Sensory Over-responsivity Symptoms Research Articles

Shared and distinct biological mechanisms for anxiety and sensory over-responsivity in youth with autism versus anxiety disorders.

Sensory over-responsivity (SOR) is a prevalent cross-diagnostic condition that is often associated with anxiety. The biological mechanisms underlying the co-occurrence of SOR and anxiety symptoms are not well understood, despite having important implications for targeted intervention. We therefore investigated the unique associations of SOR and anxiety symptoms with physiological and neural responses to sensory stimulation for youth with anxiety disorders (ANX), autism spectrum disorder (ASD), or typical development (TD). Age/IQ-matched youth aged 8-18 years (22 ANX; 30 ASD; 22 TD) experienced mildly aversive tactile and auditory stimuli during functional magnetic resonance imaging and then during skin conductance response (SCR) and heart rate (HR) measurements. Caregivers reported on participants' SOR and anxiety symptoms. ASD/ANX youth had elevated SOR and anxiety symptoms compared to TD. ASD/ANX youth showed similar, heightened brain responses to sensory stimulation compared to TD youth, but brain responses were more highly related to SOR symptoms in ASD youth and to anxiety symptoms in ANX youth. Across ASD/ANX youth, anxiety symptoms uniquely related to greater SCR whereas SOR uniquely related to greater HR responses to sensory stimulation. Behavioral and neurobiological over-responsivity to sensory stimulation was shared across diagnostic groups. However, findings support SOR and anxiety as distinct symptoms with unique biological mechanisms, and with different relationships to neural over-reactivity dependent on diagnostic group. Results indicate a need for targeted treatment approaches.

The Role of Pediatric Sensory Over-responsivity and Anxiety Symptoms in the Development of Family Accommodations.

Sensory over-responsivity (SOR) is linked with elevated anxiety and reduced family wellbeing. Family accommodation of anxiety relates with greater symptom severity and reduced intervention outcome. This study examined the contribution of child SOR and co-occurring anxiety symptoms to family accommodation and its consequences. Ninety families of typically developing children (ages 4-13 years), completed an online survey including the Sensory Profile 2, Screen for Child Anxiety Related Emotional Disorders (SCARED), and Family Accommodation Sensory Scale (FASENS). FASENS scores include frequency of accommodation, child impact, and family impact.Children with elevated anxiety symptoms had significantly higher sensory and FASENS scores. Stepwise linear regression indicated that only SOR symptoms significantly predicted the frequency of sensory family accommodation, while both SOR and anxiety symptoms predicted the impact of family accommodation upon child and family well-being.Both SOR and anxiety symptoms in children predict the impact of sensory family accommodations on child and family well-being.

Family Accommodation Scale for Sensory Over-Responsivity: A Measure Development Study.

Family accommodation refers to the attempt of family members (most often parents) to prevent their child’s distress related to psychopathology. Family accommodation can limit meaningful participation in personal and social routines and activities. Accommodation has been studied extensively in the context of childhood anxiety and has been linked to greater impairment, and poor intervention outcomes. Like anxiety, sensory over-responsivity (SOR) symptoms are associated with heightened distress and thus, may also be accommodated by family members. The current study describes the validation of a new pediatric family accommodation scale for SOR. Parents of 301 children ages 3–13 years completed an online survey, of which 48 had medical or developmental conditions. The survey included the Child Sensory Profile 2 and the newly developed family accommodation scale for sensory over-responsivity (FASENS). Three Sensory Profile 2 scores were analyzed: SOR, sensory under-responsivity and sensory seeking. The FASENS consists of 18 items; 12 describing the frequency of accommodation behaviors and 6 describing the impact of the accommodation on the wellbeing of the family and the child. Results indicated that the FASENS has high internal consistency (α = 0.94) as well as a significant 3-factor confirmatory model fit: (1) accommodations (i.e., avoidance and changes), (2) family impact, and (3) child impact. FASENS scores significantly correlated with SOR symptoms (r = 0.52–0.60, p < 0.001). However, they also correlated with under-responsivity and seeking (r = 0.33–0.42, p < 0.001). Parents of children with health conditions reported significantly higher FASENS scores (p < 0.002), which corresponded with their child’s significantly higher sensory scores (p < 0.001). Family accommodations for SOR occur to some extent in the general population, but their prevalence and impact are significantly greater when the child has a health condition, in addition to SOR. Additional research is needed to explore whether these accommodations are adaptive and whether families and children would benefit from learning to reduce them, as with anxiety.

