Abstract
BackgroundThe behavioral characteristics of children with autism spectrum disorder (ASD) are not only affected by their disease, but also by their parenting environment. HR-ASD has the risk of developing internalization and externalization problems. How the early development of these behavioral problems is affected by parent-child interaction is worth exploring. We tested whether parent-child interactions and parenting characteristics were associated with behavioural problems during the infant periods.MethodsThis study collected data from 91 infants at high risk for ASD and 68 matched typically developing (TD) infants, about their internalizing and externalizing behavioural problems and engagement states (i.e. positive, negative, and parent-child interactions), using free play paradigm. Parent measures were assessed using the Broad Autism Phenotypic Questionnaire (BAPQ) and Parenting Stress Index Short Form (PSI-SF) questionnaire. The core symptoms of ASD were assessed using the the Autism Diagnostic Observational Schedule (ADOS).ResultsDuring free play, infants in the HR-ASD group showed more internalizing (P < 0.001) and externalizing (P < 0.05) behaviours and less positive engagement (P < 0.01) than the TD group. In the regression analysis, we found that parenting stress had an impact on the infants’ externalizing behaviours (△R2 = 0.215). Parent negative engagement had an impact on the infants’ internalizing behaviours (△R2 = 0.451).ConclusionsThe present study revealed that children at high risk for ASD exhibited more severe internalizing and externalizing behavioural problems than TD group. The parent negative engagement is associated with behavioural problems. The findings on the contribution of parents’ factors to behavioural problems suggests that the parenting stress and parent-child interactions are important factors for mitigating behavioural problems.
Highlights
The behavioral characteristics of children with autism spectrum disorder (ASD) are affected by their disease, and by their parenting environment
The ASD at-risk group were selected on a clinical assessment by two child psychiatrists based on of the following: i) positive M-CHAT assessment results [41], ii) scores above 30 on the Childhood Autism Rating Scale (CARS) [42], iii) all cases satisfied either risk criteria for ASD or DSM-5 criteria for ASD diagnosis [43] if over 24 months of age at intake, and received both iv) the Autism Diagnostic Observational Schedule (ADOS) [44], and v) the Autism Diagnostic Interview-Revised (ADI-R) [45]
The Developmental Assessment (DQ) for language behaviour and personal-social behaviour from the Gesell Developmental Schedules differed significantly between the two groups (P < 0.001), but those for adaptive behaviour, gross motor behaviour and fine motor behaviour did not differ between the HR-ASD group and the typically developing (TD) group
Summary
The behavioral characteristics of children with autism spectrum disorder (ASD) are affected by their disease, and by their parenting environment. Emotional and behavioural problems in ASD are frequent, and rates of attention deficit-hyperactivity disorder, social anxiety, and oppositional disorder are elevated than typically developing children [8,9,10]. Emotional and behavioural problems (EBPs), including internalizing behaviours (e.g., social dysfunction, anxiety, depression, cognitive problems and avoidance symptoms) as well as externalizing behaviours (e.g., impaired concentration, hyperactivity, aggression and behavioural disorders) [4, 13,14,15]. The literature so far has mainly focused on older children with ASD, and few studies have focused on behavioral problems in high-risk autistic infants, and their findings are mixed
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