Autism & Developmental

A Comprehensive Investigation of Social Anxiety and Social Evaluative Stress in Autistic Children and Adolescents and Specific Learning Disorders.

Lievore et al. (2026) · Journal of autism and developmental disorders 2026
★ The Verdict

Autistic kids can show low heart reactivity yet high parent-rated social anxiety—use multi-modal checks, not just forms.

✓ Read this if BCBAs running social-skills groups or assessments for school-age autistic clients.
✗ Skip if Clinicians who work only with infants or adults with TBI.

01Research in Context

01

What this study did

The team put 8- to young learners kids through a five-minute "speech test."

Autistic kids, kids with specific learning disorders (SLD), and typical peers each gave a speech to two silent judges.

Parents filled out a social-anxiety checklist. The researchers filmed the talks and tracked heart rate.

02

What they found

Autistic and SLD kids were rated more anxious and gave lower-quality speeches than peers.

Surprise: autistic kids’ hearts rose less during the talk. Their bodies looked calm, yet parents still saw high anxiety.

Different signals told different stories, so one measure was not enough.

03

How this fits with other research

Bravo Balsa et al. (2024) also found odd stress signals in autistic teens. They measured saliva cortisol at home and saw higher daily output. Rachele’s lab data now add low heart reactivity and poor speech quality, showing the picture is bigger than hormones alone.

Johnson et al. (2009) first showed cortisol patterns in autistic kids are mixed: some high, some low. The new study keeps that tradition but swaps saliva for heart rate and still finds "not what you expect" results.

Together the three papers say: autistic youth can look calm outside while stress brews inside. Check many channels—heart, hormones, parent report—before you decide a child is "fine."

No clash exists; each study just adds another lens.

04

Why it matters

If you only use a questionnaire, you may miss real social stress in autistic clients. Pair parent ratings with a quick speech sample or heart-rate check. When numbers disagree, trust the pattern, not a single score, and teach coping skills even when the child looks "calm."

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Next social-skills session, have the client give a 2-minute intro while you note heart rate with a cheap finger sensor; compare to parent anxiety rating afterward.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
335
Population
autism spectrum disorder, mixed clinical
Finding
mixed

03Original abstract

The aim was to investigate trait social anxiety and social evaluative stress in autistic children and adolescents and Specific Learning Disorders (SLD). This was done by evaluating behavioral, subjective, and autonomic responses to the Trier Social Stress Test (TSST). Study 1 included 280 children and adolescents: 60 autistic without intellectual disability (ID), 70 SLD, and 150 non-diagnosed (ND) peers. Study 2 involved 55 participants: 15 autistic without ID, 15 SLD, and 20 ND. The sample was predominantly male. In Study 1, behavioral (quality of public speech) and subjective (valence, arousal, perceived competence, and worries) aspects of social stress were examined. Study 2 expands upon the first study, as physiological responses to social stress were also measured. Trait social anxiety was investigated using both parents' and children's reports in the two studies. Parents of autistic participants and with SLD reported higher trait social anxiety in their children than the parents of ND. No differences emerged from the participants' self-reports, though those autistic and with SLD were assigned lower scores in the public speech quality than ND. Autistic children and adolescents reported lower arousal and higher perceived competence than ND, while those with SLD reported a lower perception of competence. Autistic participants had a decreased cardiac reactivity across the TSST when compared to SLD and ND. Our findings show unique patterns of responses within each group, confirming that the combined investigation of trait anxiety and social stress responses could be a valuable insight in research and clinical practice.

Journal of autism and developmental disorders, 2026 · doi:10.1177/07319487211041103