Sex Differences in Salience Network Connectivity and its Relationship to Sensory Over-Responsivity in Youth with Autism Spectrum Disorder.

Individuals with autism spectrum disorder (ASD) are significantly more likely to experience sensory over-responsivity (SOR) compared to neurotypical controls. SOR in autism has been shown to be related to atypical functional connectivity in the salience network (SN), a brain network thought to help direct attention to the most relevant stimuli in one's environment. However, all studies to date which have examined the neurobiological basis of sensory processing in ASD have used primarily male samples so little is known about sex differences in the neural processing of sensory information. This study examined the relationship between SOR and resting-state functional connectivity in the SN for 37 males and 16 females with autism, ages 8-17 years. While there were no sex differences in parent-rated SOR symptoms, there were significant sex differences in how SOR related to SN connectivity. Relative to females with ASD, males with ASD showed a stronger association between SOR and increased connectivity between the salience and primary sensory networks, suggesting increased allocation to sensory information. Conversely, for females with ASD, SOR was more strongly related to increased connectivity between the SN and prefrontal cortex. Results suggest that the underlying mechanisms of SOR in ASD are sex specific, providing insight into the differences seen in the diagnosis rate and symptom profiles of males and females with ASD. LAY SUMMARY: Sensory over-responsivity (SOR) is common in autism. Most research on the neural basis of SOR has focused on males, so little is known about SOR or its neurobiology in females with autism spectrum disorder. Here despite no sex differences in SOR symptoms, we found sex differences in how SOR related to intrinsic connectivity in a salience detection network. Results show sex differences in the neural mechanisms underlying SOR and inform sex differences seen in diagnosis rates and symptom profiles in autism. Autism Res 2020, 13: 1489-1500. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

Sensory Habituation as a Shared Mechanism for Sensory Over-Responsivity and Obsessive-Compulsive Symptoms.

BackgroundSome individuals who suffer from obsessive–compulsive (OC) disorder (OCD), report disturbing sensory preoccupations. The inability to stop obsessing over stimuli resonates with a difficulty in sensory habituation. Impaired sensory habituation, to a degree that clearly dysregulates response to sensory stimuli, and impairs participation in everyday activities, can be part of a disorder known as sensory over-responsivity (SOR). Although previous studies indicated a correlation between OCD and SOR, physiological experiments show that individuals with OCD are not more sensitive to sensory stimuli than controls. In the current study, we (1) validated a sensory habituation psycho-physiological protocol and (2) tested whether a “slow to habituate” mechanism can explain the occurrence of elevated SOR and OC symptoms.MethodsWe designed a protocol to test auditory sensory habituation through electrodermal activity (EDA) recording. The protocol included two randomly ordered aversive and neutral sound conditions; each set of six everyday life sounds was presented as a continuous stimulus. During the presentation of sounds, EDA was measured and participants could press a button to shorten the stimuli. Participants also completed sensory and OC symptom questionnaires. Participants included 100 typically developing adults that were divided into high versus low OC symptom groups. Mixed models analysis was used throughout to meet the need for capturing the temporal nature of habituation.ResultsDistinct physiological indices were computed to measure sensitivity versus habituation. Habituation was slower in the aversive versus neutral condition. Sensitivity was higher for the aversive stimuli. Self-report of sensory habituation and sensitivity partially correlated with the physiological habituation indices. A comparison of the physiological pattern between those with high versus low OC symptoms revealed significant differences in the habituation and sensitivity indices, across conditions.ConclusionThe interplay between SOR and OC symptoms can be explained by a “slow to habituate” mechanism. Identifying behavioral and physiological markers of sensory problems in OCD is important for assessment, intervention and the discovery of underlying mechanisms.

Co-occurrence of Sensory Overresponsivity with Obsessive-Compulsive Symptoms in Childhood and Early Adolescence.

