, CA, USA
| | - Kaitlin K. Cummings
- Department of Psychiatry and Biobehavioral Sciences, Jane & Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jiwon Jung
- Department of Psychiatry and Biobehavioral Sciences, Jane & Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Yael H. Waizman
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | - Emilia Ninova
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jill M. Waterman
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Audra K. Langley
- Department of Psychiatry and Biobehavioral Sciences, Jane & Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- UCLA Pritzker Center for Strengthening Children and Families, Los Angeles, CA, USA
| | - Nim Tottenham
- Department of Psychology, Columbia University, New York, NY, USA
| | - Jennifer A. Silvers
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Shulamite A. Green
- Department of Psychiatry and Biobehavioral Sciences, Jane & Terry Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
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May-Benson TA, Easterbrooks-Dick O, Teasdale A. Exploring the Prognosis: A Longitudinal Follow-Up Study of Children with Sensory Processing Challenges 8-32 Years Later. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1474. [PMID: 37761435 PMCID: PMC10529144 DOI: 10.3390/children10091474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/29/2023]
Abstract
Sensory integration and processing challenges have been long recognized in children and, more recently, in adults. To understand the long-term prognosis of these challenges, more research is needed on what children with sensory integration and processing challenges look like as adults. Using the Adult/Adolescent Sensory History, researchers followed up with 102 adults who had known sensory integration and processing challenges as children to examine the following questions: What is the current sensory processing status of adults who received sensory-integration-based occupational therapy services as children? And how has the sensory processing status of adults who received sensory-integration-based services changed since childhood? This study compared performance on sensory processing measures completed as children and as adults for a follow-up group of adults. The results revealed that the severity of sensory integration and processing challenges experienced by the follow-up group decreased from childhood, with 51% of the follow-up group now scoring in the "typical" range of sensory processing. Our findings suggest that those children with sensory integration and processing challenges who are recognized and seek occupational therapy services using an ASI approach are likely to have a good long-term prognosis regarding the severity of their sensory processing functioning.
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Affiliation(s)
| | - Olivia Easterbrooks-Dick
- Spiral Foundation, Newton, MA 02458, USA; (O.E.-D.); (A.T.)
- OTA The Koomar Center, Newton, MA 02458, USA
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Williams ZJ, Schaaf R, Ausderau KK, Baranek GT, Barrett DJ, Cascio CJ, Dumont RL, Eyoh EE, Failla MD, Feldman JI, Foss-Feig JH, Green HL, Green SA, He JL, Kaplan-Kahn EA, Keçeli-Kaysılı B, MacLennan K, Mailloux Z, Marco EJ, Mash LE, McKernan EP, Molholm S, Mostofsky SH, Puts NAJ, Robertson CE, Russo N, Shea N, Sideris J, Sutcliffe JS, Tavassoli T, Wallace MT, Wodka EL, Woynaroski TG. Examining the latent structure and correlates of sensory reactivity in autism: a multi-site integrative data analysis by the autism sensory research consortium. Mol Autism 2023; 14:31. [PMID: 37635263 PMCID: PMC10464466 DOI: 10.1186/s13229-023-00563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population. METHODS Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO, and SEEK (sub)constructs. RESULTS All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses supported the validity of a supra-modal HYPER construct (ωH = .800) but not a supra-modal HYPO construct (ωH = .653), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ωH = .800; 4/7 modalities). Modality-specific subscales demonstrated significant added value for all response patterns. Meta-analytic correlations varied by construct, although sensory features tended to correlate most with other domains of core autism features and co-occurring psychiatric symptoms (with general HYPER and speech HYPO demonstrating the largest numbers of practically significant correlations). LIMITATIONS Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to caregiver report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences. CONCLUSION Of the three sensory response patterns, only HYPER demonstrated sufficient evidence for valid interpretation at the supra-modal level, whereas supra-modal HYPO/SEEK constructs demonstrated substantial psychometric limitations. For clinicians and researchers seeking to characterize sensory reactivity in autism, modality-specific response pattern scores may represent viable alternatives that overcome many of these limitations.
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Affiliation(s)
- Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA.
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA.
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA.
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Roseann Schaaf
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
- Jefferson Autism Center of Excellence, Farber Institute of Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA
| | - Karla K Ausderau
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin-Madison, Madison, WI, USA
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Grace T Baranek
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - D Jonah Barrett
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Carissa J Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rachel L Dumont
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ekomobong E Eyoh
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | | | - Jacob I Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - Jennifer H Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Heather L Green
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shulamite A Green
- Department of Psychiatry and Biobehavioral Sciences, University of California - Los Angeles, Los Angeles, CA, USA
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Elizabeth A Kaplan-Kahn
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bahar Keçeli-Kaysılı
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
| | - Keren MacLennan
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- Department of Psychology, Durham University, Durham, UK
| | - Zoe Mailloux
- Department of Occupational Therapy, College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA
| | - Elysa J Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, CA, USA
| | - Lisa E Mash
- Division of Psychology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Elizabeth P McKernan
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sophie Molholm
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
- Dominick P. Purpura Department of Neuroscience, Rose F. Kennedy Intellectual and Developmental Disabilities Research Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicolaas A J Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Caroline E Robertson
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Natalie Russo
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Nicole Shea
- Department of Psychology, Syracuse University, Syracuse, NY, USA
- Division of Pulmonology and Sleep Medicine, Department of Pediatrics, Kaleida Health, Buffalo, NY, USA
| | - John Sideris
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - James S Sutcliffe
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Teresa Tavassoli
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Mark T Wallace
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Ericka L Wodka
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
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Ben-Sasson A, Podoly TY, Lebowitz ER. The Role of Pediatric Sensory Over-responsivity and Anxiety Symptoms in the Development of Family Accommodations. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01547-4. [PMID: 37219643 DOI: 10.1007/s10578-023-01547-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 05/24/2023]
Abstract
Sensory over-responsivity (SOR) is linked with elevated anxiety and reduced family wellbeing. Family accommodation of anxiety relates with greater symptom severity and reduced intervention outcome. This study examined the contribution of child SOR and co-occurring anxiety symptoms to family accommodation and its consequences. Ninety families of typically developing children (ages 4-13 years), completed an online survey including the Sensory Profile 2, Screen for Child Anxiety Related Emotional Disorders (SCARED), and Family Accommodation Sensory Scale (FASENS). FASENS scores include frequency of accommodation, child impact, and family impact.Children with elevated anxiety symptoms had significantly higher sensory and FASENS scores. Stepwise linear regression indicated that only SOR symptoms significantly predicted the frequency of sensory family accommodation, while both SOR and anxiety symptoms predicted the impact of family accommodation upon child and family well-being.Both SOR and anxiety symptoms in children predict the impact of sensory family accommodations on child and family well-being.
