Parental Distress and Parenting Behavior in Families of Preschool Children with and Without ASD: Spillover and Buffering.

Parents of children with autism spectrum disorder (ASD) report increased distress relative to parents of children with neurotypical development. Parent well-being is generally considered a key determinant of parenting behavior, thus increased distress may spill over into less optimal parenting in families of children with ASD. However, evidence is mixed regarding the degree to which parenting is actually compromised in this population, suggesting the possibility of buffering, wherein the parenting of children with ASD may be robust against spillover from increased parental distress. The current study tested competing spillover and buffering models with regard to relations among child ASD status, parental distress, and parenting behavior. Parents of preschoolers with (n = 73) and without (n = 55) ASD completed self-report measures of parenting stress, depressive symptoms, and emotion dysregulation, as well as of positive and negative parenting behaviors. Families of preschoolers with ASD reported higher distress and negative parenting, and lower positive parenting than did their counterparts. Findings supported the spillover model for negative parenting such that increased parental distress accounted for status-group differences in negative parenting. In contrast, potential buffering was observed for positive parenting in that an inverse association between distress and parenting was observed for parents of children with neurotypical development only. Findings highlight the potential benefit of intervention to reduce parental distress in families of children with ASD, but also suggest some existing ability of these families to buffer certain parenting behaviors from deleterious effects of parent distress.

Parasympathetic functioning and sleep problems in children with autism spectrum disorder.

Respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system activity, has been linked with sleep quality among children with neurotypical development. The current study extended examination of these processes to children with autism spectrum disorder (ASD), a group at considerable risk for sleep problems. Participants included 54 children with ASD (aged 6-10 years, 43% Hispanic). RSA data were collected via a wired MindWare system during a 3-min baseline and a 3-min challenge task. Parents reported on their children's sleep problems and sleep duration using the Children's Sleep Habits Questionnaire, Abbreviated. Although no significant correlations emerged between RSA indices and parent-reported child sleep, baseline RSA and RSA reactivity interacted in the prediction of sleep problems. For children with higher RSA reactivity, higher baseline RSA was associated with fewer sleep problems, but for children with lower RSA reactivity, baseline RSA was not predictive. No main effects or interactions of RSA predicted sleep duration. Findings suggest resilience against sleep problems for children with ASD presenting with higher baseline RSA and higher RSA reactivity. Implications of these results center upon directly targeting psychophysiology (i.e., parasympathetic nervous system regulation) as a possible mechanism to improve sleep in children with ASD, and developing personalized interventions based on physiological markers of risk and resilience.

Parasympathetic withdrawal indexes risk for emotion dysregulation in children with autism spectrum disorder.

Children with autism spectrum disorder (ASD) experience significant difficulties with emotion regulation. Theory and empirical evidence suggest substantial biological contributions to regulatory challenges, which may be related to core ASD symptoms. Respiratory sinus arrythmia (RSA) is a measure of parasympathetic nervous system activity that serves as a putative biomarker for emotion regulation. Higher baseline RSA and more RSA reactivity (parasympathetic withdrawal; RSA-R) in response to challenge appear adaptive in non-clinical populations, but existing evidence for children with ASD remains inconclusive. The current study examined correlates of observed emotion dysregulation in 61 children with ASD between the ages of 6 and 10 years, including ASD symptom levels as well as both baseline RSA and concurrent RSA reactivity. Consistent with previous research, ASD symptom level was significantly correlated with observed dysregulation whereas additional factors such as child IQ were not. Baseline RSA was unrelated to observed dysregulation, but higher RSA reactivity predicted concurrent dysregulation above and beyond the contribution of child ASD symptoms. Findings contribute to an emerging understanding of dysregulation in these children, raise questions about the utility of traditional baseline RSA measures for this population, and clarify the functional significance of RSA reactivity as a risk factor for emotion dysregulation in children with ASD.

Electrodermal Activity Moderates Sleep-Behavior Associations in Children with Autism Spectrum Disorder.

