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McKenna K, Prasad S, Cooper J, King AM, Shahzeidi S, Mittal J, Zalta M, Mittal R, Eshraghi AA. Incidence of Otolaryngological Manifestations in Individuals with Autism Spectrum Disorder: A Special Focus on Auditory Disorders. Audiol Res 2024; 14:35-61. [PMID: 38247561 PMCID: PMC10801499 DOI: 10.3390/audiolres14010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by stereotyped and repetitive behavior patterns. In addition to neurological and behavioral problems, individuals with ASD commonly experience otolaryngological comorbidities. Individuals with ASD often have auditory disorders including hearing loss and auditory processing disorders such as central auditory processing disorder (CAPD), as well as both chronic and recurrent otitis media. These challenges negatively impact a person's ability to effectively communicate and may further impact their neurological functioning, particularly when not appropriately treated. Individuals diagnosed with ASD also have difficulty sleeping which contributes to increased irritability and may further aggravate the core behavioral symptoms of autism. The individuals with ASD also have a higher rate of sinusitis which contributes to the worsening of the autism behavior phenotype. The high prevalence of otolaryngological comorbidities in individuals with ASD warrants a better collaboration between their various healthcare providers and otolaryngologists with expertise in auditory, sleep, and sinus disorders in pursuit of improving the quality of life of affected individuals and their families/caregivers.
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Affiliation(s)
- Keelin McKenna
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, USA
| | - Soumil Prasad
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
| | - Jaimee Cooper
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
| | - Ava M. King
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
| | | | - Jeenu Mittal
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
| | - Max Zalta
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
| | - Rahul Mittal
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
| | - Adrien A. Eshraghi
- Hearing Research and Cochlear Implant Laboratory, Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (K.M.); (S.P.); (J.C.); (A.M.K.); (J.M.); (R.M.)
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL 33146, USA
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Carson TB, Qiu Y, Liang L, Medina AM, Ortiz A, Condon CA, Ryan N, Ambrosio J, Carcamo K, Miranda D, Palacio-Raine A. Development and validation of a paediatric version of the Khalfa Hyperacusis Questionnaire for children with and without autism. Int J Audiol 2023; 62:1187-1195. [PMID: 36053255 DOI: 10.1080/14992027.2022.2113827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 08/11/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Hyperacusis is reported to occur in 3.2-17.1% of the general paediatric population with higher rates in clinical populations such as autism spectrum disorders (ASD). Although hyperacusis is a relatively common form of decreased sound tolerance (DST), no valid paediatric hyperacusis measures are currently available. The purpose of the present study was to develop and validate a paediatric version of the Khalfa Hyperacusis Questionnaire (HQ) as a first step towards filling this measurement gap. DESIGN A cross-sectional design was used to evaluate therapist opinions of the paediatric version (P-HQ) and to field test the P-HQ in parents of children with and without ASD. Total scores were compared between ASD and non-ASD groups. STUDY SAMPLE Eleven paediatric occupational and speech therapists with expertise in ASD, 64 parents of children with ASD and 37 parents of children without ASD completed online questionnaires. Psychometric analyses were conducted. RESULTS A unidimensional construct was found underlying P-HQ and all items displayed sufficient theoretical relevance to hyperacusis and adequate psychometric properties. CONCLUSIONS The P-HQ demonstrates good internal consistency and shows promise as a potential screening tool for identifying DST in ASD. Further research is warranted to establish normative data and validate cut-off scores.
