Respiratory sinus arrhythmia and auditory processing in autism: Modifiable deficits of an integrated social engagement system?
Open accessAbstract
The current study evaluated processes underlying two common symptoms (i.e., state regulation problems and deficits in auditory processing) associated with a diagnosis of autism spectrum disorders. Although these symptoms have been treated in the literature as unrelated, when informed by the Polyvagal Theory, these symptoms may be viewed as the predictable consequences of depressed neural regulation of an integrated social engagement system, in which there is down regulation of neural influences to the heart (i.e., via the vagus) and to the middle ear muscles (i.e., via the facial and trigeminal cranial nerves). Respiratory sinus arrhythmia (RSA) and heart period were monitored to evaluate state regulation during a baseline and two auditory processing tasks (i.e., the SCAN tests for Filtered Words and Competing Words), which were used to evaluate auditory processing performance. Children with a diagnosis of autism spectrum disorders (ASD) were contrasted with aged matched typically developing children. The current study identified three features that distinguished the ASD group from a group of typically developing children: 1) baseline RSA, 2) direction of RSA reactivity, and 3) auditory processing performance. In the ASD group, the pattern of change in RSA during the attention demanding SCAN tests moderated the relation between performance on the Competing Words test and IQ. In addition, in a subset of ASD participants, auditory processing performance improved and RSA increased following an intervention designed to improve auditory processing.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The Safe and Sound Protocol stimulates the ventral vagal complex to calm autonomic state, improve auditory processing, and stimulate spontaneous social behavior.
“The Safe and Sound Protocol™ stimulates the ventral vagal complex to calm autonomic state, improve auditory processing, and stimulate spontaneous social behavior [[26], [27], [28], [29]].”
From The vagal paradox: A polyvagal solution (2023) · cites this paper as [26]
The Methods (§2.3.2) describe the intervention as the Listening Project Protocol, and the Results (§3.2) report improved auditory processing and increased respiratory sinus arrhythmia, a measure of vagal influence on the heart. The paper presents calming state regulation and social engagement as parts of a theoretical model, but does not establish direct stimulation of the ventral vagal complex or report that the intervention increased spontaneous social behavior. Its Discussion (§4.6) also cautions that the intervention findings are preliminary and not from a randomized trial. Page numbers were not supplied in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredLiterature findings on respiratory sinus arrhythmia in autism spectrum disorder are divergent, with some studies reporting significantly reduced respiratory sinus arrhythmia and others finding no atypicalities.
“Literature findings on this issue are divergent, with a number of studies reporting significantly reduced RSA [11-14], and others finding no atypicalities [47,62].”
From Functional autonomic nervous system profile in children with autism spectrum disorder (2014) · cites this paper as [13]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Porges, S. W. (2007) · Biological Psychology · doi:10.1016/j.biopsycho.2006.06.009 · Cited by 3,415 · see citing works
Self-citationMediators and Moderators of Treatment Effects in Randomized Clinical Trials
Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.10.877 · Cited by 2,562 · cited 1× · see citing works
“Moderation analysis is a methodology that statistically defines the relationship between two variables as a function of a third variable (Kraemer et al., 2002).”
PORGES, S. W. (1995) · Psychophysiology · doi:10.1111/j.1469-8986.1995.tb01213.x · Cited by 1,624 · see citing works
Self-citationThe polyvagal theory: phylogenetic substrates of a social nervous system.
