Autism & Developmental

Physiologic Arousal to Social Stress in Children with Autism Spectrum Disorders: A Pilot Study.

Levine et al. (2012) · Research in autism spectrum disorders 2012
★ The Verdict

After brief social stress, kids with high-functioning autism can show a sharp cortisol drop while their heart rate stays steady.

✓ Read this if BCBAs running social-skills groups or exposure programs for school-age clients with ASD.
✗ Skip if Practitioners focused on non-social behaviors or adult populations.

01Research in Context

01

What this study did

The team brought kids with high-functioning autism and typical peers into a lab. They gave everyone a short social stress task, then collected saliva to measure cortisol.

They also tracked heart rate and heart-rate variability to see how the children's nervous systems reacted.

02

What they found

After the task, cortisol in the autism group dropped instead of rising. The control group showed the normal small increase.

Heart-rate measures looked the same in both groups. Only the stress hormone pattern was different.

03

How this fits with other research

Duerden et al. (2012) saw the opposite pattern: autistic children had higher cortisol after a blood draw. The difference is the stressor type. Needles trigger a bigger hormone surge; social tasks may shut the system down.

Lopata et al. (2008) found that unfamiliar peers raise cortisol in autistic kids. P et al. now show that after the stress ends, the hormone can fall fast. Together they map a spike-and-drop profile you should expect during new social encounters.

McQuaid et al. (2024) later tested older youth and saw stronger cortisol and heart-rate jumps when social evaluation was added. The 2012 pilot hinted at this; the 2024 study confirms the pattern continues into the teen years.

04

Why it matters

Plan social-skills sessions in short blocks and watch for fatigue. A quick cortisol drop can look like calm, but the child may still feel internal strain. Give recovery breaks and use familiar peers when you want steady engagement.

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→ Action — try this Monday

Keep social practice segments under ten minutes and insert a quiet reset activity before starting the next trial.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
30
Population
autism spectrum disorder
Finding
mixed

03Original abstract

Little is known about arousal to socially stressful situations in children with Autism Spectrum Disorders. This preliminary study investigates physiologic arousal in children with high functioning autism (HFA, n=19) compared to a comparison group (n=11) before, during, and after the Trier Social Stress Test. The HFA group was more likely to have a decrease in salivary cortisol following the stressor, while the comparison group was more likely to have an increase (p=.02). However, there was no difference in electrodermal activity, a measure of sympathetic arousal, or vagal tone, a measure of parasympathetic activity, between groups. These findings implicate a differential neuroendocrine response to social stress in children with HFA despite similar sympathetic and parasympathetic responses during a stressor. Further studies are required to substantiate this finding.

Research in autism spectrum disorders, 2012 · doi:10.1016/j.rasd.2011.04.003