Annotation: What Do We Know about Sensory Dysfunction in Autism? A Critical Review of the Empirical Evidence

M.I.N.D. Institute & Department of Psychiatry and Behavioral Sciences, University of California-Davis, CA 95817, USA.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 01/2006; 46(12):1255-68. DOI: 10.1111/j.1469-7610.2005.01431.x
Source: PubMed


Unusual responses to sensory stimuli are seen in many children with autism. Their presence was highlighted both in early accounts of autism and in more recent first-person descriptions. There is a widespread belief that sensory symptoms characterize autism and differentiate it from other disorders. This paper examines the empirical evidence for this assumption.
All controlled experimental laboratory investigations published since 1960 were identified through systematic searches using Medline/PubMed and PsycInfo search engines. A total of 48 empirical papers and 27 theoretical or conceptual papers were reviewed.
Sensory symptoms are more frequent and prominent in children with autism than in typically developing children, but there is not good evidence that these symptoms differentiate autism from other developmental disorders. Certain groups, including children with fragile X syndrome and those who are deaf-blind, appear to demonstrate higher rates of sensory symptoms than children with autism. In reviewing the evidence relevant to two theories of sensory dysfunction in autism, over- and under-arousal theory, we find that there is very little support for hyper-arousal and failure of habituation in autism. There is more evidence that children with autism, as a group, are hypo-responsive to sensory stimuli, but there are also multiple failures to replicate findings and studies that demonstrate lack of group differences.
The use of different methods, the study of different sensory modalities, and the changing scientific standards across decades complicate interpretation of this body of work. We close with suggestions for future research in this area.