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Affiliation(s)
- Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, 199 Aba Hushi, Haifa, 3498838, Israel.
| | - Tamar Y Podoly
- Oti, Israeli Association for ASD, Reserach Center, Givat Shmuel, Israel
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Eli R Lebowitz
- Child Study Center, Yale University School of Medicine, New Haven, USA
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14
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Williams ZJ, Schaaf R, Ausderau KK, Baranek GT, Barrett DJ, Cascio CJ, Dumont RL, Eyoh EE, Failla MD, Feldman JI, Foss-Feig JH, Green HL, Green SA, He JL, Kaplan-Kahn EA, Keçeli-Kaysılı B, MacLennan K, Mailloux Z, Marco EJ, Mash LE, McKernan EP, Molholm S, Mostofsky SH, Puts NAJ, Robertson CE, Russo N, Shea N, Sideris J, Sutcliffe JS, Tavassoli T, Wallace MT, Wodka EL, Woynaroski TG. Examining the Latent Structure and Correlates of Sensory Reactivity in Autism: A Multi-site Integrative Data Analysis by the Autism Sensory Research Consortium. RESEARCH SQUARE 2023:rs.3.rs-2447849. [PMID: 36712092 PMCID: PMC9882639 DOI: 10.21203/rs.3.rs-2447849/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population. Methods Leveraging a combined sample of 3,868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO and SEEK (sub)constructs. Results All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses unambiguously supported the validity of a supra-modal HYPER construct (ω H = .800), whereas a coherent supra-modal HYPO construct was not supported (ω H = .611), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ω H = .799; 4/7 modalities). Within each sensory construct, modality-specific subscales demonstrated substantial added value beyond the supra-modal score. Meta-analytic correlations varied by construct, although sensory features tended to correlate most strongly with other domains of core autism features and co-occurring psychiatric symptoms. Certain subconstructs within the HYPO and SEEK domains were also associated with lower adaptive behavior scores. Limitations: Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to parent-report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences. Conclusion Psychometric issues may limit the degree to which some measures of supra-modal HYPO/SEEK can be interpreted. Depending on the research question at hand, modality-specific response pattern scores may represent a valid alternative method of characterizing sensory reactivity in autism.
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Schwarzlose RF, Tillman R, Hoyniak CP, Luby JL, Barch DM. Sensory Over-responsivity: A Feature of Childhood Psychiatric Illness Associated With Altered Functional Connectivity of Sensory Networks. Biol Psychiatry 2023; 93:92-101. [PMID: 36357217 PMCID: PMC10308431 DOI: 10.1016/j.biopsych.2022.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/20/2022] [Accepted: 09/21/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Sensory over-responsivity (SOR) is recognized as a common feature of autism spectrum disorder. However, SOR is also common among typically developing children, in whom it is associated with elevated levels of psychiatric symptoms. The clinical significance and neurocognitive bases of SOR in these children remain poorly understood and actively debated. METHODS This study used linear mixed-effects models to identify psychiatric symptoms and network-level functional connectivity (FC) differences associated with parent-reported SOR in the Adolescent Brain Cognitive Development (ABCD) Study, a large community sample (9 to 12 years of age) (N = 11,210). RESULTS Children with SOR constituted 18% of the overall sample but comprised more than half of the children with internalizing or externalizing scores in the clinical range. Controlling for autistic traits, both mild and severe SOR were associated with greater concurrent symptoms of depression, anxiety, obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder. Controlling for psychiatric symptoms and autistic traits, SOR predicted increased anxiety, attention-deficit/hyperactivity disorder, and prodromal psychosis symptoms 1 year later and was associated with FC differences in brain networks supporting sensory and salience processing in datasets collected 2 years apart. Differences included reduced FC within and between sensorimotor networks, enhanced sensorimotor-salience FC, and altered FC between sensory networks and bilateral hippocampi. CONCLUSIONS SOR is a common, clinically relevant feature of childhood psychiatric illness that provides unique predictive information about risk. It is associated with differences in brain networks that subserve tactile processing, implicating a neural basis for sensory differences in affected children.
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Affiliation(s)
- Rebecca F Schwarzlose
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
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Surgent O, Riaz A, Ausderau KK, Adluru N, Kirk GR, Guerrero-Gonzalez J, Skaletski EC, Kecskemeti SR, Dean III DC, Weismer SE, Alexander AL, Travers BG. Brainstem white matter microstructure is associated with hyporesponsiveness and overall sensory features in autistic children. Mol Autism 2022; 13:48. [PMID: 36536467 PMCID: PMC9762648 DOI: 10.1186/s13229-022-00524-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Elevated or reduced responses to sensory stimuli, known as sensory features, are common in autistic individuals and often impact quality of life. Little is known about the neurobiological basis of sensory features in autistic children. However, the brainstem may offer critical insights as it has been associated with both basic sensory processing and core features of autism. METHODS Diffusion-weighted imaging (DWI) and parent-report of sensory features were acquired from 133 children (61 autistic children with and 72 non-autistic children, 6-11 years-old). Leveraging novel DWI processing techniques, we investigated the relationship between sensory features and white matter microstructure properties (free-water-elimination-corrected fractional anisotropy [FA] and mean diffusivity [MD]) in precisely delineated brainstem white matter tracts. Follow-up analyses assessed relationships between microstructure and sensory response patterns/modalities and analyzed whole brain white matter using voxel-based analysis. RESULTS Results revealed distinct relationships between brainstem microstructure and sensory features in autistic children compared to non-autistic children. In autistic children, more prominent sensory features were generally associated with lower MD. Further, in autistic children, sensory hyporesponsiveness and tactile responsivity were strongly associated with white matter microstructure in nearly all brainstem tracts. Follow-up voxel-based analyses confirmed that these relationships were more prominent in the brainstem/cerebellum, with additional sensory-brain findings in the autistic group in the white matter of the primary motor and somatosensory cortices, the occipital lobe, the inferior parietal lobe, and the thalamic projections. LIMITATIONS All participants communicated via spoken language and acclimated to the sensory environment of an MRI session, which should be considered when assessing the generalizability of this work to the whole of the autism spectrum. CONCLUSIONS These findings suggest unique brainstem white matter contributions to sensory features in autistic children compared to non-autistic children. The brainstem correlates of sensory features underscore the potential reflex-like nature of behavioral responses to sensory stimuli in autism and have implications for how we conceptualize and address sensory features in autistic populations.