Relative to children without autism spectrum disorder (ASD), children with ASD experience elevated sleep problems that can contribute to behavioral comorbidities. This study explored the interaction between psychophysiology and sleep to determine which children with ASD may be at risk for, or resilient to, effects of poor sleep on daytime behavior. Participants included 48 children (aged 6-10 years) with ASD. Measures of sympathetic nervous system activity (electrodermal activity; EDA) were collected during a baseline and in response to a laboratory challenge task. Parents reported on their children's sleep problems and behavioral functioning, including broad externalizing symptoms and situational noncompliance, using standardized questionnaires and a clinical interview. EDA moderated the significant positive associations between sleep problems and both behavioral outcomes. The link between sleep problems and broad externalizing symptoms and situational noncompliance was positive and significant in the context of lower baseline EDA and nonsignificant in the context of higher baseline EDA. Sleep problems also interacted with EDA reactivity in predicting situational noncompliance, but not broad externalizing symptoms. Findings highlight the complex interplay among sleep, daytime behavior, and psychophysiology in children with ASD. Results are interpreted in the context of differential susceptibility and dual-risk frameworks. This study underscores the importance of high-quality sleep for children with ASD, especially those with the biological sensitivity or vulnerability factors (i.e., EDA) identified in this study. Clinical implications are discussed, and directions for future research are provided.

Parental coping as a buffer between child factors and emotion-related parenting in families of children with autism spectrum disorder.

Parents of children with autism spectrum disorder (ASD) experience high levels of stress related to their children's symptoms and comorbid behavior problems. Adaptive parental coping in response to child-related stressors is proposed to serve a buffering function, and yet, little research has examined whether coping actually moderates associations between child factors and parent outcomes in this population. The few studies to do so have focused on parent well-being as the primary outcome and have not considered the degree to which child-related stressors may affect parenting and contribute to maladaptive transactional parent-child processes over time. The present study tested whether adaptive parental coping was associated with reduced associations between higher levels of child ASD symptoms and comorbid externalizing problems and poorer quality parent reactions to child negative emotions in 63 families of children with ASD. Parents reported on their children's externalizing problems, their own coping behavior, and their reactions to their children's negative emotions, and child ASD symptoms were measured through direct testing. Adaptive coping-primarily active planning-moderated the association between children's behavior problems and supportive parent reactions such that parents of children with more externalizing problems reported less supportive reactions, but only when adaptive coping was low. Child ASD symptoms did not significantly relate to parent reactions, and coping did not moderate these associations. This cross-sectional study is the first to identify parental coping as a potential protective factor for parenting behavior in families of children with ASD and comorbid behavior problems. Implications for future longitudinal research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parental Socialization of Emotion and Psychophysiological Arousal Patterns in Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) are at considerable risk for difficulties with emotion regulation and related functioning. Although it is commonly accepted that parents contribute to adaptive child regulation, as indexed by observable child behavior, theory and recent evidence suggest that parenting may also influence relevant underlying child physiological tendencies. The current study examined concurrent associations between two elements of parental socialization of emotion and measures of both sympathetic and parasympathetic nervous system activity in 61 children with ASD aged 6 to 10 years. To index parental socialization, parents reported on their reactions to their children's negative emotions, and parental scaffolding was coded from a dyadic problem-solving task. Children's baseline respiratory sinus arrhythmia (RSA), electrodermal reactivity (EDA-R), and RSA reactivity in response to challenge were obtained as measures of the children's physiological activity. Regression analyses indicated that supportive parent reactions were related to higher child baseline RSA, a biomarker of regulatory capacity. Fewer unsupportive parent reactions and higher quality scaffolding were associated with higher EDA-R, a physiological index of inhibition. The identification of these concurrent associations represents a first step in understanding the complex and likely bidirectional interplay between parent socialization and child physiological reactivity and regulation in this high-risk population.

Respiratory sinus arrhythmia, parenting, and externalizing behavior in children with autism spectrum disorder.

Children with autism spectrum disorder exhibit significant difficulties with emotion regulation. Respiratory sinus arrhythmia is a biomarker for processes related to emotion regulation, with higher baseline rates linked to beneficial outcomes. Although reduction in respiratory sinus arrhythmia in response to challenge can index adaptive processes in community samples, excessive withdrawal may suggest loss of regulatory control among children with clinical concerns. Psychophysiological risk for problems may be protected against or exacerbated by parenting environments more or less supportive of the development of children's regulatory competence. Respiratory sinus arrhythmia was examined in 61 children with autism spectrum disorder ages 6-10 years in relation to externalizing behavior, and parenting was considered as a moderator. Respiratory sinus arrhythmia was obtained during laboratory tasks, and positive parenting, negative parenting, and children's externalizing behaviors were each indexed through multiple methods. Respiratory sinus arrhythmia reactivity interacted with negative, but not positive parenting. Higher respiratory sinus arrhythmia reactivity was associated with more externalizing behavior under conditions of higher negative parenting, but with lower externalizing behavior at lower levels of negative parenting. Similarly, negative parenting was only associated with externalizing behaviors in the context of high child respiratory sinus arrhythmia reactivity. Implications for our understanding of emotion regulation in children with autism spectrum disorder, and for related interventions, are discussed.