Porges, S. W. (2001) · International Journal of Psychophysiology · doi:10.1016/s0167-8760(01)00162-3 · Cited by 1,582 · see citing works
Self-citation(2011) · Cited by 1,181 · see citing works
Principles of psychophysiology : physical, social, and inferential elements
Cacioppo, J. T., & Tassinary, L. G. (1990) · Cambridge University Press eBooks · Cited by 780 · see citing works
Bal, E., Harden, E., Lamb, D., Van Hecke, A. V., Denver, J. W., & Porges, S. W. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0884-3 · Cited by 575 · see citing works
Self-citationCarpenter's Human Neuroanatomy
Parent, A., & Carpenter, M. B. (1996) · Medical Entomology and Zoology · Cited by 561 · see citing works
Social Engagement and Attachment: A Phylogenetic Perspective
PORGES, S. W. (2003) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1301.004 · Cited by 472 · see citing works
Self-citationA Five- to Fifteen-Year Follow-up Study of Infantile Psychosis
Lockyer, L., & Rutter, M. L. (1969) · The British Journal of Psychiatry · doi:10.1192/bjp.115.525.865 · Cited by 407 · see citing works
The orbitofrontal-amygdala circuit and self-regulation of social-emotional behavior in autism
Bachevalier, J., & Loveland, K. A. (2006) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2005.07.002 · Cited by 402 · see citing works
Attention and information Processing in infants and Adults
Campbell, B. A., Hayne, H., Richardson, R., & Campbell, B. A. (2014) · Psychology Press eBooks · doi:10.4324/9781315807355 · Cited by 374 · see citing works
Love: An emergent property of the mammalian autonomic nervous system
W. Porges, S. (1998) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(98)00057-2 · Cited by 354 · see citing works
Handbook of Autism and Pervasive Developmental Disorders
LEVENTHAL, B. L., & Cook, E. H. (1988) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198803000-00032 · Cited by 332 · see citing works
Lewis, G. F., Furman, S. A., McCool, M. F., & Porges, S. W. (2012) · Biological Psychology · doi:10.1016/j.biopsycho.2011.11.009 · Cited by 264 · see citing works
Self-citationAttention and cognitive control: Unfolding the dichotic listening story
Hugdahl, K., Westerhausen, R., Alho, K., Medvedev, S. V., Laine, M., & Hämäläinen, H. (2008) · Scandinavian Journal of Psychology · doi:10.1111/j.1467-9450.2008.00676.x · Cited by 247 · see citing works
Reduced cardiac parasympathetic activity in children with autism
Ming, X., Julu, P. O. O., Brimacombe, M., Connor, S., & Daniels, M. L. (2005) · Brain and Development · doi:10.1016/j.braindev.2005.01.003 · Cited by 245 · see citing works
Autonomic regulation and attention.
Porges, S. W. (1992) · Cited by 189 · see citing works
Self-citationVan Hecke, A. V., Lebow, J., Bal, E., Lamb, D., Harden, E., Kramer, A., Denver, J., Bazhenova, O., & Porges, S. W. (2009) · Child Development · doi:10.1111/j.1467-8624.2009.01320.x · Cited by 173 · see citing works
Self-citationSpectral Analysis of Sinus Arrhythmia: A Measure of Mental Effort
Vicente, K. J., Thornton, D. C., & Moray, N. P. (1987) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1177/001872088702900205 · Cited by 168 · see citing works
Feldman, R. (2000) · Infant Mental Health Journal · doi:10.1002/1097-0355(200007)21:3 · Cited by 155 · see citing works
Patriquin, M. A., Scarpa, A., Friedman, B. H., & Porges, S. W. (2013) · Developmental Psychobiology · doi:10.1002/dev.21002 · Cited by 149 · see citing works
Self-citationPsychophysiology of cardiovascular control: models, methods and data
(1987) · Comparative Biochemistry and Physiology Part A Physiology · doi:10.1016/0300-9629(87)90307-0 · Cited by 134 · see citing works
Calkins, S. D., Graziano, P. A., Berdan, L. E., Keane, S. P., & Degnan, K. A. (2008) · Developmental Psychobiology · doi:10.1002/dev.20344 · Cited by 127 · see citing works
Vagal regulation and emotional intensity predict children's sleep problems
El‐Sheikh, M., & Buckhalt, J. A. (2005) · Developmental Psychobiology · doi:10.1002/dev.20066 · Cited by 122 · see citing works
(2010) · Handbook of Behavioral Neuroscience · doi:10.1016/b978-0-12-374593-4.00025-5 · Cited by 120 · see citing works
Borg, E., & Counter, S. A. (1989) · Scientific American · doi:10.1038/scientificamerican0889-74 · Cited by 119 · see citing works
