Commercially available wearable biosensors have the potential to enhance psychophysiology research and digital health technologies for autism by enabling stress or arousal monitoring in naturalistic settings. However, such monitors may not be comfortable for children with autism due to sensory sensitivities. To determine the feasibility of wearable technology in children with autism age 8-12 years, we first selected six consumer-grade wireless cardiovascular monitors and tested them during rest and movement conditions in 23 typically developing adults. Subsequently, the best performing monitors (based on data quality robustness statistics), Polar and Mio Fuse, were evaluated in 32 children with autism and 23 typically developing children during a 2-h session, including rest and mild stress-inducing tasks. Cardiovascular data were recorded simultaneously across monitors using custom software. We administered the Comfort Rating Scales to children. Although the Polar monitor was less comfortable for children with autism than typically developing children, absolute scores demonstrated that, on average, all children found each monitor comfortable. For most children, data from the Mio Fuse (96%-100%) and Polar (83%-96%) passed quality thresholds of data robustness. Moreover, in the stress relative to rest condition, heart rate increased for the Polar, F(1,53) = 135.70, p < 0.001, ηp² = 0.78, and Mio Fuse, F(1,53) = 71.98, p < 0.001, ηp² = 0.61, respectively, and heart rate variability decreased for the Polar, F(1,53) = 13.41, p = 0.001, ηp² = 0.26, and Mio Fuse, F(1,53) = 8.89, p = 0.005, ηp² = 0.16, respectively. This feasibility study suggests that select consumer-grade wearable cardiovascular monitors can be used with children with autism and may be a promising means for tracking physiological stress or arousal responses in community settings. LAY SUMMARY: Commercially available heart rate trackers have the potential to advance stress research with individuals with autism. Due to sensory sensitivities common in autism, their comfort wearing such trackers is vital to gathering robust and valid data. After assessing six trackers with typically developing adults, we tested the best trackers (based on data quality) in typically developing children and children with autism and found that two of them met criteria for comfort, robustness, and validity.

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