Sensory overresponsivity (SOR) is characterized by challenges in integrating and responding to everyday sensory experiences. Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts, ritualistic behaviors, and sensory phenomena. There is some evidence that individuals with co-occurring symptoms of SOR and OCD experience more severe anxiety than those with symptoms of OCD alone, but most studies employed small numbers of participants (typically with an OCD diagnosis) assessed at a single time point. Our 2-fold objective was to replicate previous research showing an association between OCD symptoms and SOR symptoms concurrently and to extend these analyses longitudinally in a large, birth-register-based sample. Twins (N = 1613) and their primary caregivers participated in a multimodal, multimethod, longitudinal study. Primary caregivers completed the SOR inventory for their offspring at the age of 8 years, and twins completed the adult sensory profile at the age of 13 years. Parents completed the OCD module of the Diagnostic Interview Schedule for Children-IV when twins were 8 years; twins completed the same module at 13 years. Linear regression models tested for the concurrent and longitudinal associations between SOR and OCD controlling for socioeconomic status. Concurrently, participants' likelihood of exhibiting OCD symptoms increased with each symptom of tactile or auditory overresponsivity at 8 years and 13 years (odds ratio = 1.1-2.7). However, SOR measured at age 8 years was unrelated to adolescent OCD symptoms at 13 years and vice versa. SOR symptoms, although significantly related to concurrent OCD symptoms, do not appear to precede OCD symptoms, suggesting that SOR symptoms may reflect another type of OCD sensory phenomenon rather than a comorbid condition.

Sensory Over-Responsivity: An Early Risk Factor for Anxiety and Behavioral Challenges in Young Children.

Anxiety disorders are prevalent and significantly impact young children and their families. One hypothesized risk factor for anxiety is heightened responses to sensory input. Few studies have explored this hypothesis prospectively. This study had two goals: (1) examine whether sensory over-responsivity is predictive of the development of anxiety in a large prospective sample of children, and (2) identify whether anxiety mediates the relationship between sensory over-responsivity and behavioral challenges. Children's sensory and anxiety symptoms were assessed in a community sample of 917 at 2-5 and again in 191 of these children at 6years old. Parents also reported on a number of additional behavioral challenges previously found to be associated with both sensory over-responsivity and anxiety separately: irritability, food selectivity, sleep problems, and gastrointestinal problems. Forty three percent of preschool children with sensory over-responsivity also had a concurrent impairing anxiety disorder. Preschool sensory over-responsivity symptoms significantly and positively predicted anxiety symptoms at age six. This relationship was both specific and unidirectional. Finally, school-age anxiety symptoms mediated the relationship between preschool sensory over-responsivity symptoms and both irritability and sleep problems at school-age. These results suggest sensory over-responsivity is a risk factor for anxiety disorders. Furthermore, children who have symptoms of sensory over-responsivity as preschoolers have higher levels of anxiety symptoms at school-age, which in turn is associated with increased levels of school-age behavioral challenges.

Sensory over-responsivity in trichotillomania (hair-pulling disorder)

ObjectiveThis study was an initial investigation of sensory-over responsivity (SOR) to external sensations among individuals with trichotillomania (TTM). MethodsAdults endorsing DSM-5 TTM criteria (N = 609) and a non-affected comparison sample (N = 268) completed a self-report survey. ResultsThe majority of the TTM group endorsed SOR symptoms; three-quarters endorsed at least mild tactile and auditory SOR. About 15% endorsed SOR symptoms in the severe to extreme range. TTM participants had significantly higher mean scores in both auditory (t (652.89) = −6.51, p < .001, d = .45) and tactile (t (655.24) = −8.38, p < .001, d = .58) modalities than comparison participants, with medium effect sizes. Greater levels of SOR were related to greater levels of perfectionism and by-proxy pulling urges. SOR was significantly and positively correlated with functional impairment when controlling for TTM severity. ConclusionThis study expands prior work in obsessive-compulsive related disorders by contributing the first data about associations between TTM and over-responsivity to external sensations. Findings collectively suggest SOR may be related to maladaptive emotion regulation processes in TTM. A novel measure of SOR was developed and administered in this study.

Not Just Right Experiences: Association with Obsessive Compulsive Symptoms and Sensory Over-Responsivity

ABSTRACTIndividuals with obsessive-compulsive disorder describe “not just right experiences” as a constant uncomfortable feeling of imperfection toward sensory stimuli. This study examined the relation between “not just right experiences,” obsessive-compulsive disorder and sensory over-responsivity symptoms. Sixty college students participated in the in vivo “not just right experiences” assessment. This included four tasks for which participants rated pre-task discomfort, post-task discomfort, and urge to counteract auditory, visual, and tactile stimuli. “Not just right experiences” scores significantly correlated with obsessive-compulsive disorder scores. Tactile, auditory, and visual sensory over-responsivity scores were correlated with specific “not just right experiences” scores. Sensory over-responsivity is rarely addressed in obsessive-compulsive disorder while it contributes to symptomatology and participation.

