Deficits in sensory modulation have been linked clinically with impaired attention, arousal, and impulsivity for years, but a clear understanding of the relationship between sensory modulation disorders and attention deficit hyperactivity disorder (ADHD) has proven elusive. Our preliminary work suggested that patterns of salivary cortisol and electrodermal responsivity to sensation may be linked to different groups of children with ADHD; those with and without sensory over-responsivity (SOR). Additionally, SOR has been linked to anxiety, and anxiety has been linked to ADHD. A clearer understanding of the relationship between anxiety, SOR, and ADHD may support a better understanding of ADHD diagnostic subtypes. We examined neuroendocrine, electrodermal and behavioral characteristics and sought to predict group membership among 6- to 12-year-old children with ADHD and SOR (ADHDs), ADHD and no SOR (ADHDt), and typicals (TYP). Behavioral questionnaires were completed to document SOR and anxiety. Lab testing used a Sensory Challenge Protocol (SCP) with concurrent electrodermal measurement and the collection of cortisol prior to and following the SCP. Results substantiated links between SOR and anxiety, in both TYP and ADHD children. Results suggests that ADHD should be considered in conjunction with anxiety and sensory responsivity; both may be related to bottom-up processing differences, and deficits in prefrontal cortex/hippocampal synaptic gating.

Sleep problems have been frequently identified in children with autism spectrum disorders (ASD). It has been proposed that some sleep problems are due to sensory sensitivity. The purpose of this study was to examine the relationship between physiologic responses to sensation and sleep in children with and without ASD. Fifty-five children participated in the study (ASD, n = 27; typical, n = 28). All children participated in a sensory challenge laboratory protocol. Electrodermal reactivity and salivary cortisol were used as physiological indicators of sensory responsivity. Behavioral data were collected using the Sensory Profile and the Child Behavior Checklist. Results confirmed that children with ASD have a higher prevalence of atypical sensory behaviors and sleep disturbances than typical children. Behavioral and physiological measures were able to predict good sleepers versus poor sleepers with 85.7% accuracy, suggesting that atypical sensory behaviors are important to consider in relation to sleep deficits in children.

OBJECTIVE. Approximately 25% of children with attention deficit hyperactivity disorder (ADHD) have a comorbid anxiety disorder. The purpose of this study was to determine whether sensory overresponsivity (SOR) is related to elevated levels of anxiety in children with ADHD. METHOD. Twenty-four children ages 6 to 10 with ADHD and 24 children without ADHD participated in this study. All parents completed a Revised Children's Manifest Anxiety Scale (RCMAS) with their child. Children in the ADHD group were subdivided into ADHD + SOR and ADHD-only groups using the Sensory Over-Responsivity Inventory. RESULTS. Children in the ADHD + SOR group were significantly more anxious than both the ADHD-only and non-ADHD (control) groups. Children with ADHD + SOR were also more likely to have clinically significant anxiety (determined by total scores on the RCMAS). CONCLUSIONS. Occupational therapists treating children with ADHD and SOR should be aware that these children may also have anxiety and discuss options with families for prevention or treatment.