Parent-child interaction in children with autism spectrum disorders and anxiety

An emerging body of research reflects high rates of co-occurring anxiety symptoms in children with autism spectrum disorder (ASD), however our understanding of the nature of anxiety in this population is in its infancy. Despite this, it is clear anxiety can have a significant impact on functioning and quality of life for children with ASD. The aim of this study was to examine potential causal and maintaining factors of anxiety in children with ASD,specifically in relation to parent-child interactions, and parent and child cognitive factors. The study was based on an experimental design with a sample of parent-child dyads comprising children with anxiety disorders (n = 20), children with ASD and anxiety (n = 19), and non-clinical children (n = 18). The thesis is comprised of three separate papers utilising this sample. Paper 1: Parent-child interaction in children with autism spectrum disorder and anxiety disorders; Paper 2: Parental fear of negative child evaluation and its association with parental overinvolvement in children with autism spectrum disorder and anxiety disorders; Paper3: Ambiguous threat interpretation in children with autism spectrum disorder and anxiety disorders. The results indicated parents of children with ASD and anxiety were significantly more involved than parents of children with anxiety alone; and parental fear of negative child evaluation (FNCE) was associated with higher levels of anxiety and involvement, with parents of children with ASD reporting significantly higher levels of FNCE. With respect to child threat interpretation, anxious children reported significantly higher levels of perceived threat in social situations as compared to children with both ASD and anxiety. The findings provide preliminary support for the role of overinvolvement in the development and/or maintenance of anxiety in children with ASD that emphasises a relationship between parent-child interaction and anxiety. However an important distinction, and area of further research, is the interaction between core ASD symptoms and anxiety. Furthermore, the findings suggest possible differences in threat interpretation bias between typically developing children with anxiety and children with both ASD and anxiety, with a possible lack of interpretation bias in social situations for children with ASD and anxiety.