Emotion Regulation Strategies in Preschoolers with Autism Spectrum Disorder: Associations with Wellbeing, Sleep and Temperament

Background:  Emotional dysregulation has been shown to be strongly associated with challenging behaviours and mental health problems in children. Recent studies have highlighted that children with Autism Spectrum Disorder (ASD) use less adaptive strategies for regulating their emotion and tend to have a limited repertoire of regulatory behaviours compared to their typically developing (TD) peers, however it is unknown how these strategies map on to wellbeing, mental health and associated factors in children with ASD.

Objectives:  To explore differences in emotion regulation strategies between children with ASD and matched controls and to examine relationships between emotion regulation strategies, mental health, quality of life, sleep quality and temperament.

Methods:  44 children with ASD and 29 matched controls (2- 4 years) were administered tasks from the Laboratory Temperament Assessment Battery. Tasks were designed to mimic everyday life experiences in which children would need to regulate low-level stress (e.g. waiting for a snack). Coders blind to diagnostic group coded twelve emotion regulation strategies (see Figure 1), ranging from adaptive (e.g. social strategies) to maladaptive (e.g. avoidance) strategies. Parents reported on their child’s mental health, quality of life, sleep quality and temperament.

Results:  As can be seen in Figure 1, children with ASD used significantly fewer social strategies mediated through unfamiliar people (researchers), t(71) = 4.87, p < .001, more avoidance, t(71) = -3.68, p < .001, and marginally more physical comfort from their parents, t(71) = -1.90, p = .06, compared to controls. For children with ASD, greater wellbeing was related to less perceptual disengagement, r(41) = -.30, p= .05, and self-soothing, r(41) = -.28, p= .07. For children with ASD only, longer sleep time was related to social strategies, mediated through unfamiliar people r(43) = .42, p< .01. Social strategies mediated through family members was negatively associated with effortful control in the TD group, r(27) = -.36, p= .06, but positively associated in the in the ASD group r(42) = .33, p= .03.

Conclusions:  These findings suggest that children with ASD use less adaptive and more frequent physical comfort strategies than children without ASD. Unique relationships of emotion regulation strategies in ASD were identified, highlighting the link of sleep with social strategies and wellbeing with less use of maladaptive strategies. TD children who have higher effortful control skills appear to rely less on family members to mediate low-level stress, whereas for the children with ASD this relationship is reversed.