A prospective study of associations between early fearfulness and perceptual sensitivity and later restricted and repetitive behaviours in infants with typical and elevated likelihood of autism.
Nisha Narvekar, Virginia Carter Leno, Greg Pasco and 3 others
PMID 35021899WHAT IT FOUND
In infants with and without a family history of autism, higher fearfulness and perceptual sensitivity at 24 months predicted more restricted and repetitive behaviours and social communication difficulties at 36 months.
These early temperamental traits were not specific to repetitive behaviours alone.
Key findings
01Higher levels of shyness and perceptual sensitivity at 24 months were significantly associated with heightened levels of restricted and repetitive behaviours (RRB) at 36 months.
02The associations between early temperamental traits and later outcomes were not specific to RRB, as shyness and perceptual sensitivity at 24 months were also associated with social communication difficulties (SCI) at 36 months with comparable strength.
03Higher fear at 14 months predicted higher perceptual sensitivity at 24 months, but the reverse pathway was not significant.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
All data on infant temperament and later autistic traits were based on parent report, which introduces shared method variance; parents may have reported consistency due to a stable view of their child rather than actual behavioural stability. The study did not measure restricted and repetitive behaviours before 24 months, so it cannot definitively rule out that early RRB caused the later anxiety or sensory differences. The sample was enriched for autism likelihood, though findings held when diagnosed infants were excluded. The definition of 'perceptual sensitivity' in the questionnaires may conflate sensory detection with emotional reactivity to sensory input.
Declared interests
T.C. served as a paid consultant to F. Hoffmann-La Roche Ltd. and Servier, and received royalties from Sage Publications and Guilford Publications. G.P. is a licensed ADOS-2 trainer and receives income from delivering ADOS-2 training. Funding was provided by the UK Medical Research Council, Autistica, Autism Speaks, and the Innovative Medicines Initiative.
The easy way to misread this
Do not assume that treating early fearfulness or sensory sensitivity will specifically reduce restricted and repetitive behaviours. The study found that these traits predicted social communication difficulties just as strongly as they predicted repetitive behaviours, suggesting they are markers of broader autistic traits rather than a specific cause of one symptom domain.