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Affiliation(s)
- Tana B Carson
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Yuxi Qiu
- Department of Department of Counseling, Recreation and School Psychology, College of Arts, Sciences and Education, Florida International University, Miami, FL, USA
| | - Lu Liang
- Department of Psychology, College of Arts, Sciences and Education, Florida International University, Miami, FL, USA
| | - Angela M Medina
- Department of Communication Sciences and Disorders, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Annie Ortiz
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Courtney A Condon
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Nicaela Ryan
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Jenna Ambrosio
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Karina Carcamo
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Dana Miranda
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Alexandra Palacio-Raine
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
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Gimlette S, Stapleton E. The interface of paediatric ENT and autism spectrum disorder: a complex conundrum for otolaryngologists. J Laryngol Otol 2023; 137:1083-1089. [PMID: 36073036 DOI: 10.1017/s0022215122001980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Autism spectrum disorder is a lifelong neurodevelopmental condition encompassing complex physical and neurological symptoms, including complex sensory symptoms. This review explores the interface between autism spectrum disorder and paediatric ENT. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses ('PRISMA') guideline, a robust literature search and review was conducted by two researchers. Thirty-four papers were filtered into the final review. RESULTS Published literature clearly demonstrates potential for autism spectrum disorder to present in the form of auditory and other sensory symptoms to ENT surgeons and audiologists who may not fully appreciate this complex condition. Despite this well-documented link, auditory symptoms, auditory processing disorders and hearing loss within autism spectrum disorder remain poorly understood. CONCLUSION Improved recognition and understanding of autism spectrum disorder by otolaryngologists could enable more effective diagnostic and management strategies for autistic children who present with auditory and other sensory symptoms. In light of the current 'autism epidemic,' there is an urgent need for further research on this theme.
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Affiliation(s)
- S Gimlette
- University of Manchester Medical School, Manchester, UK
| | - E Stapleton
- Department of Otolaryngology, Manchester Royal Infirmary, UK
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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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Li Y, Xie T, Cardoso Melo RD, de Vries M, Lakerveld J, Zijlema W, Hartman CA. Longitudinal effects of environmental noise and air pollution exposure on autism spectrum disorder and attention-deficit/hyperactivity disorder during adolescence and early adulthood: The TRAILS study. ENVIRONMENTAL RESEARCH 2023; 227:115704. [PMID: 36940817 DOI: 10.1016/j.envres.2023.115704] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Exposure to ambient noise and air pollution may affect the manifestation and severity of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). However, evidence is limited, and most studies solely assessed environmental exposures during pregnancy and early childhood. OBJECTIVE To examine the longitudinal effects of ambient noise and air pollutants on ASD and ADHD symptom severity during adolescence and early adulthood. METHODS Using a longitudinal design, we included 2750 children between 10 and 12 years old from the TRacking Adolescents' Individual Lives Survey (TRAILS) in the Netherlands, who were assessed in 6 waves from 2001 to 2017. ASD was measured by the Children's Social Behavior Questionnaire and the Adult Social Behavior Questionnaire. ADHD was measured by Child Behavior Checklist and the Adult Behavior Checklist. Ambient noise and air pollution exposures, including Ozone (O3), soot, sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter 2.5 (PM2.5), and PM10 were modeled at the residential level according to standardized protocols. The longitudinal associations between exposures and symptom outcomes were examined using linear mixed models. RESULTS We found evidence that higher levels of exposure to PM were associated with more severe ASD and ADHD symptoms. This association decreased over time. We did not observe any other consistent associations of noise or other air pollutants with ASD and ADHD severity. CONCLUSION The current study provides evidence for the negative impact of PM on ASD and ADHD symptoms. We did not find evidence of the negative health impact of other air pollutants and noise exposures on ASD or ADHD symptoms. Our study adds more evidence on the presence of associations between PM air pollution and neurodevelopmental diseases among adolescents and young adults.
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Affiliation(s)
- Yiran Li
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, Groningen, Netherlands.
| | - Tian Xie
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, Groningen, Netherlands.
