Elevated cortisol during play is associated with age and social engagement in children with autism

Abstract

BackgroundThe hallmark characteristic of autism is impaired reciprocal social interaction. While children find social interaction stress-reducing, many children with autism may find social interaction stress-inducing. The current study was designed to examine stress responsivity as measured by cortisol by comparing children with autism to neurotypical peers during an ecologically valid 20-minute playground paradigm.MethodsThe experiment involved sets of three children: a child with autism, a neurotypical child, and a confederate. Participants included 45 prepubescent males between 8 and 12 years of age (21 with autism and 24 neurotypical children).ResultsChildren with autism showed fewer initiations (χ²(1) = 4.03, P = 0.044), rejected initiations from others more (χ²(1) = 7.10, P = 0.008) and spent less time interacting during motor (F(1,43) = 16.7, P = 0.0002) and cooperative (F(1,43) = 14.78, P = 0.0004) play. Repeated measures analysis of the cortisol values revealed a significant model (χ²(4) = 22.76, P < 0.0005) that included time of measurement, diagnosis and age as main effects and an interaction between diagnosis and age. Thus, as age increased among children with autism, they experienced enhanced cortisol levels while age did not modify expected cortisol levels for typical children. Stress responsivity was associated with more peripheral equipment play for motor (χ²(3) = 12.3, P = 0.006) and cooperative (χ²(3) = 8.24, P = 0.04) play as well as reduced nonverbal social skills during motor (χ²(1) = 5.52, P = 0.018) and cooperative play (χ²(1) = 4.53, P = 0.033).ConclusionsOverall, children with autism engaged in fewer social overtures and spent less time interacting than typically developing peers during play. The peer interaction paradigm resulted in significantly higher levels of cortisol in many children with autism. Distinct patterns emerged within the autism group based on developmental (older), biological (cortisol responder) and behavioral patterns (peripheral group interaction). The enhanced cortisol response was observed in children who voluntarily engaged in interaction; thus, it does not support the notion of a response to social threat. Rather, it appears to reflect attendant metabolic preparedness and enhanced arousal from engaging socially. The data suggest that many children with autism activate hypothalamic-pituitary-adrenal responses in relatively benign social situations, which appears to be a function of age and level of social engagement. The findings support the need to teach coping strategies in addition to fundamental social skills to youth with autism.

Autistic characteristics in adults with epilepsy

“…Research investigating stress in children with and without ASD during an ecologically valid benign social interaction found that those with ASD had significantly higher cortisol levels, reflecting enhanced arousal from social engagement (Corbett et al, 2010). This study demonstrated that not just stressful social interaction but 'benign' social interaction results in the increase of cortisol in those with ASD.…”

“…Lorna Wing (1981) suggests that those with ASD lack the ability to understand the rules of social behaviour. Research investigating stress in children with and without ASD during an ecologically valid benign social interaction found that those with ASD had significantly higher cortisol levels, reflecting enhanced arousal from social engagement (Corbett, Schupp, Simon, Ryan, & Mendoza, 2010). Structural abnormalities found in the autistic amygdalae have been identified, which is significant as the amygdalae play an important role in social and emotional engagement (Toal et al, 2010).…”

Psycho-Behavioral Spiral of Disturbances in Prosocial Behavior, Stress Response, and Self-Regulation inSubstance-Related and Addictive Disorders

“…There is no association between depression characteristics and salivary cortisol levels [125]. Markedly enhanced blood or salivary cortisol response were found in ASD children when exposed to social stress [126,127]. In schizophrenia patients, salivary cortisol secretion was slightly increased by exposure to stress [128].…”

Perinatal Immune Activation and Risk of Autism

“…Evening cortisol levels positively correlated to daily stressors in children with autism (Corbett et al, 2009). Moreover, increase in age of autistic children correlated with increased cortisol levels during social interaction stress (Corbett et al, 2010). CRH has also been shown to increase intestinal permeability of human colonic biopsies, while maternal separation stress and CRH are associated with a dysfunctional mucosal barrier in rodents (Soderholm et al, 2002).…”