RESEARCH ARTICLE

Classification of Children With Autism Spectrum Disorder by Sensory

Subtype: A Case for Sensory-Based Phenotypes
Alison E. Lane, Cynthia A. Molloy, and Somer L. Bishop

This study examines whether sensory differences can be used to classify meaningful subgroups of children with autism
spectrum disorder (ASD). Caregivers of children with ASD aged 2–10 years (n = 228) completed the Short Sensory Profile.
Model-based cluster analysis was used to extract sensory subtypes. The relationship of these subtypes to age, gender,
autism symptom severity, and nonverbal intelligence quotient (IQ) was further explored. Four distinct sensory subtypes
were identified: (a) sensory adaptive; (b) taste smell sensitive; (c) postural inattentive; and (d) generalized sensory
difference. The sensory subtypes differ from each other on two dimensions: (a) the severity of reported sensory differences;
and (b) the focus of differences across auditory, taste, smell, vestibular and proprioceptive domains. Examination of the
clinical features of each subtype reveals two possible mechanisms of sensory disturbance in autism: (a) sensory hyper-
reactivity; and (b) difficulties with multisensory processing. Further, the sensory subtypes are not well explained by other
variables such as age, gender, IQ, and autism symptom severity. We conclude that classification of children using sensory
differences offers a promising method by which to identify phenotypes in ASD. Sensory-based phenotypes may be useful
in identifying behavioral features responsive to specific interventions thereby improving intervention effectiveness.
Further validation of the sensory-based phenotypes by establishing neural and physiological correlates is recommended.
Autism Res 2014, 7: 322–333. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

Keywords: sensory; autism; phenotypes; subtypes; children; classification; model-based cluster analysis; Short Sensory Profile

Introduction higher levels of sensory hyperreactivity predicted higher

Previous studies have reported that many children with
autism spectrum disorder (ASD) exhibit behaviors and
emotional responses associated with sensory differences,
such as sensory hyperreactivity (e.g., covering ears to loud,
unexpected sounds), sensory hypo-reactivity (e.g., failure
to react to painful stimuli), and sensory seeking (e.g.,
licking or smelling objects) [Baker, Lane, Angley, & Young,
2008; Baranek, Boyd, Poe, David, & Watson, 2007; Rogers
& Ozonoff, 2005; Tomchek & Dunn, 2007]. These differ-
ences are unrelated to sensory loss (i.e., hearing loss, visual
impairment, etc.) and are significantly more prevalent in
children with ASD than in typically developing children
[Ben-Sasson et al., 2009]. Individuals with ASD and their
families report that sensory differences contribute signifi-
cantly to caregiver burden and social isolation [Koenig &
Kinnealey, 2008]. Moreover, sensory differences have been
included in the DSM-5 diagnostic criteria for ASD
[American Psychiatric Association, 2013]. Recently, asso-
ciations have been made between patterns of sensory
difference and the core deficits of ASD [Boyd et al., 2010;
Hilton, Graver, & LaVesser, 2007; Lane, Young, Baker, &
Angley, 2010]. Specifically, Boyd et al. [2010] reported that
levels of repetitive behaviors in ASD, and sensory seeking
was associated with ritualistic/need for sameness behav-
iors. Others have observed significant associations
between sensory hyperreactivity and social communica-
tion, social motivation, and performance of social activi-
ties [Hilton et al., 2007; Reynolds, Bendixen, Lawrence, &
Lane, 2011]. In Lane et al. [2010], maladaptive behaviors
and communication competence varied depending on
sensory subtype in autistic disorder.
Findings such as these support the hypothesis that
close examination of sensory differences may elucidate
behavioral subgroups or phenotypes of children with
ASD. A phenotype is the classification of disorder based
on specific physical and behavioral characteristics that
are considered relevant to its further understanding or
management [Center for the Study of Language and
Information, Stanford University, 2013]. Phenotyping
efforts in complex neurodevelopmental disorders such as
ASD are considered critical to the identification of sub-
groups of children who are similar to each other behav-
iorally and who may, therefore, share etiological
similarities and/or respond similarly to intervention
[Gottesman & Gould, 2003].

From the School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia (A.E.L.); Harrison Community Network, Harrison,
Ohio (C.A.M.); Center for Autism and the Developing Brian (CADB), Weill Cornell Medical College, White Plains, New York (S.L.B.)
Received May 22, 2013; accepted for publication January 24, 2014
Address for correspondence and reprints: Alison E. Lane, School of Health Sciences, University of Newcastle, University Drive, Callaghan, NSW 2308,
Australia. E-mail: alison.lane@newcastle.edu.au
Published online 17 March 2014 in Wiley Online Library (wileyonlinelibrary.com)
DOI: 10.1002/aur.1368
© 2014 International Society for Autism Research, Wiley Periodicals, Inc.

