Is sensory over‐responsivity distinguishable from childhood behavior problems? A phenotypic and genetic analysis

Abstract

Background Although impaired sensory processing accompanies various clinical conditions, the question of its status as an independent disorder remains open. Our goal was to delineate the comorbidity (or lack thereof) between childhood psychopathology and sensory over-responsivity (SOR) in middle childhood using phenotypic and behavior genetic analyses. Method Participants (N=970) were drawn from the Wisconsin Twin Project, a population-based sample of twins and their families. Mothers completed a sensory responsivity checklist when their offspring were on average 7 years old, followed by a diagnostic interview (Diagnostic Interview Schedule for Children; DISC) within 6 – 12 months. We examined the incidence of DISC diagnoses - ADHD, Conduct Disorder, Oppositional Defiance Disorder, Agoraphobia, General Anxiety, OCD, Panic disorder, Separation Anxiety, Social Phobia, Specific Phobia, Depression, Enuresis, Trichtolloma, Tics, selective mutism, and Pica -among children with SOR, and vice-versa. Children with Autism or PDD were excluded from the present study. Additionally, we examined parent reported physical health diagnoses among non-diagnosed children and three groups of children with SOR and/or DISC diagnoses. Biometric models explored common underlying genetic and environmental influences on symptoms of SOR and psychopathology. Results A majority of individuals who screened positive for SOR did not qualify for a DISC diagnosis (58.2%), and vice versa (68.3%). Children who screened positive for SOR only and typical children had similar rates of physical health problems. Turning to a dimensional approach, multivariate twin models of demonstrated that modest covariation between SOR and DISC symptoms could be entirely accounted for by common underlying genetic effects. Conclusions Our results suggest that SOR occurs independently of recognized childhood psychiatric diagnoses but is also a relatively frequent comorbid condition with recognized diagnoses. Genetic sources of this comorbidity are implicated.

The Role of Sensory Modulation Deficits and Behavioral Symptoms in a Diagnosis for Early Childhood

“…The absence of a high correlation between sensory and behavioral symptoms in both groups suggests that these symptoms reflect different conditions, which confirms our hypothesis and is supported by other studies [25,26,50]. It is important to note that the correlation between Withdrawn syndrome (on CBCL) and avoidance sensory symptoms (assessed with the ITSP) in children with RDSP was only moderate.…”

“…This question suggests that there is a need to analyze the relationship between these symptoms [17,[24][25][26].…”

ASD Validity

“…Many very young TD children express RRBs, including restricted interests, repetitive motor behaviors, change resistance, and/or atypical sensory responsiveness (Camarata 2014;Harrop et al 2013;Van Hulle et al 2012). In fact, Harrop et al (2013) noted that young TD children and young children diagnosed with ASD express similar rates of RRBs.…”

Sensory Over-Responsivity in a Sample of Children Seeking Treatment for Anxiety

“…However, this information is largely based on anecdotal case reports, 20,21 studies using a broader definition of sensory problems 14 (e.g., including both over- and under-responsiveness), and research using unsystematically diagnosed or poorly characterized samples. In the Carter et al 3 and Van Hulle et al 15 studies, rates of specific psychiatric disorders were not reported, but the rate of diagnoses within the broad domains of internalizing disorders among those with SOR ranged from 10.0% 3 to 70.4% 15 and externalizing disorders from 18.5% 3 to 50.4%. 15 …”

“…Two large scale studies examined rates of SOR and co-occurring DSM-IV 13 diagnoses in well-characterized, population-based samples of typically developing children (i.e., children without cognitive disabilities or autism spectrum disorders). 3,14,15 Both samples were school-aged children (7–10 years old; 3 7 years old 15 ) whose parents completed a structured diagnostic interview (Diagnostic Interview Schedule for Children) 16 and the Sensory Over-Responsivity Inventory (SensOR), 17 a parent-report measure of SOR in the tactile and auditory domains. SOR status was based on the SensOR but criteria differed in each study, such that children were classified has having SOR if parents endorsed ≥ 4 items in the Carter et al study and ≥ 6 tactile or ≥ 4 auditory items in the Van Hulle et al study.…”