Executive Functioning: A Mediator Between Sensory Processing and Behaviour in Autism Spectrum Disorder.
Teaching emotion regulation can break the chain that turns sensory overload into hitting or tantrums in autistic youth.
01Research in Context
What this study did
Fernandez-Prieto et al. (2021) asked 79 autistic youth and their parents to fill out three short surveys. One survey tracked sensory quirks like sound sensitivity or seeking motion. The second measured everyday executive skills, especially keeping emotions in check. The third listed behavior problems such as tantrums or aggression.
The team then ran a mediation test to see if emotion-control skills sit in the middle between sensory issues and problem behaviors.
What they found
Emotion regulation acted like a bridge. When sensory input was off, weak emotion control carried the trouble straight into behavior problems. The numbers showed this path was statistically significant.
In plain words, sensory issues do not cause meltdowns by themselves; poor emotion control turns the sensory spark into the behavioral fire.
How this fits with other research
Heald et al. (2020) saw the same raw link a year earlier: lower emotion regulation went hand-in-hand with more peer and behavior struggles. Montse adds the mediation lens, showing emotion regulation is the active middle step, not just a side note.
Ko et al. (2024) and Terroux et al. (2025) zoom in on preschoolers. They find cool executive skills like inhibition and working memory explain over half of autism symptom variance. Montse widens the age range and spotlights the hot skill of emotion control, extending the EF story downward and upward in age.
Cai et al. (2018) looks almost contradictory at first glance. They say intolerance of uncertainty, not sensory processing, mediates the link between emotion regulation and anxiety. The two studies simply test different outcomes: Montse predicts broad behavior problems; Ying predicts anxiety and depression. Both mediators can be true at once.
Why it matters
If a client covers his ears and then hits, do not just work on tolerating noise. Add emotion-regulation drills: pause-and-plan cards, rating scales, or deep-breathing scripts. Strengthening that middle skill can shrink the bridge that turns sensory overload into problem behavior. You get two gains for the price of one target.
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02At a glance
03Original abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction, executive functioning, sensory-perceptual abilities and behaviour, such as anxious/depressed states, attention problems, aggression, or somatic complains. However, the dynamic relationship between these dimensions remains to be addressed. Therefore, we explored the link between executive functions, sensory processing and behaviour in 79 children and adolescents with ASD. Results showed significant associations between all dimensions-executive functions, sensory processing and behaviour. Furthermore, using structural equation modelling methods, we observed a mediation effect of executive functioning, specifically the domain pertaining to emotion regulation and control, and in the relationship between sensory processing abnormalities and behavioural problems. We discuss the importance of emotion regulation as a mediator between sensory processing and behavioural impairments and its impact in social competence in ASD.
Journal of autism and developmental disorders, 2021 · doi:10.1177/0013164413495237