View in EDS HTML Full Text PDF Full Text

Brief Report: Sensory Features Associated with Autism after Controlling for ADHD Symptoms

Saved in:
Bibliographic Details
Title: Brief Report: Sensory Features Associated with Autism after Controlling for ADHD Symptoms
Language: English
Authors: Ellen C. Masters (ORCID 0000-0002-9586-0606), Kevin M. Antshel (ORCID 0000-0002-1139-7790), Wendy R. Kates (ORCID 0000-0003-3358-2572), Natalie Russo (ORCID 0000-0001-5229-3552)
Source: Journal of Autism and Developmental Disorders. 2025 55(7):2578-2586.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 9
Publication Date: 2025
Sponsoring Agency: National Institutes of Health (NIH) (DHHS)
Contract Number: 1R01MH10153601
Document Type: Journal Articles
Reports - Research
Descriptors: Attention Deficit Hyperactivity Disorder, Symptoms (Individual Disorders), Sensory Integration, Autism Spectrum Disorders, Age Differences, Gender Differences, Intelligence Quotient, Profiles, Prediction, Genetics, Children, Adolescents, Scores, Child Behavior, Rating Scales
Assessment and Survey Identifiers: Behavior Assessment System for Children
DOI: 10.1007/s10803-023-06046-y
ISSN: 0162-3257
1573-3432
Abstract: Background: Sensory processing differences are reported both in children with ADHD and in children with autism. Given the substantial overlap between autism and ADHD, the current study examined which sensory features were uniquely predictive of autistic traits after controlling for ADHD symptoms, age, IQ, and sex in a sample of children and adolescents with autism aged 6-17 years. Methods: The sample included 61 children and adolescents with autism. The Sensory Profile was used to examine Dunn's quadrant model (seeking, sensitivity, avoiding, registration), ADHD symptoms were measured using hyperactivity and attention problems BASC-2 T-scores, and autistic traits were measured using the AQ. Results: After controlling for age, IQ, sex, and ADHD symptoms, Dunn's sensitivity quadrant predicted autistic traits. Conclusions: Findings provide insight into the phenotype of autism and ADHD. Sensory sensitivity may be unique to autism over and above elevated ADHD symptoms that are commonly seen in this population.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1474256
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwHvjeh1gFMCFwI9xdO7YiC7AAAA4TCB3gYJKoZIhvcNAQcGoIHQMIHNAgEAMIHHBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDIWcHviUF9B7ZUHlVAIBEICBmTFqnnpM3Q-MdIVBUq4fuhVXtYFFYPpYT1PJIkes-kfEb6xpGGCMXMGiR3TA69HcDDIe_dwxw8e_o5Yikr_MujCY5aZUaB0idIoxoJ8Awgc21sQ8lcwyDaSvK9RQOQrJApz5wtpWp1wfIHlxOpq6uv7IxezmaaurO8EW3cAidtjaAUVzUUrI38XGfRQztJuoQI8g7H3tJB3YDQ==
Text:
  Availability: 1
  Value: <anid>AN0185941309;aut01jul.25;2025Jun17.02:48;v2.2.500</anid> <title id="AN0185941309-1">Brief Report: Sensory Features Associated with Autism After Controlling for ADHD Symptoms </title> <p>Background: Sensory processing differences are reported both in children with ADHD and in children with autism. Given the substantial overlap between autism and ADHD, the current study examined which sensory features were uniquely predictive of autistic traits after controlling for ADHD symptoms, age, IQ, and sex in a sample of children and adolescents with autism aged 6–17 years. Methods: The sample included 61 children and adolescents with autism. The Sensory Profile was used to examine Dunn's quadrant model (seeking, sensitivity, avoiding, registration), ADHD symptoms were measured using hyperactivity and attention problems BASC-2 T-scores, and autistic traits were measured using the AQ. Results: After controlling for age, IQ, sex, and ADHD symptoms, Dunn's sensitivity quadrant predicted autistic traits. Conclusions: Findings provide insight into the phenotype of autism and ADHD. Sensory sensitivity may be unique to autism over and above elevated ADHD symptoms that are commonly seen in this population.</p> <p>Keywords: Autism; Sensitivity; ADHD; Psychology and Cognitive Sciences Psychology</p> <p>Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10803-023-06046-y.</p> <p>Autism[<reflink idref="bib1" id="ref1">1</reflink>] is characterized by deficits in social communication and social interaction as well as restricted, repetitive patterns of behaviors (RRB), interests, or activities including sensory symptoms (American Psychiatric Association, [<reflink idref="bib1" id="ref2">1</reflink>]). Important changes have been made to the diagnostic criteria of autism over the years, leading to an expanded phenotype (Mottron, [<reflink idref="bib34" id="ref3">34</reflink>]) that require researchers to consider the growing heterogeneity of symptom presentation. In <emph>DSM-5</emph> (APA, [<reflink idref="bib1" id="ref4">1</reflink>]), sensory features were added to the RRB criterion, and Attention-Deficit/Hyperactivity Disorder (ADHD) and autism can now be diagnosed at the same time. These two changes have led to significant increases in the number of studies examining autism and sensory features as well as autism and ADHD. However, sensory features are not unique to autism, and are also common among those with ADHD (Bijlenga et al., [<reflink idref="bib6" id="ref5">6</reflink>]; Dunn & Bennett, [<reflink idref="bib15" id="ref6">15</reflink>]; Ghanizadeh, [<reflink idref="bib18" id="ref7">18</reflink>]; Little et al., [<reflink idref="bib31" id="ref8">31</reflink>]). Additionally, rates of co-occurrance between autism and ADHD range from 40 to 70% (Faraone et al., [<reflink idref="bib17" id="ref9">17</reflink>]) leading to calls to examine the role of sensory features in these intersecting conditions (Kern et al., [<reflink idref="bib28" id="ref10">28</reflink>]). However, no studies have examined the intersection of both attention and hyperactivity with sensory features in an autistic population. Thus, it is not presently known whether, and which, sensory features might be uniquely relevant to autism in the presence of ADHD symptoms.</p> <p>Here we assess which sensory features remain predictive of autistic traits after controlling for ADHD symptoms in a group of children and adolescents with autism. In so doing, we use the Sensory Profile (SP; Dunn, [<reflink idref="bib12" id="ref11">12</reflink>]) to examine one conceptual model of sensory features: Dunn's quadrant model ([<reflink idref="bib13" id="ref12">13</reflink>]).</p> <hd id="AN0185941309-2">Theoretical Model of Sensory Features</hd> <p>Dunn's ([<reflink idref="bib11" id="ref13">11</reflink>]; [<reflink idref="bib13" id="ref14">13</reflink>]) sensory processing framework consists of four modality-independent sensory quadrants formed by the intersection of neurological and behavioral continua (1997), which represent observable behavioral outcomes. These four quadrants include seeking, the degree to which a child seeks to obtain sensory input; avoiding, the degree to which a child is bothered by, and attempts to limit, sensory input; sensitivity, the degree to which a child detects sensory input; and registration, the degree to which a child does not seem to register sensory input. Within this model an individual can exhibit any combination of these patterns (Dunn, [<reflink idref="bib12" id="ref15">12</reflink>]).