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Updated: Aug 9, 2026

Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges
Published on: February 25, 2016
The ontogeny of autonomic measures in 6- and 12-month-old infants
Abbey Alkon1, Suzanne Lippert, Nicole Vujan
1School of Nursing, University of California, San Francisco, CA 94143-0606, USA. abbey.alkon@nursing.ucsf.edu
Insights
This study developed a protocol to measure infant autonomic nervous system activity (sympathetic and parasympathetic). Resting measures showed moderate stability from 6 to 12 months, indicating developmental changes.
Area of Science:
- Developmental psychology
- Pediatric autonomic nervous system function
- Infant physiological development
Background:
- The autonomic nervous system (ANS) regulates vital functions and is crucial for development.
- Measuring ANS activity in infants presents methodological challenges.
- Understanding ANS development in infancy is key to identifying potential health risks.
Purpose of the Study:
- To establish a standardized protocol for measuring preejection period (PEP) and respiratory sinus arrhythmia (RSA) in infants.
- To assess ANS reactivity and stability during resting and challenging conditions.
- To investigate developmental changes in PEP and RSA from 6 to 12 months of age.
Main Methods:
- A 7-minute reactivity protocol was administered to 194 Latino infants at 6 months and 181 at 12 months.
- Preejection period (PEP), a sympathetic nervous system measure, and respiratory sinus arrhythmia (RSA), a parasympathetic nervous system measure, were recorded.
- Data analysis focused on feasibility, protocol efficacy, and stability of autonomic measures.
Main Results:
- Measuring PEP and RSA in infants using the protocol was feasible.
- The protocol successfully elicited significant changes in autonomic activity.
- Individual resting autonomic measures demonstrated moderate stability between 6 and 12 months.
- Reactivity measures, however, were not stable over this period.
- Significant developmental changes were observed in heart rate and RSA means from 6 to 12 months.
Conclusions:
- The developed protocol is effective for measuring infant autonomic nervous system function.
- Infant autonomic responses undergo developmental changes between 6 and 12 months.
- Despite developmental shifts, individual rank order of resting autonomic measures shows moderate stability, suggesting predictable individual differences.
Abstract:
The purpose of this study was to develop a standardized protocol to measure preejection period (PEP), a measure of sympathetic nervous system, and respiratory sinus arrhythmia (RSA), a measure of parasympathetic nervous system, during resting and challenging states for 6- and 12-month-old infants and to determine developmental changes and individual stability of these measures. A 7-min reactivity protocol was administered to Latino infants at 6 months (n=194) and 12 months (n=181). Results showed: (1) it is feasible to measure PEP and RSA in infants, (2) the protocol elicited significant autonomic changes, (3) individual resting autonomic measures were moderately stable from 6 to 12 months, but reactivity measures were not stable, and (4) heart rate and RSA resting and challenge group means changed significantly from 6 to 12 months. Findings suggest that although infants' autonomic responses show developmental changes, individuals' rank order is stable from 6 to 12 months of age.