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Affiliation(s)
- Olivia Surgent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI USA
| | - Ali Riaz
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
| | - Karla K. Ausderau
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI USA
| | - Nagesh Adluru
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Radiology, University of Wisconsin-Madison, Madison, WI USA
| | - Gregory R. Kirk
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
| | - Jose Guerrero-Gonzalez
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI USA
| | - Emily C. Skaletski
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI USA
| | - Steven R. Kecskemeti
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
| | - Douglas C Dean III
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI USA
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI USA
| | - Susan Ellis Weismer
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Andrew L. Alexander
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI USA
| | - Brittany G. Travers
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705 USA
- Occupational Therapy Program in the Department of Kinesiology, University of Wisconsin-Madison, Madison, WI USA
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Interventions for Sensory Over-Responsivity in Individuals with Autism Spectrum Disorder: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101584. [PMID: 36291519 PMCID: PMC9601143 DOI: 10.3390/children9101584] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
Individuals with autism spectrum disorder (ASD) often exhibit sensory over-responsivity (SOR), which is characterized by an overwhelmingly negative reaction to or avoidance of sensory stimulation. Despite the detrimental effects of SOR on people’s personal and social lives, the knowledge of and interventions for the issue remain limited. This paper collates and reviews studies on SOR and information on the potential for effective interventions for people with ASD. This review reveals evidence that SOR has a close relationship with anxiety, depression, insomnia, and family life impairment and an underlying mechanism related to SOR. Four interventions and their theoretical bases in sensory-motor processing are discussed in this paper, namely, physical activity (PA), sensory integration therapy (SIT), mindfulness-based cognitive therapy (MBCT), and cognitive behavioral therapy (CBT). These interventions focus on establishing coping strategies for regulating the emotional response to sensory information, and they have been found to be effective and to have the potential to help children with ASD reduce their SOR behaviors. This paper provides guidance for selecting appropriate interventions and for further investigation of more effective interventions in the future.
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Efraim Kaufman A, Weissman-Fogel I, Rosenthal MZ, Kaplan Neeman R, Bar-Shalita T. Opening a window into the riddle of misophonia, sensory over-responsiveness, and pain. Front Neurosci 2022; 16:907585. [PMID: 35992931 PMCID: PMC9381840 DOI: 10.3389/fnins.2022.907585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Misophonia and sensory over-responsiveness (SOR) share physiological and psychological symptoms. While individuals with SOR demonstrate pain perception alterations, these were not explored in misophonia. Methods This exploratory study comprised thirty healthy adults with (n = 15; based on the Misophonia Questionnaire) and without misophonia. The Sensory Responsiveness Questionnaire (SRQ) was used for evaluating sensory responsiveness. In addition, psychophysical tests were applied for quantification of: (i) stimulus-response function of painful stimuli, (ii) the individual perceived pain intensity, (iii) pain modulation efficiency, (iv) auditory intensity discrimination capability, and (v) painful and unpleasantness responses to six ecological daily sounds using the Battery of Aversiveness to Sounds (BAS). Results Individuals with misophonia reported higher scores in the SRQ-Aversive (p = 0.022) and SRQ-Hedonic (p = 0.029) scales as well as in auditory (p = 0.042) and smell (p = 0.006) sub-scales, indicating higher sensory responsiveness. Yet they were not identified with the SOR type of sensory modulation dysfunction. Groups did not differ in the pain psychophysical tests, and in auditory discrimination test scores (p > 0.05). However, in the misophonia group the BAS evoked higher pain intensity (p = 0.046) and unpleasantness (p <0.001) ratings in the apple biting sound, and higher unpleasantness rating in the scraping a dish sound (p = 0.007), compared to the comparison group. Conclusion Findings indicate increased sensory responsiveness in individuals with misophonia, yet not defined as SOR. Thus, this suggests that misophonia and SOR are two distinct conditions, differing in their behavioral responses to painful and non-painful stimuli.
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Affiliation(s)
- Adi Efraim Kaufman
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - M. Zachary Rosenthal
- Department of Psychiatry and Behavioral Sciences, Center for Misophonia and Emotion Regulation, Duke University Medical Center, Durham, NC, United States
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ben-Sasson A, Podoly TY, Lebowitz E. Family Accommodation Scale for Sensory Over-Responsivity: A Measure Development Study. Front Psychol 2022; 13:867508. [PMID: 35651554 PMCID: PMC9150753 DOI: 10.3389/fpsyg.2022.867508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
Family accommodation refers to the attempt of family members (most often parents) to prevent their child's distress related to psychopathology. Family accommodation can limit meaningful participation in personal and social routines and activities. Accommodation has been studied extensively in the context of childhood anxiety and has been linked to greater impairment, and poor intervention outcomes. Like anxiety, sensory over-responsivity (SOR) symptoms are associated with heightened distress and thus, may also be accommodated by family members. The current study describes the validation of a new pediatric family accommodation scale for SOR. Parents of 301 children ages 3-13 years completed an online survey, of which 48 had medical or developmental conditions. The survey included the Child Sensory Profile 2 and the newly developed family accommodation scale for sensory over-responsivity (FASENS). Three Sensory Profile 2 scores were analyzed: SOR, sensory under-responsivity and sensory seeking. The FASENS consists of 18 items; 12 describing the frequency of accommodation behaviors and 6 describing the impact of the accommodation on the wellbeing of the family and the child. Results indicated that the FASENS has high internal consistency (α = 0.94) as well as a significant 3-factor confirmatory model fit: (1) accommodations (i.e., avoidance and changes), (2) family impact, and (3) child impact. FASENS scores significantly correlated with SOR symptoms (r = 0.52-0.60, p < 0.001). However, they also correlated with under-responsivity and seeking (r = 0.33-0.42, p < 0.001). Parents of children with health conditions reported significantly higher FASENS scores (p < 0.002), which corresponded with their child's significantly higher sensory scores (p < 0.001). Family accommodations for SOR occur to some extent in the general population, but their prevalence and impact are significantly greater when the child has a health condition, in addition to SOR. Additional research is needed to explore whether these accommodations are adaptive and whether families and children would benefit from learning to reduce them, as with anxiety.
