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Anxiety Disorders and Sensory Over-Responsivity in Children with Autism Spectrum Disorders: Is There a Causal Relationship?
Open accessAbstract
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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“Rather than considering SPD as a contributing cause of anxiety, the authors show that anxiety can also be considered a mediator of the relationship between IU and SPD on the basis that anxiety resulting from IU might lead to hypervigilance and, thus, hypersensitivity to the sensory environment”
From Examining a model of anxiety in autistic adults (2024) · cites this paper as Green & Ben-Sasson (2010)
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“Sensory function in ASD samples may be marked by both over-responsivity (e.g., experiencing various sounds as painful) and under-responsivity (e.g., repeated touching of objects). Both extremes may occur in the same children (Green and Ben-Sasson, 2010; Wigham et al., 2015; Watts et al., 2016).”
From Sensory, emotional and cognitive contributions to anxiety in autism spectrum disorders (2017) · cites this paper as Green and Ben-Sasson, 2010
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“Another factor which is thought to play an important role in anxiety in autism is sensory sensitivities (Green and Ben-Sasson 2010).”
From Experiences of autism acceptance and mental health in autistic adults (2018) · cites this paper as Green and Ben-Sasson 2010
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Cites
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Todd, G., & Branch, R. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108355605.029
Sensory Overresponsivity as a Predictor of Amplitude Discrimination Performance in Youth with ASD
McKernan, E. P., Cascio, C. J., & Russo, N. N. (2020) · Springer eBooks · doi:10.1007/978-1-4614-6435-8_102476-1
Qian, X. J. (2022) · Advances in Social Science, Education and Humanities Research/Advances in social science, education and humanities research · doi:10.2991/assehr.k.220704.029
“Anxiety Spectrum Disorders problems are common in children and adolescents with ASD, and anxiety emotion has worsened the severity of impairment [9-11].”
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Goel, A. (2023) · Springer eBooks · doi:10.1007/978-3-031-42383-3_1
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Thompson, B. L. (2024) · Contemporary clinical neuroscience · doi:10.1007/978-3-031-66932-3_6
Sensory Processing and Anxiety: Within and Beyond the Autism Spectrum
Zoltowski, A. R., Convery, C. A., Eyoh, E. E., Plump, E., Sullivan, M., Arumalla, E. R., Quinde-Zlibut, J. M., Keçeli-Kaysılı, B., Lewis, B. J., & Cascio, C. J. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_557
Su, A., Shen, J., & Koyama, S. (2025) · F1000Research · doi:10.12688/f1000research.161090.1
Conversations on echolalia: Seven music therapists discuss their experience with autistic echolalia
Marom, M. K., Gilboa, A., & Bodner, E. (2025) · The Arts in Psychotherapy · doi:10.1016/j.aip.2025.102295
Riga, V. D., Makhortykh, A. E., Galstyan, D. S., de Abreu, M. S., & Kalueff, A. V. (2025) · Behavioural Brain Research · doi:10.1016/j.bbr.2025.115677
Mei, Q., Yang, R., Guo, Z., Zeb, S., Liew, B. X. W., Fernandez, J., & Yu, L. (2025) · Human Movement Science · doi:10.1016/j.humov.2025.103384
McLean, M. A., Weinberg, J., Synnes, A. R., Miller, S. P., & GRUNAU, R. E. (2025) · Developmental Psychobiology · doi:10.1002/dev.70064
Metadata
- 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
- Published
- 2010-04-10
- Volume
- 40
- Issue
- 12
- Pages
- 1495-1504
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- 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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