Abstract
Deficits in sensory modulation have been linked clinically with impaired attention, arousal, and impulsivity for years, but a clear understanding of the relationship between sensory modulation disorders and attention deficit hyperactivity disorder (ADHD) has proven elusive. Our preliminary work suggested that patterns of salivary cortisol and electrodermal responsivity to sensation may be linked to different groups of children with ADHD; those with and without sensory over-responsivity (SOR). Additionally, SOR has been linked to anxiety, and anxiety has been linked to ADHD. A clearer understanding of the relationship between anxiety, SOR, and ADHD may support a better understanding of ADHD diagnostic subtypes. We examined neuroendocrine, electrodermal and behavioral characteristics and sought to predict group membership among 6- to 12-year-old children with ADHD and SOR (ADHDs), ADHD and no SOR (ADHDt), and typicals (TYP). Behavioral questionnaires were completed to document SOR and anxiety. Lab testing used a Sensory Challenge Protocol (SCP) with concurrent electrodermal measurement and the collection of cortisol prior to and following the SCP. Results substantiated links between SOR and anxiety, in both TYP and ADHD children. Results suggests that ADHD should be considered in conjunction with anxiety and sensory responsivity; both may be related to bottom-up processing differences, and deficits in prefrontal cortex/hippocampal synaptic gating.
Highlights
Deficits in sensory modulation have been linked clinically with impaired attention, arousal, and impulsivity since the early 1970s (Ayres, 1972)
Sensory over-responsivity (SOR) is a type of sensory modulation disorders (SMD) characterized by responses to sensory stimuli that are faster, longer, or more intense than what would be expected with typical sensory responsivity (Miller et al, 2007)
Our preliminary findings had indicated different patterns of cortisol response to sensory challenge in children with attention deficit hyperactivity disorder (ADHD) and SOR (ADHDs), compared to that seen in children with ADHD but no SOR (ADHDt) and typical children (TYP)
Summary
Deficits in sensory modulation have been linked clinically with impaired attention, arousal, and impulsivity since the early 1970s (Ayres, 1972). Understanding the central nervous system processes linking sensory modulation disorders (SMD) and attention deficit hyperactivity disorder (ADHD) has proven challenging. In order to distinguish SMD from ADHD, and/or clarify the relationship between the two, a more thorough understanding of the central nervous system processes as well as behavioral symptomatology within and between the disorders is necessary. Our preliminary findings had indicated different patterns of cortisol response to sensory challenge in children with ADHD and SOR (ADHDs), compared to that seen in children with ADHD but no SOR (ADHDt) and typical children (TYP). Other investigators have indicated that a blunted cortisol response to stressful situations in children with ADHD was commonly, not invariably, seen (King et al, 1998; Kariyawasam et al, 2002; Hong et al, 2003). Why some children with ADHD have a blunted response while others do not has to this point not been well explained; examining cortisol relative to sensory modulation may provide needed clarification
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