Les anomalies sensorielles sont désormais reconnues comme des symptômes-clés dans les troubles du spectre autistique (TSA), et sont reprises pour la première fois dans les critères diagnostiques internationaux du DSM-5. Leur importance clinique est illustrée par les témoignages des parents et des personnes présentant un TSA, ainsi que par les nombreuses études qui se sont intéressées au cours des dernières années à cette question sous différents angles. Plusieurs modèles explicatifs de l’autisme se sont développés à partir des atypies de la perception sensorielle relevées dans les TSA. Dans cet article, nous parcourons les données épidémiologiques, cliniques et neurophysiologiques sur ce sujet dans le but de donner une image d’ensemble des connaissances actuelles. Nous relevons la grande variabilité qui caractérise ces symptômes, tant d’un individu à l’autre qu’au fil du temps. Les mécanismes physiologiques et biologiques sous-jacents n’en sont pas encore élucidés. Dans un deuxième temps, nous discutons l’articulation de ces données avec les principaux modèles explicatifs des TSA basés sur la perception. Certains de ces modèles nous paraissent prometteurs : ils prennent en compte la complexité et la variabilité des présentations cliniques des TSA tout en proposant des hypothèses concernant les processus neurobiologiques sous-jacents. Enfin, nous abordons les pistes d’explorations futures, notamment avec la recherche translationnelle.

Since the publication of the Diagnostic and Statistical Manual of mental disorders: DSM-5, sensory processing anomalies have for the first time been identified as diagnostic criteria in the international classification and thus been recognized as part of the core symptoms in autism spectrum disorders (ASDs). Their clinical relevance and their critical importance for the patients is underlined by numerous first-person accounts, and many recent studies have investigated their epidemiology as well as their behavioral and neurophysiological links with the other core symptoms of ASDs. In the past years, several explanatory models of autism have been developed in relation with the atypical sensory processing features found in these disorders.

In this article, we summarize the research data about sensory anomalies in ASDs with regard to epidemiology, clinical presentations, and neurophysiology. We then summarize the latest explanatory theories based on perception in autism, and discuss the implications of the recent data in relation with them, as well as the latest research directions.

Sensory anomalies in ASDs are characterized by the variability of their presentation and of their clinical impact, not only between individuals but also in time. At present the underlying physiological mechanisms and their relation with the other core symptoms in autism are not fully understood, but much progress has been made in the last years, as research focus on these anomalies has been increasing. Several models show interesting perspectives for explaining atypical sensory processing as well as other core symptoms in ASDs. Some could account for the complexity and clinical features variability of the autism spectrum, as well as provide indications for underlying neurological processes and even treatment possibilities.

More research is needed in order to verify the validity of these models and hopefully to unify the perception of the underlying mechanisms leading to ASDs. Translational approaches are especially of a great interest, as we will need to understand the links between the behavioral clinical aspects, the neurological functioning, the molecular processes and the genetical substratum. But it will also be necessary to continue reflecting on the very definition of what we call ASDs with every new step in our knowledge about these complex disorders.