Cited by 327Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesChild and Adolescent Psychosocial and Emotional Development

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Anxiety Disorders and Sensory Over-Responsivity in Children with Autism Spectrum Disorders: Is There a Causal Relationship?

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Green, Shulamite A., Ben-Sasson, Ayelet·2010·Journal of Autism and Developmental Disorders

DOI 10.1007/s10803-010-1007-xPMC PMC2980623

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Abstract

Anxiety disorders and sensory over-responsivity (SOR) are common in children with autism spectrum disorders (ASD), and there is evidence for an association between these two conditions. Currently, it is unclear what causal mechanisms may exist between SOR and anxiety. We propose three possible theories to explain the association between anxiety and SOR: (a) SOR is caused by anxiety; (b) Anxiety is caused by SOR; or (c) SOR and anxiety are causally unrelated but are associated through a common risk factor or diagnostic overlap. In this paper, we examine support for each theory in the existing anxiety, autism, and neuroscience literature, and discuss how each theory informs choice of interventions and implications for future studies.

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Fig. 1 Primary anxiety model portraying the theoretical pathway from symptoms of anxiety disorders to over-reaction to sensory stimuli. This pathway is then maintained and exacerbated through conditioningCC BY-NC · PubMed Central

Fig. 2 Primary SOR model portraying the theoretical pathway from symptoms of sensory over-responsivity to anxiety disorders. SOR may lead to specific phobia through classical conditioning. Additionally, due to the unpredictability, uncontrollability, and frequency of sensory stimuli in the environment, it may lead to generalized anxiety through context conditioningCC BY-NC · PubMed Central

Fig. 3 Third model demonstrating how a third variable might explain the association between SOR and anxiety. This relationship could be caused by a general risk factor to both conditions such as an overactive amygdala, or be due to diagnostic overlapCC BY-NC · PubMed Central

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The role of the amygdala in fear and anxiety
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Background
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Background
Behavioral manifestations of autism in the first year of life
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“Currently, SOR can be identified in infants later diagnosed with ASD (Zwaigenbaum et al. 2005), which is much earlier than anxiety is usually diagnosed.”
Background
Neuroanatomy of autism
Amaral, D. G., Schumann, C. M., & Nordahl, C. W. (2008) · Trends in Neurosciences · doi:10.1016/j.tins.2007.12.005 · Cited by 1,492 · cited 2×
“There is evidence that children with ASD have increased amygdala volumes compared to typically developing children, and that amygdala size is positively correlated with anxiety and severity of social-communication symptoms in these children (Amaral et al. 2008; Juranek et al. 2006).”
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BackgroundInfluential
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“It is also important to ask whether, theoretically, a preverbal child with low cognitive ability can be anxious, as some theories of anxiety relate anxiety to conscious cognitive processing and anticipation of future events (e.g., Beck and Clark 1997 ).”
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The human amygdala and the emotional evaluation of sensory stimuli
Zald, D. H. (2003) · Brain Research Reviews · doi:10.1016/s0165-0173(02)00248-5 · Cited by 1,062 · cited 3×
“The amount of enhancement in the sensory response is correlated with the amount of amygdala activation, which suggests that children with SOR may have over-active amygdalas (Zald 2003).”
BackgroundInfluential
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Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2005.01546.x · Cited by 975 · cited 1×
“Reports of SOR rates of 56–70% in children with ASD (Baranek et al. 2006; Ben-Sasson et al. 2007b) indicate elevated levels of SOR relative to rates of 10–17% in the general population (Ben-Sasson et al. 2009; Ben-Sasson et al. 2007b).”
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Concept Evolution in Sensory Integration: A Proposed Nosology for Diagnosis
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“This may be an indicator of poor modulation of vestibularproprioceptive input, which is often observed in children with SOR ( Miller et al. 2007 ).”
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Items 101–200 of 327

