# Heart rate variability biofeedback to reduce anxiety in autism spectrum disorder – a mini review

## TL;DR

This review examines how heart rate variability biofeedback can help reduce anxiety in people with autism spectrum disorder.

## Contribution

The paper provides a mini review of heart rate variability biofeedback's effectiveness for anxiety in autism, highlighting gaps and future research directions.

## Key findings

- Heart rate variability biofeedback shows positive short-term effects on anxiety in autism.
- Long-term follow-up and accurate assessment methods are needed for reliable outcomes.
- Future studies should consider device types, training settings, and additional measures like cortisol.

## Abstract

There is a reported high prevalence of anxiety in people with autism spectrum disorder. This mini review appraises existing research investigating heart rate variability biofeedback to help manage symptoms of anxiety in people with autism spectrum disorder. A thorough search of electronic databases was conducted to find relevant literature. Consultation with experts and a librarian helped develop search terms following the PICO framework. Five databases were searched, and screening was undertaken using Covidence software, with the process outlined in a PRISMA flowchart. The latest review showed positive short-term effects but there is a need for long-term follow-up. Future investigations should consider device type, training settings, and control interventions. Accurate heart rate variability assessment independent of biofeedback devices is crucial. Additional measures like cortisol assessment and user feedback are recommended for comprehensive evaluation. The findings highlight progress in the evidence base and offer insight to future directions.