Relationships between Child Factors and Parental Mental Health Symptoms

Background: Parents of children with developmental disabilities present with higher rates of anxiety, depression and stress than parents of typically developing children. Furthermore, there is a higher prevalence of these mental health symptoms in parents of children with autism spectrum disorder (ASD) than in parents of children with other developmental disabilities (Dumas, Wolf, Fisman & Culligan, 1991; Sanders & Morgan, 1997; Taylor & Warren, 2012). We aimed to explore relationships between parental symptoms and behavioral characteristics of children with ASD.

Objectives: In a sample of children with ASD and their mothers, we examined possible relationships between child and parent symptoms and behaviors.

Methods: Participants included thirty-three 5- to 8-year old children with ASD (M = 72.1 months, SD = 15.6 months) and their mothers. All children had an ASD diagnosis as confirmed by the Autism Diagnostic Observation Schedule (ADOS). Parents reported on their children’s behavioral and emotional symptoms using the Child Behavior Checklist—Preschool and School Age (CBCL/1.5-5 and CBCL/6-18). Parents also completed the Repetitive Behavior Scale—Revised (RBS-R) to assess children’s repetitive behaviors. Additionally, mothers reported their own depression, anxiety, and stress symptoms using the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the Parenting Stress Index—Fourth Edition (PSI-4), respectively.

Results: Scores for maternal anxiety on the BAI were positively correlated with child ritualistic behaviors on the RBS-R Ritualistic Behavior subscale (r = .376, p = .034, n = 32). For children ages 6 and above (n = 15), somatic complaints on the CBCL also correlated with maternal anxiety (somatic complaints: r = .597, p = .019). Additionally, higher BDI-II scores and higher scores on the Parental Distress subscale of the PSI-4 correlated with lower rates of child participation in extracurricular activities as reported on the CBCL/6-18 (depression: r = -.575, p = .025; parental distress: r = -.587, p = .021).

Conclusions: Maternal mental health symptoms correlated with a number of child factors. Children of mothers with higher levels of anxiety showed higher rates of somatic symptoms compared with children of mothers with lower levels of anxiety. Additionally, maternal anxiety was correlated with child ritualistic behavior. Given that anxiety symptoms have a genetic component, it is possible that children of anxious mothers also have greater symptoms of anxiety, which in these young children may manifest as somatic complaints and/or heightened ritualistic behaviors. Children’s involvement in extracurricular activities was negatively correlated with maternal depression and parenting distress, meaning that children whose mothers showed higher levels of depression or distress were less likely to be involved in activities. Further work is needed to determine the directionality of these relationships and consider the possibility of bidirectional interactions. Further understanding can help inform future interventions to best support both children with ASD and their parents.