Emotional Coherence Difficulties in Preschoolers with Autism: Evidence from Internal Physiological and External Communicative Discoordination

Background: The ability to communicate stress is important as it signals to others that help is needed and, for young children, creates learning opportunities around managing emotions. Many children with Autism Spectrum Disorder (ASD) have difficulties clearly expressing emotions and communicating these expressions to others. What is not clear, however, is whether this represents a general reactivity difference in this population, or whether this means that despite reacting physiologically, children may not be communicating this stress with expressive behaviors (e.g., facial expressions). Hence, children with ASD may have difficulties with coordinating internal and external reactions, or emotional coherence, relative to typically developing (TD) children.

Objectives: The aim in the study was to determine the association between internal physiological emotional reactivity and external communicative emotional reactivity in children with ASD, relative to TD children.

Methods: Preschoolers with autism (ASD) and TD preschoolers watched a relaxing video (resting state task) and participated in a low-level stress task from the Laboratory Temperament Assessment Battery (the Transparent Box Task), whilst wearing a wireless ECG monitor to measure heart rate (beats per minute), as an index of physiological reactivity. Children’s emotional communication behaviors (facial, vocal and bodily expressions) were coded offline by reliable coders, who were blind to diagnostic group and study aims.

Results: Preliminary results (n=20 TD, 16 ASD) showed that whilst all children reacted to the low-level stress task, relative to the resting state task, by displaying emotional communicative behaviors, only in the TD group was children’s increase in heart rate correlated for facial (r = .36, p = .06) and vocal expressions (r = .33, p = .08; bodily expressions and heart rate were not correlated in the TD group: r =- .06, p = .40.) For the ASD group, no associations were found between their internal physiological and external communicative reactions (heart rate and facial reactivity: r = -.24, p = .21; vocal reactivity: r = -.20, p = .25; bodily reactivity: r = -.19, p = .26). See Figure 1 and 2 for vocal reactivity scatterplots as an example.

Conclusions: Children with ASD may have more difficulty expressing physiological emotional reactions via communicative behaviour, relative to their peers. Given that co-regulation strategies (e.g., driven by a social partner, such as mother) which are prevalent in preschoolers, and associated learning opportunities for emotion management, are reliant on the child first signalling their stress to others, such an expressive impairment may contribute to emotion regulation difficulties downstream. A 2-year follow-up of the sample is currently underway and presentation will include results on prediction of emotional coherence to emotion regulation and challenging behaviour in the children. Given the recent technological advances in wearable biosensing, our results suggest incorporation of heart rate signalling in intervention for children with ASD may show promise, through signalling children’s stress on their behalf, allowing parents and teachers to intervene and create learning opportunities for emotional expression and regulation.