Skip to main content

Advertisement

SpringerLink
Log in

Linking Anxiety and Insistence on Sameness in Autistic Children: The Role of Sensory Hypersensitivity

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Sensory hypersensitivity and insistence on sameness (I/S) are common, co-occurring features of autism, yet the relationship between them is poorly understood. This study assessed the impact of sensory hypersensitivity on the clinical symptoms of specific phobia, separation anxiety, social anxiety and I/S for autistic and typically developing (TD) children. Parents of 79 children completed questionnaires on their child’s difficulties related to sensory processing, I/S, and anxiety. Results demonstrated that sensory hypersensitivity mediated 67% of the relationship between symptoms of specific phobia and I/S and 57% of the relationship between separation anxiety and I/S. No relationship was observed between sensory hypersensitivity and social anxiety. These mediation effects of sensory hypersensitivity were found only in autistic children, not in TD children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Notes

  1. While researchers and clinicians often feel more comfortable using person-first language such as “individuals with autism,” autistic individuals have endorsed identity-first language that incorporates autism as a component of their identity over person-first language (61% vs. 28%; Kenny et al. 2015). While autistic individuals themselves bear the full ability to choose which terminology is used, these preferences also coincide with parents of autistic children (51% vs 22%; Kenny et al. 2015) and self-advocates (Sinclair 1999, Brown & ASAN, 2016; IFA 2016). As such, we will respect this preference and use this language throughout this manuscript.

References

  • Ahadi, B., & Basharpoor, S. (2010). Relationship between sensory processing sensitivity, personality dimensions and mental health. Journal of Applied Sciences, 10, 570–574.

    Article  Google Scholar 

  • Ambler, P. G., Eidels, A., & Gregory, C. (2015). Anxiety and aggression in adolescents with autism spectrum disorders attending mainstream schools. Research in Autism Spectrum Disorders, 18, 97–109.

    Article  Google Scholar 

  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th edn.). Arlington, VA: American Psychiatric Association.

    Book  Google Scholar 

  • Arendt, K., Hougaard, E., & Thastum, M. (2014). Psychometric properties of the child and parent versions of spence children’s anxiety scale in a Danish community and clinical sample. Journal of Anxiety Disorders, 28(8), 947–956.

    Article  PubMed  Google Scholar 

  • Auyeung, B., Baron-Cohen, S., Wheelwright, S., et al. (2008). The autism spectrum quotient: Children’s version (AQ-Child). Journal of Autism and Developmental Disorders, 38(7), 1230–1240.

    Article  PubMed  Google Scholar 

  • Baum, S. H., Stevenson, R. A., & Wallace, M. T. (2015). Behavioral, perceptual, and neural alterations in sensory and multisensory function in autism spectrum disorder. Progress in Neurobiology, 134, 140–160.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ben-Sasson, A., Hen, L., Fluss, R., et al. (2009). A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(1), 1–11.

    Article  PubMed  Google Scholar 

  • Boelen, P. A., Reijntjes, A., & Carleton, R. N. (2014). Intolerance of uncertainty and adult separation anxiety. Cognitive Behaviour Therapy, 43(2), 133–144.

    Article  PubMed  Google Scholar 

  • Boswell, J. F., Thompson-Hollands, J., Farchione, T. J., et al. (2013). Intolerance of uncertainty: a common factor in the treatment of emotional disorders. Journal of Clinical Psychology, 69(6), 630–645.

    Article  PubMed  Google Scholar 

  • Boyd, B. A., Baranek, G. T., Sideris, J., et al. (2010). Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Research, 3(2), 78–87.

    PubMed  PubMed Central  Google Scholar 

  • Ermer, J., & Dunn, W. (1998). The sensory profile: A discriminant analysis of children with and without disabilities. American Journal of Occupational Therapy, 52(4), 283–290.

    Article  PubMed  Google Scholar 

  • Gadermann, A. M., Guhn, M., & Zumbo, B. D. (2012). Estimating ordinal reliability for likert-type and ordinal item response data: A conceptual, empirical, and practical guide. Practical Assessment, Research & Evaluation, 17(3), 1–13.