322 Autism Research 7: 322–333, 2014 INSAR

 Phenotyping efforts in ASD have considered features
such as face processing abilities, sensitivity to social
reward, motor imitation, memory, executive function,
language ability, and restricted and repetitive behaviors
[Bishop et al., 2013; Dawson et al., 2002; Lord, Leventhal,
& Cook, 2001]. Barriers to the utility of these features as
a means of ASD phenotyping include that many are dif-
ficult to measure reliably in children younger than 3 years
of age and in some individuals with severe autism symp-
toms or cognitive impairments. Further, differences in
language function and sensitivity to social reward, once
emerging sufficiently to allow reliable observation, may
not be useful in the early identification of ASD. A system-
atic investigation of sensory-based phenotypes in ASD,
however, is indicated given the frequency of reported
difficulties in this area and preliminary indicators of
strong links between sensory differences and specific
symptom and behavioral profiles [Boyd et al., 2010; Lane
et al., 2010]. Additionally, sensory differences, as one
aspect of a temperament profile, may be observable in
early infancy prior to the time when clinically significant
ASD symptoms are recognized [Baranek, 1999; Clifford
et al., 2013].
Previous studies have explored sensory differences
within subgroups of children with ASD further strength-
ening the case for the development of sensory-based ASD
phenotypes. In a study by Liss, Saulnier, Fein, and
Kinsbourne [2006], sensory hyperreactivity was found to
be a discriminating characteristic of individuals with
ASD, over-focused attention, exceptional memory, and
perseverative behavior. Further, Ausderau et al. [2013],
report that autism severity and developmental function-
ing varied on the basis of sensory differences. Specifically,
increased sensory differences were associated with
increased autism severity and lower IQ. In work by Lane
and colleagues, distinct sensory subtypes within ASD
have been identified. First, Lane and colleagues [2010]
identified a triad of sensory subtypes in children with
autistic disorder (n = 54), aged 3–8 years using the Short
Sensory Profile [SSP; McIntosh, Miller, & Shyu, 1999a]. A
novel analysis technique, model-based cluster analysis,
was applied to examine trends in the presentation of
sensory differences. Subtypes were distinguishable from
each other on the basis of the frequency of reported
differences in attending to relevant auditory stimuli in
the context of a busy background, hypo-reactivity and
sensory seeking (low, medium, and high frequency of
symptoms), and the sensory modalities most affected.
Response to taste, smell, movement, and proprioceptive
sensation varied most between the three subtypes [Lane
et al., 2010]. Lane, Dennis, and Geraghty [2011] repli-
cated and refined these findings in an independent
sample of 30 children with autistic disorder and pervasive
developmental disorder—not otherwise specified. These
authors concluded that sensory subtypes were best
INSAR Lane et al./Sensory phenotypes in autism
described as: (a) mild sensory differences with a focus in
auditory filtering and seeking difficulties; (b) moderate
sensory differences with extreme difficulties in taste/
smell sensitivity; and (c) moderate–severe sensory differ-
ences in all sensory domains. Classification of children
with ASD using the sensory subtypes proposed by Lane
and colleagues allows for more systematic examination of
behavioral and symptom profiles. Preliminary work sug-
gests that children with ASD whose sensory differences
are characterized by extreme taste and smell sensitivity
appear to have more severe communication impairments
and are pickier eaters [Lane, et al., in press; Lane et al.,
2010]. Further, children experiencing the highest fre-
quency of sensory differences display more maladaptive
behavior [Lane et al., 2010].
Methodological issues, however, limit this preliminary
work. First, detailed examinations of systematic variance
in behavior and symptoms require large sample sizes for
conclusive findings. Second, only one study to date has
included representation across the full spectrum of ASD.
This limits conclusions being made about the role of
autism symptom severity and IQ in the expression of
sensory differences. Third, studies to date have mea-
sured sensory differences at differing time points in the
care path of the participants. Some participants were
newly diagnosed, while others had received several
years of intervention. It is possible, therefore, that some
of the variance in sensory differences reported previ-
ously in ASD samples is related more to intervention
experience rather than to features inherent to the
disorder.
This study proposes to examine further the case for
sensory-based phenotypes in ASD by answering the fol-
lowing questions:
1. What are the sensory subtypes in a large sample of
children at the time of their ASD diagnosis? How do
these subtypes compare to those reported in previous
sensory subtype investigations?
2. What is the relationship between sensory subtype, age,
gender, autism symptom severity, and IQ?
This study addresses the limitations of previous enqui-
ries by: (a) analyzing data from a large sample of children
with ASD; (b) establishing sensory differences at the point
of diagnosis; and (c) examining sensory difference along-
side comprehensive behavioral and diagnostic data col-
lected using a standard protocol. Based on the previous
literature, we hypothesized that at the time of diagnosis,
children with an ASD would exhibit sensory differences
that vary in severity, and are characterized by focal diffi-
culties in auditory filtering, hypo-reactivity, sensory
seeking, taste/smell sensitivity, and vestibular and pro-
prioceptive processing. Further, these differences will
conform to a subtype structure similar to that reported in
Lane et al. [2010, 2011]. In relation to the second study
323
question, we hypothesize that: more frequent sensory
differences will be related to increased autism symptom
severity; lower developmental functioning (assessed by
age and IQ) will be related to increased sensory differ-
ences; and no sensory differences will be apparent
between males and females.
Methods
Participants
Participants for this study were individuals presenting to
a major, Midwestern US autism specialist center for diag-
nostic assessment of ASD between 2008 and 2010. Par-
ticipants were included in the study if: (a) they were
ultimately diagnosed with an ASD by the evaluation
team; and (b) they completed the comprehensive battery
of diagnostic evaluations provided by the center. All par-
ticipants were aged between 2–10 years, which aligns
with the recommended age range for the primary
measure of sensory differences (discussed below) and pre-
vious studies investigating sensory subtypes. A total of
228 participants met the above criteria and were included
in the study. Table 1 provides a description of the partici-
pant characteristics.
Procedure and Design
This study involved the secondary analysis of data col-
lected at the specialist center. The center is a member of
the Autism Treatment Network (ATN) and follows a
nationally derived consensus protocol for the evaluation
and management of children with ASDs (http://
www.autismspeaks.org/science/programs/atn/index.php
#ATN). Data used in this study were sourced from a data-
base maintained by the center. De-identified data pertain-
ing to the variables of interest in this study were extracted
from the site database by facility staff, blind to the objec-
tives of the study. Prepared data were then forwarded to
the first author for analysis (described below). Appropri-
ate approvals for the study were gained from the relevant
Institutional Review Boards.
All participants were administered diagnostic and other
measures by trained clinicians using approved ATN pro-
tocols. This multidisciplinary assessment included inde-
pendent evaluations by a developmental pediatrician,
child psychologist, and speech-language pathologist. Fol-
lowing this assessment, a diagnosis of ASD was made by
the developmental pediatrician. All data included in this
study were collected at or close to the time of diagnosis.
The ATN protocol requires that all assessments be com-
pleted within 9 months of each other.
Instrumentation
Instruments used to evaluate the key study variables are
described below.
1. Autism symptom severity was calculated using the Cali-
brated Severity Score (CSS) from the Autism Diagnosis
Observation Schedule [ADOS; Lord et al., 2000]. The
ADOS is a well-established, standardized diagnostic
tool for ASD. Four different modules of the ADOS are
available for use depending on the expressive language
skills of the child. In this study modules 1–3 only were
used (module 1: n = 108; module 2: n = 64; module 3:
n = 52). Module 1 is intended for children who are
preverbal or with very limited language abilities (i.e.,
no more than single words or short phrases), module 2
is intended for children who use flexible phrase
speech, and module 3 is intended for children who use
complex sentences, which are defined as sentences
with two or more clauses.
2. Nonverbal IQ (NVIQ) was used to estimate each child’s
cognitive ability. NVIQ has been found to be more

Table 1. Participant Characteristics

n Mean Standard deviation Range

All participants age (months) 228 60.71 26.86 24–130

Male age 203 60 26.15 24–130
Female age 25 66.44 32.01 26–130
Nonverbal IQ 174 72.43 23.08 21–132
ADOS CSS 224 6.84 1.82 2–10
SSP 228
Tactile 226 26.91 5.58 10–35
Taste/smell sensitivity 226 12.47 5.69 4–20
Movement sensitivity 228 12.69 2.99 3–15
Under-responsive/Seeks sensation 226 21.25 6.39 7–35
Auditory filtering 228 17.19 5.04 6–30
Low energy weak 228 24.94 6.69 6–30
Visual/Auditory aensitivity 223 17.47 4.79 5–25
SSP overall 223 132.89 25.04 52–179

ADOS CSS, Autism Diagnostic Observation Schedule Calibrated Severity Score; SSP, Short Sensory Profile.

