Parental Stress and Proband Mental Health As Predictors of Mental Health in Toddlers at High-Risk for Autism Spectrum Disorders

Saturday, May 14, 2016: 11:30 AM-1:30 PM
Hall A (Baltimore Convention Center)
K. Hudry1, K. Crea2 and C. Dissanayake3, (1)Olga Tennison Autism Research Centre, Melbourne, Australia, (2)Olga Tennison Autism Research Centre, Bundoora, VIC, Australia, (3)Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia

Autism Spectrum Disorders (ASD) are diagnosable from toddlerhood and have a significant and pervasive impact on development and wellbeing across the lifespan. Furthermore, where a family includes one child with an ASD diagnosis, various risk factors present for adverse outcomes among later-born children, including both the genetic susceptibility for also developing ASD. However, temperamental characteristics are also heritable and unique environmental influences may present as a result of the ASD diagnosis in the older child (proband). While most ‘high-risk’ sibling research to date has focused on development of core ASD symptoms, there has been little consideration of broader factors such as emotional wellbeing and early indicators of mental health.


Using a variant on a high-risk sibling design, we investigated early emotional wellbeing and mental health indicators among the toddler-aged siblings of children with ASD, including a comparison group of low-risk controls with no family history of ASD. Specifically, we sought to identify the relative predictive value of environmental factors – parent stress and proband mental health difficulties – for toddler mental health, across the period of 2- to 3-years of age, beyond other factors such as risk status, temperament and core symptom presentation.


A sample of 30 high-risk and 28 low-risk control toddlers was followed from 2- to 3-years of age. At the first visit, parents completed the self-report Depression Anxiety Stress Scales and the Behaviour Assessment System for Children (BASC) regarding their older child, and they also completed the BASC and the Short Temperament Scale for Toddlers (STST) for their younger child at each of the 2- and 3-year visits. A comprehensive assessment was conducted with high-risk toddlers at the 3-year visit to identify subgroups with and without ASD outcome.


As anticipated, the probands of high-risk toddlers (i.e., older children with ASD) had greater parent-reported mental health difficulties – internalising and externalising problems, and broad behaviour symptoms – than did the older siblings of low-risk toddlers (i.e., those with no family history of ASD). Further, parents of high-risk toddlers had greater self-reported depression and stress than parents of low-risk controls. Across the sample as a whole, parent stress and proband mental health difficulties were significant predictors of concurrent mental health difficulties among toddlers (i.e., at the 2-year visit), and substantial continuity in these was then observed one year later (i.e., to the 3-year visit). Risk status (i.e., high- vs. low-risk group) and diagnostic outcome (i.e., ASD vs. no-ASD outcome, among the high-risk group) were not observed to confer additional risk for toddler mental health difficulties, beyond these parent and proband factors. 


Environmental risk factors may play an important role in determining mental health outcomes for young children – with effects apparent already by 2 years of age and showing continuity to 3 years – in the context of family history of ASD. It seems important therefore to monitor early social-emotional development and intervene early to support emotional wellbeing among toddlers at high-risk of ASD to support optimal developmental outcomes.