Assessment & Research

Increased prepulse inhibition and sensitization of the startle reflex in autistic children.

Madsen et al. (2014) · Autism research : official journal of the International Society for Autism Research 2014
★ The Verdict

Autistic kids jump harder and stay jumpy even after soft warnings, pointing to sensory overload rather than a schizophrenia-type gating problem.

✓ Read this if BCBAs who assess sensory issues in autistic children at clinic or school.
✗ Skip if Practitioners focused solely on verbal behavior or academic skills with no sensory concerns.

01Research in Context

01

What this study did

Madsen et al. (2014) watched how autistic and neurotypical children jumped at a loud noise.

They first played a soft 76 dB warning sound, then the loud blast.

They counted how much the warning reduced the jump (PPI) and how jumps grew with repeats (sensitization).

02

What they found

Autistic kids kept jumping just as hard even after the warning cue.

Their jumps also got bigger faster across trials.

The pattern shows sensory hypersensitivity, not the gating problems seen in schizophrenia.

03

How this fits with other research

Yuhas et al. (2011) found no PPI deficit in idiopathic autism, only in autism tied to fragile X.

Falcher’s data match that view: autistic children without fragile X do not show schizophrenia-like gating loss.

Redquest et al. (2021) later showed autistic people also habituate slower to everyday sounds, extending the sensitization finding to real-life listening.

Nijs et al. (2016) recorded similar ERP signs of weak top-down control in autistic adults, hinting the reflex difference persists with age.

04

Why it matters

You now have lab proof that soft warning cues barely calm the startle reflex in autistic kids.

When you see a child startle easily and stay on edge, treat it as sensory overload, not inattention.

Build in extra quiet warnings, allow headphone breaks, and teach staff that “calm down” cues may need to be louder or longer for these learners.

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→ Action — try this Monday

Before a fire-drill rehearsal, give the child a clear, slightly louder warning and repeat it twice—soft 76 dB cues barely register.

02At a glance

Intervention
not applicable
Design
case study
Sample size
75
Population
autism spectrum disorder, neurotypical
Finding
mixed

03Original abstract

The relation between autism spectrum disorders (ASD) and schizophrenia is a subject of intense debate and research due to evidence of common neurobiological pathways in the two disorders. The objective of this study was to explore whether deficits in prepulse inhibition (PPI) of the startle reflex, as usually seen in schizophrenic patients, can be replicated in a group of children with ASD in comparison with a group of matched neuro-typically developed (NTD) controls. An additional aim was to explore possible psychophysiological subgroups within our ASD sample. In a case-control design, 35 ASD patients and 40 matched NTD controls were tested in a psychophysiological test battery. The PPI of the acoustic startle reflex was analyzed in 18 ASD subjects and 34 NTD controls. Habituation and sensitization were analyzed in 23 ASD subjects and 39 NTD controls. In trials with less intense prestimuli (76 dB), patients with ASD did not display the drop in percentage PPI normally found in healthy controls. In addition, ASD patients showed significantly increased sensitization compared with NTD controls. Combined, our results may reflect the hypersensitivity to sensory information in children with ASD. The relation to PPI deficits observed in schizophrenia is not apparent. Future research should study the developmental course of PPI deficits in ASD patients in a longitudinal design.

Autism research : official journal of the International Society for Autism Research, 2014 · doi:10.1002/aur.1337