</p> <hd id="AN0185941309-3">Sensory Features in Autism and ADHD</hd> <p>Individuals with autism (Kern et al., [<reflink idref="bib27" id="ref16">27</reflink>]) and individuals with ADHD (Little et al., [<reflink idref="bib31" id="ref17">31</reflink>]) demonstrate elevated scores across quadrants of Dunn's ([<reflink idref="bib13" id="ref18">13</reflink>]) model. A meta-analysis noted considerable variability between individual studies in both the direction and magnitude of effects (Ben-Sasson et al., [<reflink idref="bib5" id="ref19">5</reflink>]). Specifically, Ben-Sasson et al. ([<reflink idref="bib5" id="ref20">5</reflink>]) found that sensory under-responsiveness, (similar to low registration [Dunn, [<reflink idref="bib13" id="ref21">13</reflink>]]), distinguished autistic groups from typically developing (TD) groups, but not from groups with developmental disorders (DD), or those with ADHD. Sensory seeking, a construct that Dunn ([<reflink idref="bib13" id="ref22">13</reflink>]) also measures, was heightened in autism compared to TD and DD groups, but not compared to ADHD. Further, sensory seeking was moderated by age and IQ (Ben-Sasson et al., [<reflink idref="bib5" id="ref23">5</reflink>]). Sensory over-responsiveness, which conceptually parallels Dunn's sensitivity and avoiding quadrants ([<reflink idref="bib13" id="ref24">13</reflink>]), uniquely differentiated those with autism from all other groups including those with ADHD, regardless of age, developmental level, or methodological differences (Ben-Sasson et al., [<reflink idref="bib5" id="ref25">5</reflink>]). These findings suggest both shared and unique sensory features, highlighting the need to further assess and understand the impact of ADHD symptoms as it relates to the presentation of sensory patterns in autism. Given the overlapping symptomatology and current rate of misdiagnosis between these two conditions (Kentrou et al., [<reflink idref="bib26" id="ref26">26</reflink>]; Septier et al., [<reflink idref="bib41" id="ref27">41</reflink>]), this knowledge may provide important diagnostic implications that may further enhance or contribute to current identification and treatment strategies. Sensory features are being invoked in more and more research studies and clarity is needed in understanding the unique and shared variance that sensory features play in autism, and in ADHD among those with autism.</p> <p>Here we use the SP (Dunn, [<reflink idref="bib12" id="ref28">12</reflink>]), to assess sensory features based on Dunn's ([<reflink idref="bib13" id="ref29">13</reflink>]) quadrant model, to assess unique sensory patterns in autism while controlling for ADHD symptoms. In our analysis, we controlled for age, sex, IQ, measured using the Wechsler Abbreviated Scale of Intelligence – Second Edition (WASI-II; Wechsler, [<reflink idref="bib42" id="ref30">42</reflink>]), and symptoms of inattention and hyperactivity-impulsivity, as measured by BASC-2 <emph>T</emph>-scores (Reynolds & Kamphaus, [<reflink idref="bib37" id="ref31">37</reflink>]). We hypothesized that after controlling for age, sex, IQ, and ADHD symptoms, unique sensory patterns would remain predictive of autism. Specifically, using Dunn's model we hypothesized that when controlling for ADHD symptoms, avoiding and sensitivity would predict autistic traits (Ben-Sasson et al., [<reflink idref="bib5" id="ref32">5</reflink>]; Little et al., [<reflink idref="bib31" id="ref33">31</reflink>]) in a sample of children and adolescents with autism.</p> <hd id="AN0185941309-4">Methods</hd> <p></p> <hd id="AN0185941309-5">Participants</hd> <p>Participants included 61 children and adolescents with autism between the ages of 6 and 17 years (<emph>M</emph><subs>age</subs> = 12.04, <emph>SD</emph> = 3.14; 15 female) with average cognitive abilities on average, as assessed by full-scale IQ on the WASI-II (<emph>M</emph> FSIQ = 104, <emph>SD</emph> = 13.57). Participants included in the present study were primarily White (89.7%), male (75.4%), and not Hispanic or Latinx (98.2%). All 61 participants met <emph>DSM-5</emph> criteria for ASD (APA, 2013), confirmed by the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2; Lord et al., [<reflink idref="bib33" id="ref34">33</reflink>]) and the Autism Diagnostic Interview-Revised (ADI-R; Rutter et al., [<reflink idref="bib38" id="ref35">38</reflink>]). On the BASC-2, 27.8% had clinically significant hyperactivity <emph>T</emph>-scores and 22.95% had clinically significant attention problems <emph>T</emph>-scores. As approved by the Institutional Review Board (IRB), informed consent was obtained from each caregiver and informed assent was obtained from each child. Descriptive statistics are summarized in Table 1.</p> <p>Table 1 Demographics</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left"><p>Measure</p></th><th align="left"><p><italic>M</italic></p></th><th align="left"><p><italic>SD</italic></p></th></tr></thead><tbody><tr><td align="left"><p>Age (in years)</p></td><td align="left"><p>12.04</p></td><td char="." align="char"><p>3.14</p></td></tr><tr><td align="left"><p>FSIQ estimate</p></td><td align="left"><p>104</p></td><td char="." align="char"><p>13.57</p></td></tr><tr><td align="left"><p>BASC-2</p></td><td align="left" /><td char="." align="char" /></tr><tr><td align="left"><p> Hyperactivity <italic>T</italic>-score</p></td><td align="left"><p>63.97</p></td><td char="." align="char"><p>11.56</p></td></tr><tr><td align="left"><p> Attention problems <italic>T</italic>-score</p></td><td align="left"><p>62.64</p></td><td char="." align="char"><p>7.75</p></td></tr><tr><td align="left"><p>AQ raw score</p></td><td align="left"><p>33.40</p></td><td char="." align="char"><p>6.63</p></td></tr><tr><td align="left"><p>Sensory profile reversed raw scores</p></td><td align="left" /><td char="." align="char" /></tr><tr><td align="left"><p> Registration (out of 75)</p></td><td align="left"><p>40.06</p></td><td char="." align="char"><p>11.29</p></td></tr><tr><td align="left"><p> Seeking (out of 130)</p></td><td align="left"><p>59.02</p></td><td char="." align="char"><p>15.78</p></td></tr><tr><td align="left"><p> Sensitivity (out of 100)</p></td><td align="left"><p>49.41</p></td><td char="." align="char"><p>11.96</p></td></tr><tr><td align="left"><p> Avoiding (out of 145)</p></td><td align="left"><p>79.02</p></td><td char="." align="char"><p>14.29</p></td></tr></tbody></table> </ephtml> </p> <p> <emph>N</emph> = 61. <emph>M</emph> = Mean, <emph>SD</emph> Standard deviation FSIQ has a population <emph>M</emph> of 100, <emph>SD</emph> of 15. BASC-2 scores above 70 are considered clinically significant</p> <hd id="AN0185941309-6">Measures</hd> <p></p> <hd id="AN0185941309-7">Sensory Profile (SP)</hd> <p>The SP (Dunn, [<reflink idref="bib12" id="ref36">12</reflink>]) is a 125-item caregiver questionnaire used to assess children's responses to daily sensory experiences according to eight categories: Auditory, Visual, Taste/Smell, Movement, Body Position, Touch, Activity Level, and Emotional/Social. In completing the questionnaire, caregivers are asked to report the frequency with which their child demonstrates each behavior based on a five-point Likert scale (1- Always to 5- Never), yielding a total raw score. These raw scores are used to calculate quadrant scores (Dunn, [<reflink idref="bib12" id="ref37">12</reflink>], [<reflink idref="bib13" id="ref38">13</reflink>]). This scale has been found to have good test-retest reliability across quadrant scores (Intraclass Correlation Coefficient = 0.80–0.90), as well as high internal consistency (Cronbach's α coefficients = 0.89–0.95). In the current sample, internal consistency was good across quadrant scores (Cronbach's α coefficients = 0.84–0.89). Parent-reported quadrant scores on the SP have also been shown to predict whether a child has autism (Glod et al., [<reflink idref="bib19" id="ref39">19</reflink>]). As others have done (Kern et al., [<reflink idref="bib27" id="ref40">27</reflink>]), we use parent-reported scores for all participants. Quadrant scores for the SP were determined based on the specific items on the SP delineated by Dunn ([<reflink idref="bib13" id="ref41">13</reflink>]).</p> <hd id="AN0185941309-8">Behavior Assessment System for Children, Second Edition (BASC-2)</hd> <p>The BASC-2 (Reynolds & Kamphaus, [<reflink idref="bib37" id="ref42">37</reflink>]) is a multimethod and multidimensional system used to assess a wide variety of behaviors, adaptive skills, self-perceptions, and social emotional problems in children and young adults ages 2 through 25. The BASC-2 Parent Rating Scale (PRS) is intended for caregivers to use and assesses both broad- and narrow-based emotional and behavioral domains. Here, <emph>T</emph>-scores (<emph>M</emph> = 50, <emph>SD</emph> = 10) for the hyperactivity and attention problems clinical scales were used to measure ADHD symptoms. The hyperactivity clinical scale also includes impulsivity items. On each clinical scale, <emph>T</emph>-scores of 60–69 suggest an elevated level of risk, while <emph>T</emph>-scores of 70 or higher suggest an extremely elevated level of risk (Reynolds & Kamphaus, [<reflink idref="bib37" id="ref43">37</reflink>]). The PRS demonstrates adequate psychometric properties (Bradstreet et al., [<reflink idref="bib7" id="ref44">7</reflink>]; Reynolds & Kamphaus, [<reflink idref="bib37" id="ref45">37</reflink>]) and can effectively identify individuals with externalizing problems (Reynolds & Kamphaus, [<reflink idref="bib37" id="ref46">37</reflink>]).