Mother-Child Interaction in 5- and 10-Month Old Infants at Risk for Autism Spectrum Disorder

Background: Parent-child interaction (PCI) is the first and most important context in which infants learn, influencing different domains of later development. In the context of autism spectrum disorder (ASD), characterized by social-communicative deficits, parents’ interaction with their child can be challenging. Parental behavior towards a child with or at risk for ASD is often more directive and less sensitive and infants at risk for ASD are less lively during PCI (Doussard-Roosevelt et al., 2003; Wan et al., 2012). Given the positive association of sensitive responsiveness and following the child’s focus with later language and cognitive development (Gros-Louis et al., 2014; Penela et al., 2012), it is important to investigate the generalization and possible impact of this ASD-specific interaction style on younger siblings of children with ASD. 

Objectives: The current study investigated mother-child interaction in siblings of children with ASD (high-risk sibling group, HR) and a comparison group of children with a typically developing older sibling (low-risk group, LR). Maternal, infant and dyadic interaction characteristics were compared between the two groups and the link with later cognitive and social-communicative functioning was explored. 

Methods: Participants were 55 parent-infant dyads taking part in a longitudinal study of early social-communicative skills: 21 HR infants (11 boys, 10 girls) and 34 LR infants (19 boys, 15 girls). Unstructured play interactions between mother and child were observed at 5 and 10 months and coded with the Coding Interactive Behavior coding scheme (Feldman, 1998). Cognitive development was measured at 10 and 14 months with the Mullen Scales of Early Learning (MSEL; Mullen, 1995) and social-communicative functioning at 14 months was observed with the ADOS-toddler (Lord et al., 2012).

Results: At the age of 5 months, no differences between LR and HR interactions could be observed, while at 10 months, mothers of HR children scored lower for maternal sensitivity and maternal limit setting. HR infants had lower infant involvement and higher negative emotionality scores. The HR dyadic interaction was rated lower for dyadic reciprocity and higher with regard to dyadic negative state.

Correlations within the whole sample between PCI at 10 months and MSEL and ADOS scores at 14 months showed a positive association between maternal sensitivity, infant involvement and dyadic reciprocity on the one hand and MSEL subscale scores and developmental index on the other hand. Dyadic negative state was negatively associated with MSEL scores. Furthermore, maternal sensitivity and dyadic reciprocity were negatively correlated with ADOS scores, while dyadic negative state was positively associated with ADOS scores.

Conclusions: At the age of 10, but not 5 months, PCI of HR siblings is characterized by less maternal sensitivity, infant involvement and dyadic reciprocity and more infant negative emotionality and dyadic negative state. Furthermore, these PCI characteristics are associated with lower cognitive and social-communicative functioning at 14 months. Given the positive effects of early parent-mediated interventions for young children with ASD on PCI (Oono et al., 2013), it is promising to further investigate the impact of these interventions on the developmental pathways of siblings at risk for ASD.