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Affiliation(s)
- Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Tamar Yonit Podoly
- Association for Children at Risk, Kfar Saba, Israel
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Eli Lebowitz
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
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Siepsiak M, Rosenthal MZ, Raj-Koziak D, Dragan W. Psychiatric and audiologic features of misophonia: Use of a clinical control group with auditory over-responsivity. J Psychosom Res 2022; 156:110777. [PMID: 35259551 DOI: 10.1016/j.jpsychores.2022.110777] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 02/02/2022] [Accepted: 02/27/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This cross-sectional study was designed to add to the emerging empirical literature characterizing the psychiatric and audiologic features of misophonia. Because most research to date has not compared misophonia to clinical control groups, the present study used both participants who did not report any sound intolerance problems and a clinical control group of participants with auditory over-responsivity not formally meeting criteria for a diagnosis of misophonia using proposed diagnostic criteria by Schroeder et al. (2013). Severity of misophonia symptoms, frequency of current or lifetime psychiatric disorders, loudness discomfort, and hearing loss were compared across groups. METHODS Structured interviews, questionnaires, and objective measures of audiologic functioning were administered to a sample of adult participants (N = 156). Measures included an interviewer-rated diagnostic assessment of misophonia, the MisoQuest, (Siepsiak et al., 2020), M.I.N·I (Sheehan et al., 1998), loudness discomfort level (LDL), and hearing loss (PTA). RESULTS Group differences in misophonia symptom severity among all three groups were observed: FWelch (2,50.57) = 149.92, p < .001, n2 = 0.64, validating group assignment. Psychiatric disorders were significantly more frequent in the misophonia group (71%) than in the auditory over-responsivity group (40%) and control group (40%): X2 (2, N = 142) = 14.3; p = .001; V = 0.317. A wide range of psychiatric disorders were observed in the misophonia group, (e.g., major depressive episode, suicidality and panic disorder were the most common). There were no significant differences between groups with regards to audiologic functioning. CONCLUSION Misophonia co-occurs with a variety of psychiatric disorders but does not appear to be associated with loudness discomfort or hearing impairments.
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Affiliation(s)
- M Siepsiak
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.
| | - M Z Rosenthal
- Center for Misophonia and Emotion Regulation, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States; Department of Psychology and Neuroscience, Duke University, Durham, NC, United States.
| | - D Raj-Koziak
- Tinnitus Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland; Audiology and Phoniatrics Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
| | - W Dragan
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.
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21
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Podoly TY, Derby DS, Ben-Sasson A. Sensory over-responsivity and obsessive-compulsive disorder: Measuring habituation and sensitivity through self-report, physiological and behavioral indices. J Psychiatr Res 2022; 149:266-273. [PMID: 35305380 DOI: 10.1016/j.jpsychires.2022.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/01/2022] [Accepted: 02/28/2022] [Indexed: 11/19/2022]
Abstract
Individuals with obsessive-compulsive disorder (OCD) may report Sensory Over Responsivity (SOR), but evidence for specific shared mechanism is limited. This study investigated a habituation-sensitivity mechanism in individuals with OCD (n = 30). Sensory habituation and sensitivity were compared with a neurotypical sample, divided to high (n = 30) and low (n = 30) obsessive-compulsive symptoms (HOCS and LOCS). Participants completed self-report sensory questionnaires and a physiological protocol measuring Electro Dermal Activity (EDA) while presenting aversive and neutral sounds in two conditions: Aversive stimuli followed by neutral stimuli (AVfirst), or neutral stimuli followed by aversive stimuli (NEfirst). In addition, participants could shorten the stimulus duration by pressing a key. LOCS differed from HOCS and OCD in most sensory self-report scores, with no significant difference between OCD and HOCS. HOCS had no significant differences in habituation patterns across conditions, while OCD had no differences in habituation patterns in AVfirst (p = .08) but significantly slower habituation patterns to the NEfirst neutral stimuli (p < .001). Condition order determined sensitivity for LOCS (AVfirst p = .017; NEfirst p = .045) but not for OCD and HOCS. HOCS and OCD shortened aversive stimuli by key pressing more than LOCS, with no significant difference between OCD and HOCS. The habituation process of individuals with OCD and HOCS was more influenced by stimulus type than by condition order, which might be due to a cognitive bias of prediction. Individuals with elevated OCS have difficulty relying upon sensory input to respond adaptively to the environment. This process can explain the avoidant behavior and complains of individuals with OCD not being able to ignore and to habituate to the sensory environment. These evidence warrants design of psychoeducation and intervention methods for relying on prior sensory information to improve functioning in individuals with OCD and SOR.
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Affiliation(s)
- Tamar Y Podoly
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences University of Haifa, Mount Carmel, Haifa, Israel; Cognetica: the Israeli Center for Cognitive Behavioral Therapy, Tel-Aviv, Israel.
| | - Danny S Derby
- Cognetica: the Israeli Center for Cognitive Behavioral Therapy, Tel-Aviv, Israel
| | - Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences University of Haifa, Mount Carmel, Haifa, Israel
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22
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Hamed R, Mizrachi L, Granovsky Y, Issachar G, Yuval-Greenberg S, Bar-Shalita T. Neurofeedback Therapy for Sensory Over-Responsiveness-A Feasibility Study. SENSORS 2022; 22:s22051845. [PMID: 35270991 PMCID: PMC8914621 DOI: 10.3390/s22051845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022]
Abstract
Background: Difficulty in modulating multisensory input, specifically the sensory over-responsive (SOR) type, is linked to pain hypersensitivity and anxiety, impacting daily function and quality of life in children and adults. Reduced cortical activity recorded under resting state has been reported, suggestive of neuromodulation as a potential therapeutic modality. This feasibility study aimed to explore neurofeedback intervention in SOR. Methods: Healthy women with SOR (n = 10) underwent an experimental feasibility study comprising four measurement time points (T1—baseline; T2—preintervention; T3—postintervention; T4—follow-up). Outcome measures included resting-state EEG recording, in addition to behavioral assessments of life satisfaction, attaining functional goals, pain sensitivity, and anxiety. Intervention targeted the upregulation of alpha oscillatory power over ten sessions. Results: No changes were detected in all measures between T1 and T2. Exploring the changes in brain activity between T2 and T4 revealed power enhancement in delta, theta, beta, and gamma oscillatory bands, detected in the frontal region (p = 0.03−<0.001; Cohen’s d = 0.637−1.126) but not in alpha oscillations. Furthermore, a large effect was found in enhancing life satisfaction and goal attainment (Cohen’s d = 1.18; 1.04, respectively), and reduced pain sensitivity and anxiety trait (Cohen’s d = 0.70). Conclusion: This is the first study demonstrating the feasibility of neurofeedback intervention in SOR.
