Abstract
Individuals diagnosed with autism tend to process sensory information differently than individuals without autism, resulting for instance in increased sensitivity to sounds or smells. This leads to challenges in everyday life and may restrict the individual's daily functioning. How direct this link is, however, is currently unclear. We investigated this question in 289 twins of whom 60 were diagnosed with autism and further 61 were diagnosed with other neurodevelopmental disorders. We looked at the association between unusual sensory processing and adaptive skills, both across individuals and within-twin pairs, testing whether individuals with higher levels of atypical sensory processing showed reduced adaptive skills compared to their twins. Since twins share 50%-100% of their genes and part of their environment (e.g. family background), associations within-twin pairs are free from effects of these familial factors. We found that an increased sensitivity to, as well as the avoiding of, sensory input (hyper-responsiveness) was linked to reduced adaptive skills across individuals-but not within-twin pairs. We also found an association between the degree to which individuals seek for sensory input (sensation seeking) and reduced adaptive skills, but only in individuals diagnosed with autism. The results suggest that sensory hyper-responsiveness has negative effects on individuals' general ability to function, but that this link is influenced by familial factors and hence not direct. In addition, sensation seeking behaviors might have a negative impact on adaptive skills specifically in autistic individuals.
Highlights
Alongside impairments in social communication and interaction, atypical sensory processing is considered a defining diagnostic criterion of autism spectrum disorder (ASD) within the domain of restricted and repetitive behaviors, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013, pp. 50–59)
In a recent twin study on a sample largely overlapping with the current study’s, we found that genetics influenced the association between sensory sensitivity and autistic traits, while other domains of altered sensory processing assessed with the Adult/Adolescent Sensory Profile (AASP; low registration and sensation avoiding) persisted even within monozygotic (MZ) twins and were influenced by non-shared environment (Neufeld et al, 2021)
We addressed the gaps in the literature by investigating (a) the specific relationships between the four quadrants of atypical sensory processing assessed with the AASP and adaptive functioning while adjusting for ASD diagnosis and other neurodevelopmental diagnoses, age, sex, and cognitive ability
Summary
Alongside impairments in social communication and interaction, atypical sensory processing is considered a defining diagnostic criterion of autism spectrum disorder (ASD) within the domain of restricted and repetitive behaviors, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013, pp. 50–59). Atypical sensory processing is considered one of the earliest signs of ASD (Ben-Sasson et al, 2007), observed as early as at 6 months of age in individuals who are later diagnosed with ASD (Germani et al, 2014). A recent meta-analysis of 55 studies found a high incidence of hypo-responsiveness in ASD compared to typically developing (TD) individuals and increased hyper-responsiveness even compared to clinical comparison groups (Ben-Sasson et al, 2019). Adding to the phenotypic complexity in ASD, both hypo- and hyper-responsiveness often co-occur in the same individual (Baranek et al, 2006; Ben-Sasson et al, 2007; Mayer, 2017)
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