Cited by 370Autism Spectrum Disorder ResearchMultisensory perception and integrationGenetics and Neurodevelopmental Disorders

The DOI matches its Crossref record; 366 of the 366 references it cites were found in a registry or an index; none of the 262 sources its claims cite is checked for support yet.

Behavioral, perceptual, and neural alterations in sensory and multisensory function in autism spectrum disorder

Open access
Baum, Sarah H., Stevenson, Ryan A., Wallace, Mark T.·2015·Progress in Neurobiology

Abstract

Although sensory processing challenges have been noted since the first clinical descriptions of autism, it has taken until the release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013 for sensory problems to be included as part of the core symptoms of autism spectrum disorder (ASD) in the diagnostic profile. Because sensory information forms the building blocks for higher-order social and cognitive functions, we argue that sensory processing is not only an additional piece of the puzzle, but rather a critical cornerstone for characterizing and understanding ASD. In this review we discuss what is currently known about sensory processing in ASD, how sensory function fits within contemporary models of ASD, and what is understood about the differences in the underlying neural processing of sensory and social communication observed between individuals with and without ASD. In addition to highlighting the sensory features associated with ASD, we also emphasize the importance of multisensory processing in building perceptual and cognitive representations, and how deficits in multisensory integration may also be a core characteristic of ASD.

Overview

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Written from the paper’s full text.

TL;DR

This review argues that sensory and multisensory processing alterations are a core, underappreciated cornerstone of autism spectrum disorder (ASD), not merely an additional symptom. It synthesizes behavioral, perceptual, and neural evidence showing both unisensory differences and multisensory integration deficits that may cascade into social-communicative and cognitive symptoms.

Key findings

  • Sensory abnormalities are highly prevalent in ASD, reported in up to 87% of individuals, and were formally included in the DSM-5 diagnostic profile in 2013; the paper cites an ASD incidence of 1 in 68 children, and as high as 1 in 42 for boys.
  • ASD shows a simple/complex dissociation: intact or enhanced processing of simple stimuli (e.g., pitch, first-order visual features, some tactile thresholds) but difficulties with complex stimuli (e.g., second-order visual features, speech/prosody, face and object processing). In Järvinen-Pasley studies, individuals with ASD outperformed typically developing peers on pitch perception but underperformed on sentence content.
  • Multisensory integration is reduced in ASD beyond what unisensory performance predicts: less benefit from visible speech in noise, diminished McGurk fusion, reduced sound-induced flash illusion, delayed rubber-hand and crossed-hand illusion effects, and altered audiovisual temporal acuity. EEG studies report decreased multisensory integration as early as 100 ms, with 100–130 ms effects correlated with clinical severity, and weaker/delayed auditory-somatosensory integration around 175 ms.
  • Neural findings include reduced functional and structural connectivity, atypical face/voice/STS/FFA responses, reduced GABA in auditory/motor and frontal cortex, and excitation/inhibition imbalance; approximately 30% of individuals with ASD report seizures, and 50–70% of children with ASD show abnormal electrical activity during sleep.

Methods

  • Design: narrative review of behavioral, perceptual, neuroimaging (fMRI, DTI, resting-state), EEG/ERP, and plasticity/remediation literature on sensory and multisensory function in ASD.
  • Data or sample: no primary sample; synthesizes published studies comparing individuals with ASD and typically developing controls, including children and adults.
  • Main analysis: qualitative synthesis and theoretical framing within theory of mind, weak central coherence, predictive coding, reduced sensory precision/reliability, excitation/inhibition imbalance, and temporal binding hypotheses.

Limitations

  • Stated in the paper: ASD sensory research often focuses on a single sense or a small subset of tasks, limiting generalization; no strong consensus exists on a unifying theory of ASD; resting-state fMRI studies are confounded by motion and data-scrubbing artifacts; sensory integration therapy is based on subjective therapist judgments; better empirical characterization and computational modeling are needed.
  • Stated in the paper: ASD heterogeneity and difficulty parsing sensory contributions from attention, executive function, and social-cognitive factors complicate interpretation.
  • Evident from the text: as a narrative review, it does not systematically search or quantify the literature, conduct a meta-analysis, or present primary data to test causal claims.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.pneurobio.2015.09.007

Cites

366 of 366 references verified0 citation errors · 0 not checkable

Statistics

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Verification

Claims the paper makes

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  • Probably not a substantial claim. 21
  • It may state two separate claims as one. 40
57 of 57
  • The paper relies on this without support.

    Little fMRI work has examined multisensory networks and integration in ASD.

    “Surprisingly little work has been done to examine multisensory networks and multisensory integration using fMRI in individuals with ASD.”
  • The paper relies on this without support.

    Oscillations at different EEG frequency bands reflect the brain's ability to coordinate communication across separate neuronal populations.

    “In general, oscillations at different frequency bands observed in EEG are thought to reflect the ability of the brain to coordinate the communication of information across separate populations of neurons.”
  • The paper relies on this without support.

    Sensory integration therapy (SIT) is one of the most commonly employed approaches used in ASD treatment and therapy.

    “although sensory integration therapy (SIT) is one of the most commonly employed approaches used in ASD treatment and therapy”
  • The paper relies on this without support.

