Autism Spectrum Disorder and Specific Phobia: the Role of Sensory Sensitivity: Brief Review

Abstract

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder affecting approximately 1 in 59 children (Baio et al. MMWR Surveillance Summaries, 67(6), 1, 2018). A commonly experienced psychiatric comorbidity in ASD is anxiety. Although this is known, little research has been done on the specific issues concerning specific phobia in ASD, even though specific phobias (SPs) are present in up to 40% of children with ASD. As one of the leading treatments for anxiety, cognitive behavioral therapy (CBT) has been adapted for many different populations, including children with ASD. However, the work that has been done on treatment of SP in ASD has been mostly case studies from an operant perspective. These case studies have not, to our knowledge, utilized CBT; however, they suggest that behaviorally based treatments may be effective. Still, they do not explore potential mechanisms associated with the co-occurrence of these disorders, such as sensory sensitivity, that may be responsible for these differences. Within the context of ASD, Green and Ben-Sasson (Journal of autism and developmental disorders, 40(12), 1495-1504, 2010) suggest a model of SP based on classical fear conditioning theory, which suggests sensory sensitivities cause anxieties by conditioning children to associate aversive sensations with certain objects that consequently come to elicit fear and anxiety. Here, we suggest three potential modifications of CBT to address sensory sensitivity in youth with ASD. In offering these modifications, we attempt to address explicitly the potential mechanisms underlying the development of SP in youth with ASD.