</p> <hd id="AN0185941309-9">Autism Spectrum Quotient (AQ)</hd> <p>The AQ (Baron-Cohen et al., [<reflink idref="bib3" id="ref47">3</reflink>]) is a self- or parent-report measure of autistic traits that differ in the phrasing but not the content of questions. All versions (child, adolescent, and adult) assess social skills, attention switching, attention to detail, communication, and imagination. Here we use total AQ score which reflects the simple sum of raw scores. While scoring differs slightly across versions, scores on the AQ-Child were transformed to reflect the original dichotomous scoring scale used and endorsed by developers of the AQ (Baron-Cohen et al., [<reflink idref="bib3" id="ref48">3</reflink>]; Ruzich et al., [<reflink idref="bib39" id="ref49">39</reflink>]). As such, each autistic trait endorsed (either slightly or definitely) received a score of 1, whereas each autistic trait denied (either slightly or definitely) received a score of 0, allowing for a maximum score of 50 (Baron-Cohen et al., [<reflink idref="bib3" id="ref50">3</reflink>]; Ruzich et al., [<reflink idref="bib39" id="ref51">39</reflink>]). A total score of 32 is currently considered the suggested cut-off for identifying those with elevated autistic traits (Baron-Cohen et al., [<reflink idref="bib3" id="ref52">3</reflink>]; Ruzich et al., [<reflink idref="bib39" id="ref53">39</reflink>]). All three versions of the AQ demonstrate good construct validity and face validity as those with a diagnosis of autism score significantly higher than those without a diagnosis (Auyeung et al., [<reflink idref="bib2" id="ref54">2</reflink>]; Baron-Cohen et al., [<reflink idref="bib3" id="ref55">3</reflink>], [<reflink idref="bib4" id="ref56">4</reflink>]).</p> <hd id="AN0185941309-10">Procedure</hd> <p>The data were collected across a series of experimental studies (not reported here) conducted in the Center for Autism Research and Electrophysiology at Syracuse University. The sample was recruited from the community through word of mouth, distribution of flyers at pediatricians' offices and local libraries, and through community listservs. Autism diagnoses were confirmed using the ADOS-2 (Lord et al., [<reflink idref="bib33" id="ref57">33</reflink>]) and the ADI-R (Rutter et al., [<reflink idref="bib38" id="ref58">38</reflink>]) by research reliable clinicians. All participants also completed IQ testing using the WASI-II (Wechsler, [<reflink idref="bib42" id="ref59">42</reflink>]). Given the nature of the research questions being asked in the parent study, participants with IQ's below 70 were excluded.</p> <p>Participants between the ages of 16 and 17 completed the AQ self-report form, while for those between 6 and 15 years of age, parents completed the AQ parent-report form (Auyeung et al., [<reflink idref="bib2" id="ref60">2</reflink>]; Baron-Cohen et al., [<reflink idref="bib3" id="ref61">3</reflink>], [<reflink idref="bib4" id="ref62">4</reflink>]). In all cases, parents also completed the SP and the BASC-2. All item scores on the SP (Dunn, [<reflink idref="bib12" id="ref63">12</reflink>], [<reflink idref="bib13" id="ref64">13</reflink>]) were reverse scored such that higher scores reflect higher rates of sensory features. To account for missing data (4.92% missing items; 13.11% respondents with any missing data) variable mean substitution was used (Downey & King, [<reflink idref="bib10" id="ref65">10</reflink>]).</p> <hd id="AN0185941309-11">Statistical Analysis</hd> <p>Statistical analyses were conducted using the Statistical Package for Social Sciences (SPSS), version 26 (IBM, [<reflink idref="bib23" id="ref66">23</reflink>]) and <emph>R</emph>, Version 1.2.5033 (R Studio Team, [<reflink idref="bib35" id="ref67">35</reflink>]). Hierarchical multiple regression was used to assess the prediction of autistic traits (i.e., total AQ scores), based on sensory features while covarying for age, sex, IQ, and ADHD symptoms.</p> <hd id="AN0185941309-12">Results</hd> <p></p> <hd id="AN0185941309-13">Descriptive Analyses</hd> <p>Means and standard deviations of study variables are presented in Table 1. Mean raw scores for each sensory quadrant fell within the average range (Dunn, [<reflink idref="bib13" id="ref68">13</reflink>]). Mean <emph>T</emph>-scores for both the hyperactivity and attention problems BASC-2 scales fell within the elevated risk range (Reynolds & Kamphaus, [<reflink idref="bib37" id="ref69">37</reflink>]). The mean raw score for the AQ fell above the cut-off score for distinguishing individuals with clinically significant levels of autistic traits (Baron-Cohen et al., [<reflink idref="bib3" id="ref70">3</reflink>]).</p> <hd id="AN0185941309-14">Autistic Traits Predicted by Sensory Features, Controlling for Age, IQ, Sex, and ADHD Symptom...</hd> <p>The full model was significant [<emph>F</emph>(<reflink idref="bib9" id="ref71">9</reflink>, 51) = 5.57, <emph>p</emph> = 0.001], with an <emph>R</emph><sups>2</sups> of 0.496 (adjusted <emph>R</emph><sups>2</sups> = 0.407; see Table 2). Step 1 indicated no significant effect of age in relation to autistic traits [<emph>F</emph>(<reflink idref="bib1" id="ref72">1</reflink>, 59) = 0.29, <emph>p</emph> = 0.60], adjusted <emph>R</emph><sups>2</sups> = − 0.012. Step 2 indicated that FSIQ was significantly associated with autistic traits after controlling for age [<emph>F</emph>(<reflink idref="bib1" id="ref73">1</reflink>, 58) = 5.97, p = 0.02], with an <emph>R</emph><sups>2</sups> of 0.098 (adjusted <emph>R</emph><sups>2</sups> = 0.067) such that higher FSIQ scores correlated with higher levels of autistic traits. In Step 3, sex was significant [<emph>F</emph>(<reflink idref="bib1" id="ref74">1</reflink>, 57) = 5.25, p = 0.03], with an <emph>R</emph><sups>2</sups> of 0.174 (adjusted <emph>R</emph><sups>2</sups> = 0.130), such that being female significantly correlated with higher autistic traits (<emph>r</emph> = − 0.31). Step 4 indicated that ADHD symptoms, specifically hyperactivity (<emph>p</emph> = 0.04), were significantly associated with autistic traits [<emph>F</emph>(<reflink idref="bib2" id="ref75">2</reflink>, 55) = 3.29, <emph>p</emph> < 0.05], with an <emph>R</emph><sups>2</sups> of 0.262 (adjusted <emph>R</emph><sups>2</sups> = 0.195). Lastly, Step 5 indicated that sensory features measured by sensory quadrants together accounted for a significant portion of the variance (40.7%) in autistic traits [<emph>F</emph>(<reflink idref="bib4" id="ref76">4</reflink>, 51) = 5.90, <emph>p</emph> = 0.001], with an <emph>R</emph><sups>2</sups> of 0.496 (adjusted <emph>R</emph><sups>2</sups> = 0.407). Specifically, sensitivity was significantly predictive of autistic traits (<emph>p</emph> = 0.008).</p> <p>Table 2 Hierarchical regression using Dunn's ([<reflink idref="bib13" id="ref77">13</reflink>]) sensory quadrants</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2"><p>Variable</p></th><th align="left" rowspan="2"><p><italic>B</italic></p></th><th align="left" colspan="2"><p>95% CI for <italic>B</italic></p></th><th align="left" rowspan="2"><p><italic>SE B</italic></p></th><th align="left" rowspan="2"><p>β</p></th><th align="left" rowspan="2"><p><italic>R</italic><sup>2</sup></p></th><th align="left" rowspan="2"><p>Δ<italic>R</italic><sup>2</sup></p></th></tr><tr><th align="left"><p><italic>LL</italic></p></th><th align="left"><p><italic>UL</italic></p></th></tr></thead><tbody><tr><td align="left"><p>Step 1</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>0.005</p></td><td char="." align="char"><p>0.005</p></td></tr><tr><td align="left"><p> Constant</p></td><td char="." align="char"><p>31.63***</p></td><td char="." align="char"><p>24.81</p></td><td char="." align="char"><p>38.44</p></td><td char="." align="char"><p>3.40</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Age</p></td><td char="." align="char"><p>0.15</p></td><td char="." align="char"><p>− 0.40</p></td><td char="." align="char"><p>0.70</p></td><td char="." align="char"><p>0.27</p></td><td char="." align="char"><p>0.07</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Step 2</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>0.098</p></td><td char="." align="char"><p>0.093*</p></td></tr><tr><td align="left"><p> Constant</p></td><td char="." align="char"><p>15.56*</p></td><td char="." align="char"><p>0.87</p></td><td char="." align="char"><p>30.26</p></td><td char="." align="char"><p>7.34</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Age</p></td><td