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Restoy D, Oriol-Escudé M, Alonzo-Castillo T, Magán-Maganto M, Canal-Bedia R, Díez-Villoria E, Gisbert-Gustemps L, Setién-Ramos I, Martínez-Ramírez M, Ramos-Quiroga JA, Lugo-Marín J. Emotion regulation and emotion dysregulation in children and adolescents with Autism Spectrum Disorder: A meta-analysis of evaluation and intervention studies. Clin Psychol Rev 2024; 109:102410. [PMID: 38401510 DOI: 10.1016/j.cpr.2024.102410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 01/14/2024] [Accepted: 02/19/2024] [Indexed: 02/26/2024]
Abstract
Children and adolescents with Autism Spectrum Disorder (ASD) often experience challenges in emotion regulation (ER) and emotion dysregulation (ED) which can interfere with their adaptive functioning. This study aimed to systematically review and meta-analyze the evidence on ER/ED in children and/or adolescents with ASD, examining its relationship with the following variables: internalizing and externalizing symptoms, cognitive function and social skills, and the effectiveness of non-pharmacological interventions addressing ER difficulties. Both electronic and manual searches were conducted to identify potential studies. Fifty-five studies were included in the meta-analysis. A statistically significant between-group difference was found, suggesting greater ER/ED challenges in the ASD group. Also, the ASD group showed more maladaptive ER strategies and fewer adaptive ER strategies compared to the non-ASD participants. Additionally, more severe ASD and poorer social skills were associated with greater ED and poorer ER skills, respectivelly. Furthermore, there was a significant correlation between internalizing symptomatology and both adaptive and maladaptive ER strategies. Studies of non-pharmacological interventions showed significant improvement in both ER and ED. These results imply that assessing ER/ED in children and adolescents with ASD should be part of the evaluation process, and it should also be a focal point for intervention in this population.
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Affiliation(s)
- Damián Restoy
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | | | - Teresa Alonzo-Castillo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - María Magán-Maganto
- Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain
| | - Ricardo Canal-Bedia
- Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain
| | - Emiliano Díez-Villoria
- Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain
| | - Laura Gisbert-Gustemps
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Imanol Setién-Ramos
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - María Martínez-Ramírez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Jorge Lugo-Marín
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
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Sung YS, Lin CY, Chu SY, Lin LY. Emotion Dysregulation Mediates the Relationship Between Sensory Processing and Behavior Problems in Young Children with Autism Spectrum Disorder: A Preliminary Study. J Autism Dev Disord 2024; 54:738-748. [PMID: 36441430 DOI: 10.1007/s10803-022-05839-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 11/29/2022]
Abstract
Emotion dysregulation is one of the challenges that children with autism spectrum disorder (ASD) and their families face. It is unclear whether emotion dysregulation plays a mediating role in the relationship between sensory processing patterns and problem behaviors among these children. This study examined the relations between emotion dysregulation, behavioral problems, and sensory processing patterns among fifty-seven young children with ASD. Behavioral problems and sensory processing patterns were moderately to strongly correlated with emotion dysregulation. The relationship between sensory processing patterns and behavioral problems was significant with emotion dysregulation as a mediator. These findings help identify the relationship between emotion dysregulation, sensory processing patterns, and behavioral problems to facilitate the planning of intervention strategies for young children with ASD.