Parent-Offspring Transmission of Internalizing and Sensory over-Responsivity Symptoms in Adolescence.

Reactions to sensory experiences are an overlooked correlate of affective regulation, despite the importance of bodily states on psychological processes. Children who display sensory over-responsivity (i.e., adverse reactions to typical sensations) are at greater risk for developing affective disorders. We extended this literature to adolescents and their middle-aged parents. Participants in a birth record-based study of families of adolescent twins (N=506 families; 1012 adolescents; 53% female) completed a subset of items from the Adult Sensory Profile. We derived adolescent self-reported internalizing disorder symptoms and parent affective diagnoses from structured diagnostic interviews. Structural equation models tested the relationship between parent sensory over-responsivity symptoms and affective diagnoses and their adolescent offspring's sensory over-responsivity and internalizing symptoms. Adolescent sensory over-responsivity symptoms were correlated with internalizing disorder symptoms. Parents with a diagnosis of anxiety or depression (mothers only) reported more frequent SOR symptoms than parents without a diagnosis. Parent depression was significantly related to adolescent sensory over-responsivity symptoms, over and above parent sensory over-responsivity symptoms (β=0.26, p<0.001 for mothers; β=0.13, p=0.004 for fathers). Father alcohol abuse/dependency also predicted offspring sensory over-responsivity symptoms. Offspring of parents with affective disorders were at additional risk for sensory dysregulation via parents' influence on offspring internalizing problems.

Reduced modulation of thalamocortical connectivity during exposure to sensory stimuli in ASD.

Recent evidence for abnormal thalamic connectivity in autism spectrum disorders (ASD) and sensory processing disorders suggests the thalamus may play a role in sensory over-responsivity (SOR), an extreme negative response to sensory stimuli, which is common in ASD. However, there is yet little understanding of changes in thalamic connectivity during exposure to aversive sensory inputs in individuals with ASD. In particular, the pulvinar nucleus of the thalamus is implicated in atypical sensory processing given its role in selective attention, regulation, and sensory integration. This study aimed to examine the role of pulvinar connectivity in ASD during mildly aversive sensory input. Functional magnetic resonance imaging was used to examine connectivity with the pulvinar during exposure to mildly aversive auditory and tactile stimuli in 38 youth (age 9-17; 19 ASD, 19 IQ-matched typically developing (TD)). Parents rated children's SOR severity on two standard scales. Compared to TD, ASD participants displayed aberrant modulation of connectivity between pulvinar and cortex (including sensory-motor and prefrontal regions) during sensory stimulation. In ASD participants, pulvinar-amygdala connectivity was correlated with severity of SOR symptoms. Deficits in modulation of thalamocortical connectivity in youth with ASD may reflect reduced thalamo-cortical inhibition in response to sensory stimulation, which could lead to difficulty filtering out and/or integrating sensory information. An increase in amygdala connectivity with the pulvinar might be partially responsible for deficits in selective attention as the amygdala signals the brain to attend to distracting sensory stimuli. Autism Res 2017, 10: 801-809. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Sensory over responsivity and obsessive compulsive symptoms: A cluster analysis

BackgroundSeveral studies have examined the sensory component in Obsesseive Compulsive Disorder (OCD) and described an OCD subtype which has a unique profile, and that Sensory Phenomena (SP) is a significant component of this subtype. SP has some commonalities with Sensory Over Responsivity (SOR) and might be in part a characteristic of this subtype. Although there are some studies that have examined SOR and its relation to Obsessive Compulsive Symptoms (OCS), literature lacks sufficient data on this interplay. ObjectivesFirst to further examine the correlations between OCS and SOR, and to explore the correlations between SOR modalities (i.e. smell, touch, etc.) and OCS subscales (i.e. washing, ordering, etc.). Second, to investigate the cluster analysis of SOR and OCS dimensions in adults, that is, to classify the sample using the sensory scores to find whether a sensory OCD subtype can be specified. Our third goal was to explore the psychometric features of a new sensory questionnaire: the Sensory Perception Quotient (SPQ). MethodA sample of non clinical adults (n=350) was recruited via e-mail, social media and social networks. Participants completed questionnaires for measuring SOR, OCS, and anxiety. ResultsSOR and OCI-F scores were moderately significantly correlated (n=274), significant correlations between all SOR modalities and OCS subscales were found with no specific higher correlation between one modality to one OCS subscale. Cluster analysis revealed four distinct clusters: (1) No OC and SOR symptoms (NONE; n=100), (2) High OC and SOR symptoms (BOTH; n=28), (3) Moderate OC symptoms (OCS; n=63), (4) Moderate SOR symptoms (SOR; n=83). The BOTH cluster had significantly higher anxiety levels than the other clusters, and shared OC subscales scores with the OCS cluster. The BOTH cluster also reported higher SOR scores across tactile, vision, taste and olfactory modalities. The SPQ was found reliable and suitable to detect SOR, the sample SPQ scores was normally distributed (n=350). ConclusionsSOR is a dimensional feature that can influence the severity of OCS and may characterize a unique sensory OCD subtype.

