Assessment and Treatment of Anxious Avoidant Responses to Auditory Stimuli via Physiological and Behavioral Methodologies

Abstract

Avoidance of specific sensory stimuli is commonly reported in autistic individuals, which can significantly impact functioning. In practice, clinicians often rely on dubious therapies for treatment of avoidant responses (e.g., sensory integration therapy). Methodologically, clinicians and researchers have relied solely on direct observations to identify the assumed stimuli and associated overt concerning behavior via single-case designs and verbal reports, as internal responding is often difficult to objectively measure. The current study examined the anxious avoidant responses to auditory stimuli and the associated concerning behavior of a 13-year-old male diagnosed with ASD, specifically to sounds of food consumption. An antecedent analysis was conducted alongside a treatment analysis using both direct behavioral observation and galvanic skin response to measure both overt behavioral and autonomic responding. Treatment analysis resulted in reductions in both concerning behavior (68% reduction) and autonomic nervous system activation (47% reduction) with implementation of a behaviorally based intervention package combining progressive relaxation training with competing preferred activities. The convergent validity between behavioral and physiological measures supports the integration of objective physiological measurement with traditional behavioral assessment methods.