Title: Parent-child Interaction in Children with Autism Spectrum Disorder Who Vary in Symptom Severity and Level of Functioning
Description: The context of parenting children with Autism Spectrum Disorders (ASD) is understood to be extremely stressful and presents unique parenting challenges. Research with typically developing families has demonstrated that parent-child relationship difficulties and ineffectual/negative parenting practices are likely to exist in the context of high parental stress and child behavior problems, but few studies have observed parenting behaviors in families with a child with ASD. This study examined three well-established components of parenting (i.e., emotional support, instruction/patience, and negative parenting/psychological abuse) using the Psychological Multifactor Care Scale – ASD Adapted Version (Donnelly, Brassard, & Hart, 2014; Brassard, Hart, & Hardy, 1993) through observations of a structured and unstructured parent-child interactions in a sample of children diagnosed using gold standard ASD assessments (N=30; Autism Diagnostic Interview – Revised, Rutter, Le Couteur, & Lord, 2003; Autism Diagnostic Observation Schedule, Second Edition, Lord et al., 2012).

It was hypothesized that the relationships of parents and children with ASD would be similar to those of parents and neurotypical children but that these relationships would be moderated by cognitive ability (Full Scale IQ) and ASD symptom severity. The sample, of largely African American and Hispanic, working and middle class urban families, demonstrated high rates of positive parenting and low rates of negative parenting, and significantly better parenting compared with lower income urban maltreating and comparison families in a previous study using the same observational measure (Brassard et al., 1993). Child cognitive level and symptom severity did not have the expected moderation effects between parent and child behaviors. Similar to neurotypically developing children, children with ASD acted more negatively towards their parents when negative parenting was exhibited in the structured task. In the unstructured task this relationship was moderated by cognitive level, suggesting that what is perceived by higher functioning children as intrusive, might function as helpful direction for lower functioning children.

Conversely, when higher functioning children display negativity towards their parents, their parents may act more negatively in turn. Higher levels of negative parenting were related to lower levels of the child’s experience of the session in the unstructured task, but not in the structured task, indicating that negative parenting may be perceived variably by type of task. Positive parenting was related to the degree to which children were observed to have a good experience of the session, and this relationship was moderated by comorbidity of other disorders (mostly Attention-Deficit Hyperactivity Disorder) in the unstructured session; children without comorbid disorders were observed to have better experiences in the session, in comparison to children with comorbid disorders, when their parents exhibited greater amounts of positive parenting. The presence of a comorbid disorder was also associated with the degree to which parents exhibit patience in the structured task. Parents displayed higher levels of patience and less negative parenting with children that did not have comorbid disorders.

Implications for parents with children with ASD and comorbid disorders are discussed. Lastly, in regards to parent ethnicity, Hispanic parents tended to have children who directed less negativity towards their parents. Clinical implications for families and practitioners working with children with ASD and future research directions regarding parenting in the context of ASD are discussed.