324 Lane et al./Sensory phenotypes in autism INSAR

 stable than verbal IQ (VIQ) in children with ASD
[Begovac, Begovac, Majic, & Vidovic, 2009] and is less
confounded with language ability. NVIQ was calculated
in two ways depending on the test that was adminis-
tered. Younger children or children with significant
cognitive impairments were administered the Mullen
Scales of Early Learning [MSEL; Mullen, 1995]. The
MSEL is a standardized assessment of development and
provides scores for gross motor, fine motor, visual
reception (nonverbal problem solving), receptive lan-
guage, and expressive language. The MSEL does not
yield separate NVIQ scores, so it was necessary to cal-
culate a nonverbal ratio IQ (also called a deviation IQ).
This was done by dividing the child’s nonverbal mental
age by his/her chronological age and multiplying by
100 [see Bishop, Guthrie, Coffing, & Lord, 2011].
Older children, who were cognitively capable of doing
so, completed the Stanford Binet 5th Edition [SB5; Roid,
2003]. The SB5 is designed for individuals aged 2–85+
years and yields separate NVIQ and VIQ scores. For
children who received the SB5, a standard NVIQ score
was used.
Complete NVIQ data were available for 174 partici-
pants in our sample. Table 1 details the mean NVIQ
scores for the sample. Participants without available
NVIQ data were generally determined by the evaluating
psychologist to be unable to participate in or complete
reliable IQ testing.
3. Sensory differences were assessed in our sample using
the Short Sensory Profile (SSP). The SSP is a 38-item
parent questionnaire designed to measure behaviors
associated with differences in the modulation of
everyday, environmental sensory stimuli in children
aged 3–10 years [McIntosh et al., 1999a]. Scores are
derived for seven domains: (a) tactile; (b) taste/smell;
(c) movement; (d) visual/auditory sensitivity; (e)
under-responsive/seeks sensation; (f) auditory filter-
ing; and (g) low energy/weak, and for overall sensory
modulation function. Example items for each of the
seven domains are listed in Table 2. Scores on each
SSP domain are then compared to normative data
from 1,200 typically developing children. Higher
scores relate to more typical performance, whereas
lower scores indicate that either a probable or definite
difference in sensory function is likely. Internal con-
sistency of overall and subdomain sections of the SSP
has been reported as ranging between r = 0.70–0.90
along with acceptable discriminative validity (>95%
in differentiating children with and without sensory
impairments) [McIntosh et al., 1999a; McIntosh,
Miller, Shyu, & Hagerman, 1999b]. The SSP and its
parent measure, the Sensory Profile, are used exten-
sively in clinical practice.
INSAR Lane et al./Sensory phenotypes in autism
Table 2. Example Short Sensory Profile Items
SSP domain Example items
Tactile sensitivity Item 4: Reacts emotionally or aggressively to
touch
Item 7: Rubs or scratches out a spot that has been
touched
Taste/Smell Item 8: Avoids certain tastes or food smells that
sensitivity are typically part of children’s diets
Item 10: Will only eat certain tastes
Movement Item 13: Fears falling or heights
sensitivity Item 14: Dislikes activities where head is upside
down (for example, somersaults, roughhousing)
Under-responsive/ Item 18: Touches people and objects
Seeks sensation Item 19: Doesn’t seem to notice when face or
hands are messy
Auditory filtering Item 22: Is distracted or has trouble functioning if
there is a lot of noise around
Item 26: Doesn’t respond when name is called but
you know the child’s hearing is OK
Low energy/Weak Item 29: Tires easily, especially when standing or
holding particular body position
Item 32: Props to support self (even during
activity)
Visual/Auditory Item 34: Responds negatively to unexpected or
sensitivity loud noises
Item 38: Is bothered by bright lights after others
have adapted to the light
Analysis
Statistical analyses were conducted using the Statistical
Package for the Social Sciences (SPSS v 19.0, New York,
New York, USA) and R (v 2.15, Vienna, Austria). Descrip-
tive statistics for all key variables were generated for the
sample. Model-based cluster analysis [mclust: Zhong &
Ghosh, 2003] was applied to SSP scores to identify
sensory subtypes and address study question 1. Standard-
ized z-scores from the seven SSP sensory domains (Miller
& Schoen, personal communication) were submitted to
this analysis replicating the method used in previous
studies [Lane et al., 2010, 2011].
Z-scores correspond to the number of standard devia-
tions above or below the normative mean. Based on the
SSP interpretation guide, z-scores at or above −1 are clas-
sified as “Typical Performance.” Z-scores that fall between
−1 and −2 are classified as “Probable Difference.” In the
case where an individual scores within the “Probable
Difference” range, supporting observations from other
sources, e.g., parent or teacher comments, clinical obser-
vations, are used to determine if this sensory area is
impacting on functional performance. Z-scores that fall
below −2 are considered to indicate “Definite Difference,”
and these sensory areas are likely to be functionally lim-
iting [McIntosh et al., 1999a]. Further, the Sensory Pro-
cessing Disorder research consortium uses the following
guidelines to identify clinical cases: Total SSP score
> = −3.0 OR two or more SSP domains > = −2.5 OR one SSP
325
domain > = −4.0 (Miller & Schoen, personal communica-
tion). We adopted the guidelines from both the SSP
manual and the Sensory Processing Disorder research
consortium to guide our interpretation of sensory
subtypes.
Model-based cluster analysis compares the fit to the
data of a number of possible models using the Bayesian
Information Criteria (BIC) to determine the best model
[Zhong & Ghosh, 2003]. A high BIC indicates that an
optimal trade-off between the fit of the model to the data
and the complexity of the model (i.e., numbers of clusters
or numbers of parameters) has been achieved. Use of the
BIC allows simultaneous comparison of a number of dif-
ferent cluster models that have differing complexity. This
clustering technique has the advantage over traditional
hierarchical methods that only consider proximity of
scores to each other but not the complexity of the model.
One-way analysis of variance (ANOVA) with Tukey post-
hoc analyses was used to determine the sensory differ-
Figure 1. Bayesian Information Criteria values for each Gaussian
ences between clusters.
model (each represented by a different icon) considered in the
After classification of each child into a sensory subtype, analysis. Each Gaussian model used in this analysis is identified in
one-way ANOVA was used to examine differences in age, the figure legend by a combination of the letters E, V, and I. The
autism symptom severity, and NVIQ between sensory sequence of the letters indicates specific variance and geometric
subtypes (study question 2). Differences in gender features of each model. For a detailed description of this method-
between subtypes were determined using chi-square ology, please see Fraley and Raftery [2007].
analysis.
40.2%) displays clinically significant differences in taste/
smell sensitivity but typical function in low energy weak;
Results
cluster 3 (n = 23, 10.3%) displays typical function in
taste/smell sensitivity but clinically significant difference
Table 1 reports the descriptive results for key variables of
in low energy weak; and cluster 4 (n = 29, 12.1%) is char-
interest in this study. Chronological age was calculated
acterized by clinically significant differences in both
from the date of SSP administration. As NVIQ data were
taste/smell sensitivity and low energy weak.
not available for all participants, one-way ANOVA was
One-way ANOVAs with Tukey post-hoc analyses further
used to compare participants with (n = 174) and without
clarified the differences in SSP domain scores between
(n = 54) NVIQ scores on age, gender, and sensory subtype
clusters (Table 3). First, all clusters display some differ-
membership to examine equivalence between the groups.
ences from typical in the domains of auditory filtering
No significant differences were found between groups
and under-responsive/seeks sensation. These differences
(age: P = 0.43; gender: P = 0.59; subtype: P = 0.11).
are mild in cluster 1, moderate in clusters 2 and 3, and
severe in cluster 4. Second, cluster 1 displays no differ-
Sensory Subtypes in ASD ences in any other domain. Third, cluster 2 displays an
extreme score in the area of taste/smell sensitivity, and
A four cluster solution was determined to be the most
cluster 3 displays an extreme score in low energy weak.
parsimonious and interpretable after inspection of the
Fourth, cluster 4 displays differences in all domains and is
BIC values and consideration of five, six, seven, and eight
the only cluster to show atypical movement sensitivity.
cluster solutions. Figure 1 shows a comparison of the
On the basis of these results, we propose that each
BICs for each model considered in the analysis. As can be
cluster corresponds to a distinct sensory subtype in ASD.
seen, the value of the BIC peaks at four components
The subtypes are characterized as follows:
(clusters). The four cluster solution is presented in
Figure 2. Visual inspection indicated that these clusters 1. Sensory adaptive (Cluster 1)—typical function in five
are most clearly distinguishable when viewing the of the seven sensory domains; mild elevation in audi-
scatterplot of taste/smell sensitivity against low energy tory filtering and under-responsive/seeks sensation;
weak scores. In the cluster solution for our sample, cluster participants classified in this cluster do not meet the
1 (n = 84, 37.5%) displays typical function on both taste/ criteria for clinical cases of sensory processing disorder
smell sensitivity and low energy weak; cluster 2 (n = 92, as described in the “Analysis” section and, therefore,