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“Given the substantial co-occurrence of anxiety and SOR in children with ASD, these therapies may be adaptable to target SOR [140].”
Background
Anxiety in youth with autism spectrum disorders: implications for treatment
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“[14] It is also common for children with ASD to experience sensory hyper-responsivity and become particularly anxious in response to normal levels of sensory input.[23] For example, youth with ASD are often anxious about eating certain foods due to textural issues and some may even report being fearful of vomiting as…”
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Sensory Modulation in Children with Developmental Coordination Disorder Compared to Autism Spectrum Disorder and Typically Developing Children
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Bart, O., Bar‐Shalita, T., Mansour, H. A., & Dar, R. (2016) · Physical & Occupational Therapy In Pediatrics · doi:10.1080/01942638.2016.1185504 · Cited by 26
“Green and Ben-Sasson (2010) proposed three models worthy of further study: (i) anxiety as a symptom of or caused by SOR; (ii) SOR as a symptom of or caused by anxiety; and (iii) the presence of both anxiety and SOR, linked by a different factor (non-causal model).”
Background
Brief Report: Prevalence and Severity of Auditory Sensory Over-Responsivity in Autism as Reported by Parents and Caregivers
Carson, T. B., Valente, M. J., Wilkes, B. J., & Richard, L. F. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-04991-0 · Cited by 26
“Across the lifespan for those with ASD, anxiety and over-responsivity to different types of sensory stimuli have been closely linked (Gillott & Standen, 2007; Green & Ben-Sasson, 2010; Mazurek et al., 2012; Syu & Lin, 2018).”
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Uljarević, M., Labuschagne, I., Bobin, R., Atkinson, A., & Hocking, D. R. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3631-9 · Cited by 25
“It has been suggested that sensory features, in particular sensory hypersensitivity (i.e. overresponsiveness to sensory stimulation) are important factors in the development and maintenance of anxiety in ASD (Green and Ben-Sasson 2010; Green et al.”
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“Sensory over-responsivity has been hypothesized to be either caused by anxiety, a consequence of anxiety, or simply associated with anxiety through a common factor (Green & Ben-Sasson, 2010).”
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Muskett, A., Radtke, S. R., White, S., & Ollendick, T. H. (2019) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-019-00159-w · Cited by 23
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“…of a weak integration capacity, referring to extreme difficulties when relating diverse sources of information, as well as sensory hypersensitivity, social misunderstanding, and deficient emotional regulation (Bellini, 2004; Green et al., 2010; Happé and Frith, 2006; Scarpa and Reyes, 2011).”
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Cakar, M. E., Okada, N. J., Cummings, K. K., Jung, J., Bookheimer, S. Y., Dapretto, M., & Green, S. A. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1337921 · Cited by 24
“Anxiety severity was included as a covariate in these analyses to examine the unique effect of SOR over and above anxiety, due to previously reported high correlations between SOR and anxiety symptoms (e.g., 45, 52).”
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Adra, N., Cao, A., Makris, N., & Valera, E. M. (2020) · Brain Imaging and Behavior · doi:10.1007/s11682-020-00302-w · Cited by 11
“Though preliminary, these findings are consistent with the primary anxiety model of Green and Ben-Sasson (2010), who proposed three theories on the link between SOR and anxiety: the primary anxiety model, primary SOR model, and a non-causal model linking the two conditions (Green and Ben-Sasson…”
Result
Higher Intersubject Variability in Neural Response to Narrative Social Stimuli Among Youth With Higher Social Anxiety
Camacho, M. C., Balser, D., Furtado, E., Rogers, C. E., Schwarzlose, R. F., Sylvester, C. M., & Barch, D. M. (2023) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2023.08.020 · Cited by 11
“For example, children with social anxiety symptoms may also have heightened or otherwise atypical sensory responses, 29-33 which could lead to altered emotion reasoning development through alterations in the early phases of emotion processing.”
Background
