Children with autism show altered autonomic adaptation to novel and familiar social partners

Neuhaus, Emily; Bernier, Raphael A.; Beauchaine, Theodore P.

doi:10.1002/aur.1543

Cited by 50Autism Spectrum Disorder ResearchHeart Rate Variability and Autonomic ControlAction Observation and Synchronization

Children with autism show altered autonomic adaptation to novel and familiar social partners

Neuhaus, Emily, Bernier, Raphael A., Beauchaine, Theodore P.·2016·Autism Research

DOI 10.1002/aur.1543

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Abstract

Social deficits are fundamental to autism spectrum disorder (ASD), and a growing body of research implicates altered functioning of the autonomic nervous system (ANS), including both sympathetic and parasympathetic branches. However, few studies have explored both branches concurrently in ASD, particularly within the context of social interaction. The current study investigates patterns of change in indices of sympathetic (pre-ejection period; PEP) and parasympathetic (respiratory sinus arrhythmia; RSA) cardiac influence as boys (ages 8-11 years) with (N = 18) and without (N = 18) ASD engage in dyadic social interaction with novel and familiar social partners. Groups showed similar patterns of autonomic change during interaction with the novel partner, but differed in heart rate, PEP, and RSA reactivity while interacting with a familiar partner. Boys without ASD evinced decreasing sympathetic and increasing parasympathetic influence, whereas boys with ASD increased in sympathetic influence. Boys without ASD also demonstrated more consistent ANS responses across partners than those with ASD, with parasympathetic responding differentiating familiar and novel interaction partners. Finally, PEP slopes with a familiar partner correlated with boys' social skills. Implications include the importance of considering autonomic state during clinical assessment and treatment, and the potential value of regulation strategies as a complement to intervention programs aiming to support social cognition and behavior. Autism Res 2016, 9: 579-591. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

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Neuhaus et al. found that children with ASD had a normal heart rate and RSA response to interactions with a novel partner, indicating typical autonomic reactivity.
“Neuhaus et al. (49) found that, in contrast to their expectations, the children with ASD had a normal heart rate and RSA response to interactions with a novel partner, indicating typical autonomic reactivity (Figure 5).”
From Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory (2022) · cites this paper as [49]
Based on heart rate and RSA data, most children with autism do not display autonomic dysfunction.
“Based on heart rate and RSA data, most children with autism do not display autonomic dysfunction.”
From Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory (2022) · cites this paper as [49]

