Evidence for decreased parasympathetic response to a novel peer interaction in older children with autism spectrum disorder: a case-control study

Abstract

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.

Autism Spectrum Disorder in Children Is Not Associated With Abnormal Autonomic Nervous System Function: Hypothesis and Theory

“…Kushki et al ( 27 ) and Muscatello et al ( 30 ) did not observe baseline RSA differences. Corbett et al reported that children with ASD did not show poor autonomic regulation during social interaction with novel peers, based on similar RSA values ( 31 ).…”

“…Muscatello et al ( 30 ) studied the pre-ejection period, and no difference was found related to social tasks. However, the pre-ejection period is a measure of ventricular contractility and is not a good measure of general sympathetic functioning ( 59 ).…”

“…Muscatello et al ( 30 ) exposed participants to a social interaction protocol, the Trier Social Stress Test-Friendly (TSST-F). The data show that “ASD and typically developing youth did not differ in mean RSA or RSA responsivity during the TSST-F paradigm when controlling for age.” Instead of giving the study the title that no evidence of autonomic dysfunction was found, the title became “Evidence for decreased parasympathetic response to a novel peer interaction in older children with autism spectrum disorder.” The term “decreased parasympathetic” does not appear in the study itself; instead, the term “blunted” is used; however, no statistical differences were found.…”

“…Some persons with ASD might find mental tasks relaxing, or it may be related to the functioning of the amygdala ( 35 ). Interestingly, Muscatello et al ( 30 ) studied the effect of social interactions to promote a relaxing environment. Indeed, the RSA increased, but did so similarly in the control and the ASD group.…”

Altered interpersonal distance regulation in autism spectrum disorder

“…An invention in our experimental design is that we combined interpersonal distance measurement with heart rate registration. In social behaviour parasympathetic regulation, the flexibility of vagal tone plays an important role according to Porges' polyvagal theory (Muscatello et al, 2021;Porges, 2003Porges, , 2009. Resting high-frequency HRV was found to be associated with cooperative behaviour, using less disengagement and more socially adaptive emotion regulation strategies among healthy adults (Beffara et al, 2016;Geisler et al, 2013).…”