char="." align="char"><p>0.17</p></td><td char="." align="char"><p>− 0.36</p></td><td char="." align="char"><p>0.70</p></td><td char="." align="char"><p>0.26</p></td><td char="." align="char"><p>0.08</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> FSIQ</p></td><td char="." align="char"><p>0.15*</p></td><td char="." align="char"><p>0.03</p></td><td char="." align="char"><p>0.28</p></td><td char="." align="char"><p>0.06</p></td><td char="." align="char"><p>0.31*</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Step 3</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>0.174</p></td><td char="." align="char"><p>0.076*</p></td></tr><tr><td align="left"><p> Constant</p></td><td char="." align="char"><p>21.16**</p></td><td char="." align="char"><p>6.15</p></td><td char="." align="char"><p>36.17</p></td><td char="." align="char"><p>7.50</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Age</p></td><td char="." align="char"><p>0.10</p></td><td char="." align="char"><p>− 0.42</p></td><td char="." align="char"><p>0.61</p></td><td char="." align="char"><p>0.26</p></td><td char="." align="char"><p>0.05</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> FSIQ</p></td><td char="." align="char"><p>0.14*</p></td><td char="." align="char"><p>0.02</p></td><td char="." align="char"><p>0.26</p></td><td char="." align="char"><p>0.06</p></td><td char="." align="char"><p>0.28</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Sex</p></td><td char="." align="char"><p>− 4.26*</p></td><td char="." align="char"><p>− 7.99</p></td><td char="." align="char"><p>-0.54</p></td><td char="." align="char"><p>1.86</p></td><td char="." align="char"><p>− 0.28*</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Step 4</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>0.262</p></td><td char="." align="char"><p>0.088*</p></td></tr><tr><td align="left"><p> Constant</p></td><td char="." align="char"><p>9.96</p></td><td char="." align="char"><p>− 11.77</p></td><td char="." align="char"><p>31.68</p></td><td char="." align="char"><p>10.84</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Age</p></td><td char="." align="char"><p>0.15</p></td><td char="." align="char"><p>− 0.34</p></td><td char="." align="char"><p>0.65</p></td><td char="." align="char"><p>0.25</p></td><td char="." align="char"><p>0.07</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> FSIQ</p></td><td char="." align="char"><p>0.14*</p></td><td char="." align="char"><p>0.02</p></td><td char="." align="char"><p>0.26</p></td><td char="." align="char"><p>0.06</p></td><td char="." align="char"><p>0.29*</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Sex</p></td><td char="." align="char"><p>− 4.07*</p></td><td char="." align="char"><p>− 7.73</p></td><td char="." align="char"><p>− 0.42</p></td><td char="." align="char"><p>1.82</p></td><td char="." align="char"><p>− 0.27*</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Hyperactivity</p></td><td char="." align="char"><p>0.18*</p></td><td char="." align="char"><p>0.01</p></td><td char="." align="char"><p>0.35</p></td><td char="." align="char"><p>0.09</p></td><td char="." align="char"><p>0.32*</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Attention problems</p></td><td char="." align="char"><p>− 0.03</p></td><td char="." align="char"><p>− 0.30</p></td><td char="." align="char"><p>0.24</p></td><td char="." align="char"><p>0.13</p></td><td char="." align="char"><p>− 0.03</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p>Step 5</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /><td char="." align="char"><p>0.496</p></td><td char="." align="char"><p>0.234**</p></td></tr><tr><td align="left"><p> Constant</p></td><td char="." align="char"><p>11.48</p></td><td char="." align="char"><p>− 9.22</p></td><td char="." align="char"><p>32.19</p></td><td char="." align="char"><p>10.31</p></td><td char="." align="char" /><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Age</p></td><td char="." align="char"><p>0.03</p></td><td char="." align="char"><p>− 0.46</p></td><td char="." align="char"><p>0.53</p></td><td char="." align="char"><p>0.25</p></td><td char="." align="char"><p>0.02</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> FSIQ</p></td><td char="." align="char"><p>0.08</p></td><td char="." align="char"><p>− 0.03</p></td><td char="." align="char"><p>0.19</p></td><td char="." align="char"><p>0.05</p></td><td char="." align="char"><p>0.17</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Sex</p></td><td char="." align="char"><p>− 4.70**</p></td><td char="." align="char"><p>− 8.17</p></td><td char="." align="char"><p>− 1.22</p></td><td char="." align="char"><p>1.73</p></td><td char="." align="char"><p>− 0.31**</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Hyperactivity</p></td><td char="." align="char"><p>0.21*</p></td><td char="." align="char"><p>0.05</p></td><td char="." align="char"><p>0.37</p></td><td char="." align="char"><p>0.08</p></td><td char="." align="char"><p>0.37*</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Attention problems</p></td><td char="." align="char"><p>− 0.13</p></td><td char="." align="char"><p>− 0.37</p></td><td char="." align="char"><p>0.11</p></td><td char="." align="char"><p>0.12</p></td><td char="." align="char"><p>− 0.15</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Registration</p></td><td char="." align="char"><p>0.07</p></td><td char="." align="char"><p>− 0.12</p></td><td char="." align="char"><p>0.25</p></td><td char="." align="char"><p>0.09</p></td><td char="." align="char"><p>0.11</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Seeking</p></td><td char="." align="char"><p>− 0.09</p></td><td char="." align="char"><p>− 0.22</p></td><td char="." align="char"><p>0.04</p></td><td char="." align="char"><p>0.07</p></td><td char="." align="char"><p>− 0.22</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Sensitivity</p></td><td char="." align="char"><p>0.28**</p></td><td char="." align="char"><p>0.08</p></td><td char="." align="char"><p>0.48</p></td><td char="." align="char"><p>0.10</p></td><td char="." align="char"><p>0.50**</p></td><td char="." align="char" /><td char="." align="char" /></tr><tr><td align="left"><p> Avoiding</p></td><td char="." align="char"><p>0.00</p></td><td char="." align="char"><p>− 0.17</p></td><td char="." align="char"><p>0.17</p></td><td char="." align="char"><p>0.09</p></td><td char="." align="char"><p>0.01</p></td><td char="." align="char" /><td char="." align="char" /></tr></tbody></table> </ephtml> </p> <p> <emph> CI</emph> confidence interval; <emph>LL</emph> lower limit; <emph>UL</emph> upper limit <emph> N</emph> = 61. *<emph>p</emph> <.05, **<emph>p</emph> <.01, ***<emph>p</emph> <.001</p> <hd id="AN0185941309-15">Discussion</hd> <p>The focus of this study was to determine whether, and which, sensory features were associated with autism after controlling for age, IQ, sex, and concurrent ADHD symptoms in a group of children and adolescents with autism.Three primary findings emerged. First, sex was significantly associated with autistic traits, such that being female was associated with higher autistic traits in our sample. Second, ADHD symptoms—especially hyperactivity—were significantly associated with autistic traits. Lastly, after controlling for ADHD, sensory sensitivity was found to significantly predict autistic traits.</p> <hd id="AN0185941309-16">Sensitivity Remains Predictive of Autism</hd> <p>Sensory sensitivity remained predictive of autistic traits even after controlling for age, IQ, sex, and ADHD symptoms. Previous researchers have found all of Dunn's ([<reflink idref="bib12" id="ref78">12</reflink>]; [<reflink idref="bib14" id="ref79">14</reflink>]) four sensory quadrants to be elevated across children with autism and children with ADHD (Little et al., [<reflink idref="bib31" id="ref80">31</reflink>]). However, our findings, which account for ADHD symptoms among youth with autism, suggest that sensory sensitivity is particularly important to our understanding of sensory features in autism, at least for school-age children and adolescents with autism without cognitive impairments. This is consistent with findings from Ben-Sasson and colleagues' ([<reflink idref="bib5" id="ref81">5</reflink>]) meta-analysis in which sensory over-responsiveness (conceptually parallel to Dunn's [[<reflink idref="bib13" id="ref82">13</reflink>]] sensitivity) uniquely differentiated those with autism from those with ADHD, while other sensory features such as sensor under-responsiveness and sensory seeking did not. Although the current study did not include a group of children with ADHD without autism to compare to, our findings provide meaningful contributions to this line of research regarding the phenotype of autism and ADHD symptoms. As such, sensory sensitivity may be unique to autism over and above the elevated symptoms of ADHD that are commonly seen in this population. Theoretically, the intersectionality of these two conditions may not simply yield additive effects, but rather interactive effects, which should be examined directly in future research.