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“In youth with ASD especially, lower baseline RSA and blunted parasympathetic increase to social interaction have been related to the severity of social symptoms [24, 26, 29, 30, 79].”
Background
Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory
Barbier, A., Chen, J.-H., & Huizinga, J. D. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.830234 · Cited by 24 · see citing works
The implications of sympathetic and parasympathetic regulatory coordination for understanding child adjustment
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Comparison of Physiological and Biochemical Autonomic Indices in Children with and without Autism Spectrum Disorders
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“Autistic children exhibited an increased sympathetic activity, whereas TD children exhibited a decrease in sympathetic influence during social interaction with a familiar person [24].”
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Development and Parasympathetic Regulation in Male and Female Adolescents with Autism Spectrum Disorder: A Two-Timepoint Longitudinal Study
Muscatello, R. A., Pachol, A., Romines, A., Smith, I., & Corbett, B. A. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05664-2 · Cited by 21 · see citing works
Atypical Response to Affective Touch in Children with Autism: Multi-Parametric Exploration of the Autonomic System
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“However, the results were generally mixed with some studies showing children with ASD demonstrating lower resting and task-specific cardiac vagal activity (e.g., Guy et al., 2014; Neuhaus et al., 2016), whereas others found no significant group difference (e.”
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Autonomic nervous system responses to social stimuli among autistic individuals: A systematic review and meta‐analysis
Zadok, E., Golan, O., Michal Lavidor, B., & Gordon, I. (2023) · Autism Research · doi:10.1002/aur.3068 · Cited by 9 · see citing works
“Among autistic individuals, studies have reported lower baseline levels of RSA (Van Hecke et al., 2009), as well as reduced RSA reactivity in response to emotional facial expressions (Bal et al., 2010; Mathewson et al., 2011) and during social interactions (Neuhaus et al., 2016).”
Background
The Physiological and Clinical-Behavioral Effects of Heart Rate Variability Biofeedback in Adolescents with Autism: A Pilot Randomized Controlled Trial
Thoen, A., Alaerts, K., Prinsen, J., Steyaert, J. G., & Damme, T. V. (2024) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-024-09638-1 · Cited by 8 · see citing works
“Consequently, a training that specifically tar - gets the up-regulation of cardiac vagal modulation, such as HRVB (Lehrer & Gevirtz, 2014), is an interesting avenue for further exploration (Coulter et al., 2022; Matsushima et al., 2016; Neuhaus et al., 2016; Patriquin et al., 2014).”
Oxytocin and cardiometabolic interoception: Knowing oneself affects ingestive and social behaviors
Smith, J. A., Eikenberry, S. A., Scott, K. A., Baumer-Harrison, C., de Lartigue, G., de Kloet, A. D., & Krause, E. G. (2022) · Appetite · doi:10.1016/j.appet.2022.106054 · Cited by 8 · see citing works
Heart Rate Variability as a Translational Biomarker for Emotional and Cognitive Deficits
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Electrodermal activity spectral and nonlinear analysis – potential biomarkers for sympathetic dysregulation in autism
Višňovcová, Z., Ferencová, N., Grendár, M., Ondrejka, I., Olexova, L. B., Bujnakova, I., & Tonhajzerová, I. (2023) · General Physiology and Biophysics · doi:10.4149/gpb_2022011 · Cited by 7 · see citing works
Social context in stress and autism: comparing physiological profiles across two social paradigms in youth with and without autism spectrum disorder
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Behavioral and Autonomic Responses in Treating Children with High-Functioning Autism Spectrum Disorder: Clinical and Phenomenological Insights from Two Case Reports
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“More specifically, the PNS plays an important role in social functioning by innervating several organs in the face and in the neck and affecting various functions, including cardiac activity, which are related to social behavior and communication [18].”
Background
Auditory attention in autism spectrum disorder: An exploration of volumetric magnetic resonance imaging findings
Lalani, S. J., Duffield, T. C., Trontel, H. G., Bigler, E. D., Abildskov, T. J., Froehlich, A. L., Prigge, M. B. D., Travers, B. G., Anderson, J. S., Zielinski, B. A., et al. (2017) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2017.1373746 · Cited by 6 · see citing works
A Pilot Study of Responses to Interparental Conflict in Children with Autism Spectrum Disorder
Ekas, N. V., & Kouros, C. D. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04802-y · Cited by 6 · see citing works
Differences in cardiac vagal modulation and cortisol response in adolescents with and without Autism Spectrum Disorder
Thoen, A., Alaerts, K., Steyaert, J. G., Pleysier, S., & Damme, T. V. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102166 · Cited by 4 · see citing works
Strategic social decision making undergoes significant changes in typically developing and autistic early adolescents
Liu, W., Shah, N., Ma, I., & Rosenblau, G. (2024) · Developmental Science · doi:10.1111/desc.13463 · Cited by 6 · see citing works
Diagnostic and Physical Effects in Parasympathetic Response to Social Evaluation in Youth With and Without Autism Spectrum Disorder
Muscatello, R. A., Kim, A., Vandekar, S., & Corbett, B. A. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05224-0 · Cited by 4 · see citing works
Corneal confocal microscopy demonstrates sensory nerve loss in children with autism spectrum disorder
Khan, A., Kamal, M., Alhothi, A., Gad, H., Adan, M. A., Ponirakis, G., Petropoulos, I. N., & Malik, R. A. (2023) · PLoS ONE · doi:10.1371/journal.pone.0288399 · Cited by 4 · see citing works
Social Behavior Forecasts Moment‐to‐Moment Changes in RSA in Infants With Autism
Yurkovic‐Harding, J., Narayanan, V., & Bradshaw, J. L. (2026) · Developmental Science · doi:10.1111/desc.70196 · Cited by 2 · see citing works
Immediate effect of physical activity on the autonomic nervous system in individuals with autism spectrum disorders of different age groups: a randomised trial
Ahmed, M. M., Alawna, M., Youssef, A. S. A., Amin, W. M., Alajam, R. A., Morsy, W. E., Fayed, E., & Mohamed, A. A. (2024) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2023-001822 · Cited by 2 · see citing works
Pubertal developmental, body mass index, and cardiovascular autonomic function in children and adolescents with and without autism spectrum disorder: a four-time point accelerated longitudinal study
Muscatello, R. A., Cola, M., Vandekar, S., & Corbett, B. A. (2025) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-025-09602-y · Cited by 3 · see citing works
“Several studies have reported reduced cardiovascular parasympathetic regulation in autistic children (e.g., [75, 78, 107]), adolescents (e.g., [25, 35, 70–72]), and adults [62, 93, 96].”
Influential
The physiological and clinical-behavioral effects of HRV biofeedback in adolescents with autism: a pilot randomized controlled trialPreprint
Thoen, A., Alaerts, K., Prinsen, J., Steyaert, J. G., & Damme, T. V. (2023) · medRxiv · doi:10.1101/2023.05.31.23290775 · Cited by 2 · see citing works
“Consequently, a training that specifically targets the up-regulation of cardiac vagal modulation, such as HRVB (Lehrer & Gevirtz, 2014), is an interesting avenue for further exploration (Coulter et al., 2022; Matsushima et al., 2016; Neuhaus et al., 2016; Patriquin et al., 2014).”
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Two-week trampoline intervention improves anxiety and motor performance in children with autism spectrum disorder: A randomized controlled feasibility study
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Additional file 1 of Evidence for decreased parasympathetic response to a novel peer interaction in older children with autism spectrum disorder: a case-control study
Muscatello, R. A., Vandekar, S., & Corbett, B. A. (2021) · Figshare · doi:10.6084/m9.figshare.13550757

