The role of alexithymia in parent–child interaction and in the emotional ability of children with autism spectrum disorder

Abstract

Children with autism spectrum disorder (ASD) have more emotional difficulties than typically developing (TD) children. Of all the factors that impact children's emotional development, parents, and the way they interact with their children, are of crucial importance. The present study compared the amount of parent–child interactions among 35 dyads of parents and their children with ASD and 41 dyads of parents and their TD children, aged between 3 and 13 years, during a frustration‐eliciting situation. We further examined whether children's alexithymia is linked to parent–child interactions and whether parent–child interactions are linked to children's emotional difficulties. We found that parents of children with ASD interacted significantly less with their children than parents of TD children. This reduced interaction was better explained by children's alexithymia than by children's ASD diagnosis. Finally, parent–child interaction mediated the relationship between children's ASD diagnosis and children's emotion regulation ability, as well as some aspects of children's emotional reactivity but only if not accounting for children's alexithymia levels. Our results demonstrate the determinant role children's alexithymia plays on parent–child interactions and on how these interactions are linked to children's difficulties in emotion regulation and emotional reactivity. Results are discussed in light of how parent–child interactions and the emotional ability of children with ASD can be improved by targeting children's alexithymia. Autism Res 2019, 12: 458–468 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary In the present research, we found that parents of children with autism interact less with their children compared to parents of typically developing children. We also found that this decreased interaction is linked to children's difficulties to recognize, describe, and distinguish emotions, a triad of difficulties known as alexithymia. Furthermore, parents' interaction with their children explains emotional reactivity and emotion regulation problems in children with autism. However, if we take into consideration children's alexithymia, then parents' interaction with their children is not related to their children's emotional difficulties in reactivity and regulation. Therefore, to improve the interaction between parents and their children with autism, and the emotional development of these children, we recommend interventions that teach children with autism how to recognize, describe, and distinguish emotions in themselves and others.

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

“…A recent study found a relationship between children’s alexithymia and a reduction in parent–child interactions in the presence of a diagnosis of ASD, when compared to parents of typically developed children ( Costa et al, 2019 ). Moreover, a 2019 review have revealed that parental verbal responsiveness to their children’s focus of attention predicted children’s expressive and receptive language ( Edmunds et al, 2019 ).…”

Alexithymia, Not Autism Spectrum Disorder, Predicts Perceived Attachment to Parents in School-Age Children

“…Studies reported that alexithymia in children with ASD was associated with less expressive coherence (Costa et al, 2017), empathy, and perspective taking (Lartseva et al, 2015) as well as lower enjoyment of prosocial interactions (Gebauer et al, 2014). Moreover, as highlighted by Costa et al (2019), alexithymia in children (more than ASD status) can negatively affect parent-child relationships, explaining the reduced amount of dyadic exchanges. The mismatch between arousal activation and subjective experience of feelings (Gaigg et al, 2018) may also contribute to the formation of less coherent child representation influencing how information is encoded and processed.…”

“…Therefore, there is a substantial lack of research concerning the association between alexithymia and attachment in children with ASD. A recent study (Costa et al, 2019) found that alexithymia predicts reduced parent-child interaction more than ASD status, suggesting the need to consider its impact on quality of relationship in future research. In fact, the study did not include a specific measure of attachment relationship to parents, which represents a core feature of child socioemotional development.…”

“…Given that neither ASD status nor symptoms severity showed a significant influence on the perception of attachment security in ASD, it could be interesting to consider the role of alexithymia in predicting this socioaffective domain. According to a bidirectional perspective, child characteristics may influence the quality of parent -child interaction (Costa et al, 2019), altering parental attitudes and caregiving behaviors. Therefore, specific subclinical phenomenon such as impairments in identifying and describing one's own feelings as well as difficulty in distinguishing emotion from bodily sensations (Silani et al, 2008) can affect the way in which children perceive their attachment relationship with their parents.…”

Observed emotional reactivity in response to frustration tasks in psychiatrically hospitalized youth with autism spectrum disorder

“…Costa et al (2017) coded valence of facial expressions and behaviors in 10-s intervals during a toy-removal task and reported more negative behaviors and more negative facial expressions in school-aged children with ASD compared to typically developing peers. Another more recent study by Costa et al (2019) examined ER (frequency of negative, neutral, and positive facial expressions) in children (aged 3–13 years) with and without ASD during a toy-removal task with their parent and found a higher frequency of negative and neutral, and lower frequency of positive, facial expressions among ASD youth. Taken together, this research generally suggests increased negativity in response to frustration in ASD youth, but also points to the importance of considering multiple methods for quantifying negative response in order to better understand what this increased negativity looks like.…”