Salience Network Connectivity in Autism Is Related to Brain and Behavioral Markers of Sensory Overresponsivity

The salience network, an intrinsic brain network thought to modulate attention to internal versus external stimuli, has been consistently found to be atypical in autism spectrum disorders (ASD). However, little is known about how this altered resting-state connectivity relates to brain activity during information processing, which has important implications for understanding sensory overresponsivity (SOR), a common and impairing condition in ASD related to difficulty downregulating brain responses to sensory stimuli. This study examined how SOR in youth with ASD relates to atypical salience network connectivity and whether these atypicalities are associated with abnormal brain response to basic sensory information. Functional magnetic resonance imaging was used to examine how parent-rated SOR symptoms related to salience network connectivity in 61 youth (aged 8-17 years; 28 with ASD and 33 IQ-matched typically developing youth). Correlations between resting-state salience network connectivity and brain response to mildly aversive tactile and auditory stimuli were examined. SOR in youth with ASD was related to increased resting-state functional connectivity between salience network nodes and brain regions implicated in primary sensory processing and attention. Furthermore, the strength of this connectivity at rest was related to the extent of brain activity in response to auditory and tactile stimuli. Results support an association between intrinsic brain connectivity and specific atypical brain responses during information processing. In addition, findings suggest that basic sensory information is overly salient to individuals with SOR, leading to overattribution of attention to this information. Implications for intervention include incorporating sensory coping strategies into social interventions for individuals with SOR.

Neurobiology of Sensory Overresponsivity in Youth With Autism Spectrum Disorders.

More than half of youth with autism spectrum disorders (ASDs) have sensory overresponsivity (SOR), an extreme negative reaction to sensory stimuli. However, little is known about the neurobiological basis of SOR, and there are few effective treatments. Understanding whether SOR is due to an initial heightened sensory response or to deficits in regulating emotional reactions to stimuli has important implications for intervention. To determine differences in brain responses, habituation, and connectivity during exposure to mildly aversive sensory stimuli in youth with ASDs and SOR compared with youth with ASDs without SOR and compared with typically developing control subjects. Functional magnetic resonance imaging was used to examine brain responses and habituation to mildly aversive auditory and tactile stimuli in 19 high-functioning youths with ASDs and 19 age- and IQ-matched, typically developing youths (age range, 9-17 years). Brain activity was related to parents' ratings of children's SOR symptoms. Functional connectivity between the amygdala and orbitofrontal cortex was compared between ASDs subgroups with and without SOR and typically developing controls without SOR. The study dates were March 2012 through February 2014. Relative increases in blood oxygen level-dependent signal response across the whole brain and within the amygdala during exposure to sensory stimuli compared with fixation, as well as correlation between blood oxygen level-dependent signal change in the amygdala and orbitofrontal cortex. The mean age in both groups was 14 years and the majority in both groups (16 of 19 each) were male. Compared with neurotypical control participants, participants with ASDs displayed stronger activation in primary sensory cortices and the amygdala (P < .05, corrected). This activity was positively correlated with SOR symptoms after controlling for anxiety. The ASDs with SOR subgroup had decreased neural habituation to stimuli in sensory cortices and the amygdala compared with groups without SOR. Youth with ASDs without SOR showed a pattern of amygdala downregulation, with negative connectivity between the amygdala and orbitofrontal cortex (thresholded at z > 1.70, P < .05). Results demonstrate that youth with ASDs and SOR show sensorilimbic hyperresponsivity to mildly aversive tactile and auditory stimuli, particularly to multiple modalities presented simultaneously, and show that this hyperresponsivity is due to failure to habituate. In addition, findings suggest that a subset of youth with ASDs can regulate their responses through prefrontal downregulation of amygdala activity. Implications for intervention include minimizing exposure to multiple sensory modalities and building coping strategies for regulating emotional response to stimuli.

