Mother-Child Interactions Predict One-Year Changes in Autism Symptoms and Co-occurring Problems in Toddlers with an Autism Spectrum Disorder

Background: Maternal behaviors including synchrony, responsiveness, and directiveness predict language and social-emotional gains in typically and developmentally delayed children. There is also some preliminary evidence that they predict similar gains in toddlers with autism spectrum disorders (ASD).

Objectives: Examine the relation between a mother’s parenting behavior with her toddler with ASD and changes in the toddler’s ASD-related symptoms and problem behaviors one year later.

Methods: Ninety-nine mothers and their toddlers between 18 and 33 months with an ASD diagnosis participated a longitudinal research study. Developmental level was assessed using the Mullen Scales of Early Learning, autism symptoms were assessed using the Autism Diagnostic Observation Schedule (ADOS), and problem behaviors were assessed by parent report on the Infant-Toddler Social and Emotional Assessment (ITSEA). Mother-child interactions were rated on dimensions of parenting and dyadic engagement using the Parent-Child Interaction Rating Scale (PCIRS) from a 7 minute mother-child play episode in Year 1 (Y1). Factor analysis yielded 3 composite variables: Sensitive Engagement (Cronbach’s Alpha = .81), Disengaged (Chronbach’s Alpha = .73), and Cognitive Engagement (Chronbach’s Alpha = .81). Mothers and children completed the same assessments 1 year later, however only Y1 PCIRS was used in this analysis.

Results: Mean child age was 28 months, range = 18–33 months, and 75 % were male. Analyses indicated that, when controlling for the child’s age and developmental level at Y1, Disengaged parenting was significantly associated with increases in communication problems (ΔR²=.033) and social difficulty symptoms (ΔR²=.046) on the ADOS. For children with higher developmental scores in Y1, Disengaged parenting was also associated with greater gains in dysregulation (ΔR²=.036) and internalizing symptoms (ΔR²=.064).

Conclusions: Findings emphasize the importance of parenting behaviors for optimal social-communication and emotional development in toddlers with ASD, and thus have important implications for clinical practice.
Sponsor: NIMH
General Clinical Research Center