Autism & Developmental

Tackling hypo and hyper sensory processing heterogeneity in autism: From clinical stratification to genetic pathways.

Lefebvre et al. (2023) · Autism research : official journal of the International Society for Autism Research 2023
★ The Verdict

A quick hypo/hyper ratio flags sensory imbalance in autism and hints at GABA-related biology.

✓ Read this if BCBAs who assess sensory needs in autistic clients.
✗ Skip if Clinicians only working with non-autistic populations.

01Research in Context

01

What this study did

Lefebvre et al. (2023) looked at sensory processing in autistic people. They used a quick tool called the dSSP. It gives a ratio of hypo to hyper scores.

The team checked if these scores tied to genes that control GABA in the brain. GABA is a chemical that slows things down.

02

What they found

Autistic people had more varied dSSP scores than non-autistic controls. Hyposensitivity tended to travel with more GABA-gene mutations.

The ratio sometimes hides a problem. High hypo and high hyper scores can cancel out and look normal.

03

How this fits with other research

Neufeld et al. (2021) also saw sensory-adaptive links, but the link vanished when they factored in family traits. Aline’s ratio still flags risk even after genes are counted, so the tool adds speed, not conflict.

Lim et al. (2016) showed that kids in the ‘extreme-mixed’ sensory group had the worst adaptive scores and highest parent stress one year later. Aline’s dSSP gives you a one-minute way to spot that same mixed group in clinic.

Glod et al. (2017) first found that parents and kids share sensory quirks. Aline now points to GABA genes as one possible reason why the pattern runs in families.

04

Why it matters

You can run the dSSP while the family waits. A lopsided ratio tells you to dig deeper, even if the total score looks fine. Pair it with parent report and keep an eye on GABA-linked meds or sensory diets that need tweaking.

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Add the dSSP ratio to your intake packet; watch for near-zero scores that may mask mixed hypo-hyper profiles.

02At a glance

Intervention
not applicable
Design
other
Sample size
1136
Population
autism spectrum disorder
Finding
positive

03Original abstract

As an integral part of autism spectrum symptoms, sensory processing issues including both hypo and hyper sensory sensitivities. These sensory specificities may result from an excitation/inhibition imbalance with a poorly understood of their level of convergence with genetic alterations in GABA-ergic and glutamatergic pathways. In our study, we aimed to characterize the hypo/hyper-sensory profile among autistic individuals. We then explored its link with the burden of deleterious mutations in a subset of individuals with available whole-genome sequencing data. To characterize the hypo/hyper-sensory profile, the differential Short Sensory Profile (dSSP) was defined as a normalized and centralized hypo/hypersensitivity ratio from the Short Sensory Profile (SSP). Including 1136 participants (533 autistic individuals, 210 first-degree relatives, and 267 controls) from two independent study samples (PARIS and LEAP), we observed a statistically significant dSSP mean difference between autistic individuals and controls, driven mostly by a high dSSP variability, with an intermediated profile represented by relatives. Our genetic analysis tended to associate the dSSP and the hyposensitivity with mutations of the GABAergic pathway. The major limitation was the dSSP difficulty to discriminate subjects with a similar quantum of hypo- and hyper-sensory symptoms to those with no such symptoms, resulting both in a similar ratio score of 0. However, the dSSP could be a relevant clinical score, and combined with additional sensory descriptions, genetics and endophenotypic substrates, will improve the exploration of the underlying neurobiological mechanisms of sensory processing differences in autism spectrum.

Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1002/aur.2861