It's Time to Clean up! Symptom Severity Impacts Compliance Behaviors in Children at-Risk for Autism

Background:  One of the important developmental milestones during the toddler years is the ability to comply with others’ requests (Kopp, 1982). During tasks that require compliance (e.g., clean-up tasks) toddlers may demonstrate committed compliance (i.e., willingly embracing the rules) or situational compliance (i.e., obeying the rules but only after repeated reminders). On the other hand, toddlers may also display noncompliant behaviors that include defiance, resistance, or passively ignoring requests to follow the rules. Child noncompliance has been shown to be associated with later behavior problems whereas compliance is associated with adaptive social behaviors (Kuczynski & Kochanska, 1990). Children with autism spectrum disorder (ASD) have been found to exhibit heightened levels of behavior problems and maladaptive social behaviors and are more noncompliant than their typically developing peers (Bryce & Jahromi, in press). The younger siblings of children with autism often show subclinical deficits that may include behavior problems. 

Objectives:  The purpose of the current study was to examine the association between autism symptom severity and later child compliance in a group of toddlers at-risk for an autism spectrum disorder.

Methods: The sample consisted of 52 children who were the younger siblings of a child with an ASD (male n = 46, female n = 30) and 33 children with no family history of autism. Children completed the Autism Diagnostic Observation Schedule at 30 and 36 months of age and a calibrated severity score was calculated. At 36 months, children participated in a clean-up task where the parent was instructed to have their child clean-up like they normally would at home. This task lasted five minutes or until all of the toys were placed in the basket. Child compliance was rated every 15-s and scores reflecting the proportion of time engaged in compliance (committed and situational) and noncompliance (passive, resistance, and defiance) were calculated. 

 Results:  Children at-risk for an ASD were significantly less likely to engage in committed compliance, F(1,83)=4.67, p < .05. Among the group of children at-risk for an ASD, at 36 months, we found that higher levels of symptom severity predicted lower levels of committed compliance, b = -.09 (SE = .04) and higher levels of situational compliance, b = .07 (SE = .03). In addition, those children who received an eventual diagnosis of an ASD were more likely to engage in passive noncompliance, F(1,47)=5.54, p < .05. We are currently coding parent behaviors during the clean-up task and intend to examine those behaviors in relation to child behaviors during the same task.

Conclusions:  The results of the current study support previous work suggesting lower levels of compliant behavior among children with an ASD (Bryce & Kahromi, in press). This study, however, is the first to examine these among children who are at-risk for an ASD. The results have important implications for our understanding of the development of autism, as well as clinical implications for interventions targeting at-risk children.