</p> <hd id="AN0185941309-17">Association Between Sex and Autism</hd> <p>Compared to males with autism, our study found that females with autism demonstrated higher levels of autistic traits as evidenced by higher AQ scores (Baron-Cohen et al., [<reflink idref="bib3" id="ref83">3</reflink>]). This is consistent with what we know about autism, particularly the female phonotype (Ratto et al., [<reflink idref="bib36" id="ref84">36</reflink>]). Although research indicates higher rates of autism diagnoses in males than in females, with autism diagnoses occurring three to four times more often in males than in females (Loomes et al., [<reflink idref="bib32" id="ref85">32</reflink>]), there is a notable diagnostic gender bias in the <emph>DSM-5</emph> (APA, [<reflink idref="bib1" id="ref86">1</reflink>]) contributing to such differences. As such, females with autism who present with average to above average cognitive abilities are less likely to be identified or meet full diagnostic criteria compared to males with autism with similar cognitive abilities (Loomes et al., [<reflink idref="bib32" id="ref87">32</reflink>]; Ratto et al., [<reflink idref="bib36" id="ref88">36</reflink>]), and often require a greater number or more severe level of symptoms in order to be reliably diagnosed (Haney, [<reflink idref="bib21" id="ref89">21</reflink>]). Given that all participants in the current sample received a clinical diagnosis, it is most likely that the females in the current sample also endorsed higher levels of autistic traits on the AQ because they actually experience greater levels of autistic traits in terms of both quantity and severity than the males in our sample. Future considerations are warranted to adjust current diagnostic procedures to better represent the female phenotype in autism.</p> <hd id="AN0185941309-18">Association Between Autism and ADHD</hd> <p>Little is known regarding the underlying mechanism through which symptoms co-occur in autism and ADHD (Groom et al., [<reflink idref="bib20" id="ref90">20</reflink>]). Our findings, which suggest that sensory sensitivities are prominent in autism despite concurrent symptoms/heightened levels of hyperactivity, not only enhance our understanding of autism alone, but may also provide insight into current conceptualizations regarding overlapping symptoms and phenomenology in autism and ADHD. It is possible that co-occurring symptoms may be an expression of true overlap through a shared phenotype (i.e., shared genotypic and environmental interactions), may be due to a phenocopy (i.e., a variation in phenotype) in which symptoms may demonstrate an overlap (i.e., symptoms of one condition may mimic those of another), or may occur as a cooccurrence in which other underlying mechanisms remain unknown (Eapen et al., [<reflink idref="bib16" id="ref91">16</reflink>]; Groom et al., [<reflink idref="bib20" id="ref92">20</reflink>]; Septier et al., [<reflink idref="bib41" id="ref93">41</reflink>]). Future research is necessary to further explore these etiological explanations both in general and in the context of recently identified and newly emerging clinical criterion of autism such as sensory symptoms (APA, [<reflink idref="bib1" id="ref94">1</reflink>]).</p> <p>Our findings broadly suggest that sensory features, such as sensory sensitivities, may be representative of a sensory-specific phenotype within an autistic population, in which an intellectual disability is not also present (Lane et al., [<reflink idref="bib29" id="ref95">29</reflink>]; Scheerer et al., [<reflink idref="bib40" id="ref96">40</reflink>]). This needs to be reconciled both with a broader representation of individuals with autism, including those without co-occurring intellectual disabilities and/or higher support needs, as well as with the ADHD literature in which sensory sensitivities are also elevated, but generally do not consider autistic symptoms in their analyses (Cheung & Siu, [<reflink idref="bib9" id="ref97">9</reflink>]; Dunn & Bennet, [<reflink idref="bib15" id="ref98">15</reflink>]; Little et al., [<reflink idref="bib31" id="ref99">31</reflink>]). Future research is needed to examine the extent to which autistic traits may impact sensory processing patterns found in children with ADHD. In doing so, future ADHD researchers should consider controlling for autistic traits in sensory focused research, as our findings broadly suggest that autistic traits may account for some of the variance in sensory sensitivities found in ADHD.</p> <hd id="AN0185941309-19">The Role of Inattention, Hyperactivity and Potential Item Overlap</hd> <p>The current findings suggest that ADHD symptoms are significantly predictive of autistic traits after controlling for age, IQ, and sex, and that symptoms of hyperactivity appear to be driving that relationship. Although our findings regarding attention problems and autistic traits did not indicate a significant predictive relationship between the two, a negative coefficient for attention problems as a predictor (<emph>B</emph> = − 0.170) suggests that for every one-unit increase in attention problems <emph>T</emph>-scores, autistic traits (AQ raw scores) decreased by 0.170. In other words, our findings show that attention problems are not significantly predictive of autistic traits, at least in this predominantly male sample.</p> <p>Importantly, the predictive value of hyperactivity, but not attention problems, was unrelated to differences in the variability of scores on these measures. Specifically, the sample's mean <emph>T</emph>-score for hyperactivity (<emph>M</emph> = 63.97, <emph>SD</emph> = 11.56; Table 1) had a larger standard deviation than that of <emph>T</emph>-scores for attention problems (<emph>M</emph> = 62.64, <emph>SD</emph> = 7.75; Table 1). However, the standard error of the mean (<emph>SEM</emph>), which reflects the dispersion of the variance, was the same for hyperactivity (<emph>SEM</emph> = 8.19) and attention problems (<emph>SEM</emph> = 8.02). As such, variability appears not to be the likely reason for why hyperactivity, but not attention problems, was predictive.</p> <p>It is possible that items on the BASC-2 (Reynolds & Kamphaus, [<reflink idref="bib37" id="ref100">37</reflink>]) for hyperactivity overlap with items on the SP (Dunn, [<reflink idref="bib12" id="ref101">12</reflink>]). We examined items on each measure of interest and found that some items included in the hyperactivity scale on the BACS-2 may generally overlap with items on the SP. For instance, the items "rocks unconsciously (for example, while watching TV)" or "rocks in desk/chair/on floor" on the SP (Dunn, [<reflink idref="bib12" id="ref102">12</reflink>]) may be endorsed by parents about their child's behavior. Future work focused on the discriminant validity of these scales within ADHD and autistic populations might be useful in disentangling these constructs.</p> <hd id="AN0185941309-20">Clinical Implications</hd> <p>Previous research has noted that misdiagnosis often occurs due to the high phenotypic overlap between autism and ADHD (Septier et al., [<reflink idref="bib41" id="ref103">41</reflink>]). Although future research is needed to provide more direct implications for clinicians, findings from the current study suggest that sensory sensitivities may be one feature that distinguishes features of autism from symptoms of ADHD, at least in children and adolescents with autism. This may be beneficial in practice, especially when working with children and adolescents who present with an autism diagnosis and potentially co-occurring symptoms of ADHD. Specifically, sensory sensitivities might be particularly relevant to differential diagnosis between and within autism as our findings suggest that sensory sensitivities are significantly associated with autistic traits but go above and beyond what would be expected given the heightened levels of ADHD symptoms in our sample. Future research could enhance current assessment and diagnostic processes, and ultimately provide individualized interventions that address specific sensory-processing features across various settings and populations.