Sensory Response Patterns Are Associated with Attentional Deficits in Preschoolers with ASD

Background:  Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are common childhood neurodevelopmental disorders that often co-occur, and include both sensory processing and attention difficulties. Many individuals with ASD demonstrate aberrant sensory response patterns, including hyporesponsiveness, hyperresponsiveness, and sensory seeking (Baranek et al., 2006). Children with ADHD also demonstrate sensory deficits, particularly hyperresponsivness.  Children at-risk for and diagnosed with ASD demonstrate attentional disengagement differences, and children with ADHD exhibit poor sustained attention. These findings suggest a link between sensory and attentional processes early in development; however, research regarding the nature of and relations between attention and sensory difficulties in ASD are limited. 

Objectives:  Aim one of this study explores the extent to which sensory response patterns are related to ADHD symptoms in preschoolers with ASD. Aim two investigates the degree to which sensory responsiveness and ADHD symptoms predict orienting and sustained attention during a naturalistic eye-tracking paradigm. 

Methods:  Participants included preschoolers with ASD (N=25, Mean Age=4.47 years, Range=2.27-5.98 years; Mean Nonverbal IQ=64.3 +/- 24.6). ASD diagnosis was based on the ADOS-2 and ADI-R. The Sensory Experiences Questionnaire (Baranek et al., 2006) yielded scores for hyporesponsiveness, hyperresponsiveness, and sensory seeking, and the Behavior Assessment System for Children (Reynolds & Kamphaus, 2004) provided inattention/hyperactivity scores. Measures of orienting (time to first look) and sustained attention (proportion of time looking) were derived from a naturalistic eye-tracking paradigm in which participants viewed an actress and four dynamic, nonsocial stimuli (Chawarska et al., 2012). Final results will include additional participants’ data.  

Results:  All three sensory response patterns were significantly, positively correlated with attention problems, with hyporesponsiveness showing the strongest relation (r=0.55, p<0.01), followed by hyperresponsiveness and sensory seeking (r=0.49, p<0.05). Hyperresponsiveness was significantly, positively related to hyperactivity (r=0.44, p<0.05). Total sensory scores (collapsed across all patterns) were significantly, positively associated with both attention problems (r=0.71, p<0.01) and hyperactivity (r=0.46, p<0.05). Hyporesponsiveness and attention problems showed trends toward significance (t=1.99, p=0.06; t=1.77, p=0.09) as positive predictors of orienting to dynamic stimuli, accounting for 16.5% and 13.5% of the variance in time to first look, respectively. Sensory response patterns and attention deficits were not predictors of proportion of time looking at dynamic, nonsocial stimuli. 

Conclusions:  Sensory response patterns were associated with attentional deficits in preschoolers with ASD. All patterns related to difficulties maintaining attention and hyperresponsiveness related to hyperactivity. Additionally, hyporesponsiveness and attention problems showed trends toward predicting attentional orienting speed to dynamic, nonsocial stimuli. These findings shed light on early sensory symptoms’ relations to the presence of attentional deficits in preschoolers with ASD, identify relations between sensory and attentional behaviors across measures, and can inform behavioral interventions targeting sensory responsiveness and attentional patterns in ASD.