Decreased interoceptive accuracy in children with autism spectrum disorder and with comorbid attention deficit/hyperactivity disorder

Interoception refers to the awareness of internal physiological state. Several previous studies reported that people with autism spectrum disorders (ASD) and adults with attention-deficit/hyperactivity disorder (ADHD) have diverse patterns of interoception, but the extent of literature is limited and inconsistent. This study aimed to investigate the interoceptive accuracy (IA) in children with ASD, children with comorbid ASD and ADHD, and typically developing (TD) children with high and low levels of autistic traits. We administered the eye-tracking interoceptive accuracy task (EIAT) to 30 children with ASD, 20 children with comorbid ASD and ADHD, and 63 TD controls with high and low levels of autistic traits. Parent-report scales concerning ASD and ADHD symptoms were collected. ASD children with and without comorbid ADHD both exhibited lower IA than TD children. Reduced IA was also found in TD children with high-autistic traits relative to those with low-autistic traits. IA was negatively correlated with autistic and ADHD symptoms. Atypical cardiac interoception could be found in children with ASD. Difficulties in sensing and comprehending internal bodily signals in childhood may be related to both ASD and ADHD symptoms. Lay Summary: The present study examined interoceptive accuracy (IA) in children with autism spectrum disorders (ASD), children with comorbid ASD and attention-deficit/hyperactivity disorder (ADHD), and typically developing (TD) children with high and low levels of autistic traits. ASD children with and without comorbid ADHD both exhibited lower IA than TD children. TD children with high-autistic traits exhibited decreased IA compared to those with low-autistic traits. These results have implications for understanding sensory atypicality found in ASD and ADHD.