</p> <hd id="AN0185941309-21">Limitations</hd> <p>The current study has a number of limitations. First, the measures were mostly parent-report forms besides the AQ-Adult (Baron-Cohen et al., [<reflink idref="bib3" id="ref104">3</reflink>]). Although previous findings suggest some parent-report forms may reveal more externalizing symptoms than self-report forms, while self-report forms may reveal more internalizing symptoms than parent-report forms, these differences may vary due to assessment type, as well as age and developmental level of the child (Hope et al., [<reflink idref="bib22" id="ref105">22</reflink>]). In line with participatory research, future studies should include self-report measures for several reasons. Not only will this increase opportunities for autistic individuals to share their perspectives, but there may be more to glean from the self-reported sensory patterns experienced by autistic individuals themselves. In addition to this, future studies should include observational measures as well, especially for sensory features. Future research may also want to include diagnostic interviews such as the ADHD module of the K-SADS-PL (Kaufman et al., [<reflink idref="bib24" id="ref106">24</reflink>]) in their battery to confirm ADHD symptoms.</p> <p>Second, ADHD was measured at the symptom level rather than diagnostic level. Although this methodology reduces the external validity of our findings for the ADHD population, it in turn increases the external validity of our findings for the autistic population as this was solely explored in a sample of children and adolescents with confirmed autism diagnoses. Third, our sample's racial make-up was predominantly White despite having had conducted our study in a racially and ethnically diverse location and almost all participants had IQs in the average range, impacting the generalizability of findings. Future studies should include more representative samples of autistic individuals across different levels of support needs as well as across various racial, ethnic, cultural and gender identities.</p> <p>Lastly, the broader age-range of participants (aged 6–17 years) varied from the age-range in which the SP Caregiver form was originally normed on (aged 3–10 years; Dunn, [<reflink idref="bib12" id="ref107">12</reflink>]). Although this study included some SP Caregiver forms for older adolescents, the results of this study were based on individual SP raw scores as this measure does not include standard nor scaled scores. The SP Caregiver form has been used in previous research with older adolescents and adults (age-range = 3–43 years; Kern et al., [<reflink idref="bib27" id="ref108">27</reflink>]). Our methodology regarding this measure is therefore consistent with previous research. The current study also controlled for age in our analyses and therefore accounted for this potential limitation. Future studies, however, should aim to address this by including SP Self-Report forms for older adolescents either in addition to or instead of using SP Caregiver forms among this specific age-group, as the presentation of sensory features and items used to assess may potentially vary across childhood and adolescence. Future studies may also want to explore the relationship between sensory features (particularly sensitivity) and social cognition, as such sensory features may underlie some of the social communication difficulties seen in autism.</p> <hd id="AN0185941309-22">Conclusions</hd> <p>Findings suggest that specific sensory features are predictive of autism, despite there being significant associations between ADHD symptoms and autistic traits within our sample. Sensory sensitivity was significantly associated with autism after controlling for ADHD. Given that these sensory patterns remained predictive of autistic traits when controlling for age, sex, IQ, and ADHD symptoms, our results suggest that sensory features may provide expanded ways to understand the growing heterogeneity of symptom presentation in autism, and potentially aid in diagnosis and treatment among children and adolescents with autism without cognitive impairments.</p> <hd id="AN0185941309-23">Acknowledgments</hd> <p>The authors would like to thank Winnie Dunn for personally sharing the most updated item formulary for SP quadrant scoring (2006). Special thanks to Grace Baranek and Emily Campi for providing insight into the current study's findings. Special thanks also to the participating families, all current and previous CARE Lab members for their assistance in data collection, as well as Beth Prieve and Devon Pacheco from the Pediatric Audiology Lab.</p> <hd id="AN0185941309-24">Author Contributions</hd> <p>NR and ECM: conceptualized the idea for this project. ECM: wrote the paper and analyzed the data. KMA: contributed to the design and intellectual feedback. WRK: participated in intellectual feedback. All authors read and approved the final manuscript.</p> <hd id="AN0185941309-25">Funding</hd> <p>This project was supported by the National Institutes of Health 1R01MH101536-01 (PI: Russo), the Hill Collaboration for Environmental Medicine (PI: Russo), and the Collaboration for Unprecedented Success and Excellence (PI: Russo).</p> <hd id="AN0185941309-26">Declarations</hd> <p></p> <hd id="AN0185941309-27">Conflict of interest</hd> <p>The authors declare that they have no conflicts of interest of which they are aware of.</p> <hd id="AN0185941309-28">Ethical Approval</hd> <p>All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.</p> <hd id="AN0185941309-29">Informed Consent</hd> <p>Informed consent was obtained from all individual participants included in the study.</p> <hd id="AN0185941309-30">Supplementary Information</hd> <p>Below is the link to the electronic supplementary material.</p> <p>Graph: Supplementary material 1 (PDF 497.2 kb)</p> <hd id="AN0185941309-31">Abbreviations</hd> <p></p> <p>• SP</p> <p></p> <ulist> <item> Sensory profile</item> <p></p> </ulist> <p>• AQ</p> <p></p> <ulist> <item> Autism spectrum quotient</item> </ulist> <hd id="AN0185941309-32">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0185941309-33"> <title> References </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 20135; American Psychiatric Publishing. 10.1176/appi.books.9780890425596</bibtext> </blist> <blist> <bibl id="bib2" idref="ref54" type="bt">2</bibl> <bibtext> Auyeung B, Baron-Cohen S, Wheelwright S, Allison C. The Autism spectrum quotient: Children's version (AQ-Child). Journal of Autism and Developmental Disorders. 2008; 38; 7: 1230-1240. 10.1007/s10803-007-0504-z. 18064550</bibtext> </blist> <blist> <bibl id="bib3" idref="ref47" type="bt">3</bibl> <bibtext> Baron-Cohen S, Wheelwright S, Skinner R, Martin J, Clubley E. The Autism spectrum quotient (AQ): Evidence from Asperger syndrome/high functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders. 2001; 31: 5-17. 10.1023/A:1005653411471. 11439754</bibtext> </blist> <blist> <bibl id="bib4" idref="ref56" type="bt">4</bibl> <bibtext> Baron-Cohen S, Hoekstra RA, Knickmeyer R, Wheelwright S. The autism-spectrum quotient (AQ): Adolescent version. Journal of Autism and Developmental Disorders. 2006; 36; 3: 343-350. 10.1007/s10803-006-0073-6. 16552625</bibtext> </blist> <blist> <bibl id="bib5" idref="ref19" type="bt">5</bibl> <bibtext> Ben-Sasson A, Gal E, Fluss R, Katz-Zetler N, Cermak SA. Update of a meta-analysis of sensory symptoms in ASD: A new decade of research. Journal of Autism and Developmental Disorders. 2019; 49; 12: 4974-4996. 10.1007/s10803-019-04180-0. 31501953</bibtext> </blist> <blist> <bibl id="bib6" idref="ref5" type="bt">6</bibl> <bibtext> Bijlenga D, Tjon-Ka-Jie JYM, Schuijers F, Kooij JJS. Atypical sensory profiles as core features of adult ADHD, irrespective of autistic symptoms. European Psychiatry. 2017; 43: 51-57. 10.1016/j.eurpsy.2017.02.481. 