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Affiliation(s)
- Yi-Shan Sung
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shin Ying Chu
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (H-CARE), National University of Malaysia, Kuala Lumpur, Malaysia
| | - Ling-Yi Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Kose S, Turer F, Inal Kaleli I, Calik Senturk HN, Ozuysal Uyar DH, Bildik T. The Relationship Between Social Skills and Sensory Profile, Emotion Regulation, and Empathizing/Systemizing in Adolescents on the Autism Spectrum. J Autism Dev Disord 2023:10.1007/s10803-023-06190-5. [PMID: 38127185 DOI: 10.1007/s10803-023-06190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
This study aims to evaluate the relationship between social skills and sensory features, emotion regulation, and empathy in adolescents on the autism spectrum. One hundred and twenty-three adolescents were included in the study (50 autistic, 73 typically developing-TD adolescents). The participants filled out the Adolescent/Adult Sensory Profile (AASP) and Emotion Regulation Questionnaire. Parents of the participants completed the Child Empathy and Systemizing Quotient (EQ-C/SQ-C) and Autism-Social Skills Profile (ASSP) scales. Social reciprocity, social participation/avoidance, ASSP total scores, empathy and systemizing scores were lower, and detrimental social behaviors, low registration sensory profile scores were higher in the autism spectrum group. While a difference between genders was observed in sensory sensitivity, sensation avoiding, low registration quadrants and empathy scores, no gender and group interaction was found in any domain. Social skill total scores were correlated to sensation seeking and low registration sensory features, empathy, systemizing, and reappraisal emotion regulation scores. A hierarchical multiple linear regression analysis was conducted controlling for group and gender, sensation seeking (p = .032, β = 0.138), low registration (p = .012, β = - 0.215) of the AASP, and empathy (p < .001, β = 0.555) and systemizing (p = .033, β = 0.138) scores of the EQ/SQ-C was found to significantly predict social skill total scores. Although emotional regulation strategies may play a role, sensory processing features and empathy and systemizing skills seem to be the more significant contributors to social skills during adolescence. Interventions targeting sensory processing and especially improving empathy and systematization skills may positively affect social skills in adolescents on the autism spectrum.
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Affiliation(s)
- Sezen Kose
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Furkan Turer
- Department of Child and Adolescent Psychiatry, Corlu State Hospital, Tekirdag, Turkey.
| | - Ipek Inal Kaleli
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Hilal Nur Calik Senturk
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Damla Hazal Ozuysal Uyar
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir, Turkey
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4
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Xia C, Wei T, Tang Q, Zheng H, Chen G, Lu J. Depression and Associated Factors among Family Caregivers of Children with Disabilities: Analysis of Intergenerational Differences. Healthcare (Basel) 2023; 11:2693. [PMID: 37830730 PMCID: PMC10572526 DOI: 10.3390/healthcare11192693] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023] Open
Abstract
Family caregivers of children with disabilities might face high risks of depression, whereas the existing literature focused more on parents neglecting grandparents. This study investigated 380 parents and 108 grandparents of children with disabilities to identify depression and associated factors. Descriptive statistics, Chi-square test, Mann-Whitney U test, and multivariable logistic regression were performed to describe the participants' characteristics and risks of depression and identify significant factors. Results showed that parents (35.5%) had higher risks of depression than grandparents (32.4%), but statistical differences were not found. Children's sleep problems (AOR = 1.751, 95%CI = 1.019, 3.008), harmonious family relationships (AOR = 0.694, 95%CI = 0.569, 0.846), and better barrier-free construction (AOR = 0.742, 95%CI = 0.568, 0.970) were significantly associated with depression among parents. As for grandparents, higher education (AOR = 4.108, 95%CI = 1.526, 11.057) and caring for children who experience frequent mood swings (AOR = 2.242, 95%CI = 1.161, 4.329) were associated with higher risks of depression. Further, house ownership (AOR = 0.167, 95%CI = 0.031, 0.887), higher family cohesion (AOR = 0.545, 95%CI = 0.297, 1.000), and better barrier-free construction (AOR = 0.401, 95%CI = 0.185, 0.869) were associated with lower odds of depression. Therefore, both parents and grandparents of children with disabilities had high risks of depression and thus required urgent attention. Healthcare providers and policymakers should develop and implement interventions considering intergenerational differences to reach optimal efficiency.
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Affiliation(s)
- Cong Xia
- School of Health Management, Anhui Medical University, Hefei 230032, China;
| | - Ting Wei
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Qi Tang
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Hongying Zheng
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai 200032, China; (T.W.); (Q.T.); (H.Z.)
