A systematic review of cardiac autonomic reactivity to face-to-face social stressor stimuli in children and adolescents with autism spectrum disorder

Background

Research suggests that individuals with autism spectrum disorder (ASD) exhibit heightened responses to social stressors, putting them at higher risk to psychopathology. However, the findings are inconsistent. Considering the unavoidable social interactions in daily life, synthesizing the literature on physiological reactivity to social stressor stimuli in individuals with ASD is crucial.

Aims

To investigate the cardiac autonomic reactivity to face-to-face social stressor stimuli in children and adolescents with ASD.

Methods

Literature was identified from four databases and grey literature. The inclusion criteria were children and youth with ASD aged 18 or below, social stimuli that occurred face-to-face, and physiological measures of cardiac autonomic reactivity.

Results

Twenty studies were included, with a sample size of 1064 (548 ASD samples). Five unique measures were reported. A preliminary pattern of blunted respiratory sinus arrhythmia (RSA) reactivity was found in ASD compared to the typically developing (TD) individuals. Interestingly, a pattern of higher or no significant differences in heart rate (HR) responses in ASD compared to TD was noted when a familiar person was used, but blunted when a novel person was used.

Conclusions

Atypical cardiac autonomic reactivity in ASD was demonstrated with contrasting responses depending on familiarity. Implications for interventions are discussed.