    Google Scholar 

  • Gal, E., Dyck, M. J., & Passmore, A. (2010). Relationships between stereotyped movements and sensory processing disorders in children with and without developmental or sensory disorders. The American Journal of Occupational Therapy, 64(3), 453–461.

    Article  PubMed  Google Scholar 

  • Gjevik, E., Eldevik, S., Fjæran-Granum, T., et al. (2011). Kiddie-SADS reveals high rates of DSM-IV disorders in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 41(6), 761–769.

    Article  PubMed  Google Scholar 

  • Glod, M., Riby, D. M., Honey, E., et al. (2015). Psychological correlates of sensory processing patterns in individuals with autism spectrum disorder: A systematic review. Review Journal of Autism and Developmental Disorders, 2(2), 199–221.

    Article  Google Scholar 

  • Glod, M., Creswell, C., Waite, P., et al. (2017). Comparisons of the factor structure and measurement invariance of the spence children’s anxiety scale—parent version in children with autism spectrum disorder and typically developing anxious children. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-017-3118-0.

    PubMed  Google Scholar 

  • Goldsmith, H. H., Hulle CAV, Arneson, C. L., et al. (2006). A population-based twin study of parentally reported tactile and auditory defensiveness in young children. Journal of Abnormal Child Psychology, 34(3), 378–392.

    Article  Google Scholar 

  • Gotham, K., Bishop, S. L., Hus, V., Huerta, M., Lund, S., Buja, A., ... & Lord, C., (2013). Exploring the relationship between anxiety and insistence on sameness in autism spectrum disorders. Autism Research, 6(1), 33–41.

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Green, S. A., Ben-sasson, A., Soto, T. W., et al. (2012). Anxiety and sensory over-responsivity in toddlers with autism spectrum disorders: Bidirectional effects across time. Journal of Autism and Developmental Disorders, 42(6), 1112–1119.

    Article  PubMed  PubMed Central  Google Scholar 

  • Green, S. A., Hernandez, L., Tottenham, N., et al. (2015). Neurobiology of sensory overresponsivity in youth with autism spectrum disorders. JAMA psychiatry, 72(8), 778–786.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hodgson, A. R., Freeston, M. H., Honey, E., et al. (2016). Facing the unknown: Intolerance of uncertainty in children with autism spectrum disorder. Journal of applied research in intellectual disabilities: JARID.

  • Jitlina, K., Zumbo, B., Mirenda, P., et al. (2017). Psychometric properties of the spence children’s anxiety scale: Parent report in children with autism spectrum disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-017-3110-8.

    PubMed  Google Scholar 

  • Kanner, L. (1943). Autistic disturbances of affective contact, pp. 217–250.

  • Kerns, C., Kendall, P. C., Berry, L., et al. (2014). Traditional and atypical presentations of anxiety in youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(11), 2851–2861.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kerns, C. M., & Kendall, P. C. (2012). The Presentation and classification of anxiety in autism spectrum disorder. Clinical Psychology: Science and Practice, 19(4), 323–347.

    Google Scholar 

  • Kim, J. A., Szatmari, P., Bryson, S. E., et al. (2000). The prevalence of anxiety and mood problems among children with autism and asperger syndrome. Autism: the international journal of research and practice, 4(2), 117–132.

    Article  Google Scholar 

  • Lane, A. E., Molloy, C. A., & Bishop, S. L. (2014). Classification of children with autism spectrum disorder by sensory subtype: A case for sensory-based phenotypes: Sensory phenotypes in autism. Autism Research, 7(3), 322–333.

    Article  PubMed  Google Scholar 

  • Lane, S. J., Reynolds, S., & Dumenci, L. (2012). Sensory overresponsivity and anxiety in typically developing children and children with autism and attention deficit hyperactivity disorder: Cause or coexistence? American Journal of Occupational Therapy, 66(5), 595–603.

