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Updated: Feb 12, 2026

Measuring Cardiac Autonomic Nervous System ANS Activity in Toddlers - Resting and Developmental Challenges
Published on: February 25, 2016
Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder:
Jorge L Cavalcante Neto1, Antonio R Zamunér2, Bianca C Moreno3
1Núcleo de Estudos em Neuropediatria e Motricidade, Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil.
Insights
Children with Developmental Coordination Disorder (DCD) and those at risk (r-DCD) show impaired cardiac autonomic control. This dysfunction includes reduced parasympathetic activity and blunted responses to postural changes, impacting overall health.
Area of Science:
- Pediatric Neurology
- Cardiovascular Physiology
- Autonomic Nervous System Function
Background:
- Developmental Coordination Disorder (DCD) and at-risk (r-DCD) children exhibit motor impairments affecting daily life.
- These children may also present cardiac autonomic control abnormalities, further limiting health and functionality.
- Understanding autonomic control in DCD is crucial for comprehensive management.
Purpose of the Study:
- To assess cardiac autonomic control using linear and nonlinear heart rate variability (HRV) analysis.
- To compare autonomic function between DCD, r-DCD, and typically developed children (CG) under supine and orthostatic conditions.
- To investigate potential links between motor impairments and cardiovascular regulation.
Main Methods:
- Recruited 13 DCD, 19 r-DCD, and 18 CG children (aged 8.08-8.50 years).
- Utilized a validated HR monitor to record R-R intervals for HRV analysis.
- Applied linear, nonlinear, and symbolic HRV methods during supine and orthostatic (standing) tests.
Main Results:
- The DCD group showed blunted cardiac autonomic adjustment to orthostatic stress, unlike r-DCD and CG.
- DCD children exhibited lower parasympathetic modulation in the supine position compared to r-DCD and CG.
- Only the CG group demonstrated a significant increase in heart rate and specific symbolic index changes from supine to standing.
Conclusions:
- Children with DCD and r-DCD display cardiac autonomic dysfunction, including altered sympathetic/parasympathetic balance and reduced complexity.
- A blunted autonomic response to orthostatic challenges was observed in the DCD group.
- Cardiovascular health interventions should be integrated into the management of DCD, even with milder motor deficits.
Abstract:
Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001) and 2UV (p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.
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