Bidirectional Relationship Between Anxiety Symptoms In Mothers and Young Children with Autism and the Moderating Effects of Sensory Over-Responsivity

Background: There is a paucity of research examining bidirectional relationships between parent and child affective symptoms. Research examining the unidirectional relationship between parental well being and child ASD symptoms tends to implicitly and often explicitly suggest one of the family members as the impetus for dyadic partner’s distress (Tehee, Honan, & Hevey, 2009). Of particular interest is the relationship between parental anxiety and child anxiety, since anxiety problems can be especially debilitating to individuals with ASD (Greig & MacKay, 2005) by adversely impacting school performance, peer relationships, family functioning, and further exacerbating the core deficits of ASD (Bellini, 2004; Sze & Wood, 2007). Exploring the bidirectional relationship of anxiety symptoms in mothers and their young children presents the issue in a family systems context, as opposed to assuming unidirectional causality. In addition, given the association between anxiety disorders and sensory over-responsivity (SOR) in children with ASD (Ben-Sasson et al., 2008; Liss et al., 2006), we further examined the role of SOR in the relationship between maternal and child anxiety.

Objectives: 1) To examine bidirectional relationship of maternal and child anxiety symptoms across three time points; 2) To explore moderating effects of the level of the child’s SOR (high vs. low) on the relationship between maternal and child anxiety.

Methods: Mothers (n = 167) of young children with ASD (n = 177; mean age = 28 months at baseline) that participated in a longitudinal study examining developmental trajectories of toddlers newly diagnosed with ASD and family adjustment and well-being, completed the Beck Anxiety Index (Beck et. al, 1988), the Infant Toddler Social Emotional Assessment (ITSEA; Carter & Briggs-Gowan, 2003), and the Infant Toddler Sensory Profile (ITSP; Dunn, 2002) at three different time points (baseline, 12-month follow-up, and 24-month follow-up). The ITSEA’s General Anxiety scale was used as a measure of child anxiety.

Results: A cross-lagged panel model was used to test the bidirectional relationship between maternal anxiety and anxiety in young children with autism. Sensory over-responsivity (SOR) was tested for its moderating effect of child and maternal anxiety. Model fit was good (RMSEA=0.042; SRMR= 0.037; CFI=0.966), with relationships between maternal and child anxiety being strongest in the SOR group (β = 0.25)

Conclusions: Results suggest that there is a bidirectional relationship between maternal and child anxiety, and that this relationship is moderated when the child with ASD has SOR. This study provides evidence for further exploration of interventions focusing on addressing maternal and child anxiety as a correlated construct.