Effects of service dogs on children with ASD’s symptoms and parents’ well-being: On the importance of considering those effects with a more systemic perspective
Dollion, N., Poirier, M., Auffret, F., François, N., Plusquellec, P., Grandgeorge, M., Handi’Chiens, & Mira, F. (2024) · PLoS ONE · doi:10.1371/journal.pone.0295702 · Cited by 12
Selective Mutism in Children With and Without an Autism Spectrum Disorder: The Role of Sensory Avoidance in Mediating Symptoms of Social Anxiety
Ludlow, A., Osborne, C., & Keville, S. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05674-0 · Cited by 10
“While previous research has indicated sensory difficulties underlie anxiety behaviours in children with ASD (Green & Ben-Sasson, 2010; Uljarević et al., 2016), the relationship with social anxiety has been less well established (Spain et al., 2018, Bellini, 2004, Black et al., 2017).”
Background
Quality of life and clinical correlates in cognitively-able autistic adults: A special focus on sensory characteristics and perceived parental support
Lin, C.-Y., Wu, Y.-L., Chien, Y., & Gau, S. S. (2024) · Journal of the Formosan Medical Association · doi:10.1016/j.jfma.2024.03.022 · Cited by 10
A Trans-Diagnostic Investigation of Attention and Diverse Phenotypes of “Auditory Hyperreactivity” in Autism, ADHD, and the General Population
Dwyer, P., Williams, Z., Lawson, W., & Rivera, S. M. (2025) · Journal of Attention Disorders · doi:10.1177/10870547251361226 · Cited by 9
“Unfortunately, if the threat is an uncomfortable sensory stimulus, noticing and focusing attention on it could then increase one’s discomfort (Green & Ben-Sasson, 2010).”
Social Anxiety and Response to Touch
Ludlow, A., Roberts, H., & Gutierrez, R. G. (2015) · SAGE Open · doi:10.1177/2158244015580854 · Cited by 12
“It remains a possibility that sensory sensitivity is innately characteristic of both conditions and may be important in highlighting those with either of these disorders (Green & Ben-Sasson, 2010).”
A review of prevalence studies of Autism Spectrum Disorder by latitude and solar irradiance impact
Syed, S., Moore, K., & March, E. (2017) · Medical Hypotheses · doi:10.1016/j.mehy.2017.09.012 · Cited by 10
Touch and olfaction/taste differentiate children carrying a 16p11.2 deletion from children with ASD
Osório, J. M. A., Rodríguez‐Herreros, B., Romascano, D., Junod, V., Habegger, A., Pain, A., Richetin, S., Yu, P., Isidor, B., Maldergem, L. V., et al. (2021) · Molecular Autism · doi:10.1186/s13229-020-00410-w · Cited by 10
Barriers to Inclusive Learning for Autistic Individuals
Waisman, T., Alba, L. A., & Green, S. A. (2022) · PEDIATRICS · doi:10.1542/peds.2020-049437q · Cited by 9
Self-citation
Developmental Impacts of Early Sensory Patterns on School-Age Adaptive, Maladaptive, and Participation Outcomes in Autistic and Non-autistic Children
Chen, Y., Sideris, J. H., Watson, L. R., Crais, E. R., & Baranek, G. T. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06494-0 · Cited by 9
“The link between sensory hyperresponsiveness and inter-nalizing behavior, such as anxiety, has been well supported by both behavioral and neurological evidence (Ben-Sasson et al., 2009; Carpenter et al., 2019; Green & Ben-Sasson, 2010; Green et al., 2012).”
Linking Sensory Integration and Processing With Mental Health in Autism: A Retrospective Review of Survey Data
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
Sensory processing in Sotos syndrome and Tatton-Brown–Rahman Syndrome.
Smith, H. L., Lane, C., Al‐Jawahiri, R., & Freeth, M. (2023) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0000837 · Cited by 9
Vestibular sensory dysfunction: neuroscience and psychosocial behaviour overview
Kreivinienė, B. (2016) · SOCIAL WELFARE INTERDISCIPLINARY APPROACH · doi:10.21277/sw.v2i6.263 · Cited by 9
Relationship between social anxiety and separation anxiety symptoms with insistence on sameness with the mediating role of sensory hypersensitivity
Keshavarz, S., & Esmaeilpour, K. (2025) · BMC Psychology · doi:10.1186/s40359-025-02369-w · Cited by 8
“This sensory hypersensitivity can lead to increased social anxiety, as individuals with ASD may find social interactions overwhelming and uncomfortable [13].”
Experiences of interoception and anxiety in autistic adolescents: A reflexive thematic analysis
Kiera, A., Jonahs, S., Mary, B., Geoffrey, B., & Polly, W. (2025) · Autism · doi:10.1177/13623613251314595 · Cited by 6
“…finding that hyperawareness can cause anxiety is consistent with models proposed within the context of more general sensory sensitivity in autism (Green & Ben-Sasson, 2010; Hazen et al., 2014), as illustrated in Acker and colleagues’ (2018) interpretative phenomenological analysis of interviews…”
