Sensory Reactivity in Children Referred for Autism Evaluation: Associations with Autism Symptoms and Adaptive Skills

TL;DR

The study finds that sensory differences in children referred for autism evaluations are linked to lower adaptive functioning and may reflect co-occurring issues like anxiety.

Contribution

The study provides new insights into how sensory differences relate to adaptive functioning in children with and without autism in clinical settings.

Findings

Non-autistic children showed higher sensory avoiding and sensitivity than autistic children.

Higher sensory differences were associated with lower adaptive functioning across communication, daily living skills, and socialization.

Abstract

What are the main findings?
Sensory differences are evident across developmental conditions.Sensory differences predict adaptive functioning in children with and without autism in clinically referred populations.

Sensory differences are evident across developmental conditions.

Sensory differences predict adaptive functioning in children with and without autism in clinically referred populations.

What are the implications of the main findings?
Understanding sensory differences across developmental conditions has implications for differential diagnosis.Results highlight the importance of examining sensory behaviors in children with diverse clinical profiles.

Understanding sensory differences across developmental conditions has implications for differential diagnosis.

Results highlight the importance of examining sensory behaviors in children with diverse clinical profiles.

Background: The present study examines sensory differences in children referred for autism evaluations and explores associations between sensory differences, autism symptomatology, and adaptive skills. Using a clinically referred sample, this study captures the heterogeneity of diverse developmental profiles observed in everyday clinical practice and provides a nuanced understanding of sensory differences in an ecologically valid way in the context of autism assessments. Methods: Participants included 238 children (41 females/3–14 years), referred to a university-based autism clinic due to concerns related to autism. Autism diagnoses were confirmed using the Autism Diagnostic Observation Schedule-2, DSM-5 criteria, and expert clinical judgement informed by comprehensive multidisciplinary evaluation. Additional measures were collected to obtain information on sensory processing (Sensory Profile-2/SP-2) and adaptive functioning (Vineland-II/-3). Diagnostic outcomes were classified as autism (n = 121) versus non-autism (n = 117). Results: Non-autistic children scored higher than autistic children in sensory avoiding and sensitivity, with no group differences in sensory seeking or registration as measured by the SP-2. Correlational analysis showed negative associations between sensory differences and both autism symptomatology and adaptive functioning. Regression analysis further indicated that higher sensory differences predicted lower adaptive functioning, with sensory sensitivity showing the most widespread associations across communication, daily living skills, and socialization. Conclusions: Non-autistic children exhibited greater sensory avoiding and sensitivity than autistic children, which may possibly reflect co-occurring concerns such as anxiety or attentional difficulties (e.g., avoiding noisy environments due to anxiety rather than sensory sensitivity). Across groups, higher sensory differences showed consistent associations with lower adaptive functioning, highlighting the importance of assessing sensory behaviors in children with diverse clinical profiles.

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