Toward an Interdisciplinary Understanding of Sensory Dysfunction in Autism Spectrum Disorder: An Integration of the Neural and Symptom Literatures

Abstract

Sensory processing differences have long been associated with autism spectrum disorder (ASD), and they have recently been added to the diagnostic criteria for the disorder. The focus on sensory processing in ASD research has increased substantially in the last decade. This research has been approached from two different perspectives: the first focuses on characterizing the symptoms that manifest in response to real world sensory stimulation, and the second focuses on the neural pathways and mechanisms underlying sensory processing. The purpose of this paper is to integrate the empirical literature on sensory processing in ASD from the last decade, including both studies characterizing sensory symptoms and those that investigate neural response to sensory stimuli. We begin with a discussion of definitions to clarify some of the inconsistencies in terminology that currently exist in the field. Next, the sensory symptoms literature is reviewed with a particular focus on developmental considerations and the relationship of sensory symptoms to other core features of the disorder. Then, the neuroscience literature is reviewed with a focus on methodological approaches and specific sensory modalities. Currently, these sensory symptoms and neuroscience perspectives are largely developing independently from each other leading to multiple, but separate, theories and methods, thus creating a multidisciplinary approach to sensory processing in ASD. In order to progress our understanding of sensory processing in ASD, it is now critical to integrate these two research perspectives and move toward an interdisciplinary approach. This will inevitably aid in a better understanding of the underlying biological basis of these symptoms and help realize the translational value through its application to early identification and treatment. The review ends with specific recommendations for future research to help bridge these two research perspectives in order to advance our understanding of sensory processing in ASD.

Longitudinal assessment of stability of sensory features in children with autism spectrum disorder or other developmental disabilities

“…These high correlations are consistent with prior findings for toddlers with ASD [Green et al, ], and demonstrate that over a several‐year period preschool/school‐age children with elevated sensory scores are likely to retain their high standing relative to other children. Analogous to what has been postulated in the area of temperament [e.g., Strelau, ; Henderson & Wachs, ], inter‐individual consistency in sensory response patterns may reflect both: (a) prolonged influence of genetic or neurophysiologic mechanisms linked to ASD or DD, but which nonetheless vary among children [e.g., Marco, Hinkley, Hill, & Nagarajan, ; Green et al, ; Schauder & Bennetto, ]; and (b) longstanding environmental consistencies, such as parental accommodations or recurring situational parameters that affect the manifestation of sensory features [e.g., Gray, ; Brown & Dunn, ; Bagby et al, ].…”

Heterogeneity of sensory features in autism spectrum disorder: Challenges and perspectives for future research

“…Studies of sensory features in ASD have appeared in the literature for over 40 years across the disciplines of cognitive science, experimental psychology, neuroscience, and occupational therapy [see for example, Baranek, David, Poe, Stone, & Watson, ; Happe & Frith, 2006; Ornitz, ; Pellicano & Burr, ]. We now know that individuals with ASD experience difficulties in perceiving, integration and modulating their responses to daily sensory stimuli across auditory, visual, somatosensory, and proprioceptive domains, and that these difficulties are present throughout the life span, including in infancy prediagnosis [see Rogers & Ozonoff, ; Schaaf & Lane, and Schauder & Bennetto, for reviews of this literature]. The literature to date has charted these difficulties at neural [e. g., Marco et al, ], psychophysical [e.g., tactile: Cascio et al, ; visual: Tavassoli, Latham, Bach, Dakin, & Baron‐Cohen, ; auditory: Bonnel et al, ], physiological [e.g., Marco et al, 2011], and self‐report levels [e.g., Ausderau et al, ; Robertson & Simmons, ].…”

“…Although structured and semistructured observational protocols do not suffer from issues inherent in the use of questionnaire measures, they also have their own limitations such as potential lack of ecological validity, temporal and contextual restrictedness, and influence of “noise” variables, for example, the child's temporary mood or somatic health issues [Zentner & Bates, ]. Instruments to assess the physiological components of sensory features include electroencephalogram (EEG), magnetic resonance imaging (MRI & fMRI) and magnetoencephalogram [MEG; Marco et al, 2011; Schauder & Bennetto, ]. While these assessments provide a more precise measurement of neural function associated with sensory processing, the protocols are not yet clinic‐ready.…”

“…While these assessments provide a more precise measurement of neural function associated with sensory processing, the protocols are not yet clinic‐ready. Further, it is recognized that these tools, on their own, are insufficient to fully characterize the functional implications of sensory alterations for individuals with ASD in their daily lives [Schauder & Bennetto, ].…”

“…In summary, it is difficult to reconcile information gained from questionnaire, observational and physiological measures since these different modes of assessments sample different contexts and different levels of information. As recently identified, the optimal way to assess sensory features is one that is comprehensive, multidimensional and multimodal, combining observational, physiological and questionnaire‐based measures [Schauder & Bennetto, ]. Good examples of this line of work are previous studies that have combined the use of questionnaires with observational [Watson et al, ] and physiological laboratory protocols [Schoen, Miller, Brett‐Green, & Nielsen, ] as well as new measures designed to assess perceived performance on basic sensory perception abilities rather than experience of sensory stimuli [Tavassoli et al, ].…”