Trajectories of Sensory Over-Responsivity from Early to Middle Childhood: Birth and Temperament Risk Factors.

Sensory over-responsivity, a subtype of sensory modulation disorder, is characterized by extreme negative reactions to normative sensory experiences. These over-reactions can interfere with daily activities and cause stress to children and their families. The etiology and developmental course of sensory over-responsivity is still largely unknown. We measured tactile and auditory over-responsivity in a population-based, typically developing sample of twins (N=978) at age two years via a caregiver report temperament questionnaire and again at age seven years via a sensory over-responsivity symptom inventory. Participating twins were treated as singletons although all analyses controlled for clustering within families. Children were divided into four trajectory groups based on risk status at both ages: low symptom (N=768), remitted (N=75), late-onset (N=112), and chronic (N=24). A subset of children who screened positive for SOR in toddlerhood (N = 102) took part in a pilot study focused on sensory over-responsivity at four years of age. Children in the chronic group had more severe symptoms of sensory sensitivity at age four years, including more motion sensitivity, than the other trajectory groups. Children in the chronic group had a younger gestational age and were more likely to be low birth-weight than the low symptom group. Differences between remitted and late-onset groups and the low-symptoms group were inconsistent across measures. Sensory over-responsivity was modestly correlated across ages (r = .22 for tactile over-responsivity and r = .11 for auditory over-responsivity), but symptoms were more stable among children born prematurely or who had more fearful and less soothable temperaments. A clear implication is that assessment over development may be necessary for a valid sensory processing disorder diagnosis, and a speculative implication is that sensory over-responsivity symptoms may be etiologically heterogeneous, with different causes of transient and stable symptoms.

Sensory over-responsivity in a sample of children seeking treatment for anxiety.

Sensory over-responsivity (SOR) refers to an exaggerated, intense, or prolonged behavioral response to ordinary sensory stimuli. The relationship of SOR to psychiatric disorders remains poorly understood. The current study examined the SOR construct within typically developing children with clinically significant anxiety, including the prevalence and course of SOR symptoms and relationship between SOR symptoms, demographic factors, and psychopathology. Children presenting at an anxiety specialty clinic (n = 88) completed a psychiatric diagnostic assessment, which included parent-report measures of SOR, anxiety, obsessive-compulsive disorder (OCD), and global behavior and child-report measures of anxiety, depression, and OCD. Sensory over-responsivity symptoms were very common: 93.2% were bothered by at least 1 tactile or auditory sensation, and the mean number of bothersome sensations was 9.2 (SD = 7.4). SOR symptoms were reported to be "moderately bothersome" on average and to onset at an early age. Sensory Over-Responsivity Inventory (SensOR) scores did not differ by psychiatric disorder diagnosis, but SensOR scores significantly correlated with measures of OCD and depression. Higher SensOR scores were associated with greater global impairment. A high rate of SOR symptom occurrence was observed in this sample of children seeking anxiety treatment, suggesting that SOR may not be entirely independent of anxiety and may be closely associated with OCD. Future research on the validity and nosology of SOR using psychiatric samples is warranted.

Early and Concurrent Features of ADHD and Sensory Over-Responsivity Symptom Clusters

Objective: This study aimed to characterize clusters of children based on ADHD and sensory over-responsivity (SOR) symptoms, and to compare their markers. Method: Parents of 922 infants completed the Infant–Toddler Social and Emotional Assessment (ITSEA) Sensory Sensitivity, Attention, and Activity/Impulsivity scales at three time points during early childhood and the Child Behavior Checklist (CBCL) and SensOR inventory during elementary school age. Results: Four school-age clusters emerged from the CBCL ADHD and SensOR scores: (a) elevated SOR symptoms only (n = 35); (b) elevated ADHD symptoms only (n = 38); (c) elevated ADHD and SOR symptoms (ADHD + S, n = 35); and (d) low ADHD and SOR symptoms (n = 814). The SOR and ADHD + S clusters had higher early Sensitivity scores than the ADHD and Low clusters. The ADHD and ADHD + S clusters differed from the SOR and Low clusters in their early Attention and Activity/Impulsivity scores. Conclusion: SOR and ADHD symptoms occur independently and consistently over time.

