Examining the latent structure and correlates of sensory reactivity in autism: a multi-site integrative data analysis by the autism sensory research consortium

Abstract

Background Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these “supra-modal” traits in the autistic population. Methods Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3–18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a “general response pattern” factor for each supra-modal construct and determine the added value of “modality-specific response pattern” scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO, and SEEK (sub)constructs. Results All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses supported the validity of a supra-modal HYPER construct (ωH = .800) but not a supra-modal HYPO construct (ωH = .653), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ωH = .800; 4/7 modalities). Modality-specific subscales demonstrated significant added value for all response patterns. Meta-analytic correlations varied by construct, although sensory features tended to correlate most with other domains of core autism features and co-occurring psychiatric symptoms (with general HYPER and speech HYPO demonstrating the largest numbers of practically significant correlations). Limitations Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to caregiver report of observable behaviors and excluded multisensory items that reflect many “real-world” sensory experiences. Conclusion Of the three sensory response patterns, only HYPER demonstrated sufficient evidence for valid interpretation at the supra-modal level, whereas supra-modal HYPO/SEEK constructs demonstrated substantial psychometric limitations. For clinicians and researchers seeking to characterize sensory reactivity in autism, modality-specific response pattern scores may represent viable alternatives that overcome many of these limitations.

Measurement matters: A commentary on the state of the science on patient reported outcome measures (PROMs) in autism research

“…Although large databases (e.g., Feliciano et al, 2018;Hall et al, 2012) are promising and likely an important step for future research, straightforward use of these samples for PROM evaluation is often precluded by a lack of clarity in sample characterization, questionable representativeness of large samples (Rødgaard et al, 2022), time-intensive data cleaning, and fraudulent responses within online surveys (Harrop et al, 2021). The pooling together of many smaller samples that utilize the same or similar measures in an integrative data analysis is one promising alternative that has previously been leveraged within the autism literature (e.g., Magiati et al, 2017;Sturm et al, 2017;Williams, Schaaf, et al, 2023).…”

Novel Parent Survey Measures Sensory Behaviors Incorporating Sensory Modality and Stimulus Intensity

“…11 To characterize patterns of sensory differences, various questionnaires have been developed. 12, 13 For children, specifically those with autism, sensory questionnaires mainly utilize parent-report measures. The Short Sensory Profile (SSP) 14 an abbreviated version of Dunn's Sensory Profile 15,16 evaluates sensory behaviors of children with a discriminant validity of >95% in identifying sensory processing differences.…”

“…18 The SEQ assesses hyper-and hyposensitivity but does not provide sensory modality-specific sub-scores for all five senses which are important in characterizing patterns of sensory changes. 13 Importantly, hyper-and hyposensitivity are not binary classifications or even mutually exclusive labels. For example, multiple studies have shown that individuals diagnosed with autism display both hypersensitivity and hyposensitivity, sometimes even within the same modality.…”