ASD Symptoms As Predictors of Negative Outcomes in Parents and Typically-Developing Siblings

Background: Literature examining typically-developing (TD) siblings and parents of children with ASD suggests that both may be at risk for negative outcomes due to a variety of factors.  However, because many TD siblings and parents adjust appropriately, maladjustment in family members seems to only occur under certain conditions.  Research has shown that characteristics of children with ASD may predict adjustment in family members. Due to the heterogeneous nature of ASD symptoms, it follows that family adjustment may differ according to ASD symptom manifestation. 

Objectives: This exploratory study investigated how different ASD symptom domains predicted parental stress and psychopathology as well as parent- and self-reported emotional and behavioral maladjustment in TD siblings. 

Methods: A total of 113 families participated. Ages of children with ASD ranged from 3-17 years (M = 11.98, SD = 3.29); ages of TD siblings ranged from 11-17 years (M = 13.32, SD = 1.81). Parents completed the Strength and Difficulties Questionnaire (SDQ) about the TD sibling (assessed emotional and behavioral functioning) and the Children’s Social Behavior Questionnaire (CSBQ) about the child with ASD (assessed ASD symptom severity). Parent also completed the Questionnaire on Resources and Stress – Short Form (assessed parental stress) and Symptom Checklist-10-Revised (assessed parental psychopathology) about themselves. Finally, TD siblings self-reported via the SDQ. 

Results: Preliminary correlations (Table 1) showed that general ASD symptoms in children with ASD significantly related to parental stress, (r = .51, p < .001), parental psychopathology (r = .33, p < .001), parent-reported maladjustment in TD siblings (r = .43, p < .001), and self-reported maladjustment in TD siblings (r = .23, p = .01).  To better understand the nature of these relations, four separate regression analyses were conducted to examine which specific ASD symptom domains uniquely predicted the aforementioned criterion variables (if any), while accounting for variance contributed by other symptom domains (Table 2).  Parental stress and parental psychopathology scores were separately regressed onto CSBQ subscales scores (i.e., the ASD symptom domains). Stereotyped behavior (β = .27, p = .01) was the only unique predictor of parental stress.  The overall model predicting parental psychopathology was significant (R² = .14, p = .01); however, none of the ASD symptom domains emerged as unique predictors. Both parent- and self-reported TD sibling SDQ Total scores were separately regressed onto CSBQ subscale scores.  Behavior not appropriate to social situations/aggressive (β = .28, p = .01) and stereotyped behavior (β = .22, p = .04) emerged as significant predictors of parent-reported TD sibling maladjustment, whereas social withdrawal/lack of social interest (β = .28, p = .01) emerged as the only significant predictor of self-reported TD sibling maladjustment. 

Conclusions: Results indicate that certain types of ASD symptoms may relate differently to negative outcomes in family members.  Additionally, these associations appear to vary for different family members and according to who serves as the reporter (e.g., parent versus typically-developing sibling). These findings can guide further research on predictors of maladjustment among families of a child with ASD and also can inform interventions for these families.