Social Emotional and Problem Behaviors in Children with Autism Spectrum Disorders: Associations with Child and Family Impairment

With greater attention to early detection and diagnosis of autism spectrum disorders (ASDS), an increasing number of young children are receiving early intervention services for the social and communicative impairments associated with these conditions.   This is extremely important, as early intervention greatly improves long-term adaptation.  Studies of older children suggest that many children and adolescents with ASD have co-occurring psychiatric disorders such as anxiety disorders.  Moreover, impairment in ASDs may be exacerbated when other psychiatric conditions are present.   Although some investigators have begun to report on temperamental variation and sensory problems in young children with ASD, there has been little attention to the extent to which co-occurring social-emotional and behavioral problems may associated with core ASD symptoms or with child and family impairment.  The focus of this presentation is on internalizing, externalizing and dysregulation problems in very young children with ASD and their relation to child and family impairment. In addition, stability of behavior problems will be examined. 

Data will be presented from a longitudinal study of approximately 100 toddlers with ASD and their parents.  Toddlers were enrolled when they were between 18- to 33-months of age and seen at two annual follow-up visits.  All children met criteria for ASD based on the Autism Diagnostic Interview, the Autism Diagnostic Observation Schedule (ADOS) and the clinical impression of an experienced clinician.  Parents completed the Infant-Toddler Social and Emotional Assessment (ITSEA; Carter & Briggs-Gowan, 2006), and the Family Life Impairment scale.  The ITSEA is a 166-item parent report questionnaire that measures social-emotional/behavioral problems and competencies in 1- to 3-year olds. The ITSEA assesses four broad domains of behavior (Internalizing, Externalizing, Dysregulation, and Competencies). Items are rated on a 3-point scale from 0=Not true/Rarely to 2=Very True/Often.  The Family Life Impairment Scale (FLIS; Briggs-Gowan et al, 1997) is a parent-report scale that assesses the extent to which the parent perceives that their child’s behavior, personality, or special needs limit the child’s participation in typical family activities or negatively affect the parent.  

Specific questions that will be addressed in this presentation include:  (1) Are social-emotional and problem behaviors reported by mothers and fathers in the toddler and preschool period stable among children with ASDs? (2) Are social-emotional and problem behaviors correlated with core autism symptoms in this young age group? and (3) Controlling for core autism symptoms and cognitive functioning, do social-emotional and behavior problems contribute uniquely to family impairment?