This report focuses on the emergence of and bidirectional effects between anxiety and sensory over-responsivity (SOR) in toddlers with autism spectrum disorders (ASD). Participants were 149 toddlers with ASD and their mothers, assessed at 2 annual time points. A cross-lag analysis showed that anxiety symptoms increased over time while SOR remained relatively stable. SOR positively predicted changes in anxiety over and above child age, autism symptom severity, NVDQ, and maternal anxiety, but anxiety did not predict changes in SOR. Results suggest that SOR emerges earlier than anxiety, and predicts later development of anxiety.
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American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV). Washington, DC: American Psychiatric Association.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (DSM-IV-TR) (4th ed.). Washington, DC: American Psychiatric Association.
Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006). Sensory experience questionnaire: Discriminating sensory features in young children with autism, developmental delays, and typical development. Journal of Child Psychology and Psychiatry, 47(6), 591–601.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897.
Bellini, S. (2004). Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19(2), 78–86.
Ben-Sasson, A., Carter, A. S., & Briggs-Gowan, M. J. (2009). Prevalence and correlates of sensory over-responsivity from infancy to elementary school. Journal of Abnormal Child Psychology, 37(5), 705–716.
Ben-Sasson, A., Carter, A. S., & Briggs-Gowan, M. J. (2010). The development of sensory over-responsivity from infancy to elementary school. Journal of Abnormal Child Psychology, 38(8), 1193–1202.
Ben-Sasson, A., Cermak, S. A., Orsmond, G. I., Carter, A. S., Kadlec, M. B., & Dunn, W. (2007). Extreme sensory modulation behaviors in toddlers with autism. American Journal of Occupational Therapy, 61(5), 584–592.
Ben-Sasson, A., Cermak, S. A., Orsmond, G. I., Tager-Flusberg, H., Kadlec, M. B., & Carter, A. S. (2008). Sensory clusters of toddlers with autism spectrum disorders: Differences in affective symptoms. Journal of Child Psychology and Psychiatry, 49(8), 817–825.
Briggs-Gowan, M. J., Carter, A. S., & Schwab-Stone, M. (1996). Discrepancies among mother, child, and teacher reports: Examining the contributions of maternal depression and anxiety. Journal of Abnormal Child Psychology, 24(6), 749–765.
Carter, A. S., Black, D., Tewani, S., Connolly, C., Kadlec, M. B., & Tager-Flusberg, H. (2007). Sex differences in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 86–97.
Carter, A. S., & Briggs-Gowan, M. J. (2005). The infant-toddler social and emotional assessment (ITSEA) manual. San Antonio, TX: Harcourt Assessment.
Carter, A. S., Briggs-Gowan, M. J., Jones, S. M., & Little, T. D. (2003). The infant-toddler social and emotional assessment (ITSEA): Factor structure, reliability, and validity. Journal of Abnormal Child Psychology, 31, 495–514.
Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young children and their families: A conceptual model. Infants and Young Children, 9(4), 23–35.
Dunn, W. (1999). Sensory profile user’s manual. San Antonio, TX: Psychological Corporation.
Dunn, W. (2002). The infant/toddler sensory profile: User’s manual. New York: Psychological Corporation.
Edelson, S. M., Edelson, M. G., Kerr, D. C. R., & Grandin, T. (1999). Behavioral and physiological effects of deep pressure on individuals with autism: A pilot study investigating the efficacy of Grandin’s ‘Hug Machine’. American Journal of Occupational Therapy, 53, 145–152.
Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2004). Psychiatric symptoms in preschool children with PDD and clinic and comparison samples. Journal of Autism and Developmental Disorders, 34(4), 379–393.
Green, S. A., & Ben-Sasson, A. (2010). Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders: Is there a causal relationship? Journal of Autism and Developmental Disorders, 40(12), 1495–1504.
Hardan, A. Y., Minshew, N. J., Melhem, N. M., Srihari, S., Jo, B., Bansal, R., et al. (2008). An MRI and proton spectroscopy study of the thalamus in children with autism. Psychiatry Research: Neuroimaging, 163(2), 97–105.
Hitoglou, M., Ververi, A., Antoniadis, A., & Zafeiriou, D. (2010). Childhood autism and auditory system abnormalities. Pediatric Neurology, 42(5), 309–314.
Interdisciplinary Council on Developmental, Learning Disorders. (2005). Diagnostic manual for infancy and early childhood. Bethesda: ICDL.
Kern, J. K., Trivedi, M. H., Grannemann, B. D., Garver, C. R., Johnson, D. G., Andrews, A. A., et al. (2007). Sensory correlations in autism. Autism, 11(2), 123–134.
Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4(2), 117–132.
Kinnealey, M., & Fuiek, M. (1999). The relationship between sensory defensiveness, anxiety, depression and perception of pain in adults. Occupational Therapy International, 6(3), 195–206.
Lane, S. J. (2002). Sensory modulation. In A. C. Bundy, S. J. Lane, & E. A. Murray (Eds.), Sensory integration: Theory and practice (2nd ed., pp. 101–122). Philadelphia: FA. Davis.
Lecavalier, L. (2006). Behavioral and emotional problems in young people with pervasive developmental disorders: Relative prevalence, effects of subject characteristics, and empirical classification. Journal of Autism and Developmental Disorders, 36(8), 1101–1114.
Liss, M., Saulnier, C., Fein, D., & Kinsbourne, M. (2006). Sensory and attention abnormalities in autistic spectrum disorders. Autism, 10(2), 155–172.
Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63, 694–701.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.
Lord, C., Rutter, M., & Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.
Miller, L., Anzalone, M., Lane, S., Cermak, S., & Osten, E. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61, 135–140.
Mullen, E. M. (1995). Mullen scales of early learning (AGS Ed.). Los Angeles: Western Psychological Corp.
Muris, P., Steerneman, P., Merckelbach, H., Holdrinet, I., & Meesters, C. (1998). Comorbid anxiety symptoms in children with pervasive developmental disorders. Journal of Anxiety Disorders, 12(4), 387–393.
Parham, L. D., & Mailloux, Z. (2005). Sensory integration. In: J. Case-Smith (Ed.). Occupational therapy for children (5th ed., pp. 356–409). St. Louis, MO: Elsevier Mosby (Original work published 1985).
Pfeiffer, B., & Kinnealey, M. (2006). Treatment of sensory defensiveness in adults. Occupational Therapy International, 10(3), 175–184.
Pfeiffer, B., Kinnealey, M., Reed, C., & Herzberg, G. (2005). Sensory modulation and affective disorders in children and adolescents with Asperger’s disorder. The American Journal of Occupational Therapy, 59, 335–345.
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
Reynolds, S., & Lane, S. J. (2008). Diagnostic validity of sensory over-responsivity: A review of the literature and case reports. Journal of Autism and Developmental Disorders, 38(3), 516–529.
Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., et al. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45(9), 1094–1103.
Schoen, S. A., Miller, L. J., Brett-Green, B. A., & Nielsen, D. M. (2009). Physiological and behavioral differences in sensory processing: A comparison of children with autism spectrum disorder and sensory modulation disorder. Frontiers in Integrative Neuroscience, 3(29), 1–11.
Sparrow, S., Balla, D., & Cicchetti, D. (1984). Vineland adaptive behavior scales. Circle Pines, MN: American Guidance Service.
Stagnitti, K., Raison, P., & Ryan, P. (1999). Sensory defensiveness syndrome: A paediatric perspective and case study. Australian Occupational Therapy Journal, 46(4), 175–187.
Sukhodolsky, D. G., Scahill, L., Gadow, K. D., Arnold, L. E., Aman, M. G., McDougle, C. J., et al. (2008). Parent-rated anxiety symptoms in children with pervasive developmental disorders: Frequency and association with core autism symptoms and cognitive functioning. Journal of Abnormal Child Psychology, 36, 117–128.
Talay-Ongan, A., & Wood, K. (2000). Unusual sensory sensitivities in autism: A possible crossroads. International Journal of Disability, Development and Education, 47(2), 201–212.
Weisbrot, D. M., Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). The presentation of anxiety in children with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15(3), 477–496.
This research was conducted as part of the Studies to Advance Autism Research and Treatment (STAART) center at Boston University. Funding was provided by National Institute of Mental Health grant U54 MH 66398 (Helen Tager-Flusberg, Center Principal Investigator, Alice S. Carter, Project Principal Investigator) as well as grants from the National Alliance for Autism Research (Alice S. Carter, Principal Investigator) and the Boston University General Clinical Research Center. We are grateful to the families of the children in this study, whose participation in our project inspires this work and makes it possible.
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Green, S.A., Ben-Sasson, A., Soto, T.W. et al. Anxiety and Sensory Over-Responsivity in Toddlers with Autism Spectrum Disorders: Bidirectional Effects Across Time. J Autism Dev Disord 42, 1112–1119 (2012). https://doi.org/10.1007/s10803-011-1361-3
- Autism spectrum disorders
- Sensory over-responsivity