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Affiliation(s)
- Ruba Hamed
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Limor Mizrachi
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Yelena Granovsky
- Laboratory of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Rambam Health Care Campus, Technion, Haifa 3109601, Israel;
| | - Gil Issachar
- Biomedical Engineering Department, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Shlomit Yuval-Greenberg
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel;
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-525437631
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Stein Duker LI, Grager M, Giffin W, Hikita N, Polido JC. The Relationship between Dental Fear and Anxiety, General Anxiety/Fear, Sensory Over-Responsivity, and Oral Health Behaviors and Outcomes: A Conceptual Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042380. [PMID: 35206566 PMCID: PMC8872083 DOI: 10.3390/ijerph19042380] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 01/28/2023]
Abstract
Dental fear and anxiety (DFA) is common across the lifespan and represents a barrier to proper oral health behaviors and outcomes. The aim of this study is to present a conceptual model of the relationships between DFA, general anxiety/fear, sensory over-responsivity (SOR), and/or oral health behaviors and outcomes. Two rounds of literature searches were performed using the PubMed database. Included articles examined DFA, general anxiety/fear, SOR, catastrophizing, and/or oral health behaviors and outcomes in typically developing populations across the lifespan. The relationships between the constructs were recorded and organized into a conceptual model. A total of 188 articles were included. The results provided supporting evidence for relationships between DFA and all other constructs included in the model (general anxiety/fear, SOR, poor oral health, irregular dental attendance, dental behavior management problems [DBMP], and need for treatment with pharmacological methods). Additionally, SOR was associated with general anxiety/fear and DBMP; general anxiety/fear was linked to poor oral health, irregular attendance, and DBMP. This model provides a comprehensive view of the relationships between person factors (e.g., general anxiety/fear, SOR, and DFA) and oral health behaviors and outcomes. This is valuable in order to highlight connections between constructs that may be targeted in the development of new interventions to improve oral health behaviors and outcomes as well as the experience of DFA.
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Affiliation(s)
- Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
- Correspondence:
| | | | - Willa Giffin
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - Natasha Hikita
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (W.G.); (N.H.)
| | - José C. Polido
- Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA;
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Isaacs D, Key AP, Cascio CJ, Conley AC, Riordan H, Walker HC, Wallace MT, Claassen DO. Cross-disorder comparison of sensory over-responsivity in chronic tic disorders and obsessive-compulsive disorder. Compr Psychiatry 2022; 113:152291. [PMID: 34952304 PMCID: PMC8792289 DOI: 10.1016/j.comppsych.2021.152291] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Sensory over-responsivity (SOR) refers to excessively intense and/or prolonged behavioral responses to environmental stimuli typically perceived as non-aversive. SOR is prevalent in several neurodevelopmental disorders, including chronic tic disorders (CTDs) and obsessive-compulsive disorder (OCD). Few studies have examined the extent and clinical correlates of SOR across disorders, limiting insights into the phenomenon's transdiagnostic clinical and biological relevance. Such cross-disorder comparisons are of particular interest for CTDs and OCD given their frequent co-occurrence. OBJECTIVE We sought to compare the magnitude of SOR between adults with CTD and adults with OCD and to identify the clinical factors most strongly associated with SOR across these disorders. METHODS We enrolled 207 age- and sex-matched participants across four diagnostic categories: CTD without OCD (designated "CTD/OCD-"; n = 37), CTD with OCD ("CTD/OCD+"; n = 32), OCD without tic disorder ("OCD"; n = 69), and healthy controls (n = 69). Participants completed a self-report battery of rating scales assessing SOR (Sensory Gating Inventory, SGI), obsessive-compulsive symptoms (Dimensional Obsessive-Compulsive Scale, DOCS), inattention and hyperactivity (Adult ADHD Self-Report Screening Scale for DSM-5, ASRS-5), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). CTD participants were also administered the Yale Global Tic Severity Scale (YGTSS). To examine between-group differences in SOR, we compared SGI score across all groups and between pairs of groups. To examine the relationship of SOR with other clinical factors, we performed multivariable linear regression. RESULTS CTD/OCD-, CTD/OCD+, and OCD participants were 86.7%, 87.6%, and 89.5%, respectively, more likely to have higher SGI total scores than healthy controls. SGI total score did not differ between CTD/OCD-, CTD/OCD+, and OCD groups. In the regression model of log-transformed SGI total score, OCD diagnosis, DOCS score, and ASRS-5 score each contributed significantly to model goodness-of-fit, whereas CTD diagnosis and YGTSS total tic score did not. CONCLUSION SOR is prevalent in adults with CTD and in adults with OCD but does not significantly differ in magnitude between these disorders. Across CTD, OCD, and healthy control adult populations, SOR is independently associated with both obsessive-compulsive and ADHD symptoms, suggesting a transdiagnostic relationship between these sensory and psychiatric manifestations. Future cross-disorder, longitudinal, and translational research is needed to clarify the role and prognostic import of SOR in CTDs, OCD, and other neurodevelopmental disorders.
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Affiliation(s)
- David Isaacs
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Alexandra P Key
- Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, United States.
| | - Carissa J Cascio
- Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, United States; Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Alexander C Conley
- Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Heather Riordan
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Harrison C Walker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Mark T Wallace
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, United States; Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Department of Psychology, Vanderbilt University, Nashville, TN, United States.