    Article  PubMed  Google Scholar 

  • Leekam, S., Tandos, J., McConachie, H., et al. (2007). Repetitive behaviours in typically developing 2-year-olds. Journal of Child Psychology and Psychiatry, 48(11), 1131–1138.

    Article  PubMed  Google Scholar 

  • Leekam, S. R., Nieto, C., Libby, S. J., et al. (2007). Describing the sensory abnormalities of children and adults with autism. Journal of Autism and Developmental Disorders, 37(5), 894–910.

    Article  PubMed  Google Scholar 

  • Leekam, S. R., Prior, M. R., & Uljarevic, M. (2011). Restricted and repetitive behaviors in autism spectrum disorders: A review of research in the last decade. Psychological Bulletin, 137(4), 562–593.

    Article  PubMed  Google Scholar 

  • Leyfer, O. T., Folstein, S. E., Bacalman, S., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861.

    Article  PubMed  Google Scholar 

  • Lidstone, J., Uljarević, M., Sullivan, J., et al. (2014). Relations among restricted and repetitive behaviors, anxiety and sensory features in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 8(2), 82–92.

    Article  Google Scholar 

  • Lord C, Rutter M, DiLavore P, et al. (2012) Autism diagnostic observation schedule, 2nd edition. Torrance, CA: Western Psychological Services.

    Google Scholar 

  • Louwerse, A., Eussen MLJM, Ende, J., et al. (2015). ASD symptom severity in adolescence of individuals diagnosed with PDD-NOS in childhood: stability and the relation with psychiatric comorbidity and societal participation. Journal of Autism and Developmental Disorders, 45(12), 3908–3918.

    Article  PubMed  PubMed Central  Google Scholar 

  • Magiati, I., Ong, C., Lim, X. Y., et al. (2016). Anxiety symptoms in young people with autism spectrum disorder attending special schools: Associations with gender, adaptive functioning and autism symptomatology. Autism: the international journal of research and practice, 20(3), 306–320.

    Article  Google Scholar 

  • Maisel, M. E., Stephenson, K. G., South, M., et al. (2016). Modeling the cognitive mechanisms linking autism symptoms and anxiety in adults. Journal of Abnormal Psychology, 125(5), 692–703.

    Article  PubMed  Google Scholar 

  • Mayer, J. L. (2017). The Relationship between autistic traits and atypical sensory functioning in neurotypical and ASD adults: A spectrum approach. Journal of Autism and Developmental Disorders, 47(2), 316–327.

    Article  PubMed  Google Scholar 

  • Mazurek, M. O., Vasa, R. A., Kalb, L. G., et al. (2012). Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders. Journal of Abnormal Child Psychology, 41(1), 165–176.

    Article  Google Scholar 

  • Mazzone, L., Postorino, V., De Peppo, L., et al. (2013). Mood symptoms in children and adolescents with autism spectrum disorders. Research in Developmental Disabilities, 34(11), 3699–3708.

    Article  PubMed  Google Scholar 

  • McCormick C, Hepburn S, Young GS, et al. (2015) Sensory symptoms in children with autism spectrum disorder, other developmental disorders and typical development: A longitudinal study. Autism. Available from: http://aut.sagepub.com/cgi/doi/10.1177/1362361315599755 (Accessed 11 October 2015).

  • McIntosh, D. N., Miller, L. J., Shyu, V., & Hagerman, R. J. (1999). Sensory-modulation disruption, electrodermal responses, and functional behaviors. Developmental Medicine & Child Neurology, 41(9), 608–615.

    Article  Google Scholar 

  • Mukaddes, N. M., & Fateh, R. (2010). High rates of psychiatric co-morbidity in individuals with asperger’s disorder. The World Journal of Biological Psychiatry, 11(2–2), 486–492.

    Article  PubMed  Google Scholar 

  • Muris, P., Steerneman, P., Merckelbach, H., et al. (1998). Comorbid anxiety symptoms in children with pervasive developmental disorders. Journal of Anxiety Disorders, 12(4), 387–393.