| | - Raniere Dener Cardoso Melo
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, Groningen, Netherlands
| | - Maaike de Vries
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, Netherlands
| | - Jeroen Lakerveld
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Wilma Zijlema
- The Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003, Barcelona, Spain; CIBER Epidemiolo'gıa y Salud Pública (CIBERESP), Melchor Fernandez ' Almagro, 3-5, 28029, Madrid, Spain
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, Groningen, Netherlands
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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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Auditory symptoms and autistic spectrum disorder: A scoping review and recommendations for future research. J Otol 2022; 17:239-246. [PMID: 36249920 PMCID: PMC9547110 DOI: 10.1016/j.joto.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/24/2022] [Indexed: 11/22/2022] Open
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Williams ZJ, Cascio CJ, Woynaroski TG. Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The duke-vanderbilt misophonia screening questionnaire. Front Psychol 2022; 13:897901. [PMID: 35936331 PMCID: PMC9355318 DOI: 10.3389/fpsyg.2022.897901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Misophonia is a newly described disorder of sound tolerance characterized by strong negative emotional reactions to specific "trigger" sounds, resulting in significant distress, pathological avoidance, and impairment in daily life. Research on misophonia is still in its infancy, and most existing psychometric tools for assessing misophonia symptoms have not been extensively validated. The purpose of the current study was to introduce and psychometrically validate the duke-vanderbilt Misophonia Screening Questionnaire (DVMSQ), a novel self-report measure of misophonia symptoms that can be used to determine misophonia "caseness" in clinical and research settings. Employing large online samples of general population adults (n = 1403) and adults on the autism spectrum (n = 936), we rigorously evaluated the internal structure, reliability, validity, and measurement invariance of the DVMSQ. Results indicated that 17 of the 20 original DVMSQ items fit well to a bifactor structure with one "general misophonia" factor and four specific factors (anger/aggression, distress/avoidance, impairment, and global impact). DVMSQ total and subscale scores were highly reliable in both general population and autistic adult samples, and the measure was found to be approximately invariant across age, sex, education level, and autism status. DVMSQ total scores also correlated strongly with another measure of misophonia symptoms (Duke Misophonia Questionnaire-Symptom Scale), with correlations between these two measures being significantly stronger than correlations between the DVMSQ and scales measuring other types of sound intolerance (Inventory of Hyperacusis Symptoms [General Loudness subscale] and DSM-5 Severity Measure for Specific Phobia [modified for phonophobia]). Additionally, DVMSQ items were used to operationalize diagnostic criteria for misophonia derived from the Revised Amsterdam Criteria, which were further updated to reflect a recent consensus definition of misophonia (published after the development of the DVMSQ). Using the new DVMSQ algorithm, 7.3% of general population adults and 35.5% of autistic adults met criteria for clinically significant misophonia. Although additional work is needed to further investigate the psychometric properties of the DVMSQ and validate its theory-based screening algorithm using best-estimate clinical diagnoses, this novel measure represents a potentially useful tool to screen for misophonia and quantify symptom severity and impairment in both autistic adults and the general population.
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Affiliation(s)
- 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,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States,*Correspondence: Zachary J. Williams,
| | - Carissa J. Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States,Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Tiffany G. Woynaroski
- 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,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States,Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, United States
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Bi XB, He HZ, Lin HY, Fan XZ. Influence of Social Support Network and Perceived Social Support on the Subjective Wellbeing of Mothers of Children With Autism Spectrum Disorder. Front Psychol 2022; 13:835110. [PMID: 35401352 PMCID: PMC8989138 DOI: 10.3389/fpsyg.2022.835110] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
This study explored the relations between the social support network of mothers of children with autism spectrum disorder (ASD), perceived social support, and their subjective wellbeing. The participants were mothers of children with ASD in Shanghai. Their social support network structure was explored via the nomination method. Perceived social support was measured using the Revised Social Provisions Scale for Autism (R-SPS-A), and the mothers’ subjective wellbeing was assessed using the Index of Wellbeing, Index of General Affect. A significant correlation was observed between the subjective wellbeing of mothers of children with ASD and perceived social support. Meanwhile, perceived social support was significantly correlated with the effectiveness of overall social support. Finally, perceived social support was also significantly correlated with the network size of social support. Moreover, the effectiveness of social support was significantly associated with the network size of social support and was highly significantly associated with the degree of intimacy of social support. Furthermore, the network size of instrumental support has a significant influence on all perceived social support subdimensions. Overall, social support effectiveness plays an important role in the social support network mechanism on perceived social support and subjective wellbeing in China.
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Affiliation(s)
- Xiao-bin Bi
- Department of Special Education, Faculty of Education, East China Normal University, Shanghai, China
| | - Hui-zhong He
- Department of Special Education, Faculty of Education, East China Normal University, Shanghai, China
- Department of Special Education, Faculty of Education, Beijing Normal University, Beijing, China
- *Correspondence: Hui-zhong He,
| | - Hai-ying Lin
- Shanghai Rehabilitation Center for Children With Disabilities, Shanghai, China
| | - Xiao-zhuang Fan
- Department of Special Education, Faculty of Education, East China Normal University, Shanghai, China
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