Alterations in electrophysiological indices of perceptual processing and discrimination are associated with co-occurring emotional and behavioural problems in adolescents with autism spectrum disorder.

There was no control group, so it cannot be said that these associations are specific to autism rather than to emotional or behavioural problems in general. The data were collected at one time point, so it cannot show whether perceptual processing differences lead to anxiety or behaviour problems, or whether the problems or autism severity influence perceptual processing. Only 43 of 83 intensively assessed participants completed the EEG task; they had higher IQ and lower sensory seeking scores than the full sample, so results may not apply to all adolescents with ASD. The behaviour problem association was not stable after adjusting for ASD severity, and a few people with very high behaviour problems may have driven it. The anxiety-related finding was not predicted and the authors describe it as exploratory, requiring replication. The sample was moderate (n=43), and many statistical tests were used, so some findings may be chance or small effects. The study measured only auditory oddball processing, not other sensory modalities. The behaviour measure was broad, so it cannot identify which specific behaviour problem is linked to perceptual processing.

Funding was provided by Research Autism, the National Institute for Health Research, The Clothworker's Foundation, the NIHR Biomedical Research Centre, the Medical Research Council, Guy's and St Thomas' Charity, and the Maudsley Charity. No author conflict-of-interest statement is given in the article text.

Do not conclude that perceptual processing differences cause emotional or behavioural problems in autism. The study is cross-sectional, had no control group, and the behaviour problem association became non-significant when autism severity was adjusted; the anxiety-related finding was unexpected and exploratory.