    Article  PubMed  Google Scholar 

  • Neal, J. A., Edelmann, R. J., & Glachan, M. (2002). Behavioural inhibition and symptoms of anxiety and depression: Is there a specific relationship with social phobia? British Journal of Clinical Psychology, 41(4), 361–374.

    Article  PubMed  Google Scholar 

  • Paquette-Smith, M., Weiss, J., & Lunsky, Y. (2014). History of suicide attempts in adults with Asperger syndrome. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 35(4), 273–277.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior research methods, instruments, & computers, 36(4), 717–731.

    Article  Google Scholar 

  • Pugliese, C. E., White, B. A., White, S. W., et al. (2013). Social anxiety predicts aggression in children with ASD: Clinical comparisons with socially anxious and oppositional youth. Journal of Autism and Developmental Disorders, 43(5), 1205–1213.

    Article  PubMed  Google Scholar 

  • Rodgers J, Wigham S, McConachie H, et al. (2016) Development of the anxiety scale for children with autism spectrum disorder (ASC-ASD). Autism Research.

  • Rodgers, J., Glod, M., Connolly, B., et al. (2012). The relationship between anxiety and repetitive behaviours in autism spectrum disorder. Journal of Autism and Developmental Disorders, 42(11), 2404–2409.

    Article  PubMed  Google Scholar 

  • Rodgers, J., Hodgson, A., Shields, K., et al. (2016) Towards a treatment for intolerance of uncertainty in young people with autism spectrum disorder: development of the coping with uncertainty in everyday situations (CUES©) programme. Journal of Autism and Developmental Disorders.

  • Russell, E., Sofronoff, K., Russell, E., et al. (2005). Anxiety and social worries in children with asperger syndrome. Australian and New Zealand Journal of Psychiatry, 39(7), 633–638.

    Article  PubMed  Google Scholar 

  • Segers, M., & Rawana, J. (2014) What do we know about suicidality in autism spectrum disorders? A systematic review. Autism Research 7(4), 507–521.

    Article  Google Scholar 

  • Silverman, W. K., & Albano, A. M. (1996) Anxiety disorders interview schedule for DSM-IV.: Child. Oxford: Oxford University Press.

    Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., et al. (2008). Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 921–929.

    Article  Google Scholar 

  • Spence SH (1998) A measure of anxiety symptoms among children. behavior research and therapy,. Behavior Research and Therapy, 36, 545–566.

    Article  Google Scholar 

  • Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: A comparative study using the short sensory profile. American Journal of Occupational Therapy, 61(2), 190–200.

    Article  PubMed  Google Scholar 

  • Tomchek, S. D., Huebner, R. A., & Dunn, W. (2014). Patterns of sensory processing in children with an autism spectrum disorder. Research in Autism Spectrum Disorders, 8(9), 1214–1224.

    Article  Google Scholar 

  • Tseng, M.-H., Fu, C.-P., Cermak, S. A., et al. (2011). Emotional and behavioral problems in preschool children with autism: Relationship with sensory processing dysfunction. Research in Autism Spectrum Disorders, 5(4), 1441–1450.

    Article  Google Scholar 

  • Tupak SV, Dresler T, Guhn A, et al. (2014) Implicit emotion regulation in the presence of threat: Neural and autonomic correlates. NeuroImage, 85, 372–379.

    Article  PubMed  Google Scholar 

  • van Steensel FJA, Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14(3), 302–317.

    Article  PubMed  PubMed Central  Google Scholar 

  • von Klitzing, K., White, L. O., Otto, Y., et al. (2014). Depressive comorbidity in preschool anxiety disorder. Journal of Child Psychology and Psychiatry, 55(10), 1107–1116.

    Article  Google Scholar 

  • Wechsler D (2011) WASI -II Wechsler abbreviated scale of intelligence – second edition. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Weiss, J. A. (2014). Transdiagnostic case conceptualization of emotional problems in youth with ASD: An emotion regulation approach. Clinical Psychology: Science and Practice, 21(4), 331–350.

    Google Scholar 

  • Weng, S.-J., Carrasco, M., Swartz, J. R., et al. (2011). Neural activation to emotional faces in adolescents with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 52(3), 296–305.

