Maternal mental health and the behavior of children with autism spectrum disorder: Unidirectional and bidirectional effects

Background: While transactional theories of development posit that child and parent functioning are reciprocally linked, few autism family studies have examined if and how differing domains of child behavior and parental mental health may mutually affect one another over time.Method: Data was collected over three time-points spanning four years from a sample of 119 mothers of children with ASD (aged 7-11 years at baseline). Cross-lagged structural equation models tested whether child problem or prosocial behavior was reciprocally related to three domains of maternal mental health: depressed mood, anger, and positive emotional well-being.Results: Findings provided mixed support for bidirectionality as reciprocal relationships were found only in models examining relations between maternal depressed mood and child problem and prosocial behavior. Apart from these two bidirectional relationships, all other significant cross-lagged effects were unidirectional and parent-driven, with prior levels of maternal mental health impacting later child behavior rather than the reverse.Conclusion: Study results add to the limited evidence base concerning directionality of parent -child effects in autism family research. Given the intertwined nature of child and maternal functioning found in this study, there is clearly a need for additional family-based interventions that target both parents and their autistic children.