You Lead, I'll Follow: Parent-Child Interactions with Infants at Risk for Autism Spectrum Disorder

Background: The literature suggests an important relationship between synchronous parent behavior and developmental outcomes for preschoolers with autism (Siller & Sigman, 2002; 2008). Preliminary work from prospective studies reveals differences in levels of parent synchrony beginning in infancy in parent-child dyads of infants who have an older sibling with autism (High-Risk, HR-ASD) compared to those who do not (Low-Risk, LR). Such differences were most evident in child-led interactions (Yirmiya, et al., 2006), suggesting that HR-ASD infants may exhibit behaviors which hamper synchronous parent-child interactions.

Objectives: In the current study, we hypothesize that differences in the quality of parent-child interactions in HR-ASD infants relate not to overall differences in parenting style, but rather to specific infant behaviors which trigger compensatory parenting strategies.

Methods: Participants included HR-ASD and LR parent-infant dyads at 12-months (N = 14). Parents were videotaped interacting with their children and a standardized set of toys for five minutes. Videotapes were coded using a scheme adapted from Siller & Sigman (2002) for both child (appropriate, inappropriate, no directed behavior) and parent behavior (undemanding, demanding, directive). Directive parent behavior was defined as parental attempts to direct the infant’s attention when the infant was either not engaging with a toy or engaging in an inappropriate fashion.  

Results: Preliminary data indicate no overall differences in parent-child interactions based purely on the infant’s risk status. However, parents of a subset of HR-ASD infants who exhibited higher levels of autism symptomatology engaged in less synchronous and more directive behavior compared to other HR-ASD and LR dyads (p = .004). Likewise, this subset of HR-ASD infants also demonstrated lower levels of appropriate child behavior than other infants (p = .009). Furthermore, parents of infants who had more abnormal scores on an autism diagnostic instrument (ADOS-T) and lower expressive language skills were more likely to use directive behavior (r = .78, p = .001; r = -.60, p = .02, respectively).

Conclusions: Results suggest that while there may be differences in the quality of parent-child interactions in HR-ASD dyads, these differences could be directly related to specific atypical child behaviors. In fact, these behaviors may make synchronous engagement challenging for parents, as many parents seemed to naturally “intervene” with directive behaviors to facilitate appropriate child behavior. These results will be discussed in terms of implications for early identification, intervention, and parent education.