Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA.
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Room 8310, Nashville, TN, 37232, USA.
Mol Autism. 2023 Aug 28;14(1):31. doi: 10.1186/s13229-023-00563-4.
Differences in responding to sensory stimuli, including sensory hyperreactivity (HYPER), hyporeactivity (HYPO), and sensory seeking (SEEK) have been observed in autistic individuals across sensory modalities, but few studies have examined the structure of these "supra-modal" traits in the autistic population.
Leveraging a combined sample of 3868 autistic youth drawn from 12 distinct data sources (ages 3-18 years and representing the full range of cognitive ability), the current study used modern psychometric and meta-analytic techniques to interrogate the latent structure and correlates of caregiver-reported HYPER, HYPO, and SEEK within and across sensory modalities. Bifactor statistical indices were used to both evaluate the strength of a "general response pattern" factor for each supra-modal construct and determine the added value of "modality-specific response pattern" scores (e.g., Visual HYPER). Bayesian random-effects integrative data analysis models were used to examine the clinical and demographic correlates of all interpretable HYPER, HYPO, and SEEK (sub)constructs.
All modality-specific HYPER subconstructs could be reliably and validly measured, whereas certain modality-specific HYPO and SEEK subconstructs were psychometrically inadequate when measured using existing items. Bifactor analyses supported the validity of a supra-modal HYPER construct (ω = .800) but not a supra-modal HYPO construct (ω = .653), and supra-modal SEEK models suggested a more limited version of the construct that excluded some sensory modalities (ω = .800; 4/7 modalities). Modality-specific subscales demonstrated significant added value for all response patterns. Meta-analytic correlations varied by construct, although sensory features tended to correlate most with other domains of core autism features and co-occurring psychiatric symptoms (with general HYPER and speech HYPO demonstrating the largest numbers of practically significant correlations).
Conclusions may not be generalizable beyond the specific pool of items used in the current study, which was limited to caregiver report of observable behaviors and excluded multisensory items that reflect many "real-world" sensory experiences.
Of the three sensory response patterns, only HYPER demonstrated sufficient evidence for valid interpretation at the supra-modal level, whereas supra-modal HYPO/SEEK constructs demonstrated substantial psychometric limitations. For clinicians and researchers seeking to characterize sensory reactivity in autism, modality-specific response pattern scores may represent viable alternatives that overcome many of these limitations.
在跨感觉模式的自闭症个体中，已观察到对感觉刺激的反应存在差异，包括感觉超敏反应（HYPER）、低敏反应（HYPO）和感觉寻求（SEEK），但很少有研究探讨自闭症人群中这些“超模式”特征的结构。
利用来自 12 个不同数据源的 3868 名自闭症青少年的综合样本（年龄 3-18 岁，代表认知能力的全范围），本研究使用现代心理计量学和荟萃分析技术，对内和跨感觉模式，探究照顾者报告的 HYPER、HYPO 和 SEEK 的潜在结构和相关性。双因素统计指数既用于评估每个超模式结构的“一般反应模式”因素的强度，也用于确定“模式特异性反应模式”分数（例如，视觉 HYPER）的附加值。贝叶斯随机效应综合数据分析模型用于检验所有可解释的 HYPER、HYPO 和 SEEK（子）结构的临床和人口统计学相关性。
所有模式特异性 HYPER 子结构都可以可靠和有效地测量，而某些模式特异性 HYPO 和 SEEK 子结构在使用现有项目进行测量时则在心理计量学上不足。双因素分析支持超模式 HYPER 结构（ω=0.800）的有效性，但不支持超模式 HYPO 结构（ω=0.653），超模式 SEEK 模型表明该结构的一个更有限的版本，排除了一些感觉模式（ω=0.800；4/7 种模式）。模式特异性子量表对所有反应模式都具有显著的附加值。元分析相关性因结构而异，尽管感觉特征往往与自闭症核心特征和共患精神症状的其他领域最相关（一般 HYPER 和言语 HYPO 表现出最大数量的实际显著相关性）。
结论可能不适用于当前研究中使用的特定项目池之外，该研究仅限于照顾者报告可观察到的行为，并且排除了反映许多“现实世界”感觉体验的多感觉项目。
在三种感觉反应模式中，只有 HYPER 在超模式水平上表现出足够的有效解释证据，而超模式 HYPO/SEEK 结构则表现出明显的心理计量学限制。对于寻求在自闭症中描述感觉反应的临床医生和研究人员，模式特异性反应模式分数可能是可行的替代方案，可以克服许多这些限制。