Accommodation through personalisation: ensuring the autistic student has an equal opportunity for success in the PhD viva voce
Sandland, B., MacLeod, A., Hall, N., & Chown, N. (2023) · Journal of Further and Higher Education · doi:10.1080/0309877x.2023.2250740 · Cited by 5
“Heightened anxiety may increase sensory sensitivities (S.A. Green and Ben-Sasson 2010), therefore rendering those more problematic during the examination Beardon (2017, 55) wrote that ‘compared to a usual sensory experience you might be highly sensitive, or less sensitive, in any or all the ways in…”
Background
Understanding the subtypes of visual hypersensitivity: Four coherent factors and their measurement with the Cardiff Hypersensitivity Scale (CHYPS)
Price, A., Sumner, P., & Powell, G. (2025) · Vision Research · doi:10.1016/j.visres.2025.108610 · Cited by 8
A Scoping Review of School-Based Strategies for Addressing Anxiety, Intolerance of Uncertainty and Prediction in Autistic Pupils
Emerson, A., & Costley, D. (2023) · Education Sciences · doi:10.3390/educsci13060575 · Cited by 11
Zen Shiatsu: A Longitudinal Case Study Measuring Stress Reduction in a Child with Autism Spectrum Disorder
Burke, A. (2014) · International Journal of Therapeutic Massage & Bodywork Research Education & Practice · doi:10.3822/ijtmb.v7i4.246 · Cited by 8
“Anxiety disorders are higher in children with ASD and may be directly related to heightened sensory response, including touch(9).”
Background
Ten questions concerning autism and auditory accessibility in buildings
Masiero, B., Caldas, F., Underwood, S. H., Rosas-Pérez, C., Algargoosh, A. S., Bettarello, F., Caniato, M., Davies, W. J., Manley, D., Remington, A., et al. (2025) · Building and Environment · doi:10.1016/j.buildenv.2025.113634 · Cited by 7
Sensory processing challenges as a novel link between early caregiving experiences and mental health
Leal, A. S. M., Alba, L. A., Cummings, K. K., Jung, J., Waizman, Y. H., Moreira, J. F. G., Saragosa‐Harris, N. M., Ninova, E., Waterman, J., Langley, A. K., et al. (2022) · Development and Psychopathology · doi:10.1017/s0954579422000633 · Cited by 9
Self-citation
Stress in autism (STREAM): A study protocol on the role of circadian activity, sleep quality and sensory reactivity
Gernert, C. C., Falter‐Wagner, C. M., Noreika, V., Jachs, B., Jassim, N., Gibbs, K., Streicher, J., Betts, H., & Bekinschtein, T. A. (2024) · PLoS ONE · doi:10.1371/journal.pone.0303209 · Cited by 9
Haptic Feedback: An Experimental Evaluation of Vibrations as Tactile Sense in Autistic People
Krishnan, K., Jomhari, N., Ayyasamy, R. K., Kareem, S. A., & Krishnan, S. (2024) · IEEE Access · doi:10.1109/access.2024.3410845 · Cited by 8
“Furthermore, there are studies [30], [31] that report that there is a possibility where these experimental evaluation results can be impacted due to being overly anxious or stressed during the interaction with a virtual object in a virtual environment via a haptic device.”
Background
A Brief Commentary on the Consensus Definition of Misophonia
Brout, J. J. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.879070 · Cited by 7
“In addition, when one considers that many individuals with misophonia also report visual sensitivity to movement (Green and Ben-Sasson, 2010) it is appropriate to have considered studies related to visual and auditory cross-modal processes.”
Background
Sensory Processing Difficulties in Opsoclonus-Myoclonus Syndrome
Green, D., Lim, M. J., Lang, B., Pohl, K., & Turk, J. (2016) · Journal of Child Neurology · doi:10.1177/0883073816634856 · Cited by 7
“The relative contribution of sensory overresponsiveness as an independent symptom is however confounded with the overlap of symptoms with those of anxiety and the lack of a ‘‘gold standard’’ for the identification of sensory modulation dysfunction or sensory processing disorder, with questionnaire report most commonly…”
Background
Sensory Modulation Disorder: Impact on Coping and Occupational Performance
Kane, A. E. (2013) · VCU Scholars Compass (Virginia Commonwealth University) · doi:10.25772/f6xq-1734 · Cited by 7
Similar overall expression, but different profiles, of autistic traits, sensory processing, and mental health between young adult males and females
Cardon, G. J., McQuarrie, M., Calton, S., & Gabrielsen, T. P. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102263 · Cited by 10
Auditory processing deficits in autism spectrum disorder: mechanisms, animal models, and therapeutic directions