Restricted autonomic flexibility in children with social phobia
Schmitz, J., Krämer, M., Tuschen‐Caffier, B., Heinrichs, N., & Blechert, J. (2011) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02417.x · Cited by 116 · see citing works
Cardiac Vagal Regulation and Early Peer Status
Graziano, P. A., Keane, S. P., & Calkins, S. D. (2007) · Child Development · doi:10.1111/j.1467-8624.2007.00996.x · Cited by 99 · see citing works
Listening Preferences in Regard to Speech in Four Children with Developmental Disabilities
Klin, A. (1992) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1992.tb00911.x · Cited by 72 · see citing works
RINIOLO, T., & PORGES, S. W. (1997) · Psychophysiology · doi:10.1111/j.1469-8986.1997.tb01748.x · Cited by 59 · see citing works
Self-citationAtrioventricular conduction versus heart size from mouse to whale
MEIJLER, F. L. (1985) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(85)80060-7 · Cited by 48 · see citing works
Autonomic regulation in fragile X syndrome
Heilman, K. J., Harden, E. R., Zageris, D. M., Berry‐Kravis, E., & Porges, S. W. (2011) · Developmental Psychobiology · doi:10.1002/dev.20551 · Cited by 42 · see citing works
Self-citationAttachment and emotional responsiveness in children with autism
Dissanayake, C., & Sigman, M. (2000) · International review of research in mental retardation · doi:10.1016/s0074-7750(00)80013-0 · Cited by 38 · see citing works
AUDITORY ABNORMALITIES IN AUTISTIC CHILDREN
Hayes, R. W., & Gordon, A. G. (1977) · The Lancet · doi:10.1016/s0140-6736(77)90278-1 · Cited by 34 · see citing works
Sluggish vagal brake reactivity to physical exercise challenge in children with selective mutism
Heilman, K. J., Connolly, S. D., Padilla, W. O., Wrzosek, M. I., Graczyk, P. A., & Porges, S. W. (2012) · Development and Psychopathology · doi:10.1017/s0954579411000800 · Cited by 31 · see citing works
Self-citationMeasures of infant behavioral and physiological state regulation predict 54‐month behavior problems
Dale, L. P., O’Hara, E. A., Schein, R., Inserra, L., Keen, J., Flores, M., & Porges, S. W. (2011) · Infant Mental Health Journal · doi:10.1002/imhj.20306 · Cited by 28 · see citing works
Self-citationCardiovascular Regulation Profile Predicts Developmental Trajectory of BMI and Pediatric Obesity
Graziano, P. A., Calkins, S. D., Keane, S. P., & O’Brien, M. (2011) · Obesity · doi:10.1038/oby.2011.98 · Cited by 24 · see citing works
(1996) · Neurology · doi:10.1212/wnl.47.1.316 · Cited by 17 · see citing works
The Scandinavian Journal of Psychology is turning 50!
Rönnberg, J. (2009) · Scandinavian Journal of Psychology · doi:10.1111/j.1467-9450.2008.00696.x · Cited by 1 · see citing works
Porges (1996) · doi:10.1002/(sici)1098-2302(199612)29:8
Flagged first, then by citations
Research works printed but not linked: 2
- Degangi GA Breinbauer C Doussard-Roosevelt J Porges SW Greenspan S 2000 Prediction of childhood problems at three years in children experiencing disorders of regulation during infancy Infant Mental Health Journal 21 156 175
- Porges SW Bauman ML Kemper TL 2005 The vagus: A mediator of behavioral and visceral features associated with autism The Neurobiology of Autism 65 78 Baltimore Johns Hopkins University Press
Cited by
Sorted by citations
Lehrer, P., Kaur, K., Sharma, A., Shah, K., Huseby, R., Bhavsar, J., Sgobba, P., & Zhang, Y. (2020) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-020-09466-z · Cited by 469 · see citing works
Comorbidity clusters in autism spectrum disorders: an electronic health record time-series analysis
Doshi-Velez, F., Ge, Y., & Kohane, I. (2014) · Pediatrics · doi:10.1542/peds.2013-0819 · Cited by 412 · see citing works
Polyvagal Theory: A Science of Safety
Porges, S. W. (2022) · Frontiers in Integrative Neuroscience · doi:10.3389/fnint.2022.871227 · Cited by 399 · see citing works
Self-citationCabrera, A., Kolacz, J., Pailhez, G., Bulbena‐Cabre, A., Bulbena, A., & Porges, S. W. (2018) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1596 · Cited by 224 · see citing works
Self-citationFunctional 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
“Baseline differences Previous literature on cardiac measures of ANS have reported either hyperarousal [10-13,62] or no baseline atypicalities in ASD [47].”
