Sensory Hyper and Hyposensitivity to Sensory Stimuli As a Diagnostic Indicator of Autism Spectrum Disorder

Background:

Research has shown that people living with Autism Spectrum Disorders (ASD) are typically sensitive to sensory stimuli. Unusual sensory interests, either seeking or avoiding sensory stimuli, were thus introduced as a new criterion for ASD (B4) in the DSM-5 (APA, 2013). This criterion is broadly defined as “Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement)” (APA, 2013, p50). The inclusion of this criterion however, lacks empirical validation.

Objectives:

To identify the diagnostic relevance of the inclusion of hypersensitivity and hyposensitivity to sensory stimuli in the DSM-5 criteria for ASD

Methods:

Data from 245 clients (171 males, 74 females) who were referred to a local private practice for an autism assessment were extracted by the author from clinical report. Two hundred and six of the participants met the DSM-5 (APA, 2013) criteria for ASD, while 39 did not. Participants were between 12 months and 45 years of age, with a mean of age of 9.11 years old (SD = 7.18).

Results:

Results indicated that although the B4 criterion had high sensitivity, its specificity was low. Meeting B4 criterion was common among persons who went on to receive an ASD diagnosis (71%). Very few of those who did not meet this criterion went on to receive a DSM-5 diagnosis (2%). It is clear that the sensitivity of this criterion is high but the specificity is questionable with 41% of those who did not receive a DSM-5 diagnosis also meeting B4 criterion. Thus while the majority of persons with ASD experience sensory difficulties, it does not appear unique to this disorder with many people without the disorder also experiencing similar concerns.

Conclusions:

Clinicians need to be vigilant when using B4 as a diagnostic criterion as its presence is not unique to ASD – its absence however is more telling.

Keywords: DSM-5, sensory behaviours