Distribution, Stability, and Continuity of Autonomic Nervous System Responsivity at 18- and 36-Months of Age

Biol Res Nurs. 2021 Apr;23(2):208-217. doi: 10.1177/1099800420943957. Epub 2020 Jul 27.


Objective: Cardiac autonomic nervous system (ANS) measures, respiratory sinus arrhythmia (RSA) and preejection period (PEP), are valid and reliable indicators of children's sensitivity to their environment; however, there are few studies of ANS measures in children less than three years of age. This study's aim was to summarize the distributions, stability, and continuity of RSA and PEP measures during resting, challenge, and reactivity for children at 18- and 36-months.

Methods: This was a cohort study of racially- and ethnically-diverse, low-income children who completed a developmentally challenging protocol while we simultaneously assessed their RSA and PEP at 18-months (N = 134) and 36-months (N = 102).

Results: The ANS resting, challenge, and reactivity measures at 18- and 36-months of age were normally distributed. The RSA resting (r = 0.29), RSA challenge (r = 0.44), PEP resting (r = 0.55) and PEP challenge (r = 0.58) measures were moderately stable but RSA (r = 0.01) and PEP reactivity (r = 0.02) were not stable from 18- to 36-months of age. There was no continuity in the ANS measures from 18- to 36-months of age with statistically significant changes in sample means for all of the ANS measures.

Discussion: These developmental changes in ANS are shown at the sample level but there are individual differences in ANS responses from 18- to 36-months that may be affected by adversity or protective factors experienced early in life.

Keywords: autonomic nervous system; cardiovascular reactivity; development; early childhood; preejection period; respiratory sinus arrythmia; stress.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arrhythmia, Sinus / physiopathology
  • Autonomic Nervous System / physiology*
  • Child Development / physiology*
  • Child, Preschool
  • Cohort Studies
  • Female
  • Heart Rate / physiology
  • Humans
  • Infant
  • Male