BackgroundResultPolyvagal theory: A biobehavioral journey to sociality
Porges, S. W. (2021) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2021.100069 · Cited by 142 · see citing works
Heart Rate Variability in Individuals with Autism Spectrum Disorders: a Meta-analysis
Cheng, Y.-C., Huang, Y.-C., & Huang, W.-L. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.08.007 · Cited by 125 · see citing works
Autonomic response in autism spectrum disorder: relationship to social and cognitive functioning
Patriquin, M. A., Hartwig, E. M., Friedman, B. H., Porges, S. W., & Scarpa, A. (2019) · Biological Psychology · doi:10.1016/j.biopsycho.2019.05.004 · Cited by 86 · see citing works
Self-citationPanju, S., Brian, J., Dupuis, A., Anagnostou, E., & Kushki, A. (2015) · Molecular Autism · doi:10.1186/s13229-015-0057-5 · Cited by 79 · see citing works
Autism spectrum disorder is associated with autonomic underarousal
BUJNAKOVA, I., ONDREJKA, I., MESTANIK, M., VISNOVCOVA, Z., MESTANIKOVA, A., HRTANEK, I., FLESKOVA, D., CALKOVSKA, A., & TONHAJZEROVA, I. (2016) · Physiological Research · doi:10.33549/physiolres.933528 · Cited by 75 · see citing works
The vagal paradox: A polyvagal solution
Porges, S. W. (2023) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2023.100200 · Cited by 52 · see citing works
“The Safe and Sound Protocol ™ stimulates the ventral vagal complex to calm autonomic state, improve auditory processing, and stimulate sponta-neous social behavior [26 – 29].”
BackgroundSelf-citationChildren with autism show altered autonomic adaptation to novel and familiar social partners
Neuhaus, E., Bernier, R. A., & Beauchaine, T. P. (2016) · Autism Research · doi:10.1002/aur.1543 · Cited by 50 · see citing works
Thapa, R., Pokorski, I., Ambarchi, Z., Thomas, E., Demayo, M., Boulton, K., Matthews, S., Patel, S., Sedeli, I., Hickie, I. B., et al. (2021) · Autism Research · doi:10.1002/aur.2437 · Cited by 44 · see citing works
Chiu, H. T., Ip, I. N., Ching, F. N. Y., Wong, B. P.-H., Lui, W.-H., Tse, C.-S., & Wong, S. W. H. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05847-x · Cited by 32 · see citing works
Kolacz, J., Lewis, G. F., & Porges, S. W. (2018) · Handbook of Behavioral Neuroscience · doi:10.1016/b978-0-12-809600-0.00003-2 · Cited by 28 · see citing works
Self-citationAutonomic responses to head-up tilt test in children with autism spectrum disorders
Bricout, V.-A., Pace, M., Dumortier, L., Favre-Juvin, A., & Guinot, M. (2018) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-017-0339-9 · Cited by 25 · see citing works
Barbier, A., Chen, J.-H., & Huizinga, J. D. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.830234 · Cited by 24 · see citing works
Kuiper, M. W. M., Verhoeven, E. W. M., & Geurts, H. M. (2016) · Autism Research · doi:10.1002/aur.1631 · Cited by 11 · see citing works
- Authors
- Porges, S. W., Macellaio, M., Stanfill, S. D., McCue, K., Lewis, G. F., Harden, E. R., Handelman, M., Denver, J., Bazhenova, O. V., & Heilman, K. J.
- Affiliations
- RTI International (US)
- University of Illinois Chicago (US)
- Corresponding author
- Porges, Stephen W.
- Venue
- International Journal of Psychophysiology
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 88
- Issue
- 3
- Pages
- 261-270
- ISSN
- 0167-8760 (ISSN-L)
- PMC
- PMC3610863
- OpenAlex
- W2138175906
- Cited by
- 120
- References
- 41
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 15 · 2020: 9 · 2019: 7 · 2018: 11 · 2017: 12 · 2016: 14 · 2015: 6 · 2014: 7 · 2013: 5
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- International Journal of Psychophysiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (MH060625, R01MH060625)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Keywords
- respiratory sinus arrhythmia, autism spectrum disorder, auditory processing, polyvagal theory, heart period, government regulation, scan-based testing, vagus nerve, middle ear muscles, children, IQ, intervention
- MeSH terms
- Acoustic Stimulation, Adolescent, Arrhythmia, Sinus, Auditory Perception, Autistic Disorder, Child, Female, Humans, Male, Social Behavior, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
