Heart Rate Variability in Adolescents with Autistic Spectrum Disorder Practicing a Virtual Reality Using Two Different Interaction Devices (Concrete and Abstract): A Prospective Randomized Crossover Controlled Trial.

Individuals with autism spectrum disorder (ASD) often experience dysregulation of the autonomic nervous system, as evidenced by alterations in heart rate variability (HRV). It can be influenced by virtual reality (VR), which affects physiological responses due to its sensitivity to environmental and emotional stimuli. This study aimed to assess HRV in individuals with ASD before, during, and after VR-based tasks over a 10-day period, specifically examining how HRV fluctuated in response to concrete (touchscreen) and abstract (webcam) interactions. Twenty-two male participants were randomly assigned to two sequences based on the order of tasks performed (starting with either the concrete or abstract task). The findings revealed significant changes in HRV indices (RMSSD, SD1, SDNN, and SD2) between the two task types. The participants engaged in abstract tasks demonstrated higher motor demands, which were indicated by decreased parasympathetic activity and an increased LF/HF ratio, suggesting greater activation of the sympathetic nervous system.