A Meta-Analysis of Odor Thresholds and Odor Identification in Autism Spectrum Disorders

Autism Spectrum Disorders (ASD) are often accompanied by atypical visual, auditory, and tactile sensory behavior. Evidence also suggests alterations of the olfactory system, but the pattern of findings appears mixed. To quantify this pattern systematically, we conducted a meta-analysis. Studies were included if they examined olfactory function (i.e., odor threshold, or odor identification) in ASD compared with healthy age-matched control groups. We also coded for the potential moderators gender, age, and IQ. Articles were identified through computerized literature search using Web of Science, PubMed, and Scopus databases. A total of 11 articles compared odor threshold and/or odor identification between cases and controls (for threshold, n = 143 ASD and 148 controls; and for identification, n = 132 ASD and 139 controls). Effects sizes showed a substantial heterogeneity. As a result, the 95% prediction intervals were wide and ranged between a large negative and a large positive effect size for odor threshold, [-1.86, 2.05], and for odor identification, [-1.51, 2.52]. Exploratory analyses suggested that age and IQ may be potential moderators. To conclude, the large heterogeneity is consistent with the notion of both hyposensitivity and hypersensitivity in individuals with ASD. However, future research needs to predict and test the specific direction of the effect to provide convincing evidence for atypical olfactory functions in ASD.