Frontiers in Psychiatry 社论：孤独症的感觉加工机制、影响与干预

Abstract

Within this broad domain, sensory hypersensitivity deserves particular attention. Rather than being regarded as a peripheral feature accompanying the "core" characteristics of autism, hypersensitivity may interact with emotional and behavioral regulation, attention, executive functioning, motor behavior, and social engagement. Indeed, sensory alterations identified early in development have been shown to be strongly associated with subsequent emotional and behavioral difficulties, further supporting the functional relevance of sensory processing beyond the sensory domain itself (3).Understanding sensory processing may therefore provide an important window into how autistic individuals experience and navigate their environments.First-person accounts provide a particularly compelling perspective on the intensity of sensory hypersensitivity, illustrating how sounds that may appear ordinary to others can be experienced as physically painful and profoundly threatening. As described in Thinking in Pictures: "When I was little, loud noises were a problem, often feeling like a dentist drill hitting a nerve. They also caused pain. I was scared to death of balloons popping because the sound was like an explosion in my ear" (4). Such first-person experiences underscore why sensory over-sensitivity should not be treated as a secondary or incidental aspect of autism, but as a major research priority with direct implications for well-being, participation, and quality of life. This Research Topic emerged from this premise. In their Opinion article, Narzisi et al. Sensory processing in autism: a call for research and action highlighted the striking discrepancy between the impact of sensory sensitivities on autistic people's lives and the attention devoted to them in research.They called for objective and developmentally informed assessment, investigation of underlying mechanisms, greater involvement of autistic people and families, and interventions and environmental adaptations capable of reducing the burden associated with sensory hypersensitivity.The contributions collected in this Research Topic approach this challenge from complementary developmental, behavioral, physiological, neurobiological, and interventional perspectives. Several contributions emphasize that there is no single or static "autistic sensory profile." Previous work in school-aged autistic children has similarly highlighted substantial heterogeneity across sensory domains, with sensory characteristics varying in relation to cognitive functioning and differing particularly in hearing, social participation, and balance and motion (5). Extending this developmental perspective, Marani et al., examining sensory characteristics from 16 months to 14 years, identified adaptive functioning as an important correlate of sensory profiles and described a non-linear association with age. Extending this perspective by considering developmental change, Marani et al. examining sensory characteristics from 16 months to 14 years, identified adaptive functioning as an important correlate of sensory profiles and described a non-linear association with age. Their findings suggest a predominance of sensory seeking and auditory processing challenges during the preschool period, followed by a shift toward hypersensitivity and avoidance, particularly in visual and oral modalities, between 8 and 12 years. These results reinforce the importance of longitudinal approaches capable of capturing sensory development rather than treating sensory characteristics as stable traits.The systematic review by Ríos Llamas et al. places hypersensitivity itself at the center of the discussion. Reviewing light and sound hypersensitivity, the authors found a literature dominated by auditory research, with evidence of reduced habituation, impaired sensory gating, and increased sensitivity to sounds, while visual hypersensitivity remains comparatively understudied. Their review also identifies a major representational gap: children and males predominate, whereas autistic females and adults remain substantially underrepresented. Future sensory research must therefore embrace a lifespan perspective and address gender imbalance while increasing ecological validity.An equally important challenge concerns how sensory processing should be measured. Chounan and Suzuki found clear differences between autistic and typically developing adolescents in caregiverreported sensory characteristics but no significant group difference in active-touch texture/material matching. Objective tactile performance was also not consistently associated with caregiver-reported sensory reactivity. This apparent discrepancy is informative: everyday hypersensitivity may not be reducible to elementary perceptual and active exploration may allow individuals to regulate sensory input in ways that are not possible when sensory events are unpredictable or Importantly, sensory processing does not operate in isolation. Ji et al. found that components of executive functioning, particularly emotional and behavioral regulation, mediated associations between sensory processing patterns and social responsiveness. These findings invite a more integrated interpretation of autistic behavior: difficulties observed in social situations may sometimes be influenced by the regulatory demands