Evidence for decreased parasympathetic response to a novel peer interaction in older children with autism spectrum disorder: a case-control study
Open accessAbstract
BACKGROUND: Individuals with autism spectrum disorder (ASD) often experience elevated stress during social interactions and may have difficulty forming and maintaining peer relationships. The autonomic nervous system (ANS) directs physiological changes in the body in response to a number of environmental stimuli, including social encounters. Evidence suggests the flexibility of the ANS response is an important driving factor in shaping social behavior. For youth with ASD, increased stress response and/or atypical ANS regulation to benign social encounters may therefore influence social behaviors, and, along with developmental and experiential factors, shape psychological outcomes. METHODS: The current study measured ANS response to a peer-based social interaction paradigm in 50 typically developing (TD) children and 50 children with ASD (ages 10-13). Respiratory sinus arrhythmia (RSA), a cardiac measure of parasympathetic influence on the heart, and pre-ejection period (PEP), a sympathetic indicator, were collected. Participants engaged in a friendly, face-to-face conversation with a novel, same-aged peer, and physiological data were collected continuously before and during the interaction. Participants also reported on state anxiety following the interaction, while parents reported on the child's social functioning and number of social difficulties. RESULTS: Linear mixed models revealed that, while there were no diagnostic effects for RSA or PEP, older youth with ASD appeared to demonstrate a blunted parasympathetic (RSA) response. Further, increased severity of parent-reported social symptoms was associated with lower RSA. Youth with ASD reported more anxiety following the interaction; however, symptoms were not related to RSA or PEP response based on linear mixed modeling. CONCLUSIONS: Physiological regulation, age, and social functioning likely influence stress responses to peer interactions for youth with ASD. Parasympathetic functioning, as opposed to sympathetic arousal, may be especially important in behavioral regulation, as older youth with ASD demonstrated atypical regulation and response to the social interaction paradigm. Future studies should help to further elucidate the developmental factors contributing to stress responses in ASD, the impact of physiological response on observable social behavior, and potential long-term consequences of chronic social stress in youth with ASD.
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When RSA goes up in response to a positive, relaxing intervention, it does so similarly in controls and children with ASD.
“Interestingly, when RSA goes up in response to a positive, relaxing intervention, it does so similarly in controls and children with ASD (30).”
From Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory (2022) · cites this paper as [30]
The Results (RSA regulation and responsivity; page not provided) report that ASD and typically developing youth did not differ in overall RSA response during the friendly peer-interaction protocol. But the Methods describe that interaction as a potential stressor for children with ASD, not a relaxing intervention, and the Discussion notes a blunted response in older youth with ASD. The claim therefore overgeneralizes the finding. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn most studies, the autonomic nervous system of children with ASD reacts to social stimuli in this normal manner, very similar to control groups.
“The fact is that in most studies, the autonomic nervous system of children with ASD reacts to social stimuli in this normal manner, very similar to control groups.”
From Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory (2022) · cites this paper as [30]
The Discussion (page unavailable) reports no overall diagnostic difference in RSA response to the study’s peer interaction, which supports similarity on that measure. It also reports reduced parasympathetic response in older youth with ASD, while the Background describes several earlier studies finding atypical autonomic responses. The paper does not establish that children with ASD respond similarly to controls in most studies. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMuscatello et al. found no difference in pre-ejection period related to social tasks.
“Muscatello et al. (30) studied the pre-ejection period, and no difference was found related to social tasks.”
From Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory (2022) · cites this paper as [30]
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- Authors
- Muscatello, R. A., Vandekar, S. N., & Corbett, B. A.
- Affiliations
- Vanderbilt University (US)
- Vanderbilt University Medical Center (US)
- Corresponding author
- Muscatello, Rachael A.
- Venue
- Journal of Neurodevelopmental Disorders
- Published
- 2021-01-09
- Volume
- 13
- Issue
- 1
- Pages
- 6-6
- ISSN
- 1866-1947 (ISSN-L)
- 1866-1955
- PMC
- PMC7797088
- OpenAlex
- W3120883516
- Cited by
- 23
- References
- 92
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 9
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Neurodevelopmental Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Autism Speaks (10616)
- National Institute of Mental Health (MH111599)
- National Center for Advancing Translational Sciences (UL1 TR000445)
- 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 › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- autism spectrum disorder, parasympathetic nervous system, autonomic nervous system, respiratory sinus arrhythmia, pre-ejection period, peer interaction, social stress, state anxiety, social functioning, children and adolescents, age differences, physiological regulation
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Autonomic Nervous System, Child, Humans, Social Behavior, Case-Control Studies, Respiratory Sinus Arrhythmia
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 ›
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