Abstract
Background: Stress is not experienced the same by everyone. Some individuals, such as individuals with Autism Spectrum Disorder (ASD), are at risk of heightened sensitivity to stress responses. ASD is a neurodevelopmental disorder commonly characterized by deficits in social communication and social interaction. Among different stressor stimuli, social stressors particularly worth our attention due to the social and communication challenges inherent to ASD. This study aims to systematically evaluate different social stressor stimuli in eliciting physiological reactivity in ASD, focusing on the children and adolescent population. Methods: We designed a study protocol for this study and submitted it to PROSPERO for systematic review registration. Any studies with children and adolescents with ASD between the ages of 0-18 in clinical and community settings will be included. All types of social stressor interventions will be included. The intended outcomes will not be restrictive. The outcome of interest will include studies with physiological activity of the participants being measured, e.g., measures related to autonomic functioning, electrodermal functioning, and cortisol level. The primary literature sources will be across four electronic databases: Medline, Embase, PsycInfo, and CINAHL. The second source of literature will be across grey literature, including ProQuest Dissertations & Theses Global and across clinical trial registries. Hand searching of references will be performed on the reference lists of all included studies. Two volunteers pursuing postgraduate-level studies will independently search and screen potential studies for eligibility. Finally, all references considered by hand-searching will be reviewed by two researchers. The methodological quality of the research will be assessed by adopting the quality assessment used by a previous study. The assessment consists of four primary categories: descriptive validity, internal validity, external validity, and statistical conclusion validity. Discussion: Considering the inconsistent methodologies and findings in previous studies, a systematic review in this area is required. We are not aware of another systematic review discussing this specific issue. The findings will have important implications for clinical practice and research studies. We anticipate that the results will be of interest to multiple audiences, including the individuals with ASD, their families and caregivers, healthcare professionals, educators, and researchers. Systematic Review Registration: PROSPERO CRD42021244039