背景:自闭症谱系条件(ASC)和定量自闭症特征(QAT)与感觉症状有关,这可能会导致焦虑,并对社会和认知发展产生不利影响。虽然感官症状可以发生在所有的感官,特定的感觉模式作为自闭症表型和焦虑因素的相对作用尚不清楚。这项研究的目的是检查哪些感觉症状最能预测高度焦虑。
方法:我们招募了257名6至11岁儿童的女性主要照顾者(49%的女孩)进行问卷调查,其中包括经典QATs的父母报告措施(社会,交际,和刚性),自闭症相关的感觉运动症状(视觉,听觉,触觉,嗅觉,味觉,前庭,本体感受,和电机),和焦虑症状。首先,贝叶斯随机搜索变量选择(SSVS)用于识别特定QAT的最可能的感觉运动预测因子以及已诊断的ASC。然后,选择的预测因子被用在另一个SSVS中,使用焦虑症状作为因变量,确定哪些与自闭症相关的感觉运动症状最有力地预测了焦虑。最后,使用线性回归估计焦虑相关感觉症状的效应大小.
结果:我们发现听觉症状和运动困难是ASC诊断的最具预测性的。发育性运动困难也与所有个人QAT密切相关,而听觉症状更有选择性地预测刚性特征。触觉症状有力地预测了社交互动QAT,本体感受症状可预测交际QAT。听觉和嗅觉处理困难最强烈地预测了焦虑结果。
结论:结果支持对神经发育人群的声音和听力的抱怨保持警惕的临床重要性,并且听觉处理困难可以被评估为患有和未患有自闭症的儿童的心理健康不良的早期标志。嗅觉处理差异似乎是与ASC或QAT相关程度较低的焦虑标记,而运动困难与自闭症高度相关,但与焦虑结局的相关性不强。我们建议,未来的研究可能集中在神经发育中枢听觉处理功能障碍的机制和后果及其与焦虑症的潜在关系上。
BACKGROUND: Autism spectrum conditions (ASC) and quantitative autistic traits (QATs) are associated with sensory symptoms, which may contribute to anxiety and adversely affect social and cognitive development. Although sensory symptoms can occur across all senses, the relative roles of specific sensory modalities as contributors to the autistic phenotype and to anxiety are not well understood. The objective of this study was to examine which sensory symptoms were most predictive of high anxiety.
METHODS: We recruited 257 female primary caregivers of children aged 6 to 11 years (49% girls) to a questionnaire study comprising parent-report measures for classical QATs (social, communicative, and rigid), autism-related sensorimotor symptoms (visual, auditory, tactile, olfactory, gustatory, vestibular, proprioceptive, and motor), and anxiety symptoms. First, Bayesian stochastic search variable selection (SSVS) was used to identify the most probable sensorimotor predictors of specific QATs as well as diagnosed ASC. Then, the selected predictors were used in another SSVS, using anxiety symptoms as a dependent variable, to identify which of the autism-relevant sensorimotor symptoms were most robustly predictive of anxiety. Finally, the effect sizes of anxiety-related sensory symptoms were estimated with linear regressions.
RESULTS: We found that auditory symptoms and motor difficulties were most predictive of ASC diagnosis. Developmental motor difficulties were also strongly related to all individual QATs, whereas auditory symptoms were more selectively predictive of rigid traits. Tactile symptoms robustly predicted social interaction QATs, and proprioceptive symptoms predicted communicative QATs. Anxiety outcomes were most strongly predicted by difficulties with auditory and olfactory processing.
CONCLUSIONS: The results support the clinical importance of being alert to complaints about sounds and hearing in neurodevelopmental populations, and that auditory processing difficulties may be evaluated as an early marker of poor mental health in children with and without diagnosed autism. Olfactory processing differences appeared to be an anxiety marker less strongly associated with ASC or QATs, while motor difficulties were highly autism-relevant but not equally strongly associated with anxiety outcomes. We suggest that future studies may focus on the mechanisms and consequences of neurodevelopmental central auditory processing dysfunction and its potential relationship to anxiety disorders.