Characterizing Auditory Sensory Stability in Autism
Adam Naples, PhD
Up to seventy percent of autistic people experience sensitivity to sounds. Autistic adults report that these symptoms worsen with stress and anxiety and can interfere with school, work, and other activities. However, despite the common report of these symptoms, there is no understanding of the mechanisms, nor are there effective ways to measure these symptoms.
Importantly, most measurement of these symptoms in autism relies on retrospective questionnaires. These measures require participants to “average” their symptoms over some time period in the past, possibly their entire lives. Such measures are well known to have “peak and end” biases in which people recall the most memorable and distressing experiences and the experiences that were most recent. This means that these questionnaires are not able to accurately capture the day-to-day lived experience of people with autism.
In this study we take the first step towards measuring the personal timing of auditory sensitivities, and their relationship with symptom report using an innovative approach. We measure auditory sensitivity using daily symptom self-reports and brief experimental auditory tasks delivered remotely over the internet. Participants will complete established self-report measures of sensory sensitivity and then will receive daily text-message or email reminders that will link to individualized questionnaires assessing sensory symptoms for that specific day. Additionally, participants will complete a brief tone detection task delivered via headphones on their computer or mobile device that will measure in-the-moment auditory perception.
The long-term goals of this study are to gain an understanding of the stability of auditory sensitivities to support subsequent mechanistic research. Currently there are no mechanistic biomarkers for auditory sensitivities in autism despite many successes in identifying group-level differences. Most research as assumed that auditory sensitivity symptoms are stable, over time, within an individual. However, if this assumption is invalid, then research that seeks to understand biological mechanisms will need to measure those symptoms at just the right time to find a brain-behavior linkage. This problem is exacerbated in autism because increased sensory sensitives are associated with avoidance of work and school. Consequently, autistic people may be less likely to participate in a research protocol on days when their symptoms are particularly distressing.
Autistic adults often report that these symptoms vary in intensity and frequency, however, there is no research that investigates if, how, or when these symptoms might vary. In this study, by determining how these sensitivities fluctuate over time, we gain a better understanding of the psychometric properties of auditory sensitivities, which provides insight into potential mechanisms. Furthermore, understanding the variability of symptom expression and auditory perception is critical information for developing and implementing successful in-person research studies.