28371743</bibtext> </blist> <blist> <bibl id="bib7" idref="ref44" type="bt">7</bibl> <bibtext> Bradstreet LE, Juechter JI, Kamphaus RW, Kerns CM, Robins DL. Using the BASC-2 parent rating scales to screen for autism spectrum disorder in toddlers and preschool-aged children. Journal of Abnormal Child Psychology. 2017; 45; 2: 359-370. 10.1007/s10802-016-0167-3. 27177744. 5108689</bibtext> </blist> <blist> <bibl id="bib8" type="bt">8</bibl> <bibtext> Bury SM, Jellett R, Spoor JR, Hedley D. It defines who I am" or "It's something I have": What language do [autistic] australian adults [on the autism spectrum] prefer?. Journal of Autism and Developmental Disorders. 2020; 53; 2: 677-687. 10.1007/s10803-020-04425-3</bibtext> </blist> <blist> <bibl id="bib9" idref="ref71" type="bt">9</bibl> <bibtext> Cheung PPP, Siu AMH. A comparison of patterns of sensory processing in children with and without developmental disabilities. Research in Developmental Disabilities. 2009; 30; 6: 1468-1480. 10.1016/j.ridd.2009.07.009. 19665348</bibtext> </blist> <blist> <bibtext> Downey RG, King CV. Missing data in Likert ratings: A comparison of replacement methods. The Journal of General Psychology. 1998; 125; 2: 175-191. 10.1080/00221309809595542. 9935342</bibtext> </blist> <blist> <bibtext> Dunn W. The impact of sensory processing abilities on the daily lives of young children and their families: A conceptual model. Infants & Young Children. 1997; 9; 4: 23-35. 10.1097/00001163-199704000-00005</bibtext> </blist> <blist> <bibtext> Dunn W. Sensory profile: User's manual. 1999; Psychological Corporation</bibtext> </blist> <blist> <bibtext> Dunn W. Sensory profile supplement: User's manual. 2006; Psychological Corporation</bibtext> </blist> <blist> <bibtext> Dunn W. Sensory profile 2: User's manual. 2014; Pearson</bibtext> </blist> <blist> <bibtext> Dunn W, Bennett D. Patterns of sensory processing in children with attention deficit hyperactivity disorder. OTJR: Occupation Participation and Health. 2002; 22; 1: 4-15. 10.1177/153944920202200102</bibtext> </blist> <blist> <bibtext> Eapen V, McPherson S, Karlov L, Nicholls L, Črnčec R, Mulligan A. Social communication deficits and restricted repetitive behavior symptoms in tourette syndrome. Neuropsychiatric Disease and Treatment. 2019; 15: 2151-2160. 10.2147/NDT.S210227. 31440054. 6666375</bibtext> </blist> <blist> <bibtext> Faraone SV, Sergeant J, Gillberg C, Biederman J. The worldwide prevalence of ADHD: Is it an American condition?. World Psychiatry. 2003; 2: 104-13. 16946911. 1525089</bibtext> </blist> <blist> <bibtext> Ghanizadeh A. Sensory processing problems in children with ADHD, a systematic review. Psychiatry Investigation. 2011; 8; 2: 89. 10.4306/pi.2011.8.2.89. 21852983</bibtext> </blist> <blist> <bibtext> Glod M, Riby DM, Rodgers J. Sensory processing profiles and autistic symptoms as predictive factors in autism spectrum disorder and Williams syndrome. Journal of Intellectual Disability Research. 2020; 64; 8: 657-665. 10.1111/jir.12738. 32400919</bibtext> </blist> <blist> <bibtext> Groom MJ, Kochhar P, Hamilton A, Liddle EB, Simeou M, Hollis C. Atypical Processing of Gaze Cues and faces explains comorbidity between Autism Spectrum disorder (ASD) and attention Deficit/Hyperactivity disorder (ADHD). Journal of Autism and Developmental Disorders. 2017; 47; 5: 1496-1509. 10.1007/s10803-017-3078-4. 28255758. 5385202</bibtext> </blist> <blist> <bibtext> Haney JL. Autism, females, and the DSM-5: Gender bias in autism diagnosis. Social Work in Mental Health. 2016; 14; 4: 396-407. 10.1080/15332985.2015.1031858</bibtext> </blist> <blist> <bibtext> Hope TL, Adams C, Reynolds L, Powers D, Perez RA, Kelley ML. Parent vs. self-report: Contributions toward diagnosis of adolescent psychopathology. Journal of Psychopathology and Behavioral Assessment. 1999; 21; 4: 349-363. 10.1023/A:1022124900328</bibtext> </blist> <blist> <bibtext> IBM Corporation. (2019). Statistical package for social sciences (26). IBM Corporation.</bibtext> </blist> <blist> <bibtext> Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry. 1997; 36; 7: 980-988. 10.1097/00004583-199707000-00021</bibtext> </blist> <blist> <bibtext> Kenny L, Hattersley C, Molins B, Buckley C, Povey C, Pellicano E. Which terms should be used to describe autism? Perspectives from the UK autism community. Autism. 2016; 20; 4: 442-462. 10.1177/1362361315588200. 26134030</bibtext> </blist> <blist> <bibtext> Kentrou V, de Veld DM, Mataw KJ, Begeer S. Delayed autism spectrum disorder recognition in children and adolescents previously diagnosed with attention-deficit/hyperactivity disorder. Autism. 2019; 23; 4: 1065-1072. 10.1177/1362361318785171. 30244604</bibtext> </blist> <blist> <bibtext> Kern JK, Garver CR, Carmody T, Andrews AA, Trivedi MH, Mehta JA. Examining sensory quadrants in autism. Research in Autism Spectrum Disorders. 2007; 1; 2: 185-193. 10.1016/j.rasd.2006.09.002</bibtext> </blist> <blist> <bibtext> Kern JK, Geier DA, Sykes LK, Geier MR, Deth RC. Are ASD and ADHD a Continuum? A comparison of pathophysiological similarities between the disorders. Journal of Attention Disorders. 2015; 19; 9: 805-827. 10.1177/1087054712459886. 23074304</bibtext> </blist> <blist> <bibtext> Lane A, Harpster K, Heathcock J. Motor characteristics of young children referred for possible autism spectrum disorder. Pediatric Physical Therapy. 2012; 24; 1: 21-29. 10.1097/PEP.0b013e31823e071a. 22207461. 8112076</bibtext> </blist> <blist> <bibtext> Lei J, Jones L, Brosnan M. Exploring an e-learning community's response to the language and terminology use in autism from two massive open online courses on autism education and technology use. Autism. 2021; 25; 5: 1349-1367. 10.1177/1362361320987963. 33567892. 8264622</bibtext> </blist> <blist> <bibtext> Little LM, Dean E, Tomchek S, Dunn W. Sensory processing patterns in autism, attention deficit hyperactivity disorder, and typical development. Physical & Occupational Therapy In Pediatrics. 2018; 38; 3: 243-254. 10.1080/01942638.2017.1390809</bibtext> </blist> <blist> <bibtext> Loomes R, Hull L, Mandy WPL. What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry. 2017; 56; 6: 466-474. 10.1016/j.jaac.2017.03.013</bibtext> </blist> <blist> <bibtext> Lord C, Rutter M, DiLavore PC, Gotham K, Bishop S. Autism diagnostic observation schedule. 20122; Western Psychological Services</bibtext> </blist> <blist> <bibtext> Mottron L. A radical change in our autism research strategy is needed: Back to prototypes. Autism Research. 2021. 10.1002/aur.2494. 34077611</bibtext> </blist> <blist> <bibtext> R Studio TeamRStudio. RStudio: Integrated development for R. 2019; RStudio, Inc.</bibtext> </blist> <blist> <bibtext> Ratto AB, Kenworthy L, Yerys BE, Bascom J, Wieckowski AT, White SW, Wallace GL, Pugliese C, Schultz RT, Ollendick TH, Scarpa A, Seese S, Register-Brown K, Martin A, Anthony LG. What about the girls? Sex-based differences in autistic traits and adaptive skills. Journal of Autism and Developmental Disorders. 2018; 48; 5: 1698-1711. 10.1007/s10803-017-3413-9. 29204929. 5925757</bibtext> </blist> <blist> <bibtext> Reynolds CR, Kamphaus RW. Behavior assessment system for children. 20042; Pearson Assessments</bibtext> </blist> <blist> <bibtext> Rutter M, Le Couteur A, Lord C. Autism Diagnostic interview-revised. 2003; Western Psychological Services</bibtext> </blist> <blist> <bibtext> Ruzich E, Allison C, Smith P, Ring H, Auyeung B, Baron-Cohen S. The autism-spectrum quotient in siblings of people with autism: The AQ in siblings of people with autism. Autism Research. 2017; 10; 2: 289-297. 10.1002/aur.1651. 27333365</bibtext> </blist> <blist> <bibtext> Scheerer NE, Curcin K, Stojanoski B, Anagnostou E, Nicolson R, Kelley E, Georgiades S, Liu X, Stevenson RA. Exploring sensory phenotypes in autism spectrum disorder. Molecular Autism. 2021; 12; 1: 67. 10.1186/s13229-021-00471-5. 34641960. 8507349</bibtext> </blist> <blist> <bibtext> Septier M, Peyre H, Amsellem F, Beggiato A, Maruani A, Poumeyreau M, Amestoy A, Scheid I, Gaman A, Bolognani F, Honey G, Bouquet C, Ly-Le Moal M, Bouvard M, Leboyer M, Bourgeron T, Delorme R. Increased risk of ADHD in families with ASD. European Child & Adolescent Psychiatry. 2019; 28; 2: 281-288. 10.1007/s00787-018-1206-0</bibtext> </blist> <blist> <bibtext> Wechsler D. Wechsler abbreviated scale of intelligence. 