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
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25
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Kozunova G, Novikov A, Stroganova T, Chernyshev B. Intolerance of Uncertainty and Challenges in Decision-making in Adults with High-Functioning Autism. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
<p style="text-align: justify;">Individuals with high-functioning autism have difficulties in decision-making in face of incomplete or ambiguous information, particularly in the context of social interaction. Tasks demanding an immediate response or deviation from the usual behavior make them feel excessive anxiety which restricts their social and professional activity. Attempts to camouflage their conservatism to others are one of the risk factors for comorbid depression. Therefore, they avoid new and non-routine situations, thus restricting their own social activity and professional development. On the other hand, insisting on sameness and clarity may give individuals with autism an advantage in long-lasting monotonous tasks. The aim of this review is to consider these symptoms from the perspective of predictive coding. A range of experimental studies has shown that most of the subjects with autism have difficulty in predicting the outcomes based on the cumulative history of interacting with the environment, as well as updating expectations as new evidence becomes available. These peculiarities of the analysis and pragmatic weighting of information may cause the trait intolerance of uncertainty and novelty avoidance of most people with autism.</p>
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Rosenthal MZ, Anand D, Cassiello-Robbins C, Williams ZJ, Guetta RE, Trumbull J, Kelley LD. Development and Initial Validation of the Duke Misophonia Questionnaire. Front Psychol 2021; 12:709928. [PMID: 34659024 PMCID: PMC8511674 DOI: 10.3389/fpsyg.2021.709928] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
Misophonia is characterized by decreased tolerance and accompanying defensive motivational system responding to certain aversive sounds and contextual cues associated with such stimuli, typically repetitive oral (e. g., eating sounds) or nasal (e.g., breathing sounds) stimuli. Responses elicit significant psychological distress and impairment in functioning, and include acute increases in (a) negative affect (e.g., anger, anxiety, and disgust), (b) physiological arousal (e.g., sympathetic nervous system activation), and (c) overt behavior (e.g., escape behavior and verbal aggression toward individuals generating triggers). A major barrier to research and treatment of misophonia is the lack of rigorously validated assessment measures. As such, the primary purpose of this study was to develop and psychometrically validate a self-report measure of misophonia, the Duke Misophonia Questionnaire (DMQ). There were two phases of measure development. In Phase 1, items were generated and iteratively refined from a combination of the scientific literature and qualitative feedback from misophonia sufferers, their family members, and professional experts. In Phase 2, a large community sample of adults (n = 424) completed DMQ candidate items and other measures needed for psychometric analyses. A series of iterative analytic procedures (e.g., factor analyses and IRT) were used to derive final DMQ items and scales. The final DMQ has 86 items and includes subscales: (1) Trigger frequency (16 items), (2) Affective Responses (5 items), (3) Physiological Responses (8 items), (4) Cognitive Responses (10 items), (5) Coping Before (6 items), (6) Coping During (10 items), (7) Coping After (5 items), (8) Impairment (12 items), and Beliefs (14 items). Composite scales were derived for overall Symptom Severity (combined Affective, Physiological, and Cognitive subscales) and Coping (combined the three Coping subscales). Depending on the needs of researchers or clinicians, the DMQ may be use in full form, individual subscales, or with the derived composite scales.
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Affiliation(s)
- M Zachary Rosenthal
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.,Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - Deepika Anand
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Clair Cassiello-Robbins
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, United States.,Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.,Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States.,Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
| | - Rachel E Guetta
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - Jacqueline Trumbull
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States
| | - Lisalynn D Kelley
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
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Abstract
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.
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28
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MacLennan K, Rossow T, Tavassoli T. The relationship between sensory reactivity, intolerance of uncertainty and anxiety subtypes in preschool-age autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2305-2316. [PMID: 34030518 DOI: 10.1177/13623613211016110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT This study found links between greater sensory hyperreactivity (e.g., over-sensitive to sensory input), intolerance of uncertainty and anxiety, including separation anxiety, in autistic pre-schoolers. Sensory hyperreactivity may predict both anxiety and intolerance of uncertainty, and anxiety and intolerance of uncertainty may both be mutually important, mediating factors. These findings have implications for early anxiety interventions. But there is a pressing need for objective assessments that can be used with preschool-age autistic children.
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Keating J, Bramham J, Downes M. Sensory modulation and negative affect in children at familial risk of ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 112:103904. [PMID: 33639605 DOI: 10.1016/j.ridd.2021.103904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/05/2021] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND/AIMS Sensory modulation difficulties are commonly reported in patients with ADHD, however there has been little focus on the development of these difficulties in young children at a higher risk of later ADHD diagnosis. This study investigated whether children with a familial history of ADHD show greater sensory modulation difficulties. We also explored whether sensory modulation was linked to negative affectivity, which has been highlighted as a potential early marker of ADHD. METHODS Parents of children under 6 years with a family history of ADHD (n = 65) and no family history (n = 122) completed questionnaires on sensory modulation and temperament. RESULTS Children from families with ADHD were reported to display extreme patterns of hyperresponsiveness and hyporesponsiveness, relative to controls. No differences emerged for the sensory seeking domain. Some children within the high-risk group reported high scores across all three sensory modulation patterns. Regression analysis revealed that hyperresponsiveness predicted higher levels of negative affect. CONCLUSIONS/IMPLICATIONS This study is the first to report greater sensory modulation difficulties in children at familial risk of ADHD. Future research should establish whether children with sensory modulation and temperament difficulties in early childhood are more vulnerable to developing ADHD.
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Affiliation(s)
- J Keating
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland.
| | - J Bramham
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
| | - M Downes
- School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland
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Faber J, Eldrup E, Selmer C, Pichat C, Hecquet SK, Watt T, Kreiner S, Karpatschof B, Gyntelberg F, Ballegaard S, Gjedde A. Reduction of Pressure Pain Sensitivity as Novel Non-pharmacological Therapeutic Approach to Type 2 Diabetes: A Randomized Trial. Front Neurosci 2021; 15:613858. [PMID: 33776633 PMCID: PMC7991917 DOI: 10.3389/fnins.2021.613858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background Autonomic nervous system dysfunction (ANSD) is known to affect glucose metabolism in the mammalian body. Tradition holds that glucose homeostasis is regulated by the peripheral nervous system, and contemporary therapeutic intervention reflects this convention. Objectives The present study tested the role of cerebral regulation of ANSD as consequence of novel understanding of glucose metabolism and treatment target in type 2 diabetes (T2D), suggested by the claim that the pressure pain sensitivity (PPS) of the chest bone periosteum may be a measure of cerebral ANSD. Design In a randomized controlled trial of 144 patients with T2D, we tested the claim that 6 months of this treatment would reduce PPS and improve peripheral glucose metabolism. Results In the active treatment group, mean glycated hemoglobin A1c (HbA1c) declined from 53.8 to 50.5 mmol/mol (intragroup p = 0.001), compared with the change from 53.8 to 53.4 mmol/mol in the control group, with the same level of diabetes treatment but not receiving the active treatment (between group p = 0.036). Mean PPS declined from 76.6 to 56.1 units (p < 0.001) in the active treatment group and from 77.5 to 72.8 units (p = 0.02; between group p < 0.001) in the control group. Changes of PPS and HbA1c were correlated (r = 0.37; p < 0.001). Conclusion We conclude that the proposed approach to treatment of T2D is a potential supplement to conventional therapy. Clinical Trial Registration: www.clinicaltrials.gov (NCT 03576430).