- China Research Center on Disability, Fudan University, Shanghai 200032, China
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Favole I, Davico C, Marcotulli D, Sodero R, Svevi B, Amianto F, Ricci FS, Arduino GM, Vitiello B. Sleep disturbances and emotional dysregulation in young children with autism spectrum, intellectual disability, or global developmental delay. Sleep Med 2023; 105:45-52. [PMID: 36963320 DOI: 10.1016/j.sleep.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVE Sleep disturbance and emotional dysregulation (ED) are common and often functionally impairing in young children with neurodevelopmental disorders (NDD). This study investigated the relationship between sleep disturbance and ED in a sample of preschoolers with ASD, intellectual disability, or global developmental delay, and examined possible predictors of their persistence over time. METHODS All children under 6 years of age clinically referred between July 2018 and May 2022 to two neuropsychiatric specialized centers for NDD received a comprehensive diagnostic evaluation, including the Child Behavior Checklist 1.5-5 (CBCL), the Autism Diagnostic Observation Schedule-2 (ADOS-2), and standardized tests of cognitive and global development. Sleep disturbances were assessed with the CBCL-sleep score, and ED with the CBCL Attention, Aggression, and Anxious/Depressed scales (CBCL-AAA). A reassessment of sleep and ED was conducted after 6 months or longer, including the Child Sleep Habits Questionnaire (CSHQ). Multivariate analyses and mixed linear regression models were conducted. RESULTS A total of 136 children, 75.7% male, median age 38.27 months, IQR 15.39, 41.2% with global developmental disorder (GDD) or intellectual disability (ID) participated in the study. Of them, 64.7% were diagnosed with autism spectrum disorder (ASD) and 35.3% with other NDD (w/o ASD). Sleep disturbances (CBCL-Sleep) and ED (CBCL-AAA) were positively correlated (p < 0.001), after accounting for age, ID/GDD and autism symptom severity, in both the entire sample and separately in each diagnostic group (ASD and NDD w/o ASD). Seventy-five children (55%) were reassessed a mean 17.2 months afterwards. There was persistence of the positive correlation between sleep problems and ED (p < 0.001) in both the entire sample and each diagnostic group. The longitudinal mixed linear model showed that ED at follow-up was predicted by baseline sleep problems (p = 0.008), ED (p < 0.001), and ASD severity (p = 0.015). CONCLUSIONS Sleep disturbances are significantly associated with ED in young children with NDD, either with or without ASD, both cross-sectionally and prospectively over time. Sleep problems represent an important comorbidity and a potential treatment target for improving emotional stability in NDD.
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Affiliation(s)
- Irene Favole
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, 10126, Turin, Italy
| | - Chiara Davico
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, 10126, Turin, Italy
| | - Daniele Marcotulli
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, 10126, Turin, Italy.
| | - Roberta Sodero
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, 10126, Turin, Italy
| | - Barbara Svevi
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, 10126, Turin, Italy
| | - Federico Amianto
- Department of Neuroscience, University of Turin, 10100, Turin, Italy
| | - Federica S Ricci
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, 10126, Turin, Italy
| | - G Maurizio Arduino
- Autism Center, Developmental Psychology and Psychopathology, ASL CN1, Cuneo, Italy
| | - Benedetto Vitiello
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, 10126, Turin, Italy
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Grzejszczak J, Gabryelska A, Gmitrowicz A, Strzelecki D. How to Make the Unpredictable Foreseeable? Effective Forms of Assistance for Children with Autism Spectrum Disorder (ASD) during the COVID-19 Pandemic. Diagnostics (Basel) 2023; 13. [PMID: 36766512 DOI: 10.3390/diagnostics13030407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/18/2023] [Accepted: 01/21/2023] [Indexed: 01/24/2023] Open
Abstract
Symptomatology in patients with the diagnosis of autism spectrum disorder (ASD) is very heterogeneous. The symptoms they present include communication difficulties, behavior problems, upbringing problems from their parents, and comorbidities (e.g., epilepsy, intellectual disability). A predictable and stable environment and the continuity of therapeutic interactions are crucial in this population. The COVID-19 pandemic has created much concern, and the need for home isolation to limit the spread of the virus has disrupted the functioning routine of children/adolescents with ASD. Are there effective diagnostic and therapeutic alternatives to limit the consequences of disturbing the daily routine of young patients during the unpredictable times of the pandemic? Modern technology and telemedicine have come to the rescue. This narrative review aims to present a change in the impact profile in the era of isolation and assess the directions of changes that specialists may choose when dealing with patients with ASD.
