Sensory processing differences and behavioural problems in children with autism: a retrospective study using statistical modelling and multi-output machine learning.

This study looked at how sensory differences affect behavior in 127 children with autism. Researchers found that children who seek lots of movement and touch experiences have more tantrums, while children who seek visual stimulation adapt better to changes. Children sensitive to sounds also had more behavioral challenges. The study identified different sensory patterns that could help predict which children might need extra behavioral support.

This retrospective study examined sensory processing differences (SPDs) and their relationship to behavioural problems in 127 children with autism aged 1-7 years. Using advanced statistical modeling and machine learning, researchers analyzed 15 sensory features across five modalities and six behavioural outcomes. Key findings revealed that vestibular/proprioceptive seeking behaviors significantly predicted frequent tantrums (OR=3.83), while visual seeking behaviors were associated with better adaptation to routine changes. Auditory sensitivity emerged as a major contributor to behavioral difficulties.

The study identified a 'multi-sensory seeking' subtype with higher tantrum rates, suggesting sensory-based profiling could help identify children at elevated behavioral risk and guide personalized interventions.

Sensory assessments should specifically evaluate vestibular/proprioceptive seeking and auditory sensitivity as behavioral risk indicators. Visual seeking behaviors may be leveraged therapeutically. Sensory-based profiling could guide personalized intervention planning and help identify children requiring additional behavioral support strategies.

Single-site retrospective design limits generalizability. Binary coding of complex sensory and behavioral phenomena may oversimplify relationships. Parent-reported data introduces potential bias. Machine learning performance described as only 'moderate', and clustering methodology requires validation in independent samples.

Sensory processing differences (SPDs) are common in children with autism, yet their specific contributions to behavioural problems remain insufficiently explored. To examine how SPDs relate to behavioural problems in children with autism and to identify key sensory predictors and sensory-based subtypes associated with behavioural risk. The retrospective study included 127 children with autism (1-7 years) who received rehabilitation training at a tertiary children's hospital between 2020 and 2024. Fifteen SPD features across visual, auditory, tactile, gustatory/olfactory and vestibular/proprioceptive modalities (covering sensitivity, hyporesponsivity and seeking behaviours) and six behavioural problems were coded as binary variables based on parent-reported questionnaires.

Associations were analysed using Phi correlations and logistic regression. A multi-output random forest with Shapley Additive Explanations (SHAP) evaluated the joint predictive value of SPDs. Hierarchical clustering using Jaccard distance was used to identify sensory subtypes and compare behavioural profiles. Vestibular/proprioceptive seeking was positively associated with frequent tantrums (φ=0.30) and emerged as an independent predictor (OR=3.83, 95% CI 1.65 to 8.90).

Visual seeking was negatively associated with difficulty adapting to routine changes (φ=-0.23; OR=0.34, 95% CI 0.15 to 0.78). The multi-output random forest showed moderate performance. SHAP analysis highlighted auditory sensitivity and multiple seeking behaviours as major contributors. Clustering revealed a 'multi-sensory seeking' subtype with higher rates of tantrums.

SPDs are meaningfully linked to behavioural problems in autism. Vestibular/proprioceptive seeking and auditory sensitivity are key behavioural risk indicators, while visual seeking may support adaptability. Sensory-based profiling has the potential to identify children at elevated behavioural risk and guide personalised intervention planning.