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Affiliation(s)
- Jens Faber
- Endocrine Unit, Department of Medicine, Herlev Gentofte University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ebbe Eldrup
- Endocrine Unit, Department of Medicine, Herlev Gentofte University Hospital, Herlev, Denmark
| | - Christian Selmer
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Caroline Pichat
- Endocrine Unit, Department of Medicine, Herlev Gentofte University Hospital, Herlev, Denmark
| | - Sofie Korsgaard Hecquet
- Endocrine Unit, Department of Medicine, Herlev Gentofte University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Torquil Watt
- Endocrine Unit, Department of Medicine, Herlev Gentofte University Hospital, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Svend Kreiner
- Institute of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Benny Karpatschof
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Finn Gyntelberg
- The National Research Center for the Working Environment, Copenhagen, Denmark
| | - Søren Ballegaard
- Endocrine Unit, Department of Medicine, Herlev Gentofte University Hospital, Herlev, Denmark
| | - Albert Gjedde
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark.,Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
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31
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Williams ZJ, He JL, Cascio CJ, Woynaroski TG. A review of decreased sound tolerance in autism: Definitions, phenomenology, and potential mechanisms. Neurosci Biobehav Rev 2021; 121:1-17. [PMID: 33285160 PMCID: PMC7855558 DOI: 10.1016/j.neubiorev.2020.11.030] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022]
Abstract
Atypical behavioral responses to environmental sounds are common in autistic children and adults, with 50-70 % of this population exhibiting decreased sound tolerance (DST) at some point in their lives. This symptom is a source of significant distress and impairment across the lifespan, contributing to anxiety, challenging behaviors, reduced community participation, and school/workplace difficulties. However, relatively little is known about its phenomenology or neurocognitive underpinnings. The present article synthesizes a large body of literature on the phenomenology and pathophysiology of DST-related conditions to generate a comprehensive theoretical account of DST in autism. Notably, we argue against conceptualizing DST as a unified construct, suggesting that it be separated into three phenomenologically distinct conditions: hyperacusis (the perception of everyday sounds as excessively loud or painful), misophonia (an acquired aversive reaction to specific sounds), and phonophobia (a specific phobia of sound), each responsible for a portion of observed DST behaviors. We further elaborate our framework by proposing preliminary neurocognitive models of hyperacusis, misophonia, and phonophobia that incorporate neurophysiologic findings from studies of autism.
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Affiliation(s)
- Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, 221 Eskind Biomedical Library and Learning Center, 2209 Garland Ave., Nashville, TN, 37240, United States; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, United States; Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States.
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Strand Building, Strand Campus, Strand, London, WC2R 2LS, London, United Kingdom.
| | - Carissa J Cascio
- Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 2254 Village at Vanderbilt, 1500 21st Ave South, Nashville, TN, 37212, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, United States.
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, United States; Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, United States.
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32
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McLean MA, Niknafs N, Scoten OC, Chau CMY, MacKay M, Weinberg J, Synnes A, Miller SP, Grunau RE. Sensory processing and cortisol at age 4 years: Procedural pain-related stress in children born very preterm. Dev Psychobiol 2020; 63:915-930. [PMID: 33377181 DOI: 10.1002/dev.22079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/08/2020] [Accepted: 12/07/2020] [Indexed: 12/28/2022]
Abstract
Children born preterm display altered sensory processing, which may manifest as hyper- and/or hypo-sensitivity to sensory information. In this vulnerable population, exposure to neonatal pain-related stress is associated with altered stress regulation, as indexed by alterations in cortisol levels. It is unknown whether sensory processing behaviors are also affected by early life adversity, and whether dysregulated cortisol is related to sensory processing problems in preterm children. We examined relationships between neonatal pain-related stress, sensory processing profiles and cortisol levels at age 4 years, and whether pathways were sex-specific. In a longitudinal prospective cohort study, N = 146 infants born 24-32 weeks gestational age were recruited from BC Women's Hospital, Vancouver, BC, Canada; neonatal factors were collected from daily chart review. At age 4 years, saliva to assay cortisol was collected three times across cognitive assessment (pre-test, during, end) and parents completed the Short Sensory Profile questionnaire. Using generalized linear modeling, independent of other neonatal factors, higher number of invasive procedures (pain/stress) was associated with more sensory processing problems (total, hypo- and hyper-sensitivity) for girls only. After accounting for neonatal factors, greater cortisol output across the assessment was associated with more total sensory processing problems in girls only, and hypersensitivity to sensory input in both boys and girls. Findings suggest that in children born very preterm, how a child responds to sensory input and cortisol reactivity to stress are related but may have different precursors. Girls may be somewhat more susceptible to neonatal pain-related stress exposure in relation to sensory processing at preschool age.
