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Sensory symptoms associated with autistic traits and anxiety levels in children aged 6–11 years
Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-1904-5554
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Autism spectrum conditions (ASC) and quantitative autistic traits (QATs) are associated with sensory symptoms, which may contribute to anxiety and adversely affect social and cognitive development. Although sensory symptoms can occur across all senses, the relative roles of specific sensory modalities as contributors to the autistic phenotype and to anxiety are not well understood. The objective of this study was to examine which sensory symptoms were most predictive of high anxiety. We recruited 257 female primary caregivers of children aged 6 to 11 years (49 % girls) to a questionnaire study comprising parent-report measures for classical QATs (social, communicative, and rigid), autism-related sensorimotor symptoms (visual, auditory, tactile, olfactory, gustatory, vestibular, proprioceptive, and motor), and anxiety symptoms. First, Bayesian stochastic search variable selection (SSVS) was used to identify the most probable sensorimotor predictors of specific QATs as well as diagnosed ASC. Then, the selected predictors were used in another SSVS, using anxiety symptoms as a dependent variable, to identify which of the autism-relevant sensorimotor symptoms were most robustly predictive of anxiety. Finally, the effect sizes of anxiety-related sensory symptoms were estimated with linear regressions. We found that auditory symptoms and motor difficulties were most predictive of ASC diagnosis. Developmental motor difficulties were also strongly related to all individual QATs, whereas auditory symptoms were more selectively predictive of rigid traits. Tactile symptoms robustly predicted social interaction QATs, and proprioceptive symptoms predicted communicative QATs. Anxiety outcomes were most predicted by difficulties with auditory and olfactory processing. The results support the clinical importance of being alert to complaints about sounds and hearing in neurodevelopmental populations, and that auditory processing difficulties may be evaluated as an early marker of poor mental health in children with and without diagnosed autism. Olfactory processing differences appeared to be an anxiety marker less strongly associated with ASC or QATs, while motor difficulties were highly autism-relevant but not equally strongly associated with anxiety outcomes. We suggest that future studies may focus on the mechanisms and consequences of neurodevelopmental central auditory processing dysfunction and its potential relationship to anxiety disorders.

Keywords [en]
Broad autistic phenotype, central auditory processing disorder, Developmental Coordination Disorder Questionnaire, dimensional measures, Glasgow Sensory Questionnaire, hyperacusis, Research Domain Criteria
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:liu:diva-200127DOI: 10.31219/osf.io/fh56zOAI: oai:DiVA.org:liu-200127DiVA, id: diva2:1825530
Funder
Swedish Research Council, 2018-02131Available from: 2024-01-09 Created: 2024-01-09 Last updated: 2024-06-27Bibliographically approved
In thesis
1. Beyond Categories: A Dimensional Approach to Autism and Sensorimotor Differences
Open this publication in new window or tab >>Beyond Categories: A Dimensional Approach to Autism and Sensorimotor Differences
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Autism spectrum conditions (ASC) encompass a range of sensory, motor, and social-communicative differences, reflecting the considerable heterogeneity within the autism spectrum. This diversity underscores the limitations of categorical diagnostic approaches, which often fail to capture the individualized manifestations of autism. Advances in genetics and neuroscience have driven a shift towards dimensional frameworks that emphasize the spectrum nature of autism and the broad autism phenotype (BAP). BAP encapsulates subclinical traits that mirror those of autism in the general population, challenging the conventional boundaries between clinical and non-clinical populations. Furthermore, sensorimotor differences, which are particularly prevalent in individuals with ASC, follow a spectrum-like pattern similar to the BAP and are predictive of developmental outcomes related to social participation, communication, and overall quality of life in people with and without ASC. However, specific descriptions of these relationships are lacking.

This dissertation investigated the complex relationships between sensorimotor differences and autistic traits (ATs). Through a series of five interconnected studies, we examined broad sensory processing patterns and specific sensory modalities, namely auditory processing and motor/proprioception, to explore their roles in autistic phenotypes.

Study 1 of the dissertation validated a Swedish translation of the Broad Autism Phenotype Questionnaire (BAPQ). By examining parents' BAP traits, the study highlighted significant associations between higher ATs and having a child with ASC. Furthermore, it confirmed the presence of all three AT domains—social interaction (ATSOC), communication (ATCOM), and cognitive rigidity (ATRIG), reinforcing the genetic and phenotypic continuity between clinical and subclinical ATs.

Study 2 and Study 3 served as broader investigations into all seven sensory modalities and their associations with ATs. Study 2 explored these modality-specific associations, using Bayesian stochastic search variable selection (SSVS) and dominance analysis. This study highlighted auditory processing difficulties as the most consistent predictor of all three AT domains. Additionally, proprioceptive and tactile processing difficulties were specifically associated with ATCOM and ATSOC, respectively.

Study 3 extended this analysis to a developing population, focusing on the relationship between sensorimotor processing, ATs, and anxiety in children aged 6-11 years. Identical to Study 2, we found tactile symptoms as a predictor of ATSOC, proprioceptive symptoms for ATCOM, and auditory symptoms for ATRIG. In addition, olfactory symptoms were selected as a predictor of ATCOM, and motor coordination was a consistent predictor of all AT domains. Using SSVS, this study also identified that auditory and olfactory processing difficulties were strong predictors of anxiety symptoms.

Building on the previous studies, Study 4 narrowed the focus to auditory processing differences, investigating specific auditory problems and their associations with the AT domains. All AT domains significantly predicted affective reactions to sounds, while difficulties with speech perception, spatial perception, and auditory stream segregation were most strongly predicted by ATCOM.

Study 5 focused on the previously found links between motor coordination and proprioceptive processing and ATCOM. Using causal mediation analysis within a counterfactual framework, this study found that cerebellar error correction deficits, measured through a finger tapping task, significantly impacted ATCOM through motor skills in childhood.

Together, this dissertation provides a comprehensive overview of the sensory processing dimensions related to the core AT domains. Specifically, the studies underscored the clinical significance of monitoring auditory and olfactory complaints in children, as these were predictive of anxiety, and emphasized that early motor deficits impact social communication development. The findings advocate for the inclusion of detailed sensory and motor assessments in neurodevelopmental evaluations to identify children at risk for poor mental health outcomes. Future research should continue to explore the mechanisms underlying sensory processing differences. Particular focus should be placed on auditory and motor/proprioceptive functions and their contributions to ATs and clinical outcomes, such as anxiety. Emphasis should also be given to longitudinal studies that track these relationships over time.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2024. p. 94
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1902
Keywords
Broad autistic phenotype, Sensory processing, Central auditory, Processing disorder, Childhood motor skills, Social pragmatic language
National Category
Neurosciences
Identifiers
urn:nbn:se:liu:diva-205601 (URN)10.3384/9789180755467 (DOI)9789180755450 (ISBN)9789180755467 (ISBN)
Public defence
2024-08-30, Berzeliussalen, Building 463, Campus US, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2024-06-27 Created: 2024-06-27 Last updated: 2024-06-28Bibliographically approved

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Bang, PeterIgelström, Kajsa

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