    Article  PubMed  Google Scholar 

  • White, S. W., Kreiser, N. L., Pugliese, C., et al. (2012). Social anxiety mediates the effect of autism spectrum disorder characteristics on hostility in young adults. Autism: The International Journal of Research and Practice, 16(5), 453–464.

    Article  Google Scholar 

  • White, S. W., Lerner, M. D., McLeod, B. D., et al. (2015). Anxiety in youth with and without autism spectrum disorder: Examination of factorial equivalence. Behavior therapy, 46(1), 40–53.

    Article  PubMed  Google Scholar 

  • White, S. W., Oswald, D., Ollendick, T., et al. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), 216–229.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wigham, S., Rodgers, J., South, M., et al. (2015). The interplay between sensory processing abnormalities, intolerance of uncertainty, anxiety and restricted and repetitive behaviours in autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(4), 943–952.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank first and foremost all the children and families who participated in this study, who have contributed their time and energy to helping others. We would also like to acknowledge our funding. RAS was funded through the Social Sciences and Humanities Research Council of Canada Insight Grant R5502A07, the Natural Sciences and Engineering Research Counsel of Canada Discovery Grant, the Western University Faculty Development Research Fund, and the Autism Research Training Program (http://www.traininautism.com/). KRB was funded through the Kay Sansom Scholarship from the Ontario Association of Developmental Disabilities, a University of Toronto Excellence NSERC Award, a University of Toronto Undergraduate Research Award, a Joseph Armand Bombardier Canada Graduate Scholarship-Masters, and the LaMarsh Centre for Child and Youth Graduate Research Award. SF was funded through NSERC Grant 216203-13 and Canadian Institutes of Health Research (CIHR) Grant 106436. MDB was funded through a Scholar Award from the James S McDonnell Foundation and an NSERC Discovery grant and Accelerator supplement. Thank you to Alyssa Counsell for statistical consulting.

Author Contributions

KRB and RAS contributed equally to the manuscript. KRB and RAS designed the study and drafted the manuscript with assistance from SF, MDB and JMB. KRB, RAS, MS, BLN and APM administered testing, collected data and participated in study coordination. KRB, RAS, SZS and SF participated in data analysis and interpretation. All authors edited and approved the final manuscript.

Author information

Author notes

  1. Ryan A. Stevenson

    Present address: Westminster Hall, University of Western Ontario, 361 Windermere Road, London, ON, N6G 2K3, Canada

Authors and Affiliations

  1. Department of Psychology, University of Toronto, Toronto, ON, Canada

    Karen R. Black, Sol Z. Sun, Aviva Philipp-Muller, Morgan D. Barense & Susanne Ferber

  2. Department of Psychology, York University, Toronto, ON, Canada

    Karen R. Black, Magali Segers, Busiswe L. Ncube & James M. Bebko

  3. Department of Psychology, Western University, London, ON, Canada

    Ryan A. Stevenson

  4. Brain and Mind Institute, Western University, London, ON, Canada

    Ryan A. Stevenson

  5. Neuroscience Program, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Ryan A. Stevenson

  6. Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Ryan A. Stevenson

  7. Rotman Research Institute at Baycrest, Toronto, ON, Canada

    Morgan D. Barense & Susanne Ferber

Authors
  1. Karen R. Black
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryan A. Stevenson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Magali Segers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Busiswe L. Ncube
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sol Z. Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aviva Philipp-Muller
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. James M. Bebko
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Morgan D. Barense
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Susanne Ferber
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ryan A. Stevenson.

Additional information

Karen R. Black and Ryan A. Stevenson contributed equally to this publication.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 13 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Black, K.R., Stevenson, R.A., Segers, M. et al. Linking Anxiety and Insistence on Sameness in Autistic Children: The Role of Sensory Hypersensitivity. J Autism Dev Disord 47, 2459–2470 (2017). https://doi.org/10.1007/s10803-017-3161-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-017-3161-x

Keywords

Search

Navigation