Exploring Emotional Regulations Strategies Used By Adolescents with Autism and Mild Intellectual Disability: A Preliminary Study

Background: Prevalence rates in Australia currently estimate that one in 70 young Australians are on the autism spectrum. Over 70% of Autistic people will have a co-occurring intellectual disability, and an equal number will also suffer from mental illness. Yet currently we know little about why, or how to better protect this vulnerable population. Autistic adolescents with Intellectual Disability (ID) have significantly higher rates of mental health disorders than their typically developing peers. Studies of the general population have linked poor emotional regulation (ER) to mental health problems. Researchers have suggested that emotional dysregulation may be a core difficulty for many people with autism. But there is dearth of research exploring the development of emotional regulation skills in Autistic adolescents with ID.

Objectives: The primary aim of this mixed method study was to investigate which adaptive ER strategies were being used successfully by Autistic adolescents with Mild ID. The secondary aim was to explore the emotional regulation strategies (both adaptive and maladaptive) being used in times of sadness, anger and anxiety.

Methods: Three focus groups were conducted with 22 key informants (parents, teachers and allied health professionals) with extensive experience supporting Autistic adolescents with ID. Quantitative data was analyzed for percentages and trends and converged with a content and thematic analysis of the qualitative data.

Results: Reports indicated that across the emotions of sad, anger and worry, numerous ER strategies are being successfully implemented by this population. Autistic Adolescents with Mild ID are reported to use a range of adaptive ER strategies, however the most commonly used strategies often involved distraction or a change of physical state, rather than engaging cognitive strategies, such as reappraisal. Adaptive ER strategies were reported to be more effective when the adolescent is displaying a lower level of emotional intensity. When emotions are at a high level of intensity, cognitive ER strategies become ineffective, with an adult carer / parent assuming responsibility for regulating the adolescents’ emotions. Parents reported less child direct self-regulation strategies and more parent guided regulation or re-direction strategies.

Conclusions: This study provides an insight into the difficulty that Autistic adolescents have in being able to control their emotions. The study also suggests that compared to their typically developing peers, this population demonstrates less ability to self-regulate and greater reliance on being regulated by others. Co-regulation strategies, which are the stepping stone for typical development, also seem to be limited across all contexts. Outcomes from this study provide the first insights into EC in Autistic adolescents with ID and have implications for future clinical intervention models. Findings from this study are being used to inform an adolescent and Mild ID adaptation of the first autism specific, evidence and emotion-based intervention, Westmead Feelings Program. The results have formed highlighted the need for a greater focus on emotion coaching for parents, teachers and professionals.