Emotional and Behavioural Problems in Adolescents with ASD Are Associated with Alterations in Neural Indices of Perceptual Processing

Background:

Many young people with autism spectrum disorder (ASD) exhibit co-occurring emotional and behavioural problems. The development of effective interventions requires greater knowledge of the causes of these problems. One approach is to explore whether variation in specific neurocognitive processes, thought to be impaired in individuals with ASD, is also associated with additional psychopathology. Perceptual/sensory processing atypicalities are often reported in ASD, but how these relate to co-occurring emotional and behavioural problems is not well explored.

Objectives:

To test the association between neural indices of perceptual processing, and emotional and behavioural problems, in a well-characterised sample of adolescents (11-15 years) with ASD (n=43; 29 males, 14 females) with a wide-range of IQ (27-129).

Methods:

Event-related potentials (ERPs) were recorded in response to both deviant (8% probability, 1200Hz) and standard tones (92% probability, 1000Hz) in an auditory oddball paradigm.

Analyses focused on perceptual sensitivity, measured by the response to deviant, as compared to standard tone (mismatch negativity; MMN), and the differential ERP response to the first (S1), second (S2) and third (S3) standard tone presented directly after the deviant tone. Multivariate regression tested the association between ERPs and parent-reported emotional and behavioural problems. Primary analyses used the ADHD, emotional and conduct problems sub-scales of the Strengths and Difficulties Questionnaire (SDQ), and the Affective Reactivity Index (ARI). Secondary analyses used the Developmental Behaviour Checklist (DBC) total behaviour problem score.

Age, sex, IQ, and ASD severity were used as covariates. Sensitivity analyses excluded those taking psychotropic medication (n=5), and then separately excluded those with epilepsy (n=2).

Results:

No association was found between MMN amplitude and SDQ sub-scales or ARI. An association was found between MMN amplitude and DBC total behaviour problem score (p<0.05), and this remained at a trend level when controlling for age, sex and IQ (p=0.07), but became non-significant when controlling for age, sex, IQ and ASD severity (p=0.11). The association remained in unadjusted sensitivity analyses (p<0.05).

A selective association was found between ERP response (N2) to S1 and SDQ emotional problems (p<0.05). No associations were found to S2 or S3. This pattern of results remained in all co-variation and sensitivity analyses (ps<0.05). Follow-up analyses showed participants who scored positively on the Social Communication Questionnaire (SCQ) item indexing repetitive behaviours had a greater ERP response to S1 as compared to those who did not (p<0.05). No association was found between ERP response and the summed score of SCQ items indexing social impairment.

Conclusions:

Results regarding the association between MMN amplitude and DBC extend prior work, which has found comparable associations between behavioural problems and perceptual hyper-sensitivity using care-giver ratings of perceptual sensitivity.

Results regarding the selective response to S1 suggest a higher initial orienting response following deviant stimuli was linked to both internalising and repetitive behaviours, and thus are interpreted within the ‘intolerance of uncertainty’ framework.

Overall, findings suggest that perceptual processing atypicalities should be investigated in aetiological models of psychopathology in ASD, and ultimately the assessment of perceptual sensitivities may be helpful in individuals with co-occurring emotional and behavioural problems.