Hair Cortisol in Young Children with Autism and Their Parents: Associations with Child Mental Health, Eating Behavior and Weight Status.

Children with autism and their parents face daily challenges that may be stressful for both. However, little is known about biological stress (hair cortisol concentrations [HCC]) in these families and its connection to children's health outcomes. This study investigates biological stress in children with autism and their parents and its associations with child mental health, eating behavior and BMI. Stress was measured in 102 young children with autism and their parents (101 mothers, 86 fathers) using HCC and self-reported parenting stress (OBVL). Child mental health was measured through autism symptoms (ADOS-2, SRS-2) and problem behavior (CBCL). Child eating behavior (CEBQ) and BMIz were also measured. Children with autism had higher HCC than their peers. Child HCC was not linked to mental health, eating behavior, or BMIz. Maternal stress (self-reported and HCC) was associated with child problem behavior. In fathers, self-reported parenting stress correlated with child autism symptoms (SRS-2) and behavior problems. Both parents' self-reported stress was associated with child eating behavior, specifically emotional undereating and overeating. In conclusion, higher HCC levels in children with autism in comparison to children from the general population, suggest differences in stress-regulation in children with autism. Given these findings, monitoring HCC in research and clinical practice could improve our understanding of stress-regulation in children with autism. The association between parental stress and children's mental health and eating behaviors, underscores the importance of considering family dynamics in clinical (preventive) interventions and in further research that addresses the mental and physical health of children with autism.