Zheng, S., & Chen, C. (2025) · Journal of Neural Transmission · doi:10.1007/s00702-025-02919-x · Cited by 6
“For example, Fragile X syndrome (FXS), a common cause of intellectual disability associated with ASD, typically manifests with pronounced sensory hypersensitivity that can lead to language delays, social anxiety, and ritualized behaviors (Green and Ben-Sasson 2010; Sinclair et al. 2017).”
Perceptual alterations in the relationship between sensory reactivity, intolerance of uncertainty, and anxiety in autistic children with and without ADHD
Powell, H. J., He, J. L., Khalil, N., Wodka, E. L., Deronda, A. C., Edden, R. A. E., Vasa, R. A., Mostofsky, S. H., & Puts, N. A. J. (2023) · Development and Psychopathology · doi:10.1017/s0954579423001360 · Cited by 10
“…between sensory differences and anxiety requires further elucidation and is likely to be complex in nature, two longitudinal studies in groups with and without autism found a unidirectional relationship between sensory hyper-reactivity and anxiety (Carpenter et al., 2019; Green & Ben-Sasson, 2010).”
Background
Psychosocial challenges and substance use among suicidal autistic individuals on social media: LLM-assisted keyword generation with human-in-the-loop refinement
Sazzed, S. (2025) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2025.106110 · Cited by 6
A comparison of the content and nature of worries of autistic and neurotypical young people as they transition from school
Waldman, J., McPaul, A., & Jahoda, A. J. (2022) · Autism · doi:10.1177/13623613221111313 · Cited by 10
“As such, surroundings may be perceived as more uncertain by autistic people, contributing to more persistent states of anxiety (Green & Ben-Sasson, 2010).”
Background
Repetitive behaviours, anxiety and sensory problems in children with autism and correlates of anxiety in their parents
Uljarević, M. (2013) · ORCA Online Research @Cardiff (Cardiff University) · Cited by 6
Abnormal resting-state brain network dynamics in toddlers with autism spectrum disorder
Li, X., Wu, S., Yang, W., Jiang, C., Zhao, Z., Wang, H., & Lin, F. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02651-7 · Cited by 5
“Consistent with the view that increased connectivity in primary sensory regions leads to overly prominent basic sensory stimuli in patients [ 41, 42], we can speculate that ASD toddlers may rely on the visual state to overly focus on this information, thereby reducing the attention to important…”
Toward Epistemic Justice: Using a Multimodal Interpretative Phenomenological Analysis Methodological Approach in Research With Autistic Children
Billington, J., Knott, F. J., & Craythorne, S. (2025) · International Journal of Qualitative Methods · doi:10.1177/16094069251346839 · Cited by 8
“In particular, oversensitivity to sensory information (e.g., light, sound, temperature etc.) has been associated with increased levels of anxiety (Carpenter et al., 2019; Green & Ben-Sasson, 2010).”
The History of Comorbidity in Autism Spectrum Disorders (ASD)
Mazurek, M. O. (2015) · Autism and child psychopathology series · doi:10.1007/978-3-319-19183-6_1 · Cited by 5
Anxiety as a Common Biomarker for School Children With Additional Health and Developmental Needs Irrespective of Diagnosis
Cross, A. J., Goharpey, N., Laycock, R., & Crewther, S. G. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01420 · Cited by 6
Sleep spindles in primates: Modeling the effects of distinct laminar thalamocortical connectivity in core, matrix, and reticular thalamic circuits
Yazdanbakhsh, A., Barbas, H., & Zikopoulos, B. (2023) · Network Neuroscience · doi:10.1162/netn_a_00311 · Cited by 6
“…attention is a hallmark of schizophrenia (Braff, 1993; Luck and Gold, 2008) whereas, difficulty switching attentional focus and sensory over-responsivity are often seen in ASD (Allen, 2001; Cheung and Lau, 2020; Fan et al., 2012; Green and Ben-Sasson, 2010; Keehn et al., 2013; Marco et al., 2011).”
Background
Pathogenicity of Endocrine Dysregulation in AutismPreprint
Swierczynski, A. (2018) · Preprints.org · doi:10.20944/preprints201805.0359.v1 · Cited by 4
“A state of threat detection and hyper-arousal often seen in anxiety is thought to be the driving force behind difficulty in shifting attention in ASD by over-attending to aversive stimuli in the environment [88].”
Background
A pilot, single-arm feasibility study of an integrated cognitive-behavioral treatment for anxiety in young autistic children
Keefer, A., Perrin, J., Singh, V., Holingue, C., Winchell, S., & Vasa, R. A. (2024) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsad093 · Cited by 6

