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BackgroundBetter indicators are needed for identifying children with early signs of developmental psychopathology.AimsTo identify measures of autonomic nervous system reactivity that discriminate children with internalising and externalising behavioural symptoms.MethodA cross-sectional study of 122 children aged 6–7 years examined sympathetic and parasympathetic reactivity to standardised field-laboratory stressors as predictors of parent— and teacher-reported mental health symptoms.ResultsMeasures of autonomic reactivity discriminated between children with internalising behaviour problems, externalising behaviour problems and neither. Internalisers showed high reactivity relative to low-symptom children, principally in the parasympathetic branch, while externalisers showed low reactivity, in both autonomic branches.ConclusionsSchool-age children with mental health symptoms showed a pattern of …