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Hare MM, Feeney KE, Parent J. Longitudinal Pathways from Parent Internalizing Symptoms to Parent and Youth Emotion Functioning. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01482-w. [PMID: 36571648 DOI: 10.1007/s10578-022-01482-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 11/13/2022] [Accepted: 12/08/2022] [Indexed: 12/27/2022]
Abstract
The current study utilized mediation analyses to examine how parental symptoms of depression and anxiety impact child emotion regulation (ER) and emotion stability (ES) through parent emotion functioning, parenting, and the coparent relationship. 564 parents of children between 3 and 17 years (Mage = 9.47; 54.4% male) were recruited via Amazon's Mechanical Turk across three time points: baseline (Wave 1), 4 months (Wave 2), 8 months (Wave 3). Mediation results demonstrated that symptoms of parent depression at Wave 1 predicted worse coparent relationships and decreases in parents' ability to identify their own emotions at Wave 2. Symptoms of parental anxiety at Wave 1 predicted decreases in positive parenting and an increased tendency to have negative secondary emotional responses, impulse-control difficulties, and difficulty accessing emotion-regulation strategies at Wave 2. Additionally, symptoms of parental anxiety at Wave 1 directly predicted lower child ER and ES at Wave 3. However, no significant indirect pathways were identified between parent symptoms and child ER and ES. Sensitivity analyses examined the effects of three youth developmental stages (i.e., early and middle childhood and adolescence), as well as parent gender (i.e., mother and father), and found no significant differences across groups. Thus, even at non-clinical levels, parental symptoms of anxiety and depression may negatively impact parenting, parent regulation, and the coparent relationship, while parental anxiety symptoms may contribute to lower child ER and ES.
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Affiliation(s)
- Megan M Hare
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, 33199, USA.
| | - Kathleen E Feeney
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, 33199, USA
| | - Justin Parent
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, 33199, USA
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, 02903, USA
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Hou S, Liu N, Zou J, Yin X, Liu X, Zhang S, Chen J, Wei Z. Young children with autism show atypical prefrontal cortical responses to humanoid robots: An fNIRS study. Int J Psychophysiol 2022; 181:23-32. [PMID: 36037937 DOI: 10.1016/j.ijpsycho.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Previous behavioral studies have found that children with autism spectrum disorder (ASD) show greater interest in humanoid robots than in humans. However, the neural mechanism underlying this is not clear. This study compared brain activation patterns between children with ASD and neurotypical children while they watched videos with robots and humans. METHOD We recruited 45 children with ASD and 53 neurotypical children aged 4-6 years and recorded their neural activity in the dorsolateral prefrontal cortex (DLPFC) using a functional near-infrared spectroscopy (fNIRS) device when the two groups interacted with a robot or a human in a video. RESULTS First, neural activity in the right DLPFC in children with ASD was significantly lower in the robot condition than in the human condition. Neural activity in the right DLPFC in children with ASD was also significantly lower than that of neurotypical children in the robot condition. Second, the neural activity in the left DLPFC between the human and robot conditions was negatively correlated in children with ASD, while it was positively correlated in neurotypical children. Moreover, neural activity in the left DLPFC in children with ASD was significantly correlated with the ADOS scores in both conditions. CONCLUSIONS While neurotypical children showed comparable neural activity to humanoid robots and human beings, the children with ASD showed significantly different neural activity under those two conditions. Children with ASD may need more selective attention resources for human interaction than for robot interaction. It is also much more difficult for children with ASD to neglect the attraction of robots. Neural activity of the left DLPFC of children with ASD is correlated with their symptoms, which maybe a possible indicator for early diagnosis. Neural activity of the right DLPFC guided their atypical reactions and engagements with robots. Our study contributes to the current understanding of the neural mechanisms responsible for the different behavioral reactions in children with ASD toward robots and humans.
