O’Nions, E; Ceulemans, E; Happé, F; Benson, P; Evers, K; Noens, I; (2019) Parenting Strategies Used by Parents of Children with ASD: Differential Links with Child Problem Behaviour. Journal of Autism and Developmental Disorders 10.1007/s10803-019-04219-2.

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Abstract

Here, we explored the structure of the ‘Parenting Strategies Questionnaire’, a new scale designed to measure parenting strategies for problem behaviour in ASD. We then examined links between child behaviour and parenting in a sample of 222 predominantly-UK parents of ASD children exhibiting behaviour found difficult or challenging. Analysis revealed three parenting subscales: Accommodation, Reinforcement Approaches and Reducing Uncertainty. Both Accommodation and Reducing Uncertainty were linked to child problem behaviour. Child factors explained up to 29% of the variance in Accommodation, with Socially Inflexible Non-compliance the strongest predictor, and up to 24% of the variance in Reducing Uncertainty, with Intolerance of Uncertainty the strongest predictor. Child factors were not related to Reinforcement Approaches. Longitudinal studies investigating these relationships are needed. Autism Spectrum Disorders (ASD) are neurodevelopmental impairments characterised by difficulties with communication, socialisation, and rigid and repetitive behaviours (Americal Psychiatric Association 2013). Problem behaviour (also referred to as ‘behaviour that challenges’ or, in the past, ‘challenging behaviour’) often occurs in children with ASD, and is more severe in ASD than in other clinical populations (e.g., Brereton et al. 2006; Estes et al. 2009). Forms of problem behaviour include oppositionality, failures to comply, destructiveness and explosiveness (e.g., Gadow et al. 2004). These behaviours are thought to reflect a dysregulated emotional state, resulting in outbursts and prolonged emotional reactions (Mazefsky et al. 2018a, b). Problem behaviour may reflect attempts by the child to reduce anxiety or distress by escaping aversive activities, or reactivity reflecting frustration when things are not on their terms (Brewer et al. 2014; Larson 2006). Demands to comply have been identified as a key trigger of reactivity in ASD (Chowdhury et al. 2016). Some individuals appear more reactive to routine demands (e.g., to wash or get dressed), and others to demands in socially challenging or novel situations (e.g., when visiting friends) (Chowdhury et al. 2016). The former ‘demand-specific’ profile resembles accounts of extreme/‘pathological’ demand avoidance (‘PDA’), which describe avoidance of and reactivity to routine demands in children with ASD (Newson et al. 2003). Some accounts of PDA explicitly attribute these behaviours to elevated anxiety and distress in the context of demands (Newson et al. 2003). In contrast, the latter ‘socially inflexible’ profile, may particularly reflect intolerance of uncertainty: the tendency to “react negatively on an emotional, cognitive, and behavioural level to uncertain situations and events” (Buhr and Dugas 2009, p. 216), which characterizes some children with ASD (Boulter et al. 2014; Larson 2006).

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