Parental Co-Regulation and Expressed Emotion As Predictors of Psychopathology in Children with ASD

Background: Individuals with an Autism Spectrum Disorder (ASD) often have comorbid mental health problems (Ooi, Tan, Lim, Goh, & Sung, 2011; Totsika, Hastings, Emerson, Lancaster, & Berridge, 2011). Parental co-regulation (i.e. motivational or emotional scaffolding, and using strategies to help their child regulate emotions) has been associated with fewer internalizing and externalizing problems in typically-developing children and those with ASD, 3 to 6 years of age (Hooven, Gottman, & Katz, 1995; Wilson et al., 2013). Indications of low parental negative expressed emotion have also been linked with fewer mental health problems in adolescents and adults with ASD (Smith, Greenberg, Seltzer, & Hong, 2008). However, expressed emotion and co-regulation have not been studied together, or examined in relation to psychopathology in older children with ASD.  

Objectives: To investigate whether parental co-regulation and expressed emotion were related to externalizing and internalizing problems in children with ASD, 8 to 12 years of age.

Methods: Twenty-nine children with ASD (86.2% male) and their caregivers (75.9% female) have participated in a larger ongoing treatment trial to improve emotion regulation, which is expected to increase to 40 participants by April 2015. Children were 8 to 12 years of age (M = 9.79, SD = 1.26), with average IQ (M = 102.90, SD = 11.91, Range: 80-125). Parental co-regulation skills (i.e. scaffolding) were measured using a behavioural coding scheme (Gulsrud, Jahromi, & Kasari, 1995), applied to parent behaviours during a standardized Emotion Discussion Task. Expressed emotion was measured using the Autism-Specific Five-Minute Speech Sample (Benson, Daley, Karlof, & Robinson, 2011). Externalizing and internalizing problems were measured via parent report on the Behavior Assessment System for Children, Second Edition – Parent Rating Scales (Reynolds & Kamphaus, 2004). Clinically significant mental health problems were measured by the Anxiety Disorders Interview Schedule for DSM-IV (ADIS; Silverman & Albano, 1996).  

Results: The following results are based on 20 participants with coded expressed emotion and co-regulation data, and data collection and analysis is ongoing. Pearson correlations were conducted to identify relationships among child characteristics (i.e. age, IQ), parent scaffolding and expressed emotion, and child internalizing and externalizing problems. Level of internalizing symptoms was negatively correlated with parent scaffolding (r = -.45, p = .046) and positively correlated with overall ADIS severity score (r = .52, p = .006) and child age (r = .46, p = .016). Level of externalizing symptoms was negatively correlated with parent scaffolding (r = -.45, p = .047) and positively correlated with overall expressed emotion (r = .47, p = .037) and ratio of critical to positive comments (r = .57, p = .009). With the increased power expected with the larger sample of 40 participants, the poster will also report on multiple regressions to further predict child psychopathology.  

Conclusions: Findings will be discussed in relation to supporting parents of children with ASD who are experiencing emotional problems, such as anxiety or aggression. Findings can help inform clinicians on how to best include parents in treatment.