Evidence for decreased parasympathetic response to a novel peer interaction in older children with autism spectrum disorder: a case-control study
Muscatello, R. A., Vandekar, S. N., & Corbett, B. A. (2021) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-020-09354-x · Cited by 23 · see citing works
Social influences on autonomic arousal in autism spectrum disorders
Turner, C. K. (2014) · W. S. Hoole Special Collections Library Manuscript Collections
Autonomic nervous system responses to social stimuli among autistic individuals: A systematic review and meta‐analysis
Zadok, E., Golan, O., Michal Lavidor, B., & Gordon, I. (2023) · Autism Research · doi:10.1002/aur.3068 · Cited by 9 · see citing works
Functional autonomic nervous system profile in children with autism spectrum disorder
Kushki, A., Brian, J., Dupuis, A., & Anagnostou, E. (2014) · Molecular Autism · doi:10.1186/2040-2392-5-39 · Cited by 141 · see citing works
Physiological Response to Social Evaluative Threat in Adolescents with Autism Spectrum Disorder
Edmiston, E. K., Jones, R. M., & Corbett, B. A. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-2842-1 · Cited by 43 · see citing works

Authors: Neuhaus, E., Bernier, R. A., & Beauchaine, T. P.
Affiliations: Seattle Children's Research Institute (US)
University of Washington (US)
The Ohio State University (US)
Corresponding author: Neuhaus, Emily
ORCID: Neuhaus, Emily
Bernier, Raphael A.
Beauchaine, Theodore P.
Venue: Autism Research
Publisher: Wiley
Published: 2015-08-25
Volume: 9
Issue: 5
Pages: 579-591
ISSN: 1939-3792 (ISSN-L)
1939-3806
DOI: 10.1002/aur.1543
OpenAlex: W1557710221
Cited by: 50
References: 64
Citations by year: 2026: 1 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 4 · 2020: 9 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 4
FWCI: 2.41
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Autism Research (publishedVersion)
PubMed (publishedVersion)
Funders: Autism Speaks
Topics: Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Social Sciences › Psychology › Social Psychology › Action Observation and Synchronization
Keywords: autism spectrum disorder, autonomic nervous system, sympathetic nervous system, parasympathetic nervous system, pre-ejection period, respiratory sinus arrhythmia, heart rate reactivity, social interaction, dyadic interaction, social skills, children
MeSH terms: Autism Spectrum Disorder, Adaptation, Physiological, Arrhythmia, Sinus, Autonomic Nervous System, Child, Heart Rate, Humans, Male, Social Behavior, Recognition, Psychology

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Children with autism show altered autonomic adaptation to novel and familiar social partners

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