OTSLPCohortJournal of autism and developmental disorders2024

Exploring the Symptom Profiles of Intolerance of Uncertainty in Autistic Children.

Amy Keefer, Vini Singh, Yeon Sik Jang and 5 others

PMID 36227445

WHAT IT FOUND

Parents reported that autistic children struggled more with the emotional distress of uncertainty than with the thoughts or behaviors.

This pattern held even when anxiety was absent. Screening for feelings of stress, inability to relax, and sleep problems may identify children needing emotion regulation support.

Key findings

01Autistic children had significantly higher total intolerance of uncertainty scores than non-autistic children, with the largest differences in affective (emotional) symptoms.

02The elevated intolerance of uncertainty in autistic children was not driven by co-occurring anxiety, as the same profile appeared when comparing autistic and non-autistic children without anxiety.

03Specific items with the strongest association to autism included unforeseen events causing distress, ambiguity causing stress, and inability to relax without knowing what will happen.

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

The IUSC has not been psychometrically validated in autistic children; the researchers assigned items to domains based on wording rather than statistical factor analysis. The study only used parent report. Autistic children may have difficulty communicating internal cognitive symptoms, so parent reports might underestimate these aspects. The sample included only children with average or above-average intelligence and without major neurological or psychiatric conditions other than anxiety, limiting generalizability to more complex presentations. P-values were not adjusted for multiple comparisons, which increases the risk of false positives.

Declared interests

Dr. Vasa receives royalties for an edited book on childhood anxiety disorders. Other authors declared no conflicts of interest.

The easy way to misread this

Do not assume that high intolerance of uncertainty scores in autistic children are solely a symptom of anxiety. The study found that autistic children without anxiety still had significantly higher affective intolerance of uncertainty scores than non-anxious non-autistic children. This suggests a core feature of autism that requires specific attention to emotion regulation, distinct from anxiety treatment.

Read it on PubMed →