Assessment & Research

Heart Rate Variability in Children With Autism Spectrum Disorder and Associations With Medication and Symptom Severity.

Thapa et al. (2021) · Autism research : official journal of the International Society for Autism Research 2021
★ The Verdict

Kids with autism have lower resting heart rate variability, especially if they take psychotropic meds or show more repetitive behaviors.

✓ Read this if BCBAs assessing kids with autism who take meds or show repetitive behaviors
✗ Skip if BCBAs working only with neurotypical clients or adults without developmental concerns

01Research in Context

01

What this study did

Thapa et al. (2021) measured resting heart rate variability in kids with autism and in kids without autism.

They also asked if medicine or repetitive behaviors changed the numbers.

02

What they found

Kids with autism had lower resting heart rate variability than their peers.

Among the autism group, those on psychotropic meds and those with more repetitive behaviors had even lower scores.

03

How this fits with other research

Thapa et al. (2019) saw the same low variability in adults, so the pattern seems lifelong.

Laposa et al. (2017) found that skin-conductance jumps also track symptom severity in kids with autism, showing the body and behavior link together.

Schaaf et al. (2015) saw flatter heart rate changes in kids at risk for developmental coordination disorder, hinting that low variability shows up across neurodevelopmental groups.

04

Why it matters

Low heart rate variability can flag stress or poor self-regulation. If a child with autism is on psychotropics or shows lots of repetitive movements, you might see even lower scores. Consider adding a quick heart-rate check to your intake or pairing it with your FBA. When numbers dip, build in calming breaks or teach diaphragmatic breathing before tough tasks.

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Take a 30-second resting pulse with a finger or watch; note if the child is on meds and log any repetitive behaviors you see.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
130
Population
autism spectrum disorder, neurotypical
Finding
negative

03Original abstract

Decreased heart rate variability (HRV) is considered a common marker of autonomic dysfunction that contributes to poor health outcomes. While some studies have suggested that children with autism spectrum disorder (ASD) show reduced HRV, research is yet to consider whether this may be associated with medication use and symptom severity. This study examined the relationship between resting state HRV, medication use and symptom severity in children diagnosed with ASD. Children with ASD (N = 86), aged between 3 and 12 years (M = 8.09), were compared to 44 neurotypical children of similar age (M = 7.15). Laboratory assessment of HRV involved 5 min of non-invasive baseline electrocardiogram assessments while participants viewed an age-appropriate non-verbal animated video. Time-domain and frequency-domain HRV measures were analyzed. ASD symptom severity was assessed using the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and Social Responsiveness Scale (SRS-2). Results indicated that children with ASD exhibited reduced resting HRV relative to neurotypical children. Subsequent analyses within the ASD group suggested that this group difference was greater in children who were taking psychotropic medication (N = 36). Our data also provides tentative evidence of a relationship between HRV and social impairment symptoms in children with ASD, with more severe repetitive behaviors (as measured by the ADOS-2) associated with decreased resting HRV. Overall, these findings suggest that HRV may be atypical in children with ASD and suggest the importance of exploring HRV as a risk factor for cardiovascular health in this group. LAY SUMMARY: Cardiac activity, such as heart rate variability (HRV), can provide insight into the autonomic nervous system. This study reports on the association between resting-state HRV and autonomic nervous system activity in young children with autism spectrum disorder (ASD) compared to neurotypical children. These results may help us understand what underlies autonomic nervous system dysfunction and the potential pathophysiological mechanisms leading to increased cardiovascular risk in ASD.

Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2437