Authors: Green, S. A., & Ben-Sasson, A.
Affiliations: University of California, Los Angeles (US)
Corresponding author: Green, Shulamite A.
ORCID: Green, Shulamite A.
Venue: Journal of Autism and Developmental Disorders
Publisher: Springer Science and Business Media LLC
Published: 2010-04-10
Volume: 40
Issue: 12
Pages: 1495-1504
ISSN: 0162-3257 (ISSN-L)
1573-3432
DOI: 10.1007/s10803-010-1007-x
PMC: PMC2980623
OpenAlex: W2097949702
Cited by: 327
References: 67
Citations by year: 2026: 28 · 2025: 32 · 2024: 25 · 2023: 28 · 2022: 19 · 2021: 32 · 2020: 25 · 2019: 24 · 2018: 17 · 2017: 13 · 2016: 17 · 2015: 12 · 2014: 19 · 2013: 17 · 2012: 11
FWCI: 0.84
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: Journal of Autism and Developmental Disorders (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Child Health and Human Development (34879-1459)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD34879-1459, 34879‐1459, R01HD034879)
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: autism spectrum disorder, anxiety disorders, sensory hypersensitivity, sensory processing, causal relationship, children, comorbidities, diagnostic overlap, risk factors, intervention
MeSH terms: Anxiety Disorders, Arousal, Child, Child Development Disorders, Pervasive, Humans, Risk Factors, Sensation Disorders

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Anxiety Disorders and Sensory Over-Responsivity in Children with Autism Spectrum Disorders: Is There a Causal Relationship?

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