Sympathetic-Parasympathetic Interaction and Externalizing Problems in Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) exhibit significant difficulties with emotion regulation and reactivity, which may be linked to underlying psychophysiology. The present study examined associations between autonomic nervous system activity and individual differences in externalizing behavior problems in children with ASD. A multisystem approach was adopted to consider the interplay between markers of sympathetic (electrodermal reactivity-EDA-R) and parasympathetic reactivity (respiratory sinus arrhythmia reactivity-RSA-R) in relation to behavioral challenges. Fifty-two children with ASD ages 6-10 years contributed complete psychophysiological data. Measures of EDA-R and RSA-R (RSA withdrawal) were obtained in response to a laboratory challenge task and parents reported on child externalizing behavior problems using a standardized questionnaire and a structured clinical interview. An equifinality model was supported, with two distinct psychophysiological pathways linked to heightened externalizing behavior problems. Greater RSA-R was associated with more externalizing problems in the context of higher levels of EDA-R, and lower EDA-R was associated with increased externalizing problems at lower levels of RSA-R. Findings underscore the importance of considering the role of psychophysiology in the unfolding of comorbid externalizing problems in children with ASD. Potential implications for tailoring coregulatory supports are discussed. Autism Res 2019, 12: 1805-1816. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorder (ASD) exhibit elevated rates of challenging behavior. This study identified specific psychophysiological profiles (low sympathetic-low parasympathetic reactivity, and high sympathetic-high parasympathetic reactivity) that may place these children at greater risk for behavior problems. Findings have implications for better understanding behavioral challenges in children with ASD, and for tailoring supports to address underlying psychophysiology.

A Cross-Sectional Examination of the Internalization of Emotion Co-regulatory Support in Children with ASD.

Cross-sectional data from Fenning et al. (J Autism Dev Disord, 48:3858-3870, 2018) were used to examine age differences in processes related to the development of emotion regulation in children with autism spectrum disorder (ASD). Forty-six children with ASD between the ages of 4 and 11 years and their primary caregivers participated in structured laboratory tasks from which parental scaffolding and child dysregulation were coded. Moderation analyses suggested increased internalization of parental co-regulatory support with age, as evidenced by more coherence in dysregulation across dyadic and independent contexts and a stronger inverse relation between parental scaffolding and independent dysregulation. Children's estimated mental age did not account for these effects. Implications for understanding and promoting the development of emotion regulation in children with ASD are discussed.

Parental criticism and behavior problems in children with autism spectrum disorder.

Associations between parent critical attitudes (a component of the Expressed Emotion construct) and behavior problems have been relatively well established in adolescents and young adults with autism spectrum disorder, but use of systems adapted for children with autism spectrum disorder and additional investigations with younger samples are needed. This study examined parental criticism, derived from a population-specific coding system, as related to behavior problems in children with autism spectrum disorder between the ages of 4 and 11 years, and considered parental warmth and children's psychophysiological reactivity as statistical moderators of these associations. In all, 40 children with autism spectrum disorder and their primary caregivers attended a visit involving collection of child electrodermal activity, parent-child interaction, a parent interview from which critical attitudes and warmth were coded, and parent report of child behavior problems. Criticism was directly related to higher child externalizing but not internalizing problems. Parental criticism interacted with warmth in the prediction of internalizing problems such that criticism was only associated with more problems in the context of moderate but not high warmth. Criticism was positively associated with externalizing problems under conditions of moderate and high, but not low, child electrodermal activity reactivity. Implications for conceptualizations of parental criticism in autism spectrum disorder, for understanding comorbid behavior problems in this population, and for intervention are discussed.

Intrinsic and Extrinsic Predictors of Emotion Regulation in Children with Autism Spectrum Disorder.

Difficulties regulating emotion have been linked to comorbid psychopathology in children with autism spectrum disorder (ASD), but little empirical work has examined predictors of dysregulation in this population. Forty-six families of children with ASD participated in a laboratory visit that included direct measurement of children's IQ, ASD symptoms, and psychophysiological reactivity. Child emotion regulation was observed during independent and co-regulatory tasks, and parental scaffolding was rated in the dyadic context. ASD symptom severity emerged as the strongest predictor of child emotion dysregulation across contexts. Child age and parental scaffolding also uniquely predicted child dysregulation in the dyadic task. Implications for conceptualizing intrinsic and extrinsic influences on emergent emotion regulation in children with ASD are discussed, as are applications to intervention.

