Parental Attunement, Insightfulness, and Acceptance of Child Diagnosis in Parents of Children With Autism: Clinical Implications

Abstract

Early parent-child relationships are an important factor influencing many domains of child development, even in the presence of autism. In this study, we investigated the associations between parent-child attunement during play, parental insightfulness, and parental acceptance of their child's diagnosis of an autism spectrum disorder. A sample of 50 parents (26 mothers and 24 fathers) of 26 children aged between 24 and 58 months were videotaped during parent-child play interactions and then interviewed about what they thought had gone through their child's head during the play interaction, and about their feelings and thoughts about their child's diagnosis. Play interactions were evaluated using a coding protocol to assess parental attunement. The results showed that parents who were more able to accept their child's diagnosis and to see things from their child's perspective were more likely to also be attuned during play interactions with their children. These findings highlight the importance of studying the parental ability of insightfulness and acceptance of their child diagnosis of ASD for the implementation of intervention programs for supporting parental attunement and improving the interactions between the parents and the children with autism spectrum disorders.

Attunement and Paternal Characteristics in Care Relationships in the Presence of Children Diagnosed with Autism

“…The results that emerged from the DAOS highlighted that in our sample the abilities to activate a bodily dialogue made up of gestures, sounds and looks (Body scale), to facilitate the child’s actions without overlapping him/her (Autonomy scale) and to understand the mental states of the child (Understanding the Child’s Mental States scale) seemed particularly deficient in most fathers. The result of a very high percentage (80%) of fathers lacking in their ability to become attuned is not in line with the results obtained in our previous study [ 19 ]. This paper stated that 48% fathers and mothers of children with ASD were lacking in parental attunement during play interactions and showed that parents who were more able to accept their child’s diagnosis and to be insightful were more likely to also become attuned with their children diagnosed with ASD [ 19 ].…”

“…The Dyadic Attunement Observation Schedule (DAOS) [ 19 ] is an observational measure of parent–child interactions during play. It consists of eight scales that make up a final score of parental attunement: (1) Joint Attention, (2) Body, (3) Interaction, (4) Space Sharing, (5) Play Sharing, (6) Autonomy, (7) Emotional Regulation, (8) Understanding a Child’s Mental States.…”

“…However, the literature deepening the parent–child relationship with ASD has highlighted in parents the feeling of being ineffective or incapable of raising their children [ 16 ]. Fathers in particular show great difficulty in accepting the diagnosis of their children [ 17 , 18 , 19 , 20 ] with high levels of anxiety, stress and anger [ 21 , 22 , 23 ], more directive and less active behaviors involving their children [ 16 , 24 , 25 ] and a reduced initiative in play situations [ 15 ]. These are all aspects that could negatively affect their ability to take care of their children [ 26 , 27 , 28 , 29 ].…”

“…Recent studies on parent–child interactions have also underlined the importance of parental attunement, which is understood to be the ability of parents to be sensitive to their child’s signals, to understand and respond to them appropriately and to adapt to their needs [ 19 ]. During parent–child interactions, attuned parents are able to simultaneously consider the motor, cognitive, social, emotional and communicative skills of their child [ 30 ], playing the role of promoting their child’s development in terms of their ability to self-regulate and their capacity to be engaged in relationships with others [ 19 ].…”

“…The results of this study also showed that fathers used a directive/active approach during play and reshaped their expectations and ideas of play in response to the affective-bodily and social-spatial experiences of their children in their living environment. In our recent study [ 19 ], we found that those parents, both mothers and fathers, who were better able to accept their children’s diagnosis of ASD and to understand their point of view were also better able to become attuned during play interactions with their children.…”