Objectives: To examine parenting stress as a moderator of the association between observed ASD symptomatology and parent reports of related child’s problem behaviors
Methods: Participants were 53 toddlers (mean CA = 21 months, range = 15.5 – 25.0 months) and their families from the initial assessment of A Multi-Site Clinical Randomized Trial of the Hanen More than Words Intervention. Included children had met a predetermined cutoff on the Screening Tool for Autism in Two-Year-Olds (STAT) and had a clinical presentation consistent with an ASD. Parent stress levels were measured using the Parenting Stress Index – Short Form (PSI-SF), which has three subscales (Parental Distress, Difficult Child, and Parent-Child Dysfunctional Interaction) and a Total Stress composite score. The Infant-Toddler Social and Emotional Assessment (ITSEA) was used to assess areas of child’s difficulties and competencies as reported by parents; the STAT was used to evaluate the different behavioral domains of the child’s impairments (i.e., play, requesting, joint attention, and imitation) in terms of ASD symptomatology. The Imitation/Play subscale of the ITSEA and the Play and Imitation subscales of the STAT were used for this report.
Results: Parents’ report of their children on the ITSEA Imitation/Play was negatively correlated with the Total Stress and the Difficult Child and Parent-Child Dysfunctional Interaction subscale scores of PSI (r = -.31, -.31, and -.40, respectively, ps < .05). No significant bivariate correlations were found between STAT Play and Imitation and ITSEA Imitation/Play. A new variable summing the Play and Imitation domains of STAT (STAT Play/Imitation) was created for use in a first moderation analysis. In order to test the moderating effect of parenting stress variables on the relationship between observational measures of child’s impairment and parental report of the child’s behaviors (Aiken & West, 1991), hierarchical multiple regression analyses were conducted.
PSI Parental Distress moderated STAT Play/Imitation in predicting the ITSEA Imitation/Play. The interaction between STAT Play/Imitation and PSI Parental Distress accounted for 10% of the total variance of parent-reported ITSEA Imitation/Play. Additional moderation analyses indicated that PSI Difficult Child and Total Stress also moderated STAT Play in predicting ITSEA Imitation/Play. The interactions between STAT Play and PSI Parental Distress, Difficult Child, and Total Stress accounted for 11%, 8%, and 9% of the total variance of ITSEA Imitation/Play, respectively. In all cases, moderation analyses indicated that the strongest associations between observed and reported child functioning occurred in parents reporting high parenting stress.
Conclusions: Higher parenting stress was associated with greater correspondence between observed and parent reported child difficulties with respect to play and imitation. It may be that higher levels of parenting stress lead parents to more realistically report their children’s behaviors while lower levels of stress are associated with less discriminating reports of child behaviors.