The relationship between sensory reactivity differences and mental health symptoms in preschool‐age autistic children
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Abstract
There is growing evidence for an association between sensory reactivity and mental health in autism. This study set out to explore the relationship between sensory reactivity and mental health in preschool‐aged autistic children. In total 54 preschool‐aged children with an Autism Spectrum Condition took part. Sensory and mental health symptoms were obtained from the Sensory Processing Scale Inventory, Sensory Assessment of Neurodevelopmental Differences and the Behavioral Assessment System for Children–3. Correlational analyses showed a relationship between sensory reactivity and mental health symptoms in autistic preschool‐aged children. Results also indicate divergence in sensory‐mental health profiles between autistic preschool‐aged children who are verbal and those who use few to no words. For the first time this study has revealed a relationship between sensory hyper‐reactivity, as well as sensory seeking, and mental health symptoms outside of anxiety in autism. Of note, this relationship between sensory hyper‐reactivity and internalizing symptoms appears to be driven by those with few to no words. This has implications for both research and clinical interventions, in particular for our understanding of the factors underlying mental health symptoms in different autistic phenotypes, as well as the possible role of functional communication in mitigating the development of mental health symptoms. Lay Summary: The present study found that in autistic preschoolers, externalizing mental health symptoms, such as hyperactivity, are related to sensory seeking (seeking out or being fascinated with sensory stimuli), and internalizing mental health symptoms, such as depression, are related to sensory hyper‐reactivity (sensitivity to sensory stimuli). Our results also show that whilst the relationships between externalizing symptoms and sensory seeking is seen across participants, the relationship between internalizing symptoms and sensory hyper‐reactivity was only seen in autistic preschoolers who used few to no words. This has important implications for the assessment of sensory differences as part of more rigorous mental health assessments, especially in autistic people who use few to no words.
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Client-related factors like irritability, lack of group identification, sensory sensitivity and avoidance, perceived lack of control, unemployment, isolation, executive dysfunctions, and genetic predispositions are associated with the development of comorbidities.
“Client-related factors like irritability, lack of group identification, sensory sensitivity and avoidance, perceived lack of control over one's life, unemployment, isolation, executive dysfunctions, and genetic predispositions are also associated with the development of comorbidities (Day et al., 2020;Rossow et al., 2021).”
From Rethinking psychological interventions in autism: Toward a neurodiversity‐affirming approach. (2025) · cites this paper as Rossow et al., 2021
The Introduction and Discussion report associations between sensory reactivity and mental-health symptoms, including irritability, in autistic preschoolers. The paper does not establish that these factors cause comorbidities to develop, and it does not support the sentence’s other listed factors, such as unemployment, perceived lack of control, executive dysfunction, or genetic predisposition. The cited passages provide no page numbers. (LLM, conf=0.88)
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Examining Sensory Overresponsiveness in Preschool Children With Retentive Fecal Incontinence
Beaudry‐Bellefeuille, I., & Lane, S. J. (2017) · American Journal of Occupational Therapy · doi:10.5014/ajot.2017.022707 · Cited by 20 · see citing works
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Sensory processing ability and eating behaviour in children with autism
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Sensory processing differences and urinary incontinence in school-aged children
Cupelli, E. T., Escallier, L. A., Galambos, N., Xiang, S., & Franco, I. (2014) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2014.01.002 · Cited by 13 · see citing works
Ellison, K. S., Bundy, M. B., Gore, J., & Wygant, D. B. (2019) · Exceptionality · doi:10.1080/09362835.2019.1579721 · Cited by 11 · see citing works
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Flagged first, then by citations
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Research works printed but not linked: 1
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In Our Own Words: The Complex Sensory Experiences of Autistic Adults
MacLennan, K., O’Brien, S., & Tavassoli, T. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05186-3 · Cited by 163 · see citing works
Self-citation“It Is a Big Spider Web of Things”: Sensory Experiences of Autistic Adults in Public Spaces
MacLennan, K., Woolley, C., andsensory, E., Heasman, B., Starns, J., George, B., & Manning, C. (2023) · Autism in Adulthood · doi:10.1089/aut.2022.0024 · Cited by 96 · see citing works
Self-citationBarriers and Facilitators of Healthcare Access for Autistic Children in the UK: a Systematic Review
Babalola, T. T., Sanguedolce, G., Dipper, L. T., & Botting, N. (2024) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-023-00420-3 · Cited by 59 · see citing works
Verhulst, I., MacLennan, K., Haffey, A., & Tavassoli, T. (2022) · Autism in Adulthood · doi:10.1089/aut.2022.0018 · Cited by 39 · see citing works
Self-citationRethinking psychological interventions in autism: Toward a neurodiversity‐affirming approach.
