Problem Behaviors of School-Age Children with and without Autism Spectrum Disorders during Mother-Child Play Tasks

Background: Dyadic synchrony, defined here as the mutual warmth and responsiveness between a mother and her child, is a largely unexplored construct in school-aged children, including those with Autism Spectrum Disorders (ASD).  Dyadic synchrony helps a child regulate their behaviors, emotions, and cognitions, leading to improved self-regulation (Deater-Deckard, Atzaba-Poria, & Pike, 2004).  We compared observed child behaviors during play with their mothers, to parent-reported problem behaviors.

Objectives: We hypothesized that children with ASD would have worse behavior scores during play, due to their symptomatology.  For both groups, we expected that low parent reports of problem behaviors would predict positive child behaviors during play.

Methods: Twenty-five 4-11 year-old boys and girls (M=7.24 years, SD=2.1 years; 88% Caucasian) participated along with their mothers.  Ten children (100% male) met the clinical cut-off for ASD on the Autism Diagnostic Observation Schedule (ADOS; Lord et al., 2000); 15 did not (40% male).  Mother-child dyads completed nine play tasks adapted from the Marschak Interaction Method (The Theraplay Institute, 2005), such as playing with figurines, completing a puzzle, drawing, and sharing a snack.  Mothers also completed survey measures (e.g., Parenting Stress Index, Short Form (PSI; Abidin, 2005); Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997); Aberrant Behaviors Checklist (ABC; Aman, Singh, Stewart, & Field, 1985)).  Two trained coders, blind to group, independently coded videotapes using the Coding System for Mother-Child Interactions (Healey et al., 2010) to score child behaviors, mother behaviors, and overall dyadic synchrony.  Total child behavior scores included three subscales: cooperation and compliance, enthusiasm, and negativity and hostility (reverse-scored).  

Results: Group differences were found on the cooperation-compliance and enthusiasm subscales, as well as the total child score. No group difference was seen for the negativity and hostility subscale. Predictors of total child behavior score included Difficult Child score on the PSI, b=.69, t(22)=16.69, p<.05, peer problems on the SDQ, b=-.49, t(22)=-9.73, p<.05, emotional problems on the SDQ, b=.67, t(22)=7.97, p<.05, hyperactivity on the ABC, b=-.83, t(22)=-9.67, p<.05, and speech problems on the ABC, b=-.62, t(22)=-7.84, p<.05.  Significant differences were found between the ASD group and the non-ASD group on all subscales listed above, p< .05-.001.  

Conclusions: The ASD group showed less compliance and enthusiasm during the play tasks, and more negative behaviors reported by parents.  Surprisingly, there was no group difference on observed negativity, indicating that “less positive” interactions were not necessarily “more negative.”  Hyperactivity and emotional problems may make a child less cooperative, enthusiastic, and focused during play with their parent.  Parent perception of their child’s problem behaviors also predicted the child’s overall negative behaviors during those tasks, indicating a rather accurate perception of these behaviors.  However, the relationships between child behaviors and speech and peer problems were slightly less clear.  It remains to be seen whether this relationship was due to ASD symptoms, or a broader connection across groups, between speech and social abilities and play behaviors. Despite power limitations and a significant gender difference between groups, our findings suggest important future directions for exploring the characteristics of mother-child relationships in this population.