326 Lane et al./Sensory phenotypes in autism INSAR

 it is considered unlikely that the sensory diffe-
rences observed are strongly impacting functional
performance.
2. Taste/Smell sensitive (Cluster 2)—extreme taste/smell
sensitivity and clinically significant concerns in audi-
tory filtering and under-responsive/seeks sensation; no
differences noted in domains assessing movement and
proprioceptive function.
3. Postural inattentive (Cluster 3)—extreme score in low
energy weak and clinically significant concerns in audi-
tory filtering and under-responsive/seeks sensation.
4. Generalized sensory difference (Cluster 4)—all
sensory domains are affected including movement
sensitivity.
Sensory Subtypes and Age, Gender, Autism Symptom
Severity, and NVIQ
Table 4 reports age, gender, autism symptom severity (as
measured by the ADOS CSS), and NVIQ data by sensory
subtype. As can be seen, no differences emerged between
sensory subtypes on the basis of gender or autism
symptom severity.
Statistically significant differences were observed,
however, between subtypes on the basis of age and NVIQ.
Post-hoc analyses clarified these differences. In terms
of age, subtype taste/smell sensitive was significantly
younger than subtype postural inattentive. There were no

Table 4. Age, Gender, nonverbal IQ and Autism Symptom

Severity by Sensory Subtype

NVIQ (SE) ADOS CSS (SD)

Subtype Age (SE) Gender (n = 174) (n = 224)

SA 4.93 Male = 77 75.71 6.79

Cluster 1 (0.22) Female = 7 (2.90) (1.63)
(n = 84)
TSS 4.70* Male = 78 65.61* 6.92
Cluster 2 (0.23) Female = 14 (2.37) (1.97)
(n = 92)
PI 6.02* Male = 20 80.32* 7.0
Cluster 3 (0.54) Female = 3 (5.40) (1.57)
(n = 23)
GSD 5.79 Male = 28 78.23 6.59
Cluster 4 (0.46) Female = 1 (5.90) (2.10)
(n = 29)
Figure 2. Model-based cluster solution on sensory features—“0”
Statistic F = 3.42 χ2 = 4.08 F = 4.00 F = .31
represents the normative mean for performance (i.e., typical per-
df = 3, 224 df = 3,170 df = 3,220
formance) on the sensory domain. Values above and below “0” P value 0.02 0.25 0.009 0.82
indicate the number of standard deviations from the normative
mean. Values above 0 and between 0 and −1 indicate no sensory SA, sensory adaptive; TSS, taste/smell sensitive; PI, postural inatten-
impairment; between −1 and −2 indicate mild sensory impairment; tive; GSD, Generalized Sensory Difference; ADOS CSS, Autism Diagnostic
below −2 indicate clinically significant sensory impairment. Each Observation Schedule Calibrated Severity Score; SD, standard deviation; SE,
icon represents a single case. standard error.

Table 3. Mean Short Sensory Profile Z-Scores by Cluster

Cluster (n) Tactile (SD) Taste smell (SD) Movement (SD) Under seeks (SD) Aud filter (SD) Low energy weak (SD) Visual aud sens (SD)

1 (84) −0.84 0.99 −0.29 −1.74 −1.96 −0.13 −0.58

(1.38) (1.15) (1.27) (1.93) (1.6) (0.71) (1.4)
2 (92) −1.97 −4.10 −0.61 −2.77 −2.78 −0.43 −1.23
(1.78) (1.32) (1.44) (1.99) (1.63) (0.99) (1.5)
3 (23) −1.59 0.76 −0.65 −2.88 −2.78 −4.32 −1.36
(1.34) (1.2) (1.22) (2.22) (1.26) (1.23) (1.24)
4 (29) −3.34 −4.48 −1.86 −4.16 −3.76 −5.49 2.56
(2.27) (1.11) (1.86) (2.01) (1.6) (1.47) (1.82)
P value 0.001 0.001 0.001 0.001 0.001 0.001 0.001

Under seeks, under-responsive/seeks sensation; Aud filter, auditory filtering; Visual aud sens, visual auditory sensitivity.

