Sensory Reactivity in Children Referred for Autism Evaluation: Associations with Autism Symptoms and Adaptive Skills

The present study examines sensory differences in children referred for autism evaluations and explores associations between sensory differences, autism symptomatology, and adaptive skills. Using a clinically referred sample, this study captures the heterogeneity of diverse developmental profiles observed in everyday clinical practice and provides a nuanced understanding of sensory differences in an ecologically valid way in the context of autism assessments.

Participants included 238 children (41 females/3-14 years), referred to a university-based autism clinic due to concerns related to autism. Autism diagnoses were confirmed using the Autism Diagnostic Observation Schedule-2, DSM-5 criteria, and expert clinical judgement informed by comprehensive multidisciplinary evaluation. Additional measures were collected to obtain information on sensory processing (Sensory Profile-2/SP-2) and adaptive functioning (Vineland-II/-3). Diagnostic outcomes were classified as autism (n = 121) versus non-autism (n = 117).

Non-autistic children scored higher than autistic children in sensory avoiding and sensitivity, with no group differences in sensory seeking or registration as measured by the SP-2. Correlational analysis showed negative associations between sensory differences and both autism symptomatology and adaptive functioning. Regression analysis further indicated that higher sensory differences predicted lower adaptive functioning, with sensory sensitivity showing the most widespread associations across communication, daily living skills, and socialization.

Non-autistic children exhibited greater sensory avoiding and sensitivity than autistic children, which may possibly reflect co-occurring concerns such as anxiety or attentional difficulties (e.g., avoiding noisy environments due to anxiety rather than sensory sensitivity). Across groups, higher sensory differences showed consistent associations with lower adaptive functioning, highlighting the importance of assessing sensory behaviors in children with diverse clinical profiles.