Influence of loud auditory noise on postural stability in autistic children: an exploratory study

Abstract

Autistic children often experience sensory processing challenges and postural instability. While auditory noise has been reported to improve balance in various populations, its effects in autistic children remain unclear. This study examined whether auditory noise could similarly influence balance in this population. Sixteen autistic and sixteen typically developing (TD) children aged 6-12 years performed a tandem stance task with and without auditory noise. Postural stability was assessed via stance duration and center of pressure (CoP) velocity. Sensory processing difficulties were evaluated using a parent-report questionnaire. Autistic children stood longer in the presence of auditory noise, while all TD children reached the maximum duration regardless of condition. A reduction in CoP velocity with auditory noise was observed across both groups. Although postural stability was correlated with sensory processing difficulties, the effect of auditory noise was not. These findings suggest that the beneficial effect of auditory noise on postural stability is applicable to autistic children, regardless of individual sensory processing profiles. This exploratory study highlights the potential of sensory-based interventions to support postural control in autism. Future research with larger samples is needed to confirm these findings and to identify the auditory stimulus characteristics that most effectively improve balance in autistic individuals.

Keywords: Auditory noise; Autism spectrum disorder; Postural control; Sensory processing; Stochastic resonance.

Fig. 1

Experimental setup. Illustration of the setup used to measure postural sway under NORMAL and NOISE conditions.

Fig. 2

Power spectral density of the auditory stimulus. The power spectral density of the rain sound stimulus (5,760,000 samples, 48 kHz sampling rate) was computed using a periodogram implemented in MATLAB 2024b. The stimulus exhibits broad spectral content in the low-frequency range.

Fig. 3

Two-dimensional CoP profiles for a representative child in the ASD group. Raw CoP trajectories are shown for the NORMAL (a) and NOISE (d) conditions. Corresponding low-frequency (< 0.3 Hz) components are shown in panels (b) and (e), and high-frequency (> 0.3 Hz) components in panels (c) and (f).

Fig. 4

Group-level CoP velocity under NORMAL and NOISE conditions. Mean CoP velocity for ASD (red) and TD (black) children along the anterior–posterior (AP) direction, separated into low- (a) and high-frequency (b) components, and along the medial–lateral (ML) direction in panels (c) and (d). Error bars represent the standard errors of the mean.

Fig. 5

Correlation between sensory processing scores and postural sway. Sensory processing difficulty was assessed using the SPM sensory total t-score. CoP velocity of the low-frequency component is shown for the NORMAL (a), NOISE (b) conditions, and the difference between the two (NORMAL − NOISE) (c) across the TD (black circles) and ASD (red circles) groups (n = 32). The blue dotted lines represent 95% confidence intervals.

Fig. 6

Comparison of CoP velocity in the NOISE condition within ASD subgroups. Children were grouped by SPM-2 hearing processing difficulty into moderate (n = 8) and severe (n = 7) subgroups. Panels (a) and (b) show CoP velocity along the AP direction for low- and high-frequency components, respectively; panels (c) and (d) show the same measures along the ML direction. Error bars denote the standard errors of the mean.