INSAR Lane et al./Sensory phenotypes in autism 327


Figure 3. Mean nonverbal IQ scores by sensory subtype.
significant differences in age between sensory adaptive,
postural inattentive, and generalized sensory difference.
In terms of NVIQ, subtype taste/smell sensitive was sig-
nificantly lower than subtype postural inattentive. No
other significant differences between subtypes were
observed for NVIQ. Figure 3 displays mean NVIQ scores
and standard error for each subtype.
Discussion
The purpose of our study was to examine further the case
for sensory-based phenotypes in ASD by (a) identifying
sensory subtypes in a large sample of children with ASD
and (b) establishing the relationship between these sub-
types and age, gender, NVIQ, and autism symptom sever-
ity. Exploration of these questions in a large sample of
children with ASD was indicated given promising pre-
liminary results in other studies.
Partial replication and further refinement of the sub-
types reported by Lane et al. [2010, 2011] is evident in this
study. Previously, three general sensory subtypes have
been described including: (a) mild sensory difference with
a focus in auditory filtering and seeking difficulties; (b)
moderate sensory difference with extreme difficulties in
taste/smell sensitivity; and (c) moderate–severe sensory
difference in all sensory domains [Lane et al., 2010, 2011].
In the current study, we identified the same three general
subtypes and revealed a new, fourth subtype. The four
sensory subtypes in this study are:
1. Sensory adaptive—predominantly typical sensory
function with mildly elevated scores in auditory filter-
ing and under-responsive seeks sensation that are
unlikely to be functionally limiting.
328 Lane et al./Sensory phenotypes in autism
2. Taste smell sensitive—characterized by extreme taste
and smell sensitivity alongside moderate-level con-
cerns in auditory filtering and under-responsive/seeks
sensation.
3. Postural inattentive (new)—characterized by extreme
difficulties in postural processing alongside moderate-
level concerns in auditory filtering and under-
responsive/seeks sensation.
4. Generalized sensory difference—experiences signifi-
cant difficulties across all areas of sensory difference.
In general, the subtypes differ from each other on the
basis of the severity of differences in auditory filtering
and under-responsive seeks sensation and in the focus of
differences in areas of taste/smell sensitivity and low
energy weak.
Of note is the large proportion (37.5%) of the sample
that met criteria for the subtype, sensory adaptive. This
finding is in contrast to previous studies that have esti-
mated the prevalence of sensory differences in ASD as
high as 92% [Tomchek & Dunn, 2007]. Sampling strategy
differences between studies may explain this result. Our
study was based on a representative referral sample (all
those presenting for diagnosis of ASD) rather than a con-
venience sample. Estimates of the prevalence of sensory
differences in ASD may have been inadvertently inflated
in previous studies by recruitment practices. Parents of
children with ASD and significant sensory differences
may have been over-represented in studies where the
research aims were focused on sensory issues. A further
difference between our study and previous investigations
is that sensory differences were assessed for all partici-
pants at or close to the time of diagnosis. While some
children with ASD receive general developmental inter-
vention prior to diagnosis, it can be inferred that the
findings of the current study represent baseline sensory
differences prior to implementation of autism-specific
intervention strategies. The finding suggests that many
children with ASD do not experience functionally limit-
ing sensory differences at diagnosis and, therefore, may
not benefit from sensory-based therapies. Subsequently,
this finding lends support to the utility of sensory differ-
ences as a means of distinguishing clinically meaningful
subgroups or phenotypes within ASD. Moreover, classifi-
cation of children presenting for diagnosis of ASD using
sensory subtypes will also assist in diagnosis using the
DSM-5. Sensory differences are now listed as one possible
manifestation of stereotypic and repetitive behaviors in
the DSM-5 criteria. Establishing the sensory subtype of
the child during the diagnostic evaluation provides an
efficient means of identifying whether this sub-criteria
has been met.
Further, examination of the nature of the behavioral
and sensory differences expressed in each subtype reveals
two possible mechanisms of sensory disturbance in
INSAR
autism: (a) sensory hyperreactivity (taste smell sensitive
and generalized sensory difference); and (b) difficulties
with multisensory processing (postural inattentive and
generalized sensory difference). This schema incorporates
and streamlines the current nosology of sensory differ-
ence expressed as: sensory modulation disorder (hyperre-
activity, hypo-reactivity, and seeking), sensory-based
movement disorder, and sensory discrimination disorder
[Ausderau et al., 2013; Miller, Anzalone, Lane, Cermak, &
Osten, 2007]. Individuals with ASD and sensory hyperre-
activity may be observed to display behaviors consistent
with intolerance and sensitivity to specific sensory stress-
ors. For example, in our subtypes, children were reported
by their parents to exhibit heightened responses to select
tastes and smells (taste smell sensitive and generalized
sensory difference) and movement, tactile, visual, and
auditory stimuli (generalized sensory difference). Simi-
larly, individuals with ASD may also display behaviors
associated with difficulties with multisensory integration
or the simultaneous processing of multiple sensory
modalities or differing elements of a single modality (e.g.,
pitch and loudness of an auditory stimulus). In our sub-
types, postural, coordination, and auditory filtering diffi-
culties may well have a base in impaired multisensory
integration. Impairment in the concurrent processing of
visual, proprioceptive, and vestibular sensory stimuli is
likely to impact the maintenance of body position and
the production of coordinated movements such as reach-
ing [Izawa et al., 2012; Sober & Sabes, 2003]. Similarly,
difficulties in identifying salient auditory stimuli within
the context of multiple auditory and other sensory inputs
(e.g., such as in a classroom) could lead to behaviors such
as those described in the auditory filtering domain of the
SSP. Additional support for these hypotheses is found
within the neurophysiological literature where observa-
tions of differences in sympathetic nervous system
activation (sensory hyperreactivity) and multisensory
processing are commonly reported [Hirstein, Iversen, &
Ramachandran, 2001; Marco, Hinkley, Hill, & Nagarajan,
2011]. Further validation of our proposed theory of
mechanisms of sensory disturbance in ASD with neuro-
physiological data is indicated.
Additional study is also required into the role of
sensory hypo-reactivity in ASD. Individuals with ASD
(especially young children) are commonly described as
experiencing behaviors consistent with high tolerance or
insensitivity to sensory stressors [Baranek, David, Poe,
Stone, & Watson, 2006; Ben-Sasson et al., 2009]. A spe-
