The Impact of Symptom Severity on Parent-Child Interaction and Relationships Among Children with Autism

Background: The abilities that constitute deficiencies in autism are known to develop in typical children through interactions and relationships with parents from infancy throughout the childhood years (Hobson, 2004).  While it is recognized that parents and children influence each other in a bidirectional process, little has been done to investigate how this occurs in the interactions and relationships between parents and children with autism (Siller & Sigman, 2002).  The impact of autism symptoms on the ability to engage in relationships that allow this development has been well documented.  What has not received equal attention are the mechanisms by which a child’s autism symptoms impact interactions and relationships with parents, therefore impacting the developmental process.

Objectives: To examine the impact of child symptom severity in children ages 4-15 years, as measured by the Autism Diagnostic Observation Schedule (ADOS), on parent-child interaction, as measured by the Dyadic Coding Scale (DCS), and parent-child relationships, as measured by the Parent Child Relationship Inventory (PCRI).

Methods: Demographic information about participants was gathered via questionnaire.  Autism symptom severity was measured using the ADOS, including updated scoring algorithms and the newly developed autism severity metric.  The severity metric allowed for accurate comparison of symptom severity across the entire sample; taking into account age, communication level, and module utilized during testing.  The DCS subscales were used to measure parent-child interaction, and the PCRI to measure parent-child relationships.  A convenience sample of 25 participants was acquired from various autism organizations in West Michigan.  Multivariate regression was used to analyze data.

Results: Intra-class correlation for coding reliability on the DCS subscales was strong and ranged from .83 to .98.  Results of the multivariate regression analysis showed significant relationships between autism symptom severity and parent-child interaction.  As autism symptom severity increased, the quality of parent-child interaction decreased.  However, a significant relationship between autism symptom severity and parent-child relationship was not found.  Autism symptom severity did not predict any of the parent-child relationship subscales.  Results indicate that autism symptom severity is related to parent-child interaction, but not to the overall parent-child relationship.

Conclusions: Study results underscore the importance of identifying patterns of parent-child interaction that may impact child functioning in positive or negative ways.  In addition, attention must be paid to the impact autism has on parent child interaction and relationships regardless of the child’s symptom levels, specifically in the area of parent communication effectiveness.  Focusing on the ways in which parents and children interact with one another on a moment-to-moment basis can provide an appropriate starting point for intervention and improved treatment outcomes.