Mother-Infant Interactions in High-Risk Infant Siblings of Children with Autism

Ming Wai Wan, BSc, MSc, PhD, Centre for Women's Mental Health Research, University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, United Kingdom, Jonathan Green, Psychiatry Research, University of Manchester, 4th Floor (East), University Place, Oxford Rd, Manchester, M13 9PL, United Kingdom, Mayada Elsabbagh, Centre for Brain and Cognitive Development, London, United Kingdom, and Mark Johnson, Centre for Brain and Cognitive Development, Birkbeck College, University of London, United Kingdom.

Background: Recent studies, based on structured assessment and parent report, suggest that infant siblings of children with autism spectrum disorder (A-sibs) are more likely than typically developing siblings (TD-sibs) to exhibit social and communicative deficits and autism symptoms. Such early atypicalities may adversely affect the mother-infant interactions in A-sibs, particularly in those at high phenotypic risk.

Objectives: To compare the quality of mother-infant interaction between young A-sib infants, with and without phenotypic autism risk, and TD-sib controls.

Methods: Mother-infant play interactions involving 30 6-9-month-old A-sibs and 30 TD-sib controls were rated, blind to dyad characteristics. A global rating scale was developed for this purpose by combining appropriate elements of two validated mother-child interaction measures.

Results: A-sibs at high phenotypic risk were less attentive to mother, had fewer positive vocalisations and showed more neutral affect than A-sibs at low phenotypic risk. Their mothers exhibited less sensitive responsiveness and less acceptance, and their overall interactions were rated as slightly less dyadic. However, low-risk A-sibs tended to show similar interaction scores as TD-sibs. A-sibs at high phenotypic risk were also more likely to show behavioural atypicalities during the interaction session than the other infants.

Conclusions: This study is the first to demonstrate that A-sib infants at high phenotypic risk and their mothers tend to differ in their interactions from others dyads. Based on a gene-environment transactional model, and on developmental research in non-ASD contexts, the findings suggest that such mother-infant relations in high-risk A-sibs may exacerbate their social and communicative difficulties. We also report on preliminary 12-15 month follow-up data. Our findings have implications for early preventative intervention.