Nanjing Brain Hospital, Affiliated with Nanjing Medical University, Child Mental Health Research Center, Nanjing, 210029, China.
BMC Psychiatry. 2021 Oct 22;21(1):523. doi: 10.1186/s12888-021-03479-6.
The behavioral characteristics of children with autism spectrum disorder (ASD) are not only affected by their disease, but also by their parenting environment. HR-ASD has the risk of developing internalization and externalization problems. How the early development of these behavioral problems is affected by parent-child interaction is worth exploring. We tested whether parent-child interactions and parenting characteristics were associated with behavioural problems during the infant periods.
This study collected data from 91 infants at high risk for ASD and 68 matched typically developing (TD) infants, about their internalizing and externalizing behavioural problems and engagement states (i.e. positive, negative, and parent-child interactions), using free play paradigm. Parent measures were assessed using the Broad Autism Phenotypic Questionnaire (BAPQ) and Parenting Stress Index Short Form (PSI-SF) questionnaire. The core symptoms of ASD were assessed using the the Autism Diagnostic Observational Schedule (ADOS).
During free play, infants in the HR-ASD group showed more internalizing (P < 0.001) and externalizing (P < 0.05) behaviours and less positive engagement (P < 0.01) than the TD group. In the regression analysis, we found that parenting stress had an impact on the infants' externalizing behaviours (△R = 0.215). Parent negative engagement had an impact on the infants' internalizing behaviours (△R = 0.451).
The present study revealed that children at high risk for ASD exhibited more severe internalizing and externalizing behavioural problems than TD group. The parent negative engagement is associated with behavioural problems. The findings on the contribution of parents' factors to behavioural problems suggests that the parenting stress and parent-child interactions are important factors for mitigating behavioural problems.
自闭症谱系障碍（ASD）儿童的行为特征不仅受其疾病影响，还受其养育环境影响。高风险自闭症儿童（HR-ASD）有发展内化和外化问题的风险。这些行为问题的早期发展如何受到亲子互动的影响值得探索。我们测试了亲子互动和养育特征是否与婴儿期的行为问题有关。
本研究使用自由游戏范式，收集了 91 名高风险 ASD 婴儿和 68 名匹配的典型发育（TD）婴儿的内化和外化行为问题以及参与状态（即积极、消极和亲子互动）的数据。使用 Broad Autism Phenotypic Questionnaire（BAPQ）和 Parenting Stress Index Short Form（PSI-SF）问卷评估父母的特征。使用自闭症诊断观察量表（ADOS）评估 ASD 的核心症状。
在自由游戏中，HR-ASD 组婴儿的内化（P < 0.001）和外化（P < 0.05）行为以及积极参与（P < 0.01）较少。在回归分析中，我们发现养育压力对外化行为有影响（△R = 0.215）。父母的消极参与对婴儿的内化行为有影响（△R = 0.451）。
本研究表明，高风险自闭症儿童表现出比 TD 组更严重的内化和外化行为问题。父母的消极参与与行为问题有关。父母因素对行为问题的贡献的研究结果表明，养育压力和亲子互动是减轻行为问题的重要因素。
