Title: Developmental Trajectories of Respiratory Sinus Arrythmia (RSA) in Toddlers with Procedural Pain

Authors: Sara Jasim (a), Amy Stern (a), Dan Flanders (b), Eitan Weinberg (b), Deena Savlov (b), Hartley Garfield (b), and Rebecca Pillai Riddell (a,b,c)

a = York University, Toronto, ON
b = University of Toronto, Toronto, ON  
c = The Hospital for Sick Children, Toronto, ON

Research Overview: Respiratory sinus arrhythmia (RSA), a measure of heart rate variability, has been shown to be an indicator of self-regulation during acutely stressful events (e.g., painful medical procedures) in the pediatric population. However, developmental patterns of RSA change during stressful events is not yet clear. Given the rapidly developing brain in the pediatric population, further research is needed to examine the developmental patterns of resting RSA and RSA reactivity over time. Resting RSA and RSA change was assessed in toddlers across their second year of life at 12- and 24-months during their routine vaccinations (N = 21 toddlers). At 24-months, resting RSA was higher and RSA reactivity decreased at all stages of the vaccination. With normative brain development, increased myelination of the autonomic system, and generally more experiences with emotions, toddlers at 24-months may be more proficient in the regulation of their distress as reflected in the reduction of RSA to allow for coping (e.g., Buss et al., 2005). RSA has been established as a biomarker for emotion regulation, thus, determining its developmental patterns during stress or pain can help clinicians to design interventions that promote more adaptive coping and minimize dysregulation. This is particularly beneficial in the pediatric population as young children may have a hard time communicating their pain or distress levels.