Poster #25 - A Systematic Review of Cardiac Autonomic Reactivity to Face-to-Face Stressor Stimuli in Autism Spectrum Disorder

• In Event: Poster Session 09

Abstract

Abstract:
Individuals with autism spectrum disorder (ASD) exhibit heightened sensitivity in their stress responses. Face-to-face social stressor stimuli particularly worth our attention due to the challenges inherent in ASD. All papers were screened following our recently published protocol. Twenty-three articles were included and implications were discussed.
1. Introduction
The activation of the autonomic nervous system (ANS) is commonly measured by cardiac autonomic functioning such as heart rate (HR) and respiratory sinus arrhythmia (RSA). The activation of the ANS deserves our attention due to its role as a primary behavioral regulator (Porges, 2001). Although some literature have found that the ANS is disrupted in ASD, findings are complicated by methodological differences. Since direct gaze can influence autonomic arousal whereas indirect gaze cannot (Hietanen et al., 2008), this review specifically includes face-to-face study design in which participants were required to be in direct contact with a live person. This is the first systematic review which investigates the cardiac autonomic reactivity to face-to-face stressor stimuli in ASD.
2. Methods
The primary literature sources were across four electronic databases (Figure 1). The second source of literature was across grey literature.
2.1. Participants: We included any studies with children and adolescents with ASD, with sample between 0 and 18 years of age.
2.2. Interventions and comparators: All types of face-to-face social stressor interventions were included.
2.3. Outcomes of interest: The outcome of interest included studies with physiological activity of the participants being measured using cardiac autonomic related measures.
2.4. Methodological quality assessment
Since existing quality assessment instruments are not suitable for non-interventional psychophysiological research studies, the quality assessment used by a study (Lydon et al., 2016) was very suitable after careful consideration.
2.5. Software considerations
Identified records were imported into Covidence where duplicates were removed.
3. Results
The analysis is still undergoing. Some examples can be found in table 1. The table with complete results will be provided at the conference.
3.1. Sample Characteristics
The total sample size was 1245, in which 633 were samples with ASD. The ages of participants ranged from 4 months to 18 years with a mean of 9.96 years.
3.2. Stimuli and Measures
There were two main types of interventions, including Trier Social Stress Test (TSST) or modified version of the test, and non-TSST related interventions. Among the non-TSST related studies, the stimulus can be largely classified into three main types: play, interaction, and task. Five unique cardiac autonomic measures were identified, in which HR (56.52%) was most commonly used.
4. Discussion
Different face-to-face social stressor stimuli and cardiac autonomic measures were used across studies, and the results varied even when the same stimulus was used. The results are mixed due to inconsistent methodologies and the heterogeneity within the ASD population. Future studies are recommended to adopt multiple measures and include details of the participants (e.g., use of medications). This study will provide important implications for clinical practice and research. The results should be of interest to multiple audiences, including the individuals with ASD, their caregivers, healthcare professionals and researchers.

Authors

• Agnes S.K. Wong, University of Toronto
  Presenting Author

• Samantha Caitlin Burns, University of Toronto

• Earl Woodruff, University of Toronto