cific subtype characterized by sensory hypo-reactivity,
however, did not emerge in this study. Items related
to hypo-reactivity on the SSP are found in under-
responsive/seeks sensation and auditory filtering. Sensory
differences of significance in these areas were noted in
all subtypes except sensory adaptive, although parents
of children classified in this subtype, endorsed mildly
INSAR Lane et al./Sensory phenotypes in autism
elevated scores in these domains. It is possible that behav-
iors associated with hypo-reactivity are ubiquitous across
individuals with ASD while presenting at different levels
of severity from mild, and not affecting function, to
severe and functionally limiting. Close examination of
the items included on these domains of the SSP and their
relationship to the core symptoms of ASD may give
insights into the underlying processes of the disorder. It
is notable that both subtypes associated with sensory
hyperreactivity, taste/smell sensitive, and generalized
sensory difference also displayed moderate–severe differ-
ences in hypo-reactivity. Two possible hypotheses for this
finding are that: (a) a more general impairment of sensory
reactivity that includes both hyper- or hypo-reactive fea-
tures is implicated in ASD or (b) that individuals with
sensory hyperreactivity engage in behaviors that mimic
hypo-reactivity (i.e., withdrawal, failure to respond) as a
means of managing an over-stimulating environment.
Alternatively, it is possible that the items included in the
SSP were insufficiently sensitive to true hypo-reactivity.
Future investigations focused on hypo-reactivity in ASD
should consider the best methods for identifying these
differences in children and explore their relationship to
features of hyperreactivity.
The second major finding from our study is that, in
general, sensory differences are not well explained by
variables such as age, NVIQ and autism symptom sever-
ity as measured by the ADOS CSS. This finding is in
contrast to those of Ausderau et al. 2013 who reported
that autism symptom severity (measured using the
Social Responsiveness Scale) was differentially impacted
by frequency of sensory differences. An important dif-
ference between the current study and that by Ausderau
et al. is in the methods used. In our study, we used
cluster analysis to identify groups of similar cases based
on sensory differences, whereas Ausderau and colleagues
were focused on detailing similarities between item scores
on a measure of sensory differences. This disparity in the
approaches of the two studies likely explains the differ-
ent results. Leekam, Nieto, Libby, Wing, and Gould
[2007] also reported age and IQ effects in their study of
sensory differences of individuals with ASD aged 32
months–38 years. Specifically, age was related to sensory
differences in oral and kinesthetic domains (differences
decreased with increasing age), younger children with
lower IQ were more likely to exhibit sensory differences
across sensory modalities and individuals with higher IQ
showed fewer visual differences. Kern et al. [2006] also
reported a decrease in sensory differences (particularly in
hyperreactivity) with increasing age in a sample aged
3–56 years. A direct comparison of the findings of these
studies with the current study is difficult, however, due
to the contrasting age groups included in each study.
Our study examined a narrow age range of 2–10 years
only. It is possible that changes in sensory differences
329
attributable to age and IQ are not readily observed
during this time period but rather are more significant
when considering development from early childhood to
adulthood.
Our findings contribute important information to
efforts to identify precise and reliable features for ASD
phenotyping. Sensory subtypes appear to provide one
means of classifying individuals with ASD in a way that
may suggest indicators for response to intervention. For
example, understanding the sensory subtype of a newly
diagnosed individual will clarify whether presenting
problem behaviors are likely to be responsive to a
sensory-based desensitization protocol (taste/smell sensi-
tive and generalized sensory difference); an approach
addressing multisensory processing impairment (postural
inattentive and generalized sensory difference) or non-
sensory-based interventions (sensory adaptive).
Further, the sensory subtype schema may allow practi-
tioners to make predictions with regard to the presenta-
tion and progression of functional difficulties in the
newly diagnosed individual. For example, the age differ-
ence observed in our sample between taste/smell sensi-
tive and other subtypes suggests that individuals in this
particular subtype may present for diagnosis earlier
because of the severity of behaviors associated with
sensory hyperreactivity. These children would also be
predicted to experience protracted difficulties with eating
diverse and novel foods [Lane et al., in press]. Subse-
quently, they may benefit from early and intensive eating
therapy to prevent secondary health concerns (vis a vis,
dietary insufficiency) and ease daily caregiver burden.
Additionally, previous research has linked sensory hyper-
reactivity with increased anxiety, gastrointestinal distur-
bance, and repetitive behavior in children with ASD,
suggesting that these children may require specific thera-
pies to address these functional limitations [Boyd et al.,
2010; Mazurek et al., 2013]. In contrast, children identi-
fied as meeting criteria for postural inattentive and
generalized sensory difference may be predicted to expe-
rience difficulties in attention and motor skills. These
individuals would likely benefit from additional motor
testing to assess the impact of multisensory processing
difficulties on this system and on other autism symp-
toms. In fact, the postural inattentive and generalized
sensory difference subtypes, together, may constitute an
additional motor phenotype. In summary, establishing
the sensory subtype of a child with ASD at the time of
diagnosis may assist in planning for targeted and indi-
vidualized intervention protocols, which maximize like-
lihood of positive outcomes for individuals and their
families.
Our finding regarding the younger age of presentation
of taste/smell sensitive indicative of sensory hyperreac-
tivity may appear to be at odds with aspects of the
previous literature. Some reports have proposed that
330 Lane et al./Sensory phenotypes in autism
hypo-reactivity in early childhood is a defining feature of
ASD vs. other developmental disabilities [Baranek et al.,
2006; Ben-Sasson et al., 2007]. We argue that, taken
together, the results of this study and previous reports
support the hypothesis that atypical sensory reactivity
(hyper- and/or hypo-reactivity) may be a discriminating
feature useful in the early identification of ASD in young
children. It also supports the hypothesis that impairment
in general sensory reactivity, as suggested earlier, is indi-
cated in ASD. One proposition worthy of consideration is
that all infants who go on to be diagnosed with ASD
experience a fundamental impairment in sensory reac-
tivity but that sensory subtype is not determined until
closer to diagnosis. Impairments in sensory reactivity in