Early sensory over‐responsivity in toddlers with autism spectrum disorders as a predictor of family impairment and parenting stress

Sensory over-responsivity (SOR) affects many individuals with autism spectrum disorders (ASD), often leading to stressful encounters during daily routines. This study describes the associations between early SOR symptoms and the longitudinal course of restrictions in family life activities and parenting stress across three time-points in families raising a child with ASD (n = 174). Covariates were child diagnostic severity, emotional problems, and maternal affective symptoms. At time 1 mean chronological age was 28.5 months. Children were administered the Autism Diagnostic Observation Schedule (ADOS) and Mullen Scales of Early Learning (MSEL). Parents completed the Infant Toddler Sensory Profile (ITSP), Infant-Toddler Social Emotional Assessment (ITSEA), Beck Anxiety Index (BAI), and the Center for Epidemiologic Studies Depression Inventory (CES-D) at time 1; and the Parenting Stress Index (PSI) and Family Life Impairment Scale (FLIS) at the three annual time-points. Latent Growth Curve Models indicated that higher SOR scores on the ITSP at time 1 were associated with higher initial levels of family life impairment and parenting stress and with a smaller magnitude of change over time. These associations were independent of severity of ADOS social-communication symptoms, MSEL composite score, ITSEA externalizing and anxiety symptoms, and maternal affective symptoms as measured by the BAI and CES-D. On average FLIS and PSI did not change over time, however, there was significant individual variability. Concurrently, SOR at time 1 explained 39-45% of the variance in family stress and impairment variables. An evaluation of SOR should be integrated into the assessment of toddlers with ASD considering their role in family life impairment and stress.

Sensory Over-Responsivity, Psychopathology, and Family Impairment in School-Aged Children

To establish the diagnostic validity of sensory overresponsivity (SOR), there is a need to document rates of SOR and the co-occurrence of SOR with other psychiatric disorders. Although this was not a diagnostic study of SOR, this study was designed to investigate rates of elevated SOR symptoms and associations between elevated SOR symptoms, psychiatric disorder status, and family impairment. From a larger birth cohort followed from infancy to school age, 338 children aged 7 to 10 years (51% boys, 49% girls) and their parents participated in an intensive assessment. Parents were interviewed with the Diagnostic Interview Schedule for Children (DISC) and completed the SensOR inventory and the Family Life Impairment Scale. Approximately one-fifth (21.2%) of children had elevated SOR symptoms. One-fourth (24.3%) of those with an elevated SOR score met criteria for a DSM-IV diagnosis, and 25.4% of children with a DSM-IV diagnosis had an elevated SOR score. Parents of children with elevated SOR alone reported a similar number of restrictions in family life as parents of those with an internalizing and/or externalizing diagnosis. SOR predicted concurrent family impairment above and beyond DSM diagnostic status and socio-demographic risk. Elevated SOR occurs in the absence of other psychiatric conditions and is associated with impairment in family life. Services for children with comorbid elevated SOR and an externalizing disorder are needed to address the extremely high level of family impairment reported.

Sensory Overresponsivity: Prenatal Risk Factors and Temperamental Contributions

The study addresses risk factors and cause of pediatric sensory over-responsivity (SOR) in a large sample of twins. At age 2 years, (a) the association of temperamental traits with concurrent SOR; (b) the association of prenatal complications with SOR; (c) the association of having a male cotwin with female SOR; and (d) the common and unique genetic causes of temperament and SOR symptoms are examined. The sample included 1026 twin pairs (mean age = 2 years 2 months) from a population-based longitudinal study. Auditory and tactile SOR symptom domains were partially independent and thus were examined separately. Temperamental negative affect and fear were moderately correlated with auditory and tactile SOR symptoms. Prenatal complications significantly predicted tactile symptoms after controlling for child characteristics. In addition, females with a male cotwin showed greater SOR at age 2 years than same-sex female dizygotic twins, suggesting a possible risk associated with in utero testosterone exposure. Both auditory and tactile SOR domains were heritable. Bivariate genetic analyses showed that each SOR domain had a similar genetic relationship with fear and negative affect. The findings suggest partially nonoverlapping causes and risk factors for tactile versus auditory SOR and indicate that prenatal factors warrant further investigation.