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Maessen B, Rombouts E, Maes B, Zink I. The relation between gestures and stuttering in individuals with Down syndrome. Research Intellect Disabil 2022; 35:761-776. [DOI: 10.1111/jar.12980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 12/15/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Babette Maessen
- Department of Neurosciences Experimental Otorhinolaryngology Leuven Belgium
| | - Ellen Rombouts
- Department of Neurosciences Experimental Otorhinolaryngology Leuven Belgium
| | - Bea Maes
- Faculty of Psychology and Educational Sciences Parenting and Special Education Research Group Leuven Belgium
| | - Inge Zink
- Department of Neurosciences Experimental Otorhinolaryngology Leuven Belgium
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Davico C, Marcotulli D, Cudia VF, Arletti L, Ghiggia A, Svevi B, Faraoni C, Amianto F, Ricci F, Vitiello B. Emotional Dysregulation and Adaptive Functioning in Preschoolers With Autism Spectrum Disorder or Other Neurodevelopmental Disorders. Front Psychiatry 2022; 13:846146. [PMID: 35479499 PMCID: PMC9035819 DOI: 10.3389/fpsyt.2022.846146] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/28/2022] [Indexed: 11/22/2022] Open
Abstract
AIM Emotional dysregulation (ED), defined by deficits in the ability to monitor and modulate the valence, intensity, and expression of emotions, is typically expressed with irritability, tantrums, mood fluctuations, and self-harm in young children with autism spectrum disorder (ASD). Although ED does not represent a diagnostic feature of ASD, its manifestations are an important contributor to functional impairment and clinical referral. This study aims to examine the relationship between ED and adaptive functioning in preschoolers clinically referred for ASD or other neurodevelopmental disorders. METHODS A sample of 100 children (74% males, mean age 39.4 ± 12.3 months), consecutively referred to a university clinic for neurodevelopmental disorders, received clinical assessments of psychopathology with the CBCL and the Autism Diagnostic Interview-Revised, of ED- with the CBCL-Attention, Anxious/Depressed, and Aggression index (CBCL-AAA), of autism symptom severity with the ADOS-2 Calibrated Severity Score (ADOS-CSS), and of global developmental/cognitive delay (GDD) with the WPPSI-IV or other age-appropriate standardized scales. Adaptive functioning was measured with the ABAS-II. Sixty-five children met DSM-5 criteria for ASD. Multivariate regression models were applied to evaluate the relative contribution of ED, ASD severity and GDD to the ABAS-II general (GAC), conceptual (CAD), social (SAD), and practical (PAD) adaptive functioning domains. RESULTS Overall (n = 100), lower adaptive functioning was associated with higher CBCL-AAA (p = 0.003), higher ADOS-CSS (p < 0.001), and presence of GDD (p = 0.023). In the ASD group (n = 65), worse CAD was predicted by GDD (p = 0.016), and worse SAD and PAD by higher ADOS-CSS (p = 0.032) and ED (p = 0.002). No sex differences were detected in the study variables. CONCLUSION Together with the severity of global developmental delay and of autism symptoms, ED is a significant contributor to impairment in adaptive functioning among young children with a neurodevelopmental disorder and, in particular, with ASD. ED could represent a specific target for early interventions aimed at enhancing adaptive functioning in early childhood.