Sympathetic Under-Arousal and Externalizing Behavior Problems in Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) commonly exhibit co-occurring externalizing behavior problems, which can impede learning opportunities and contribute significantly to caregiver stress. Substantial theory and research has linked under-arousal of the sympathetic nervous system to increased externalizing problems in children without ASD, but under-arousal has not been considered as an explanatory mechanism for individual differences among children with ASD. We tested the notion that lower electrodermal activity (EDA) would predict more externalizing problems in children with ASD, and considered the degree to which parent co-regulatory support could buffer this risk. Forty children with ASD between the ages of 4 and 11 years and their primary caregivers participated in a laboratory visit that included various play, compliance, and problem-solving regulatory tasks. EDA was measured through wireless wrist sensors, parental scaffolding was observed during a dyadic problem-solving task, and parents rated their children's externalizing behavior problems. As predicted, low EDA during the compliance-oriented tasks directly predicted higher child externalizing problems. Parental scaffolding moderated the link between under-arousal during the problem-solving regulatory tasks and externalizing problems such that the relation was observed in the context of low, but not high, support. Implications for relevant theories (e.g., fearlessness theory, stimulation-seeking theory) are discussed, and the potential for psychophysiological patterns to inform intervention with these children is considered.

Electrodermal Variability and Symptom Severity in Children with Autism Spectrum Disorder.

Associations between variability in sympathetic nervous system arousal and individual differences in symptom severity were examined for children with autism spectrum disorder (ASD). Thirty-four families participated in a laboratory visit that included continuous measurement of electrodermal activity (EDA) during a battery of naturalistic and structured parent-child, child alone, and direct testing tasks. Multiple indices of EDA were considered. Greater variability in EDA was associated with higher levels of ASD symptoms, with findings generally consistent across tasks. Intellectual functioning did not moderate the relation between EDA and ASD symptoms. Sympathetic arousal tendencies may represent an important individual difference factor for this population. Future directions and conceptualizations of EDA are discussed.

Oxytocin and parent-child interaction in the development of empathy among children at risk for autism.

This longitudinal study investigated whether variation in the oxytocin receptor gene (OXTR) and early parent-child interactions predicted later empathic behavior in 84 toddlers at high or low familial risk for autism spectrum disorder. Two well-studied OXTR single-nucleotide polymorphisms, rs53576 and rs2254298, were examined. Parent-child interaction was measured at 15 and 18 months of age during free play sessions. Empathy was measured at 24 and 30 months using a response to parental distress paradigm. While there was no direct association between parent-child interaction quality or OXTR and empathy, rs53576 moderated the relation between interaction quality and empathy. Results suggest that the interplay between OXTR and early parent-child interactions predicts individual differences in empathy in children at varying risk for atypical social development. Findings are consonant with a differential susceptibility model in which an OXTR variant may increase the social salience of interaction processes for specific allele carriers. These results increase our understanding of predictors of empathy development in young children with a wide range of social outcomes. (PsycINFO Database Record

Brief Report: A Pilot Study of Parent-Child Biobehavioral Synchrony in Autism Spectrum Disorder.

The theory of biobehavioral synchrony proposes that the predictive power of parent-child attunement likely lies in the manner with which behaviors are aligned with relevant biological processes. Symptoms of autism spectrum disorder (ASD) may challenge the formation of behavioral and physiological synchrony, but maintenance of such parent-child attunement could prove beneficial. The present study is the first to examine parent-child physiological synchrony in ASD. Parent and child electrodermal activity (EDA) was measured continuously during naturalistic free play. Parent-child EDA synchrony (positive covariation) was positively correlated with observed parent-child emotional attunement. Hierarchical linear modeling revealed that child ASD symptoms moderated the association between parent EDA and child EDA, such that EDA synchrony was stronger for children with lower ASD symptom levels.

Parent-child interaction over time in families of young children with borderline intellectual functioning.

A previous study suggested that mothers of 5-year-old children with borderline intellectual functioning displayed lower positive engagement with their children as compared with both mothers of typically developing children and mothers of children with significant developmental delays (Fenning, Baker, Baker, & Crnic, 2007). The current study integrated father data and followed these families over the subsequent 1-year period. Parent and child behavior were coded from naturalistic home observations at both waves. Results revealed that mothers of children with borderline intellectual functioning displayed a greater increase in negative-controlling parenting from child age 5 to 6 than did other mothers; fathers displayed more negative-controlling behavior in comparison to fathers of typically developing children. In addition, children with borderline intellectual functioning themselves exhibited a more significant escalation in difficult behavior than did typically developing children. Cross-lagged analyses for the sample as a whole indicated that maternal negative-controlling behavior predicted subsequent child difficulties, whereas negative paternal behavior was predicted by earlier child behavior. In conjunction with evidence from Fenning et al. (2007), these findings suggest a complex, dynamic, and systemic developmental pattern in the emotional behavior of families of children with borderline intellectual functioning. Implications and areas in need of additional research are discussed.

