OTOtherJournal of autism and developmental disorders2019

Interoception is Impaired in Children, But Not Adults, with Autism Spectrum Disorder.

Toby Nicholson, David Williams, Katie Carpenter and 1 others

PMID 31127487

WHAT IT FOUND

Children with autism spectrum disorder counted heartbeats less accurately than comparison children, while adults with autism spectrum disorder showed no such difference.

This points to a childhood difference in sensing internal body signals that was not found in adulthood.

Key findings

01Children with ASD had lower average heartbeat counting accuracy than comparison children.

02Adults with ASD did not differ from comparison adults on heartbeat counting accuracy or breathing effort accuracy.

03The lower heartbeat accuracy in children with ASD remained after accounting for time estimation ability.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study used small groups: 21 adults with ASD and 21 NT comparison adults, and 21 children with ASD and 21 NT comparison children. The adult ASD group included six of 21 participants below the ADOS cutoff, though the authors say excluding them did not change the pattern. The child study did not include the breathing task, so the breathing result applies only to adults. The paper notes that the NT children's average heartbeat accuracy was higher than the NT adults' average heartbeat accuracy, which raises the possibility of unusually able controls. The study did not test a treatment or clinical outcome, so it does not show how to change therapy.

Declared interests

The supplied text reports funding by the Economic and Social Research Council and does not include a competing interests statement.

The easy way to misread this

Do not conclude that impaired heartbeat awareness causes autism symptoms or that interoception training will improve them. This was a group comparison on laboratory tasks, not a treatment study. The child finding came from 21 children with ASD and 21 comparison children, so it should not be treated as settled evidence for all patients.

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