Autonomic nervous system responses to social stimuli among autistic individuals: A systematic review and meta-analysis

Physiological responses to environmental and social stimuli have been studied broadly in relation to psychological states and processes. This may be especially important regarding autistic individuals, who show disparities in social interactions. However, findings from studies assessing autonomic nervous system (ANS) responses of autistic individuals present contradictions, with reports showing both autonomic disparities and intact autonomic functioning. The current study aimed to review the existing literature and to estimate if there is a difference between autistic individuals and neurotypical (NT) individuals in their autonomic responses to social stimuli. Furthermore, the study examined factors that may moderate this difference, including the type of physiological function measured, the level of participation required, as well as the age and intellectual functioning of the participants. The meta-analysis revealed a small and statistically insignificant overall difference between autistic and NT individuals, albeit with high heterogeneity. A further nested moderator analysis revealed a significant difference between autistic and NT individuals in physiological response that reflects mainly a parasympathetic nervous system (PNS) activity. Another difference was found in physiological response that reflects a combined activity of the sympathetic and parasympathetic systems, but only for experimental tasks that demanded active participation in social interactions. These results suggest a distinctiveness in autonomic regulation of autistic individuals in social situations, and point to the PNS as an important study objective for future investigation. Many studies have examined the physiological responses of autistic individuals within social contexts. Yet, a clear and consistent characterization of these responses is missing. The results of this meta-analysis, a method used to synthesize research findings, showed that autistic individuals display differences from neurotypicals (NTs) in parasympathetic nervous system (PNS) responses, which relate to flexible responsiveness. Additionally, differences were found in heart rate-related responses, which reflect variable psychological processes, particularly during social interactions.