Use of Expressed Emotion (EE) in Assessing the Quality of Parent-Child Relationships: A Comparison of Young Children with and without ASD

Background: Parenting children with ASD is challenging, as would be expected when bonding with a child who has social communication impairments. Mothers of children with ASD report less gratification from their children and more stress than mothers of children with other developmental disabilities (Hastings et al., 2005). EE is predicated on the assumption that the manner in which parents talk about their children is indicative of the way they treat them (Daley, 2009).  Yelland and Daley (2009) report that high parental EE, in particular high criticism, has been shown to be associated with depression, schizophrenia, anxiety symptoms, withdrawal, somatic complaints, self-injurious behavior, delinquency, conduct disorder, oppositional defiant disorder and attention deficit/hyperactivity disorder. Measuring EE in parents of young children with ASD may shed light on their experience.

Objectives: The purpose of this research is to assess the efficacy of information gleaned from parents of young children with ASD who speak about their children for five minutes. The speech sample is subsequently coded for emotional expression (EE). Comparing the resulting profiles with those of parents of children with typical development may enable a deeper understanding of what the parents go through. Finally, by comparing EE scores with scores of parental stress in both groups it may be possible to understand relationships between subjective narrative data and stress.  

Methods: Mothers of 3-5 year old children with and without ASD (n = 70), matched on mental age, SES, and gender, were asked to express their thoughts/feelings about their child for an uninterrupted five minutes. Their speech was recorded and later analyzed for both content and tone. This five minutes speech sample (FMSS) was designed as a brief measure of EE (Magnana et al., 1986) with an adaption for young children (Daly, Sonuga-Barke & Thompson, 2003). In preschool children, five variables are analyzed: number of positive comments, number of negative comments, warmth, quality of relationship and emotional over-involvement. In addition, the mothers completed a demographic questionnaire and the parenting stress index (PSI: Abidin, 1995).

Results: Significant differences emerged on the EE scores, with mothers of ASD children revealing less warmth when discussing their children, fewer positive and more negative comments than mothers of TD children. Correlations revealed different patterns of associations in descriptions of their relationships from mothers of children with and without ASD. For mothers of ASD children, significant correlations emerged between warmth and positive comments whereas for mothers of TD children, in addition to those correlations, critical comments were significantly correlated with stress. This is despite the fact that significant group differences revealed that mothers of children with ASD reported significantly more stress in the child domain, (t = 13.540, p < 0.000), but not in the parenting domain of the PSI.

Conclusions: Results suggest that the EE measurement of the quality of parent child relationship is a viable measure for use with this population and can help identify areas which can inform practitioners working with parents of young children with ASD.