Relationships Between Autistic Trait Dimensions and Speech Understanding, Affective Sound Intolerance, and...

Decreased sound tolerance (DST) is a disabling transdiagnostic phenomenon with high clinical relevance in autism. Neurodevelopmental DST is often studied as part of a general multisensory construct that includes both hyper- and hyposensitivity. Therefore, knowledge about the potential relevance of individual differences in the auditory modality is lacking. The purpose of the study was to begin to differentiate between commonly pooled auditory functions, by incorporating psychometric tools from the field of audiology.

In a pilot sample (N = 520 adults, 23% autistic), we used Bayesian correlations to quantify the contribution of individual auditory items from the Glasgow Sensory Questionnaire to the degree of social, communicative, and rigid autistic traits measured with the Broad Autism Phenotype Questionnaire (BAPQ) subscales. Then, we recruited an independent sample (N = 175 adults, 18% autistic) to measure, more specifically, (1) emotional reactions to sounds (affective DST), (2) speech understanding difficulties, and (3) nonsocial auditory processing (spatial perception and stream segregation), using self-report questionnaires. We used multiple regression to test for associations with the autistic trait domains.

We found that all autistic traits measured by the BAPQ (social, communicative, and rigid) linearly predicted affective DST, and these associations remained when autistic participants were excluded. Difficulties with speech perception, as well as spatial perception and auditory stream segregation, were most strongly predicted by communication differences.

The robust relationship between autistic traits and emotional sound reactivity suggests that affective DST falls on a spectrum just like autism. This argues against strict dichotomization and encourages the use of continuous measures. The results support a dominant role for emotional and stress systems in autism-related DST and may suggest that detailed audiological tests are clinically useful, in particular, in the context of pragmatic language difficulties.

Why is this an important issue?: Differences in sensory perception go hand in hand with an autistic neurotype. Many individuals find everyday noises intolerable or difficult to understand, but there is little knowledge of how these experiences vary among individuals.What was the purpose of this study?: To understand which aspects of auditory processing are related to autistic characteristics, using assessment tools from the audiology field.What did the researchers do?: They studied 175 adults with different levels of autistic-like social function, communication style, and rigid thinking (18% with an autism diagnosis). They used clinical questionnaires to measure emotional reactions to sounds, speech understanding, auditory space perception, and the ability to distinguish overlapping sounds.What were the results of the study?: All autistic characteristics were linked to strong emotional reactions to sounds. Those with an autistic communication style also reported difficulties with speech perception, auditory space perception, and separating overlapping sounds.What do these findings add to what was already known?: The results highlight a role of emotional and stress responses in autistic sound sensitivity. In addition, they point to the existence of broader auditory difficulties in adults with an autistic communication style.What are potential weaknesses in the study?: It did not include laboratory measurements of auditory function.How will these findings help autistic adults now or in the future?: This study helps by breaking down specific hearing challenges in autism, such as trouble understanding speech or reacting strongly to everyday sounds, rather than looking at sensory issues as a whole. This can lead to better support and solutions for these specific difficulties.