infancy may manifest in differing behavioral and tem-
perament profiles that are highly susceptible to develop-
mental, environmental and other factors. The interplay
of these factors in early childhood may then shape the
emergence of a specific sensory subtype at the time of
diagnosis. For example, management of a hyperreactive
infant with risk factors for ASD by promoting self-
soothing and self-regulation strategies may reduce hyper-
reactivity resulting in a profile consistent with sensory
adaptive or postural inattentive at the time of diagnosis.
Alternatively, protection of a hyperreactive infant from
sensory stressors (e.g., managing the environment to
prevent unexpected sounds; only offering preferred
foods, etc.) may result in the persistence of a hyperreac-
tive profile consistent with taste/smell sensitive or gen-
eralized sensory difference. Further, neurodevelopmental
processes initiated as a means of coping with nonfunc-
tional hyperreactivity may result in a hypo-reactive
profile (e.g., withdrawal) in a young child. Alternatively,
failure to stimulate a hypo-reactive infant may result in
the delays in the development of critical sensory dis-
crimination and perceptual skills necessary for multisen-
sory processing and the performance of more complex
behaviors such as motor coordination and social com-
munication. Systematic study of these and related
hypotheses is required before definitive conclusions can
be drawn. In particular, careful assessment and monitor-
ing of sensory differences in infants and toddlers with
risk factors for ASD is required to fully understand the
emergence of sensory subtypes at diagnosis.
Limitations
Interpretations of the findings of our study are limited by
the reliance on a parent-report tool to classify sensory
difference in ASD. Parent-report tools are, however, the
most common method used in practice to identify
sensory difficulties in children with ASD and as such,
provide valuable insight into the impact of sensory dif-
ferences on the daily life context of the individual. Future
studies should augment data from parent-report tools
INSAR
with a systematic clinician-directed observational proto-
col of children’s sensory-related behaviors.
Further investigation of the relationship between NVIQ
and sensory subtypes is also indicated, as we were not
able to evaluate IQ performance in all participants in this
study. Difficulties establishing a reliable IQ in children
with ASD are common. We adopted a number of strate-
gies to optimize our assessments of this area. No signifi-
cant differences between those with and without NVIQ
data were observed in our data set leading us to conclude
that our reduced data set for IQ analyses was representa-
tive of the total group. Nevertheless, our findings should
be confirmed in other samples.
Summary and Future Research
In summary, our study has identified a method for clas-
sifying children with ASD aged 2–10 years based on
sensory differences. The sensory subtypes emerging from
this classification system are characterized by variance in
the severity of sensory differences and the focus of differ-
ences across auditory, taste, smell, vestibular, and pro-
prioceptive domains. Further, the sensory subtypes are
not well explained by other variables such as age,
gender, NVIQ, and autism symptom severity, and, as
such, offer a promising method by which to identify
sensory-based phenotypes in autism. Validation of the
sensory subtypes is needed in future studies. We would
recommend that priority be given to studies examining:
(a) neural and genetic correlates of sensory subtypes;
(b) general behavior patterns associated with sensory
subtype; (c) stability of sensory subtype over time; and
(d) response to intervention as a function of sensory
subtype membership. Findings from studies such as
these will identify patterns of physiological response to
sensory stimuli in ASD that can be paired with a more
refined understanding of the behavioral challenges asso-
ciated with sensory differences. This knowledge can then
optimize clinical decision making with regard to the pre-
scription of effective interventions for individuals with
ASD and their caregivers. A further opportunity exists to
examine the specificity of these subtypes to ASD. Appli-
cation of the classifying methodology to other popula-
tions (e.g., attention deficit hyperactivity disorder,
intellectual disability) may reveal areas of behavioral
overlap and difference in these neurodevelopmental dis-
orders further enhancing diagnostic and treatment pre-
scription processes.
Acknowledgments
The authors acknowledge the members of the Autism
Speaks Autism Treatment Network (AS ATN) for use of the
data. The data for the study was collected as part of the AS
INSAR Lane et al./Sensory phenotypes in autism
ATN. Further support came from a cooperative agreement
(UA3 MC 11054) from the U.S. Department of Health and
Human Services, Health Resources and Services Adminis-
tration, Maternal and Child Health Research Program, to
the Massachusetts General Hospital. The AS ATN includes
these members: Cincinnati Children’s Hospital Medical
Center, Patricia Manning-Courtney, MD. The views
expressed in this publication do not necessarily reflect the
views of the Autism Speaks, Inc.
Other acknowledgments: Dr. Bishop received support
from R01HD065277. Simon Dennis, Terri Mitchell, Carrie
Thomas, Chelsea Hetrick, Kerry Dalton, Kelly Tanner,
Brittany Hand, Andrew Persch, Marisa Capogreco
The authors have no conflicts of interest to declare.
References
American Psychiatric Association. (2013). Diagnostic and statis-
tical manual of mental disorders (DSM-5). Arlington, VA:
American Psychiatric Association.
Ausderau, K., Sideris, J., Furlong, M., Little, L.M., Bulluck, J., &
Baranek, G.T. (2013). National Survey of Sensory Features in
Children with ASD: Factor Structure of the Sensory Experi-
ence Questionnaire (3.0). Journal of Autism and Develop-
mental Disorders. Advance on-line publication. doi:10.1007/
s10803-013-1945-1.
Baker, A.E.Z., Lane, A., Angley, M.T., & Young, R.L. (2008). The
relationship between sensory processing patterns and
behavioural responsiveness in autistic disorder: A pilot study.
Journal of Autism and Developmental Disorders, 38, 867–
875.
Baranek, G.T. (1999). Autism during infancy: A retrospective
video analysis of sensory-motor and social behaviors at 9–12
months of age. Journal of Autism and Developmental Disor-
ders, 29, 213–224.
Baranek, G.T., Boyd, B.A., Poe, M.D., David, F.J., & Watson, L.R.
(2007). Hyperresponsive sensory patterns in young children
with autism, developmental delay and typical develop-
ment. American Journal on Mental Retardation, 112, 233–
245.
Baranek, G.T., David, F.J., Poe, M.D., Stone, W.L., & Watson, L.R.
(2006). Sensory Experiences Questionnaire: Discriminating
sensory features in young children with autism, developmen-
tal delays, and typical development. Journal of Child Psy-
chology and Psychiatry, 47, 591–601. doi:10.1111/j.1469–
7610.2005.01546.x
Begovac, I., Begovac, B., Majic, G., & Vidovic, V. (2009). Longi-
tudinal studies of IQ stability in children with childhood
autism—Literature survey. Psychiatria Danubina, 21, 310–
319.
