Relationship Among Sensory Over-Responsivity, Problem Behaviors, and Anxiety in Emerging Adults with Autism Spectrum Disorder

Association between Mothers' Emotional Problems and Autistic Children's Behavioral Problems: The Moderating Effect of Parenting Style

Mothers' emotional problems are associated with autistic children's behavioral problems. We aim to test whether parenting styles moderate associations between mothers' mood symptoms and autistic children's behavioral problems. A sample of 80 mother-autistic child dyads were enrolled at three rehabilitation facilities in Guangzhou, China. The Social Communication Questionnaire (SCQ) and the Strengths and Difficulties Questionnaire (SDQ) were used to collect the autistic symptoms and behavioral problems of the children. Mothers' depression and anxiety symptoms were measured using the Patient Health Questionnaire 9 (PHQ-9) and the General Anxiety Disorder 7-item (GAD-7) scale, respectively, and parenting styles were measured using the Parental Behavior Inventory (PBI). Our results show that mothers' anxiety symptoms were negatively associated with their children's prosocial behavior scores (β = -0.26, p < 0.05) but positively related to their social interaction scores (β = 0.31, p < 0.05). Supportive/engaged parenting styles positively moderated the effects of mothers' anxiety symptoms on their prosocial behavior score (β = 0.23, p = 0.026), whereas hostile/coercive parenting styles had a negative moderation (β = -0.23, p = 0.03). Moreover, hostile/coercive parenting styles positivity moderated the effects of mothers' anxiety symptoms on social interaction problems (β= 0.24, p < 0.05). The findings highlight, where mothers adopted a hostile/coercive parenting style while experiencing high anxiety, their autistic child may have more serious behavioral problems.

Sensory Processing and Autistic Traits: Mediation Effect of Frontal Alpha Asymmetry

A sensory processing approach can be used to intervene with behaviours in individuals with autistic symptoms. However, neural mechanisms linking sensory processing patterns and autistic features are less understood. The purpose of this study was to investigate whether frontal alpha asymmetry could mediate the relationship between atypical sensory processing and autistic traits. Seventy-three neurotypical young adults were included in this study. Resting-state brain activity was recorded using electroencephalography. After the recording, participants completed the Adolescent/Adult Sensory Profile and the Autism-Spectrum Quotient. Frontal alpha asymmetry was calculated by subtracting left frontal alpha power from right frontal alpha power. Correlation analysis was performed to find which sensory processing patterns were related to frontal alpha asymmetry and autistic traits. Mediation analysis was then conducted with sensory avoiding patterns as an independent variable, autistic traits as a dependent variable, and frontal alpha asymmetry as a mediator. Interrelations between higher sensation avoiding patterns, greater right-sided cortical activity, and increased autistic traits were found. The sensation avoiding patterns affected autistic traits directly and indirectly through right-sided cortical activity. Findings of the current study demonstrate a mediating role of frontal alpha asymmetry in the relationship between sensation avoiding patterns and autistic traits in neurotypical adults. This study suggests that sensation avoiding patterns and withdrawal-related emotions, which are associated with right-sided cortical activity, need to be considered to improve autism symptoms.

Interventions for Sensory Over-Responsivity in Individuals with Autism Spectrum Disorder: A Narrative Review

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.

The relationship between communication skills, sensory difficulties, and anxiety in children with autism spectrum disorder

Background

Despite the high prevalence of communicational differences, anxiety, and sensory processing difficulties in children with autism spectrum disorder (ASD), little is known about the nature of their experiences. Thus, the present study aimed to explore the correlation between communication skills, sensory difficulties, and anxiety in children with ASD. Fifty-three children with ASD (Mage = 8.51, SD = 2.51; males = 42) were recruited. The Persian version of the Short Sensory Profile (SSP), the Children’s Communication Checklist (CCC), and the Spence Children’s Anxiety Scale (SCAS) was used to assess the variables.

Results

The overall sensory score of children with ASD was significantly and positively correlated with most of the communication skills (P < 0.05). The overall sensory score of children with ASD was significantly and negatively correlated with all anxiety subsets of these children (P < 0.05). The social relationships score of children with ASD had a significant and negative correlation with all subsets of anxiety and a significant and positive correlation with all sensory subsets (P < 0.05). The total score of communication was significantly and negatively related to all subsets of anxiety except separation anxiety (P < 0.05).

Conclusions

Sensory processing difficulties in ASD children appear to be significantly associated with communication skills and anxiety acts as a mediator between the two.

Cross-disorder comparison of sensory over-responsivity in chronic tic disorders and obsessive-compulsive disorder

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.

A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder

While long described in anecdotal accounts of the lived experiences of autistic individuals, the phenomenon of behaving in ways that appear inconsistent with the presence of autism (or passing as non-autistic; PAN) has recently seen a dramatic increase in scrutiny in the published scientific literature. Increased research attention has coincided with a proliferation of methods, definitions, measures, and population assumptions associated with PAN. To date, however, no review has sought to systematically identify and synthesize the literature on PAN. This systematic review reflects the state of the PAN literature as of May 2020. Ninety articles were screened, 66 were identified for evaluation, and 46 met inclusion criteria and were reliably coded for study characteristics and participant characteristics. Results reveal that the PAN literature includes a relatively even mix of qualitative, quantitative, and mixed-method studies, and that a variety of terms are used for PAN (with masking and camouflage being the most frequent). Sample sizes varied widely (from one to 832 participants), with 63.06% of participants being categorized as autistic. Nearly all studies reported methods for confirming autism diagnoses, with community and clinical diagnoses being most common. The majority of studies reported participant gender, with slightly more females included than males on average, but fewer than half of all studies compared PAN across genders. Nearly all studies reported participant age, demonstrating a wide range of 2 to 79 years, with a mean age of 23.85. Conversely, only 23.91% of studies provided participant race or ethnicity data. Nearly all studies formally or informally excluded participants with intellectual disability. Finally, measures of internalizing symptoms, which are often thought to be linked to PAN, were reported in only 17.4% of studies. Implications for gaps in understanding of PAN and future directions for the field are discussed.