Impacts of Sensory Challenges on Attentional Control in Young Children with Autism

Background: Individuals with autism (ASD) often present with challenges with attentional control (Karhson & Golob, 2016). Concurrently with tasks of attention, individuals with ASD often struggle to effectively filter multisensory input (Boland et al., 2018). Thus, as additional sensory stimuli are introduced, attentional control skills like focused attention are negatively impacted (Brandwein et al., 2015). Because sensory challenges co-occur in up to 90-95% of individuals with autism (Baker et al., 2008), it is important to examine the role of sensory stimuli in the attentional control skills of young children with ASD.

Objectives: Our objective was to investigate the potential mediational role of sensory on attention focusing in ASD and typically developing (TD) populations. We hypothesized that sensory would mediate the relation between status (ASD vs. TD) and attention. Specifically, we predicted that increases in sensory would help explain the attention focusing skills for status groups. Additionally, given that children with ASD have increased sensory symptoms, we hypothesized that the relation between sensory and attention focusing would be stronger for our ASD sample.

Methods: Participants included 170 children between ages 3:0 and 6:11. Our sample comprised of 96 TD children (43% female) and 74 children with ASD (24% female). A subscale of the Autism Behavior Checklist (ABC; Krug et al. 1980) was used to determine sensory symptoms. Parents’ ratings from the Child Behavior Questionnaire (Rothbart et al., 2001) were used to evaluate children’s attentional control.

Results: A mediated multiple regression analysis was conducted to investigate the degree to which sensory mediated the relation between status and attentional focusing. Findings indicated significant indirect effects for both status groups through sensory (B = 7.389, CI₉₅ = 5.73 to 9.05) and sensory through attention (B = -.182, CI₉₅ = -.367 to -.003). Correspondingly, the total indirect effect was statistically significant (B = -1.344, CI₉₅ = -2.755 to -.184), supporting our prediction that sensory would mediate the association between status and attention. The negative valence of this effect means that children with ASD demonstrated, on average, a 1.344 point decrease in focused attention compared to the TD group as a result of the effect of status on attention through sensory.

Conclusions: Results supported our hypotheses that the ASD group would exhibit a higher frequency of sensory symptoms and that sensory symptom severity increases would impact focused attention. Sensory severity also mediated the relation between status and attention, suggesting that increased sensory behaviors relate to lower sustained attention and that this relation is stronger for children with ASD. Attentional skills have been linked with higher cognitive functioning (Lawson & Ruff, 2004) and increased sensory challenges in children with ASD are related to deficits in across multiple domains (i.e., social outcomes [Stevenson et al., 2014], daily living [Baker et al., 2008], and emotion regulation [Woo et al., 2015]). In sum, interventions that target sensory challenges may help to minimize barriers to attentional capacity in young children with ASD.