Ben-Sasson, A., Cermak, S.A., Orsmond, G.I., Tager-Flusberg, H.,
Carter, A.S., et al. (2007). Extreme sensory modulation behav-
iors in toddlers with autism spectrum disorders. American
Journal of Occupational Therapy, 61, 584–592.
Ben-Sasson, A., Hen, L., Fluss, R., Cermak, S.A., Engel-Yeger, B., &
Gal, E. (2009). A meta-analysis of sensory modulation symp-
toms in individuals with autism spectrum disorders. Journal
of Autism and Developmental Disorders, 39, 1–11.
331
Bishop, S.L., Guthrie, W., Coffing, M., & Lord, C. (2011). Con-
vergent validity of the Mullen Scales of Early Learning and
the differential ability scales in children with autism spec-
trum disorders. American Journal of Intellectual and Devel-
opmental Disabilities, 116, 331–343.
Bishop, S.L., Hus, V., Duncan, A., Huerta, M., Gotham, K., et al.
(2013). Subcategories of restricted and repetitive behaviors in
children with autism spectrum disorders. Journal of Autism
and Developmental Disorders, 43, 1287–1297. doi:10.1007/
s10803-012-1671-0
Boyd, B.A., Baranek, G.T., Sideris, J., Poe, M.D., Watson, L.R.,
et al. (2010). Sensory features and repetitive behaviors in
children with autism and developmental delays. Autism
Research, 3, 78–87.
Center for the Study of Language and Information, Stanford
University. (2013). Stanford Encyclopedia of Philosophy.
Retrieved 12 October 2009 from http://plato.stanford.edu/
entries/genotype-phenotype/#2.
Clifford, S.M., Hudry, K., Elsabbagh, M., Charman, T., Johnson,
M.H., & The BASIS Team (2013). Temperament in the first two
years of life in infants at high-risk for autism spectrum disor-
ders. Journal of Autism and Developmental Disorders, 43,
673–686.
Dawson, G., Webb, S., Schellenberg, G.D., Dager, S., Friedman,
S., et al. (2002). Defining the broader phenotype of autism:
Genetic, brain, and behavioral perspectives. Development
and Psychopathology, 14, 581–611.
Fraley, C., & Raftery, A.E. (2007). Model-based methods of clas-
sification: Using mclust software in chemometrics. Journal of
Statistical Software, 18, 1–13.
Gottesman, I.I., & Gould, T.D. (2003). The endopheno
type concept in psychiatry: Etymology and strategic inten-
tions. The American Journal of Psychiatry, 160, 636–
645.
Hilton, C., Graver, K., & LaVesser, P. (2007). Relationship
between social competence and sensory processing in chil-
dren with high functioning autism spectrum disorders.
Research in Autism Spectrum Disorders, 1, 164–173. doi:
10.1016/j.rasd.2006.10.002
Hirstein, W., Iversen, P., & Ramachandran, V.S. (2001). Auto-
nomic responses of autistic children to people and objects.
Proceedings Biological Sciences, 268, 1883–1888.
Izawa, J., Pekny, S., Marko, M.K., Haswell, C.C., Shadmehr, R., &
Mostofsky, S.H. (2012). Motor learning relies on integrated
sensory inputs in ADHD, but over-selectivity on propriocep-
tion in autism spectrum conditions. Autism Research, 5, 124–
136.
Kern, J.K., Trivedi, M.H., Garver, C.R., Grannemann, B.D.,
Andrews, A.A., et al. (2006). The pattern of sensory process-
ing abnormalities in autism. Autism: The International
Journal of Research and Practice, 10, 480–494. doi:10.1177/
1362361306066564
Koenig, K.P., & Kinnealey, M. (2008). Research brief: Sensory,
motor, and communication challenges for persons with
autism spectrum disorders. Special Interest Section Quarterly:
Sensory Integration, 31, 3–4.
Lane, A.E., Dennis, S.J., & Geraghty, M.E. (2011). Brief report:
Further evidence of sensory subtypes in autism. Journal of
Autism and Developmental Disorders, 41, 826–831.
332 Lane et al./Sensory phenotypes in autism
Lane, A.E., Geraghty, M.E., Young, G.S., & Rostorfer, J. (in press).
Problem eating behaviors in Autism Spectrum Disorder
are associated with suboptimal daily nutrient intake and
taste/smell sensitivity. ICAN: Infant, Child and Adolescent
Nutrition.
Lane, A.E., Young, R.L., Baker, A.E.Z., & Angley, M.T. (2010).
Sensory processing subtypes in autism: Association with
adaptive behavior. Journal of Autism and Developmental Dis-
orders, 40, 112–122.
Leekam, S.R., Nieto, C., Libby, S.J., Wing, L., & Gould, J. (2007).
Describing the sensory abnormalities of children and adults
with autism. Journal of Autism and Developmental Disor-
ders, 37, 894–910. doi:10.1007/s10803-006-0218-7
Liss, M., Saulnier, C., Fein, D., & Kinsbourne, M. (2006). Sensory
and attention abnormalities in autistic spectrum disorders.
Autism: The International Journal of Research and Practice,
10, 155–172. doi:10.1177/1362361306062021
Lord, C., Leventhal, B.L., & Cook, E.H. (2001). Quantifying the
phenotype of autism spectrum disorders. American Journal of
Medical Genetics (Neuropsychiatric Genetics), 105, 36–38.
Lord, C., Risi, S., Lambrecht, L., Cook, E.H., Leventhal, B.L., et al.
(2000). The autism diagnostic observation schedule-generic:
A standard measure of social and communication deficits
associated with the spectrum of autism. Journal of Autism
and Developmental Disorders, 30, 205–223.
Marco, E.J., Hinkley, L.B.N., Hill, S.S., & Nagarajan, S.S. (2011).
Sensory processing in autism: A review of the neurophysi-
ologic findings. Pediatric Research, 69(5 Pt 2), 48R–54R.
Mazurek, M., Vasa, R., Kalb, L., Kanne, S., Rosenberg, D., et al.
(2013). Anxiety, sensory over-responsivity, and gastrointesti-
nal problems in children with autism spectrum disorders.
Journal of Abnormal Child Psychology, 41, 165–176.
doi:10.1007/s10802-012-9668-x
McIntosh, D.N., Miller, L.J., & Shyu, V. (1999a). Development
and validation of the short sensory profile. In W. Dunn (Ed.),
Sensory profile: User’s manual (pp. 59–73). San Antonio, TX:
The Psychological Corporation.
McIntosh, D.N., Miller, L.J., Shyu, V., & Hagerman, R.J. (1999b).
Sensory-modulation disruption, electrodermal responses, and
functional behaviors. Developmental Medicine & Child Neu-
rology, 41, 608–615.
Miller, L.J., Anzalone, M.E., Lane, S.J., Cermak, S.A., & Osten,
E.T. (2007). Concept evolution in sensory integration: A pro-
posed nosology for diagnosis. The American Journal of Occu-
pational Therapy, 61, 135–140. doi:10.5014/ajot.61.2.135
Mullen, E. (1995). Mullen scales of early learning. Circle Pines,
MN: American Guidance Service.
Reynolds, S., Bendixen, R., Lawrence, T., & Lane, S. (2011). A
pilot study examining activity participation, sensory respon-
siveness, and competence in children with high functioning
Autism Spectrum Disorder. Journal of Autism and Develop-
mental Disorders, 41, 1496–1506. doi:10.1007/s10803-010-
1173-x
Rogers, S.J., & Ozonoff, S. (2005). Annotation: What do we know
about sensory dysfunction in autism? A critical review of the
empirical evidence. Journal of Child Psychology and Psychia-
try, 46, 1255–1268.
Roid, G. (2003). Stanford–Binet Intelligence Scales (5th ed.).
Itasca, IL: Riverside Publishing.
INSAR
Sober, S.J., & Sabes, P.N. (2003). Multisensory integration during
motor planning. The Journal of Neuroscience, 23, 6982–
6992.
Tomchek, S.D., & Dunn, W. (2007). Sensory processing in chil-
dren with and without autism: A comparative study using the
short sensory profile. The American Journal of Occupational
Therapy, 61, 190–200.
Zhong, S., & Ghosh, J. (2003). A unified framework for model-
based clustering. Journal of Machine Learning Research, 4,
1001–1037.

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