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    • "Given these observations , there has been discussion regarding whether alterations in the neurophysiology of basic perceptions might be more critical in the pathophysiology of ASD than previ - ously thought . Following this line of reasoning , a number of papers have focused on possible alterations in the basic visual capacities of ASD patients ( Gillberg , 2003 ; Dakin and Frith , 2005 ; Rogers and Ozonoff , 2005 ; Simmons et al . , 2009 ) . "
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    ABSTRACT: A common neurodevelopmental disorder, autism spectrum disorder (ASD), is defined by specific patterns in social perception, social competence, communication, highly circumscribed interests, and a strong subjective need for behavioral routines. Furthermore, distinctive features of visual perception, such as markedly reduced eye contact and a tendency to focus more on small, visual items than on holistic perception, have long been recognized as typical ASD characteristics. Recent debate in the scientific community discusses whether the physiology of low-level visual perception might explain such higher visual abnormalities. While reports of this enhanced, “eagle-like” visual acuity contained methodological errors and could not be substantiated, several authors have reported alterations in even earlier stages of visual processing, such as contrast perception and motion perception at the occipital cortex level. Therefore, in this project, we have investigated the electrophysiology of very early visual processing by analyzing the pattern electroretinogram-based contrast gain, the background noise amplitude, and the psychophysical visual acuities of participants with high-functioning ASD and controls with equal education. Based on earlier findings, we hypothesized that alterations in early vision would be present in ASD participants. This study included 33 individuals with ASD (11 female) and 33 control individuals (12 female). The groups were matched in terms of age, gender, and education level. We found no evidence of altered electrophysiological retinal contrast processing or psychophysical measured visual acuities. There appears to be no evidence for abnormalities in retinal visual processing in ASD patients, at least with respect to contrast detection.
    Frontiers in Human Neuroscience 08/2015; 9. DOI:10.3389/fnhum.2015.00460 · 2.99 Impact Factor
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    • "Miller, Schoen, Nielsen, & Baron-Cohen, 2014), can manifest as hypo-or hyper-responsivity in any of the sensory domains or as deficits in multimodal integration (Ben-Sasson et al., 2009; Khalfa et al., 2004; Marco, Hinkley, Hill, & Nagarajan, 2011; Rogers & Ozonoff, 2005), with emerging evidence of heritability (Uljarević, Prior, & Leekam, 2014). Furthermore, the relationship between severities of sensory dysfunction and autism symptomatology, family stress, and impairment is increasingly recognized (Adamson et al., 2006; Ben-Sasson, Soto, Martinez-Pedraza, & Carter, 2013; Brock, Freuler, Baranek, Watson, & Poe, 2012; Rogers, Hepburn, & Wehner, 2003). "
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    ABSTRACT: The aim of this study was to compare sensory processing in typically developing children (TDC), children with Autism Spectrum Disorder (ASD), and those with sensory processing dysfunction (SPD) in the absence of an ASD. Performance-based measures of auditory and tactile processing were compared between male children ages 8–12 years assigned to an ASD ( N =20), SPD ( N =15), or TDC group ( N =19). Both the SPD and ASD groups were impaired relative to the TDC group on a performance-based measure of tactile processing (right-handed graphesthesia). In contrast, only the ASD group showed significant impairment on an auditory processing index assessing dichotic listening, temporal patterning, and auditory discrimination. Furthermore, this impaired auditory processing was associated with parent-rated communication skills for both the ASD group and the combined study sample. No significant group differences were detected on measures of left-handed graphesthesia, tactile sensitivity, or form discrimination; however, more participants in the SPD group demonstrated a higher tactile detection threshold (60%) compared to the TDC (26.7%) and ASD groups (35%). This study provides support for use of performance-based measures in the assessment of children with ASD and SPD and highlights the need to better understand how sensory processing affects the higher order cognitive abilities associated with ASD, such as verbal and non-verbal communication, regardless of diagnostic classification. ( JINS , 2015, 21 , 1–11)
    Journal of the International Neuropsychological Society 07/2015; 21(6):1-11. DOI:10.1017/S1355617715000387 · 2.96 Impact Factor
    • "People with sensory disabilities, intellectual disabilities (IDs) or a combination of these disabilities often show behaviours that may be symptoms of autism spectrum disorder (ASD) that in fact may be caused by their disabilities (Hobson 2005; Hoevenaars-van den Boom, Antonissen, Knoors, & Vervloed 2009; Knoors & Vervloed 2011; van Gent 2012; de Vaan, Vervloed, Knoors, & Verhoeven 2013a) If it is not taken into account whether behaviours are caused by ASD or another impairment, this may lead to both underdiagnosis and overdiagnosis of ASD in this group (Jure, Rapin, & Tuchman 1991; Cass 1998; Roper, Arnold, & Monteiro 2003). The right diagnosis and proper case formulation can improve treatment, impairments include deficient contact with others, disordered social imitation and impaired joint attention (Vig & Jedrysek 1999; van Gent 2012) and a preference for objects and physical attributes over social contact (Rogers & Ozonoff 2005). People with an ID and additional visual impairments show even more problems. "
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    ABSTRACT: It is difficult to diagnose autism spectrum disorder (ASD) in people with a combination of intellectual and sensory disabilities because of overlap in behaviour. The ASD typical behaviours of people with combined intellectual and sensory disabilities are often caused by their disabilities and not by ASD. Current diagnostic tools are inadequate to differentiate between people with and without ASD when they have these combined disabilities, because tools lack norms for this population or are subjective, indirect or unable to adapt to the variety of disabilities that these people may have. Because giving a correct diagnosis is necessary for treatment and support, a new observational tool was developed to diagnose ASD in people with multiple disabilities, observation of autism in people with sensory and intellectual disabilities (OASID). Observation of autism in people with sensory and intellectual disabilities was tested on 18 participants with moderate to profound intellectual disabilities, one or dual sensory impairment, with and without ASD. Two independent experts diagnosed these participants as well in order to test the psychometric properties and differentiating abilities of OASID. Observation of autism in people with sensory and intellectual disabilities showed high inter-rater reliability, internal consistency of scales and content and construct validity. OASID could differentiate people with and without ASD without overlap. Observation of autism in people with sensory and intellectual disabilities could differentiate people with intellectual disabilities combined with sensory impairments, who clearly had or did not have signs of ASD. People with unclear signs of ADS scored in between those two groups with regard to their OASID scores. Psychometric properties of OASID are promising. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
    Journal of Intellectual Disability Research 06/2015; DOI:10.1111/jir.12206 · 2.41 Impact Factor
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