However, side-by-side comparisons of young autistic and neurotypical children suggest that the relationship between sensory processing and anxiety may be much more prominent in autism than neurotypical development ( 28). Effective sensory processing is a critical evolutionary component for managing stress and danger and there are demonstrated links between sensory sensitivity and affective disorders, including anxiety, outside of autism ( 24– 27). There is growing evidence for a strong link between atypical sensory processing and elevated anxiety in autism ( 15– 20).
While some autistic individuals manifest anxiety in ways typical of other anxious people, there are also unexpected expressions of anxiety in autism that may go overlooked, such as different underlying drives toward compulsive behavior or social avoidance than typically seen in anxiety ( 9).
These anxiety symptoms can cause significant additional distress, and have been linked to increased levels of problematic behavior ( 11, 12), difficulty with decision making ( 13), and considerable stress on family systems ( 14). Many autistic people also experience elevated levels of anxiety ( 8– 10). Atypical sensory processing has been reported in between 45 and 95% of autistic samples ( 3– 5) and is included in the most recent definitions of autism ( 6, 7). Many autistic people report unusually intense sensory processing, including hypersensitivity to multiple sensory modalities and high levels of distress even to low-threshold sensory stimuli ( 1, 2). Treatment for anxiety in autism should be informed by knowledge of unique aspects of anxiety in autism and consider the role of sensory experience and everyday psychophysiological arousal. We suggest that this and other findings could indicate chronic hyperarousal in many autistic people. There were no group differences in the rate of auditory habituation, nonetheless the overall, absolute larger pupil size remained in the autism group throughout the experiment. The autism group showed significantly larger pupil size than other groups at baseline, before any auditory stimulation. Dimensional analyses across all participants showed significant positive correlations between sensory sensitivity, sensory seeking, and sensory avoidance domains with scores from the Intolerance of Uncertainty Scale-Short Form and Penn State Worry Questionnaire.
#AUDITORY SENSITIVITY AND ANXIETY REGISTRATION#
The autism group showed atypical sensory processing on all four measured domains of the Adolescent and Adult Sensory Profile including sensory sensitivity, sensory seeking, sensory avoidance, and low registration subscales. In a subset of 80 participants we also measured self-report levels of sensory processing, anxious apprehension, and intolerance of uncertainty. We measured pupil size using including a baseline task with no auditory stimulus followed by two blocks of simple auditory habituation. This study included 95 young adult participants including autistic adults, non-autistic adults reporting to a psychotherapy clinic with high levels of anxiety, and neurotypical adults with no psychiatric concerns. Understanding how these experiences are linked to each other can contribute to improved support and intervention for reducing sensory overload and anxiety.
Many autistic people report overwhelming sensory experiences and also elevated levels of anxiety. 3Nationwide Children's Hospital, Columbus, OH, United States.
2Neuroscience Center, Brigham Young University, Provo, UT, United States.1Department of Psychology, Brigham Young University, Provo, UT, United States.
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