Graf‐Kurtulus, S., & Gelo, O. C. G. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.12874 · Cited by 34 · see citing works
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Williams, Z. J., Schaaf, R. C., Ausderau, K., Baranek, G. T., Barrett, D. J., Cascio, C. J., Dumont, R. L., Eyoh, E. E., Failla, M. D., Feldman, J. I., et al. (2023) · Molecular Autism · doi:10.1186/s13229-023-00563-4 · Cited by 35 · see citing works
Self-citationImpacts of school environment quality on autistic pupil's behaviours – A systematic review
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Self-citationRossow, T., MacLennan, K., & Tavassoli, T. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05528-9 · Cited by 18 · see citing works
Self-citationModality-specific associations between sensory differences and autistic traits
Bang, P., & Igelström, K. M. (2023) · Autism · doi:10.1177/13623613231154349 · Cited by 22 · see citing works
Lucas, C. C., Pereira, A. P. D. S., Almeida, L. S., & Beaudry‐Bellefeuille, I. (2023) · Journal of Occupational Therapy Schools & Early Intervention · doi:10.1080/19411243.2023.2203418 · Cited by 19 · see citing works
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Spielmann, V., Burke, H. K., McCulloch, S., Mason, A., & Lane, S. J. (2023) · American Journal of Occupational Therapy · doi:10.5014/ajot.2023.050127 · Cited by 10 · see citing works
Bianco, T. D., Estrin, G. L., Tillmann, J., Oakley, B. F. M., Crawley, D., Cáceres, A. S. J., Hayward, H., Potter, M., Mackay, W., Smit, P., et al. (2023) · Autism · doi:10.1177/13623613231200297 · Cited by 8 · see citing works
Browne, K., Lawson, W. B., McGarry, S., Scott, M., Girdler, S. J., & Milbourn, B. T. (2024) · Autism in Adulthood · doi:10.1089/aut.2024.0141 · Cited by 7 · see citing works
Forwarding the Science of Sensory Features in Autism and Related Conditions
Schaaf, R. C., Puts, N. A. J., Williams, Z. J., & Woynaroski, T. G. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-023-05959-y · Cited by 7 · see citing works
Sound perception of children aged 2–6 years with autism spectrum disorder
Guo, J., Kang, J., & Ma, H. (2023) · Applied Acoustics · doi:10.1016/j.apacoust.2023.109623 · Cited by 5 · see citing works
Williams, Z. J., Schaaf, R. C., Ausderau, K., Baranek, G. T., Barrett, D. J., Cascio, C. J., Dumont, R. L., Eyoh, E. E., Failla, M. D., Feldman, J. I., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-2447849/v1 · Cited by 5 · see citing works
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‘I feel trapped in my safe clothes’: The impact of tactile hyper-sensitivity on autistic adults
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Processes Associated with the Development of Depression in Autistic Individuals: A Narrative Review
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Impact of indoor environment quality on autistic behaviours in autism schools of Saudi Arabia
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COVID-19, Adverse Experiences, and Mental Health in Autistic Youth: A Population-Based Study
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Dunham-Carr, K., Feldman, J. I., Simon, D. M., Wallace, M. T., Murray, M. M., & Woynaroski, T. G. (2026) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-026-07552-5
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- Authors
- Rossow, T., MacLennan, K., & Tavassoli, T.
- Affiliations
- University of Reading (GB)
- Corresponding author
- Rossow, Timothy
- Venue
- Autism Research
- Publisher
- Wiley
- Published
- 2021-05-04
- Volume
- 14
- Issue
- 8
- Pages
- 1645-1657
- ISSN
- 1939-3792 (ISSN-L)
- 1939-3806
- OpenAlex
- W3158192194
- Cited by
- 35
- References
- 102
- Citations by year
- 2026: 10 · 2025: 3 · 2024: 8 · 2023: 10 · 2022: 3 · 2021: 1
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Autism Research (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CentAUR (University of Reading) (submittedVersion)
- Durham Research Online (Durham University) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Funders
- Autistica
- MQ: Transforming Mental Health
- University of Reading
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- sensory reactivity, autism spectrum disorder, preschool children, psychiatric symptoms, sensory seeking, internalizing problems, externalizing problems, language skills, functional communication, autism phenotype
- MeSH terms
- Autism Spectrum Disorder, Anxiety Disorders, Autistic Disorder, Child, Child, Preschool, Cognition, Humans, Mental Health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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