Behavioral and neural interrelationships of sensory difficulties, intolerance of uncertainty, and anxiety in autistic children.

PURPOSE: Autistic children often experience higher levels of sensory difficulties and anxiety, compared to their non-autistic counterparts. Available evidence suggests that intolerance of uncertainty (IU) mediates the relationship between these factors. We aimed to further the examination of the interrelationship between these phenomena, as well as their underlying neural mechanisms, in children.

METHODS

30 autistic children (ages 6-11 years) and 26 age-matched neurotypical (NT) peers participated in resting-state fMRI, as well as various behavioral assessments of sensory processing, anxiety, and IU.

RESULTS

Between-groups comparisons of behavioral scores showed higher levels of sensory processing differences, anxiety, and IU in autistic children. Mediation analysis also revealed that IU was a significant mediator between sensory difficulties and anxiety in this group. Network connectivity findings showed that connectivity between sensory cortices and cerebellar, higher order sensory, and limbic regions (esp. amygdala) were significantly correlated with sensory processing, anxiety, and IU.

CONCLUSION

We report novel behavioral and neurophysiologic findings concerning important interrelationships in autism. Our findings may be related to predictive coding accounts of autism. Our results have the potential to inform future clinical practice, in that addressing sensory and IU difficulties has the potential to lead to improvements in anxiety in autistic children.