    SIT is strongly founded in the subjective judgments of the occupational therapists administering the training.

    “it is strongly founded in the subjective judgments of the occupational therapists administering the training.”
  • The paper relies on this without support.

    SIT training is based on a different conceptual foundation than the one presented, emphasizing exposure to a wide array of sensory information to improve integration with cognitive representations.

    “SIT training is based on a somewhat different conceptual foundation than that presented above, with the major emphasis being exposure to a wide array of sensory information in an effort to improve how this information is integrated with cognitive representations.”
  • The paper relies on this without support.

    There is now increased recognition and appreciation for a role for sensory dysfunction in the context of ASD.

    “Although there is now increased recognition and appreciation for a role for sensory dysfunction in the context of ASD”
  • The paper relies on this without support.

    Work on sensory dysfunction in ASD is still in its earliest stages.

    “this work is still in its earliest stages”
  • The paper relies on this without support.

    A growing number of studies have begun to examine sensory processing in ASD.

    “While a growing number of studies have begun to examine sensory processing in ASD”
  • The paper relies on this without support.

    These studies often continue to focus on a single task or small subset of tasks within a specific sensory modality.

    “they often continue to focus on a single task or small subset of tasks within a specific sensory modality.”
  • The paper relies on this without support.

    Little has been done to bridge across genotype-phenotype, imaging, and sensory areas in ASD.

    “little has been done to bridge across these three areas”
  • The paper relies on this without support.

    Even less has been done to incorporate sensory features and sensory networks into these analyses.

    “even less has been done to incorporate sensory features and sensory networks into these analyses.”
  • The paper relies on this without support.

    Autism and schizophrenia each have elements of a disturbed sense of self.

    “each disorder has elements of a disturbed sense of self”
  • The paper relies on this without support.

    Many resting state fMRI studies are plagued with interpretational confounds.

    “Unfortunately, many resting state fMRI studies are plagued with interpretational confounds.”
  • The paper relies on this without support.

    Motion can spuriously increase correlations between areas because movement across the head is correlated.

    “Motion can spuriously increase correlations between areas because movement across the head is correlated.”
  • The paper relies on this without support.

    Efforts to reduce the effects of motion can actually introduce artifacts into the data.

    “these efforts to reduce the effects of motion can actually introduce artifacts into the data.”
  • The paper relies on this without support.

    EEG studies are relatively practical in this population; unlike fMRI, EEG does not require the same levels of stillness or exposure to loud scanning noises, which can be quite a challenge, particularly in children with ASD.

    “EEG studies are relatively practical in this population; unlike fMRI, EEG does not require the same levels of stillness or exposure to loud scanning noises, which can be quite a challenge, particularly in children with ASD.”
  • The paper relies on this without support.

    EEG studies also have the benefit of high temporal fidelity, allowing an experimenter to assess at which processing stage atypical sensory processing takes place.

    “EEG studies also have the benefit of high temporal fidelity, allowing an experimenter to assess at which processing stage atypical sensory processing takes place.”
  • The paper relies on this without support.

    EEG studies of auditory processing in ASD have provided conflicting results.

    “these studies have provided conflicting results.”
  • The paper relies on this without support.

    Studies of auditory evoked potentials (AEP) have also produced disparate results.

    “Studies of auditory evoked potentials (AEP), reflecting the processing of sound in auditory cortical regions, have also produced disparate results.”
  • The paper relies on this without support.

    Very little work has been done to examine evoked responses to touch with EEG.

    “Very little work has been done to examine evoked responses to touch with EEG.”
  • The paper relies on this without support.

    Although little consensus exists as to the precise neurobiological substrates impacted in ASD (likely a result, at least in part, of the marked heterogeneity of the disorder).

    “Although little consensus exists as to the precise neurobiological substrates impacted in ASD (likely a result, at least in part, of the marked heterogeneity of the disorder)”
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  1. Brunelle, 2009, Autism and brain imaging, Bull. Acad. Natl. Med., 193, 287

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Metadata

Authors
Baum, S. H., Stevenson, R. A., & Wallace, M. T.
Affiliations
  • Vanderbilt University (US)
  • University of Toronto (CA)
Corresponding author
Wallace, Mark T.
Venue
Progress in Neurobiology
Publisher
Elsevier BV
Published
2015-11
Volume
134
Pages
140-160
ISSN
0301-0082 (ISSN-L)
OpenAlex
W1921335093
Cited by
370
References
365
Citations by year
2026: 19 · 2025: 38 · 2024: 28 · 2023: 36 · 2022: 41 · 2021: 39 · 2020: 47 · 2019: 36 · 2018: 36 · 2017: 25 · 2016: 21 · 2015: 2
FWCI
2.75
Type
journal article
Language
en
Open access
Locations
  • Progress in Neurobiology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Scholarship@Western (Western University) (submittedVersion, cc-by-nc-nd)
Funders
  • Wallace Foundation (DC010927, CA183492, HD83211)
  • Simons Foundation Autism Research Initiative
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Multisensory perception and integration
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
Keywords
autism spectrum disorder, sensory processing, multisensory integration, multisensory processing, social communication, perceptual representation
MeSH terms
Autism Spectrum Disorder, Animals, Brain, Humans, Perception, Perceptual Disorders

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