Mother's Perceptions of Anxiety in Autism Spectrum Disorders

Background: On measures of well-being – aimed to assess stress, depression, pessimism and quality of relationships - parents of children with autism spectrum disorders report worse outcomes when compared to both parents of typically developing children and parents of children with other disabilities (Smith et al., 2010; Abbeduto et al., 2004). Such results indicate an urgent need to help parents, understand and cope with the challenges of raising a child with ASD. Among adolescents and school-aged children with ASD, anxiety-related concerns are among the most common presenting problems (Ghaziuddin, 2002). Research into this population found that between 11 and 84% experience significant impairment due to anxious symptoms (White et al., 2009). However, the underlying nature of the anxious symptoms in ASD is still unclear. A key obstacle for this area of research is that current measures of anxiety may not always be appropriate for assessing individuals with ASD.

Objectives: This exploratory study was designed to better characterize the co-occurring symptoms of anxiety in individuals with autism as described by their mothers. The rich descriptions gathered from a parent interview will help to determine whether the reported features of anxiety are representative of anxiety or characteristics of ASD. 

Methods: Mothers of children diagnosed with ASD and mothers of typically developing children diagnosed with an anxiety disorder were recruited for this study. Children were between the ages of 8 and 16. Each mother completed the Spence Children’s Anxiety Scale (SCAS, Spence, 1998) and the Social Responsiveness Scale (SRS; Constantino, 2004). Following the completion of the measures, each mother was given the Spence Children’s Anxiety Scale – Parent Interview, which was developed by Dr. Jacquie Rodgers and Ruth Jamieson of Newcastle University. This interview asked the mothers questions about 1) statements on the SCAS they indicated applied to their children; 2) statements of particular interest that may or may not have applied to their child; and 3) any other situations in which the child was anxious that was not captured by the SCAS. 

Results: Seventeen mothers were interviewed using the SCAS (9 with ASD children; 8 with anxious children). Mothers of children with ASD endorsed more statements that were on the Obsessive-Compulsive Disorder subscale of the SCAS. In comparison, mothers of typically developing children with anxiety disorders endorsed more statements on the generalized anxiety subscale of the SCAS and more somatic complaints. We highlight a number of specific SCAS items that differentiate the two groups. We are currently collecting more interviews in addition to a larger item-response analysis of SCAS questionnaire data to examine the factor structure of the SCAS in ASD children.

Conclusions: This initial analysis of the data reveals that the anxious features reported by mothers of children with ASD differ from those anxious features reported by mothers of anxious children. Ongoing work in this area will help us to refine an anxiety measure that better fits the profile of anxiety in children with ASD.