The Relationship between Sensory Processing and Behavior Correlates in Autistic Adults: A Systematic Review

Field: Psychology (Social Sciences)

Background: Autism spectrum conditions, also referred to as “autism”, is a neurodevelopmental condition that is characterized by repetitive behaviors and social-communicative differences. Functional differences in individuals with autism are likely due to how sensory stimuli are processed, presenting as hypersensitivity, hyposensitivity, or a combination of both. Differences in sensory processing can lead to behaviors that are described as sensory seeking, low registration, sensory avoiding, or sensory sensitivity. However, there is a need to consolidate existing research on the impacts of sensory differences on everyday behaviors among autistic adults. Objectives: This systematic review analyzed the existing literature on the correlation between sensory processing and behavior in adults on the autism spectrum. The primary research question was “how does sensory processing impact everyday functional behavior among autistic adults?”. Methods: Data analysis following the PRISMA guidelines began with a total of 3076 articles retrieved from the following databases: PubMed, Psychnfo, Embase, CINAHL Scopus, and Web of Science. The inclusion criteria were 1) peer-reviewed journal articles, 2) adult participants > 18 years old with an official autism diagnosis, 3) a measure of sensory processing as well as functional performance/ behavioral outcomes, and 4) statistical analyses highlighting the correlation strength between the sensory processing and behavior measures outlined in the articles. Results: A total of 3,076 articles were screened, which yielded a total of 29 peer-reviewed articles that correlated sensory differences in autism with various behavioral outcomes. These outcomes were categorized into seven overarching themes: anxiety; social integration; restrictive, repetitive behaviors (RRBs); depression and self-harm; disruptive behaviors; adaptive functioning; and savant skills. A large portion of the studies focused on anxiety (n=14) and social integration (n=9). The Adolescent/Adult Sensory Profile was the most frequently used measure of sensory processing. Notably, 22 articles (73%) demonstrated an association between hypersensitive sensory profiles (i.e., sensory avoiding and sensory sensitive) and behavioral correlates. In contrast, there was a lack of evidence that focused on sensory seeking and low registration sensory profiles. Additionally, six articles (20%) highlighted sensory processing differences as a mediator in larger paradigms affecting overall behavioral functioning in adults on the spectrum. Conclusion: Overall, the reviewed studies indicate a strong relationship between sensory processing and various behavioral outcomes in autistic adults. Longitudinal studies are needed to clarify the causal relationships between distinct sensory profiles and behavioral outcomes, with a particular focus on the sensory sensitivity profile given its prominence in the literature. Although anxiety and social integration have been well-studied, further research should target other areas, such as RRBs, depression, and aggression, to inform the development of tailored therapeutic interventions for autistic adults facing these challenges.