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Affiliation(s)
- Mia A McLean
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Nikoo Niknafs
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.,BC Women's Hospital, Vancouver, BC, Canada
| | - Olivia C Scoten
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Cecil M Y Chau
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | | | - Joanne Weinberg
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Cellular & Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Anne Synnes
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.,BC Women's Hospital, Vancouver, BC, Canada
| | - Steven P Miller
- Department of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Ruth E Grunau
- BC Children's Hospital Research Institute, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.,BC Women's Hospital, Vancouver, BC, Canada
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33
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Tillmann J, Uljarevic M, Crawley D, Dumas G, Loth E, Murphy D, Buitelaar J, Charman T. Dissecting the phenotypic heterogeneity in sensory features in autism spectrum disorder: a factor mixture modelling approach. Mol Autism 2020; 11:67. [PMID: 32867850 PMCID: PMC7457751 DOI: 10.1186/s13229-020-00367-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Heterogeneity in the phenotypic presentation of autism spectrum disorder (ASD) is apparent in the profile and the severity of sensory features. Here, we applied factor mixture modelling (FMM) to test a multidimensional factor model of sensory processing in ASD. We aimed to identify homogeneous sensory subgroups in ASD that differ intrinsically in their severity along continuous factor scores. We also investigated sensory subgroups in relation to clinical variables: sex, age, IQ, social-communication symptoms, restricted and repetitive behaviours, adaptive functioning and symptoms of anxiety and attention-deficit/hyperactivity disorder. METHODS Three hundred thirty-two children and adults with ASD between the ages of 6 and 30 years with IQs varying between 40 and 148 were included. First, three different confirmatory factor models were fit to the 38 items of the Short Sensory Profile (SSP). Then, latent class models (with two-to-six subgroups) were evaluated. The best performing factor model, the 7-factor structure, was subsequently used in two FMMs that varied in the number of subgroups: a two-subgroup, seven-factor model and a three-subgroup and seven-factor model. RESULTS The 'three-subgroup/seven-factor' FMM was superior to all other models based on different fit criteria. Identified subgroups differed in sensory severity from severe, moderate to low. Accounting for the potential confounding effects of age and IQ, participants in these sensory subgroups had different levels of social-communicative symptoms, restricted and repetitive behaviours, adaptive functioning skills and symptoms of inattention and anxiety. LIMITATIONS Results were derived using a single parent-report measure of sensory features, the SSP, which limits the generalisability of findings. CONCLUSION Sensory features can be best described by three homogeneous sensory subgroups that differ in sensory severity gradients along seven continuous factor scores. Identified sensory subgroups were further differentiated by the severity of core and co-occurring symptoms, and level of adaptive functioning, providing novel evidence on the associated clinical correlates of sensory subgroups. These sensory subgroups provide a platform to further interrogate the neurobiological and genetic correlates of altered sensory processing in ASD.
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Affiliation(s)
- J Tillmann
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. .,Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria.
| | - M Uljarevic
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford Autism Center, Stanford University, Stanford, CA, USA.,Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.,School of Psychological Science, Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, 3086, Australia
| | - D Crawley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G Dumas
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, Université de Paris, Paris, France
| | - E Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK
| | - J Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - T Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK
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34
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MacCormack JK, Castro VL, Halberstadt AG, Rogers ML. Mothers' interoceptive knowledge predicts children's emotion regulation and social skills in middle childhood. SOCIAL DEVELOPMENT 2020. [DOI: 10.1111/sode.12418] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Jennifer K. MacCormack
- Department of Psychology and Neuroscience University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Vanessa L. Castro
- Department of Psychology North Carolina State University Raleigh NC USA
| | | | - Megan L. Rogers
- Department of Psychology Florida State University Tallahassee FL USA
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35
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MacLennan K, Roach L, Tavassoli T. The Relationship Between Sensory Reactivity Differences and Anxiety Subtypes in Autistic Children. Autism Res 2020; 13:785-795. [PMID: 31909874 DOI: 10.1002/aur.2259] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 12/28/2022]
Abstract
Autistic children are at greater risk of developing anxiety than their nonautistic peers. Sensory reactivity differences have been implicated as one of the risk factors. Specifically, sensory hyperreactivity has previously been linked to anxiety, including separation anxiety and specific phobia; however, minimal research has explored the influence of sensory hyporeactivity and seeking. Therefore, the present study examined the correlational relationship between sensory reactivity differences and anxiety subtypes in 41 autistic children aged between 3 and 14 years, using parent- and self-reported measures. We found positive correlations between sensory hyperreactivity and total anxiety, separation anxiety and physical injury fears. However, when controlling for autism traits, we found sensory hyperreactivity to be related to physical injury fears and specific phobia, and sensory hyporeactivity to be related to lower total and social anxiety. We found no significant relationships between sensory seeking and anxiety. These results indicate that sensory hyperreactivity and hyporeactivity might be implicated in specific anxiety symptomology. Our results also indicate minimal agreement between parent- and self-reported anxieties, which highlights the limitations of informant reports for anxiety and the pressing need for objective anxiety assessments for autistic children to be developed. Our findings have important implications for limiting the development of anxiety in autistic children and suggest that sensory reactivity differences should be considered when developing targeted interventions for certain anxiety disorders. Autism Res 2020, 13: 785-795. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: The present study found that when considering autism traits, greater sensory hyperreactivity, such as being oversensitive to sounds, was related to elevated phobia-related symptoms and sensory hyporeactivity, such as being under-responsive to touch, was related to lower total and social anxieties. Sensory seeking, such as a fascination with lights, was not related to anxiety. Our results have important implications for targeted anxiety interventions for autistic children. However, due to minimal agreement between the parent- and child-reported scores, developing more objective measures of anxiety would be beneficial.
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36
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Lane SJ, Reynolds S. Sensory Over-Responsivity as an Added Dimension in ADHD. Front Integr Neurosci 2019; 13:40. [PMID: 31555103 PMCID: PMC6742721 DOI: 10.3389/fnint.2019.00040] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/02/2019] [Indexed: 01/07/2023] Open
Abstract
Years of research have added to our understanding of Attention Deficit Hyperactivity Disorder (ADHD). None-the-less there is still much that is poorly understood. There is a need for, and ongoing interest in, developing a deeper understanding of this disorder to optimally identify risk and better inform treatment. Here, we present a compilation of findings examining ADHD both behaviorally and using neurophysiologic markers. Drawing on early work of McIntosh and co-investigators, we examined response to sensory challenge in children with ADHD, measuring HPA activity and electrodermal response (EDR) secondary to sensory stressors. In addition, we have examined the relationship between these physiologic measures, and reports of behavioral sensory over-responsivity and anxiety. Findings suggest that sensory responsivity differentiates among children with ADHD and warrants consideration. We link these findings with research conducted both prior to and after our own work and emphasize that there a growing knowledge supporting a relationship between ADHD and sensory over-responsivity, but more research is needed. Given the call from the National Institute of Health to move toward a more dimensional diagnostic process for mental health concerns, and away from the more routine categorical diagnostic process, we suggest sensory over-responsivity as a dimension in the diagnostic process for children with ADHD.
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Affiliation(s)
- Shelly J. Lane
- Department of Occupational Therapy, College of Health and Human Science, Colorado State University, Fort Collins, CO, United States
- Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Stacey Reynolds
- Department of Occupational Therapy, Kathryn Lawrence Dragas Sensory Processing and Stress Evaluation Laboratory, Virginia Commonwealth University, Richmond, VA, United States
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