Characterizing Interoceptive Differences in Autism: A Systematic Review and Meta-analysis of Case-control Studies.
Zachary J Williams, Evan Suzman, Samantha L Bordman and 7 others
PMID 35819587WHAT IT FOUND
Autistic adults show lower accuracy on heartbeat counting but higher confidence in that performance.
They do not differ from neurotypical controls on heartbeat discrimination or self-reported attention to body sensations. These mixed results suggest interoceptive differences are not a core feature of autism.
Key findings
01Autistic individuals demonstrate significantly diminished objective interoceptive accuracy on the heartbeat counting task compared to neurotypical controls.
02Autistic individuals rate themselves as more confident in their heartbeat counting performance than controls, despite performing worse on average.
03There are no significant differences between autistic and neurotypical individuals in heartbeat discrimination performance or self-reported interoceptive attention.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The number of studies for some outcomes (HDT and confidence ratings) was small, leading to imprecise estimates. Most individual studies were underpowered to detect the small effect sizes found in the meta-analysis. Heterogeneity in self-reported interoceptive attention was high and driven by a single outlier study. The analysis did not examine correlations between interoception and clinical outcomes like anxiety or alexithymia. IQ differences between groups may have confounded heartbeat counting task results.
Declared interests
Zachary Williams has received consulting fees from Roche, Autism Speaks, and the May Institute. He serves on advisory boards for Autism Speaks and the Autism Intervention Research Network on Physical Health. Remaining authors have no conflicts.
The easy way to misread this
Do not interpret the reduced heartbeat counting accuracy as a general deficit in interoception. The lack of difference in heartbeat discrimination and the potential confounding effect of IQ suggest this finding may not reflect a true underlying inability to detect bodily signals.