1999; The Psychological Corporation</bibtext> </blist> </ref> <ref id="AN0185941309-34"> <title> Footnotes </title> <blist> <bibtext> Since we are speaking predominantly about children and adolescents, we primarily use person-first language; however, when referring to studies including adult participants or when referring to autistic traits, identity-first language is used (Bury et al. in J Autism Dev Disord 53(2):677–687, 2020; Kenny et al. in Autism 20(4):442–462, 2016; Lei et al. in Autism 25(5):1349– 1367, 2021).</bibtext> </blist> </ref> <aug> <p>By Ellen C. Masters; Kevin M. Antshel; Wendy R. Kates and Natalie Russo</p> <p>Reported by Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib34" firstref="ref3"></nolink> <nolink nlid="nl2" bibid="bib15" firstref="ref6"></nolink> <nolink nlid="nl3" bibid="bib18" firstref="ref7"></nolink> <nolink nlid="nl4" bibid="bib31" firstref="ref8"></nolink> <nolink nlid="nl5" bibid="bib17" firstref="ref9"></nolink> <nolink nlid="nl6" bibid="bib28" firstref="ref10"></nolink> <nolink nlid="nl7" bibid="bib12" firstref="ref11"></nolink> <nolink nlid="nl8" bibid="bib13" firstref="ref12"></nolink> <nolink nlid="nl9" bibid="bib11" firstref="ref13"></nolink> <nolink nlid="nl10" bibid="bib27" firstref="ref16"></nolink> <nolink nlid="nl11" bibid="bib26" firstref="ref26"></nolink> <nolink nlid="nl12" bibid="bib41" firstref="ref27"></nolink> <nolink nlid="nl13" bibid="bib42" firstref="ref30"></nolink> <nolink nlid="nl14" bibid="bib37" firstref="ref31"></nolink> <nolink nlid="nl15" bibid="bib33" firstref="ref34"></nolink> <nolink nlid="nl16" bibid="bib38" firstref="ref35"></nolink> <nolink nlid="nl17" bibid="bib19" firstref="ref39"></nolink> <nolink nlid="nl18" bibid="bib39" firstref="ref49"></nolink> <nolink nlid="nl19" bibid="bib10" firstref="ref65"></nolink> <nolink nlid="nl20" bibid="bib23" firstref="ref66"></nolink> <nolink nlid="nl21" bibid="bib35" firstref="ref67"></nolink> <nolink nlid="nl22" bibid="bib14" firstref="ref79"></nolink> <nolink nlid="nl23" bibid="bib36" firstref="ref84"></nolink> <nolink nlid="nl24" bibid="bib32" firstref="ref85"></nolink> <nolink nlid="nl25" bibid="bib21" firstref="ref89"></nolink> <nolink nlid="nl26" bibid="bib20" firstref="ref90"></nolink> <nolink nlid="nl27" bibid="bib16" firstref="ref91"></nolink> <nolink nlid="nl28" bibid="bib29" firstref="ref95"></nolink> <nolink nlid="nl29" bibid="bib40" firstref="ref96"></nolink> <nolink nlid="nl30" bibid="bib22" firstref="ref105"></nolink> <nolink nlid="nl31" bibid="bib24" firstref="ref106"></nolink>
Header DbId: eric
DbLabel: ERIC
An: EJ1474256
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Brief Report: Sensory Features Associated with Autism after Controlling for ADHD Symptoms
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Ellen+C%2E+Masters%22">Ellen C. Masters</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-9586-0606">0000-0002-9586-0606</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kevin+M%2E+Antshel%22">Kevin M. Antshel</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-1139-7790">0000-0002-1139-7790</externalLink>)<br /><searchLink fieldCode="AR" term="%22Wendy+R%2E+Kates%22">Wendy R. Kates</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-3358-2572">0000-0003-3358-2572</externalLink>)<br /><searchLink fieldCode="AR" term="%22Natalie+Russo%22">Natalie Russo</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-5229-3552">0000-0001-5229-3552</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Autism+and+Developmental+Disorders%22"><i>Journal of Autism and Developmental Disorders</i></searchLink>. 2025 55(7):2578-2586.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 9
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2025
– Name: SourceSuprt
  Label: Sponsoring Agency
  Group: SrcSuprt
  Data: National Institutes of Health (NIH) (DHHS)
– Name: NumberContract
  Label: Contract Number
  Group: NumCntrct
  Data: 1R01MH10153601
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Attention+Deficit+Hyperactivity+Disorder%22">Attention Deficit Hyperactivity Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms+%28Individual+Disorders%29%22">Symptoms (Individual Disorders)</searchLink><br /><searchLink fieldCode="DE" term="%22Sensory+Integration%22">Sensory Integration</searchLink><br /><searchLink fieldCode="DE" term="%22Autism+Spectrum+Disorders%22">Autism Spectrum Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Age+Differences%22">Age Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Gender+Differences%22">Gender Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Intelligence+Quotient%22">Intelligence Quotient</searchLink><br /><searchLink fieldCode="DE" term="%22Profiles%22">Profiles</searchLink><br /><searchLink fieldCode="DE" term="%22Prediction%22">Prediction</searchLink><br /><searchLink fieldCode="DE" term="%22Genetics%22">Genetics</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Scores%22">Scores</searchLink><br /><searchLink fieldCode="DE" term="%22Child+Behavior%22">Child Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Rating+Scales%22">Rating Scales</searchLink>
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: <searchLink fieldCode="SU" term="%22Behavior+Assessment+System+for+Children%22">Behavior Assessment System for Children</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1007/s10803-023-06046-y
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0162-3257<br />1573-3432
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Sensory processing differences are reported both in children with ADHD and in children with autism. Given the substantial overlap between autism and ADHD, the current study examined which sensory features were uniquely predictive of autistic traits after controlling for ADHD symptoms, age, IQ, and sex in a sample of children and adolescents with autism aged 6-17 years. Methods: The sample included 61 children and adolescents with autism. The Sensory Profile was used to examine Dunn's quadrant model (seeking, sensitivity, avoiding, registration), ADHD symptoms were measured using hyperactivity and attention problems BASC-2 T-scores, and autistic traits were measured using the AQ. Results: After controlling for age, IQ, sex, and ADHD symptoms, Dunn's sensitivity quadrant predicted autistic traits. Conclusions: Findings provide insight into the phenotype of autism and ADHD. Sensory sensitivity may be unique to autism over and above elevated ADHD symptoms that are commonly seen in this population.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2025
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1474256
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1474256
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1007/s10803-023-06046-y
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 2578
    Subjects:
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: Symptoms (Individual Disorders)
        Type: general
      – SubjectFull: Sensory Integration
        Type: general
      – SubjectFull: Autism Spectrum Disorders
        Type: general
      – SubjectFull: Age Differences
        Type: general
      – SubjectFull: Gender Differences
        Type: general
      – SubjectFull: Intelligence Quotient
        Type: general
      – SubjectFull: Profiles
        Type: general
      – SubjectFull: Prediction
        Type: general
      – SubjectFull: Genetics
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Adolescents
        Type: general
      – SubjectFull: Scores
        Type: general
      – SubjectFull: Child Behavior
        Type: general
      – SubjectFull: Rating Scales
        Type: general
      – SubjectFull: Behavior Assessment System for Children
        Type: general
    Titles:
      – TitleFull: Brief Report: Sensory Features Associated with Autism after Controlling for ADHD Symptoms
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Ellen C. Masters
      – PersonEntity:
          Name:
            NameFull: Kevin M. Antshel
      – PersonEntity:
          Name:
            NameFull: Wendy R. Kates
      – PersonEntity:
          Name:
            NameFull: Natalie Russo
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 07
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 0162-3257
            – Type: issn-electronic
              Value: 1573-3432
          Numbering:
            – Type: volume
              Value: 55
            – Type: issue
              Value: 7
          Titles:
            – TitleFull: Journal of Autism and Developmental Disorders
              Type: main
ResultId 1