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Affiliation(s)
- Chiara Davico
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Daniele Marcotulli
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Valentina Francesca Cudia
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Luca Arletti
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Ada Ghiggia
- Department of Psychology, University of Turin, Turin, Italy
| | - Barbara Svevi
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Chiara Faraoni
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | | | - Federica Ricci
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Benedetto Vitiello
- Section of Child and Adolescent Neuropsychiatry, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
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11
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Xia C, Zheng H, Zhang S, Tang L, Jing Q, Chen G, Sun M, Lu J. Modifiable personal and environmental factors associated with anxiety in family caregivers of children with disabilities: A comparison between parents and grandparents. J Affect Disord 2021; 295:604-611. [PMID: 34509076 DOI: 10.1016/j.jad.2021.08.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/25/2021] [Accepted: 08/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Caregivers of children with disabilities might face high risk of anxiety, but the specific influencing factors may be different between parents and grandparents. This study is to explore the influencing modifiable factors from personal and environmental dimensions, so as to provide practical reference for effectively preventing and alleviating anxiety of this population. METHODS A total of 504 primary caregivers were investigated in Shanghai, China, of which 496 parents and grandparents were included in the analysis. Risk of anxiety was measured by the Generalized Anxiety Disorder 7-item (GAD-7) Scale. Descriptive statistics, univariate analysis, and multivariable logistic regression were performed to describe the personal and environmental characteristics of parents and grandparents, risk of anxiety, and identify the significant factors. RESULTS 35.1% of the total caregivers had the risk of anxiety, parents (35.8%) were slightly more anxious than grandparents (33.1%). Among parents, children's stable emotion (AOR=0.263, 95% CI=0.113, 0.611), higher household income (AOR=0.664; 95% CI=0.519, 0.850), owning a house (AOR=0.326; 95% CI=0.174, 0.610), and better barrier-free construction (AOR=0.400; 95% CI=0.170, 0.941) were associated with lower odds of anxiety. As for grandparents, significant association was merely found in caregiving time (AOR=2.936; 95% CI=1.064, 8.107). LIMITATIONS Given the cross-sectional design, we would not infer causal relationships. CONCLUSIONS Anxiety among family caregivers of children with disabilities was not encouraging and need to be urgently concerned. To reach optimal efficiency, intergenerational differences should be considered when health care providers and policy makers taking measures to facilitate the mental health of this population.
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Affiliation(s)
- Cong Xia
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Hongying Zheng
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Shiya Zhang
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Lei Tang
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Qi Jing
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China; School of Management, Weifang Medical University, Weifang 261000, China; China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261000, China
| | - Gang Chen
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China
| | - Mei Sun
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China.
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai 200032, China; China Research Center on Disability, Fudan University, Shanghai 200032, China; China Rehabilitation and Health Institute, Weifang Medical University, Weifang 261000, China.
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Maessen B, Zink I, Maes B, Rombouts E. An experiment on measuring awareness of stuttering in individuals with Down syndrome. J Fluency Disord 2021; 68:105849. [PMID: 33862424 DOI: 10.1016/j.jfludis.2021.105849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/02/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Awareness of stuttering is likely to depend upon the development of the metalinguistic skill to discriminate between fluent speech and stuttering and the ability to identify one's own speech as fluent or stuttered. Presently, little is known about these abilities in individuals with Down syndrome (DS). PURPOSE This study investigates whether individuals with DS and typically developing (TD) children who stutter and who do not stutter differ in their ability to discriminate between fluent speech and stuttering. The second purpose of this study is to discover if this ability is correlated with their self-identification ability. METHOD An experiment to investigate awareness with tasks for discrimination of stuttering and self-identification was developed. It was administered to 28 individuals (7-19 years) with DS, 17 of them stutter and 11 do not, and 20 TD children (3-10 years), 8 of them stutter and 12 do not. Skills to discriminate stuttering were compared between these groups and correlated with self-identification within these groups. The influence of stuttering severity and developmental/chronological age on their ability to discriminate was also investigated. RESULTS The ability to discriminate does not differ significantly between the DS and TD group, but is highly influenced by developmental age. This ability correlates with self-identification but only for the TD individuals who speak fluently. CONCLUSION The ability to discriminate matures around the age of 7 and conscious awareness may rely on this ability. Differences between the present findings and earlier studies suggest that differentiation in levels and types of awareness is warranted.
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Affiliation(s)
- Babette Maessen
- Department of Neurosciences, Experimental Otorinolaryngology, KU Leuven, Belgium.
| | - Inge Zink
- Department of Neurosciences, Experimental Otorinolaryngology, KU Leuven, Belgium
| | - Bea Maes
- Parenting and Special Education Research Group, KU Leuven, Belgium
| | - Ellen Rombouts
- Department of Neurosciences, Experimental Otorinolaryngology, KU Leuven, Belgium
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