imposed by sensory environments. Consistent with the broader functional impact of sensory processing, Zhang et al. showed that sensory sensitivity and avoidance, together with social-behavioral factors, uniquely predicted parental caregiving burden.Sensory difficulties therefore extend beyond the individual, affecting family functioning and caregiver well-being.The relationship between sensory processing and everyday functioning is particularly evident in feeding. Riccio et al. found that food selectivity was significantly associated with tactile, gustatory, and olfactory sensitivities, whereas behavioral profile, intellectual functioning, and autism symptom severity were not significantly associated with food selectivity. These findings support the view that selective eating in autism may, for some individuals, be fundamentally rooted in sensory experience rather than representing merely a behavioral problem. The Research Topic also addresses the crucial question of intervention. The systematic review and meta-analysis by Lyu et al. including 16 studies and 1,319 participants, reported improvements in sensory integration measures and autism-related behaviors following sensory integration-based interventions, while also identifying intervention duration as a contributor to heterogeneity. These findings are encouraging but underscore the need for rigorous trials and precise characterization of intervention content and dosage.Al-Ghabban et al. in a randomized trial of low-frequency repetitive transcranial magnetic stimulation, reported improvements across cognitive, social, and sensory measures, including reduced sensory hypersensitivity. These preliminary results point toward possible neuromodulatory approaches, although larger studies, replication, and longer-term assessment are necessary before clinical implications can be established. Importantly, intervention need not always mean changing the autistic individual. The SENSE project by Maggio et al. examined the integration of a multisensory environment into a public school as a structured sensory break. Despite the small case series, the intervention was feasible and safe and was associated with improved sensory regulation and reduced challenging behaviors. This contribution highlights an essential principle: environments themselves can be modified to reduce sensory burden. This principle resonates strongly with the Perspective by Chilà et al. who reconsider sensory-based visual attention through a neurodiversity-informed framework, shifting the emphasis from normalization toward adaptive support. Behaviors traditionally interpreted primarily as deficits may, in some cases, represent adaptive responses to sensory demands. Supporting autistic people should therefore not automatically mean increasing tolerance of intrinsically aversive sensory experiences; it may instead require creating environments that respect individual sensory needs. Taken together, the contributions to this Research Topic support a central message: sensory processing-and hypersensitivity in particular-should move from the periphery toward the center of autism research and clinical practice. Sensory experiences can influence eating, attention, emotional and behavioral regulation, motor functioning, social participation, family life, and access to educational and community environments. At the same time, this collection demonstrates that sensory hypersensitivity is not a unitary phenomenon: subjective experience, caregiver observation, psychophysical performance, physiological responses, neurobiological measures, developmental stage, and environmental context do not necessarily map onto one another in a simple way.Consistent with this perspective, sensory over-sensitivity in autism should be regarded as a top priority for future research, with particular attention to experiences that are painful, unpredictable, or difficult to control in everyday environments.Future research should therefore adopt longitudinal, multimethod, and ecologically valid approaches; include autistic females and adults more systematically; integrate objective measures with autistic people's lived experiences; and evaluate sensory outcomes as meaningful endpoints in intervention studies. Equally importantly, research should distinguish between helping autistic individuals regulate unavoidable sensory input and modifying environments that impose unnecessary sensory burden.The field may therefore need to move beyond asking simply how sensory processing is altered in autism toward asking how sensory experiences shape autistic people's everyday lives and how sensory distress can be reduced while respecting individual sensory needs. In this sense, the contributions gathered in this Research Topic represent both a response to the call for greater scientific attention to sensory processing in autism and a starting point for a broader research agenda, one in which sensory hypersensitivity is no longer regarded as a peripheral feature of autism, but as a fundamental dimension of the autistic experience.

Keywords

autism, diagnosis, Hypersensitivity, hyposensitivity, intervention, sensory

Received

10 September 2026

Accepted

25 September 2026

Copyright

© 2026 Narzisi, Grandin, Fabbri Destro and Valagussa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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