Anxiety in Autism Spectrum Disorder (ASD) : the influence of executive and sensory processing dysfunctions

Abstract

Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder associated with difficulties with social communication and the presence of restricted and repetitive behaviours. There is significant heterogeneity of symptom profiles within the disorder. Anxiety is very common in individuals with ASD. Previous research suggests associations between executive function deficits and sensory processing atypicalities and anxiety in ASD, though neither relationship has been explored in detail. Aims: To examine the putative relationships between anxiety, executive function difficulties and sensory processing atypicalities in children with ASD, taking into account potential heterogeneity within the sample. Method: Thirty six families with a child with ASD were recruited. The children completed an anxiety questionnaire and standardised assessments of executive function. Parents completed questionnaire about their child’s anxiety, sensory processing difficulties and autism severity. 22 parents completed a follow-up study of their child’s anxiety, everyday executive function and repetitive behaviours. Correlational analysis and cluster analysis were used to examine the data. Results: Anxiety scores were high and remained stable over a twenty month period. No significant associations were found between objective measures of executive function difficulties and anxiety, though parent reported child executive difficulties were associated with heightened parent reported child anxiety.High anxiety was associated with sensory processing atypicalities, and higher levels of ASD severity. Importantly, cluster analysis revealed distinct subgroups of children in relation to anxiety, sensory and executive profiles, illustrating heterogeneity within the sample. Conclusions: The findings supports previous research that anxiety is high in children with ASD and remains high over time and is associated with sensory processing atypicalities. The relationship between executive function and anxiety varied as a function of the source of the data. Cluster analysis illustrates the importance of considering heterogeneity in ASD. Implications for clinical practice and future research are discussed.