Sympathetic Under-Arousal and Externalizing Behavior Problems in Children with Autism Spectrum Disorder

Abstract

Children with autism spectrum disorder (ASD) commonly exhibit co-occurring externalizing behavior problems, which can impede learning opportunities and contribute significantly to caregiver stress. Substantial theory and research has linked under-arousal of the sympathetic nervous system to increased externalizing problems in children without ASD, but under-arousal has not been considered as an explanatory mechanism for individual differences among children with ASD. We tested the notion that lower electrodermal activity (EDA) would predict more externalizing problems in children with ASD, and considered the degree to which parent co-regulatory support could buffer this risk. Forty children with ASD between the ages of 4 and 11 years and their primary caregivers participated in a laboratory visit that included various play, compliance, and problem-solving regulatory tasks. EDA was measured through wireless wrist sensors, parental scaffolding was observed during a dyadic problem-solving task, and parents rated their children's externalizing behavior problems. As predicted, low EDA during the compliance-oriented tasks directly predicted higher child externalizing problems. Parental scaffolding moderated the link between under-arousal during the problem-solving regulatory tasks and externalizing problems such that the relation was observed in the context of low, but not high, support. Implications for relevant theories (e.g., fearlessness theory, stimulation-seeking theory) are discussed, and the potential for psychophysiological patterns to inform intervention with these children is considered.

Sympathetic‐Parasympathetic Interaction and Externalizing Problems in Children with Autism Spectrum Disorder

“…However, recent evidence suggests that certain SNS–PNS profiles may sensitize children to parenting effects [Abaied et al, ], and it is possible that different types of parental reactions might be more or less beneficial depending upon children's underlying psychophysiology. For instance, parenting that promotes increased task engagement while providing effective behavioral contingencies may be particularly important for reducing comorbid behavior problems in children with ASD exhibiting low SNS arousal tendencies [Baker, Fenning, Erath, et al, ]. In contrast, reducing parental criticism and harsh discipline may be especially helpful for children with ASD with high SNS or PNS reactivity [Baker, Fenning, Howland, & Huynh, ; Baker et al, ].…”

“…Lower EDA-R has been identified as a risk factor for externalizing problems, with this association thought to be mediated by a reduced physiological sensitivity to threat or socialization efforts [Beauchaine et al, 2007]. A direct link between lower EDA-R in compliance contexts and externalizing behavior problems has been replicated in children with ASD, but this effect may be open to moderation when EDA-R is measured under conditions with less emphasis on compliance [Baker, Fenning, Erath, et al, 2018]. Results of the present study suggested an association between lower EDA-R during a challenge task and externalizing problems at lower and moderate levels of RSA-R.…”

“…Recent work has centered on understanding individual differences among children with ASD through examination of psychophysiological reactivity [Baker et al, ; Fenning et al, ; Lydon et al, ; Neuhaus, Bernier, & Beauchaine, ; Neuhaus et al, ; White et al, ]. Electrodermal activity (EDA) is an SNS response and index of the behavioral inhibition system, which promotes inhibition and risk assessment in situations that involve potential negative consequences [Beauchaine, ; McNaughton & Corr, ].…”

“…The current study examined interactions between SNS and PNS reactivity in the prediction of externalizing behavior problems in an ethnically and developmentally diverse sample of children with ASD ages 6–10 years. The focal age range represents an important period for parental influence on emotion regulation in children with ASD [Baker, Fenning, & Moffitt, ; Fenning et al, ] and without ASD [Morris, Silk, Steinberg, Myers, & Robinson, ], and a period that overlaps with previous examinations of physiology and externalizing behaviors in children with ASD [e.g., Baker, Fenning, Erath, et al, ; Neuhaus et al, ; Vaughn Van Hecke et al, ].…”

“…Among children with ASD, greater EDA reactivity has been linked with more social impairment and higher levels of core ASD symptoms [Fenning et al, 2017;Joseph, Ehrman, McNally, & Keehn, 2008;Kaartinen et al, 2012;Neuhaus, Bernier, & Beauchaine, 2015;Stagg, Davis, & Heaton, 2013], although not universally [Faja, Murias, Beauchaine, & Dawson, 2013;Louwerse et al, 2013;McCormick et al, 2014]. Conversely, EDA under-arousal has been associated with increased externalizing behavior problems in children with ASD, particularly when measured during compliance contexts or when accompanied by less-optimal coregulatory support [Baker, Fenning, Erath, et al, 2018].…”