Marital satisfaction and life circumstances of grown children with autism across 7 years.

We examined the extent to which marital satisfaction across 7 years in 199 mothers was associated with the characteristics (gender, age, and intellectual disability status) of their adolescent or adult child with an autism spectrum disorder (ASD) and whether fluctuations in marital satisfaction covaried with the child's autism symptoms, health, behavior problems, and closeness in the parent-child relationship. We also examined the impact of the departure of the adult child out of the family home on mothers' marital satisfaction. The effect of family context variables including the presence of an additional child with a disability, maternal education, and household income on marital satisfaction were also examined. We found that closeness in the mother-child relationship and household income had a significant effect on level of marital satisfaction, and that variability in the slope of mothers' marital satisfaction was significantly predicted by fluctuations in the behavior problems of the adolescent or adult child with an ASD. The grown child's departure out of the family home was not related to change in marital satisfaction. Interventions aimed at managing the behavior problems of adolescents and adults with ASDs may help strengthen parents' marital relationship.

Mother-child interaction and resilience in children with early developmental risk.

Although prenatal and genetic factors make strong contributions to the emergence of intellectual disability (ID), children's early environment may have the potential to alter developmental trajectories and to foster resilience in children with early risk. The present study examined mother-child interaction and the promotion of competence in 50 children with early developmental delays. Three related but distinct aspects of mother-child interaction were considered: maternal technical scaffolding, maternal positive sensitivity, and mother-child dyadic pleasure. Children were classified as exhibiting undifferentiated delays at age 3, based upon performance on developmental assessments and the absence of known genetic syndromes. Mother-child interaction was assessed at age 4 through observational ratings of structured laboratory tasks, and through naturalistic home observations. ID was identified at age 5 using the dual criteria of clinically significant delays in cognitive functioning and adaptive behavior. Maternal technical scaffolding and dyadic pleasure each uniquely predicted reduced likelihood of later ID, beyond the contributions of children's early developmental level and behavioral functioning. Follow-up analyses suggested that mother-child interaction was primarily important to resilience in the area of adaptive behavior, with scaffolding and dyadic pleasure differentially associated with particular subdomains. Implications for theories of intellectual disability and for family-based early intervention and prevention efforts are discussed.

Longitudinal effects of adaptability on behavior problems and maternal depression in families of adolescents with autism.

Research on families of individuals with autism has tended to focus on child-driven effects utilizing models of stress and coping. The current study used a family systems perspective to examine whether family level adaptability promoted beneficial outcomes for mothers and their adolescents with autism over time. Participants were 149 families of children diagnosed with autism who were between the ages of 10 and 22 years during the 3-year period examined. Mothers reported on family adaptability, the mother-child relationship, their own depressive symptoms, and the behavior problems of their children at Wave 1, and these factors were used to predict maternal depression and child behavior problems 3 years later. Family level adaptability predicted change in both maternal depression and child behavior problems over the study period, above and beyond the contribution of the dyadic mother-child relationship. These associations did not appear to depend upon the intellectual disability status of the individual with autism. Implications for autism, parent mental health, family systems theory, and intervention with this population are discussed.

Emotion Socialization by Mothers and Fathers: Coherence among Behaviors and Associations with Parent Attitudes and Children's Social Competence.

This study examined interrelations among different types of parental emotion socialization behaviors in 88 mothers and 76 fathers (co-residing with participating mothers) of 8-year-old children. Parents completed questionnaires assessing emotion socialization behaviors, emotion-related attitudes, and their children's social functioning. An observed parent-child emotion discourse task and a child social-problem solving interview were also performed. Parent gender differences and concordance within couples in emotion socialization behaviors were identified for some but not all behaviors. Fathers' reactions to child emotion, family expressiveness, and fathers' emotion coaching during discussion cohered, and a model was supported in which the commonality among these behaviors was predicted by fathers' emotion-coaching attitudes, and was associated with children's social competence. A cohesive structure for the emotion socialization construct was less clear for mothers, although attitudes predicted all three types of emotion socialization behavior (reactions, expressiveness, and coaching). Implications for developmental theory and for parent-focused interventions are discussed.