Parental Perceptions and Child Emotional and Behavioral Problems in Autism

Background:

Emotional and behavioral difficulties in children with autism are often a focal concern for families. Previous research has demonstrated that parental perceptions of their children’s autism are associated both with internal processes for parents, including stress, depressive symptoms, and meaning-making, and with external processes, including treatment choice and use of specific health services. Although there is evidence to suggest associations between parental perceptions about autism, parental stress, and children’s emotional and behavioral problems, the purpose of our study was to assess whether parental beliefs and perceptions, even after accounting for levels of parental stress and autism symptom severity, are associated with the likelihood that parents will describe their children’s emotions, conduct, peer relationships, hyperactivity, and prosocial behavior as problematic to a clinically significant degree.

Methods:

Using data from the 2011 Survey of Pathways to Diagnosis and Services, we used ordinal logistic regression models to examine associations between 377 parental reports of their perceptions about autism and their children’s emotional and behavioral problems. The outcome variable, child strengths and difficulties, was measured by parents’ responses to 25 Pathways survey questions based on the Strengths and Difficulties Questionnaire (SDQ), a parent-reported screening tool that produces a full-scale score and five subscale scores in each of the following domains: emotional problems, peer problems, conduct problems, hyperactivity, and prosocial behavior problems. 

Findings:

Results showed that parents who attributed their child’s autism to environmental factors, who experienced emotional upset or confusion about autism, or who perceived the condition to be burdensome, were more likely to report clinically significant emotional and behavioral difficulties, even in the presence of controls for condition severity.

Conclusions:

With the number of children diagnosed with autism increasing (Christensen et al., 2016), there is a greater demand for behavioral health care services.  The present study found that parental beliefs and perceptions about autism, such as that it is caused by environmental factors or that the condition is lifelong, were related to an increased likelihood that parents would report their children to have clinically significant emotional and behavioral difficulties, even in the presence of controls for condition severity.  Parental stress, as evidenced in reports that their child’s condition is a burden to themselves or the family, was also positively associated with reports of emotional and behavioral problems in children with autism.  These findings highlight the important role that beliefs and perceptions may play in parents’ descriptions of their children’s emotions and behaviors in arenas that may include the diagnostic and/or treatment setting.