PROJECT SUMMARY/ABSTRACT
Children with autism spectrum disorder (ASD) are at increased risk for internalizing symptoms—which are the
leading burden of disease worldwide among children—and their families are at greater risk of experiencing
family conflict and marital discord. However, researchers have not systematically investigated the link between
lower quality family relationships and children's internalizing symptoms. Moreover, there is also a knowledge
gap in how heterogeneity in ASD symptom severity may place some children with ASD at increased risk for
internalizing symptoms. These knowledge gaps are critical because, until they are filled, society's ability to
understand the complexities of, and ultimately prevent, comorbid internalizing symptoms will remain beyond
reach. The long-term goal is to reduce the rates of comorbid internalizing symptoms in children with ASD. The
objective in this application is to explicate the longitudinal link between family relationships—which are often
affected in families raising a child with ASD—and children's comorbid internalizing symptoms. The central
hypothesis is that accounting for heterogeneity in ASD symptom severity and investigating children's
responses to negative family interactions will increase understanding of how and for whom lower quality family
relationships pose a risk for internalizing symptoms. The rationale for the proposed research is that its
successful completion will contribute new knowledge critical for developing interventions that are targeted
toward children most at risk for elevated comorbid internalizing symptoms and address mechanisms most
salient for children with ASD. The following two specific aims will be pursued: 1) Identify those children with
ASD who are most vulnerable to exhibiting comorbid internalizing symptoms in the context of lower quality
family relationships based on ASD symptom severity; and 2) Identify the extent to which mechanisms
underlying the longitudinal association between lower quality family relationships and comorbid internalizing
symptoms, previously identified in typically-developing children, extend to children with ASD, and the extent to
which ASD symptom severity moderates these relations. The PIs' preliminary data indicates strong feasibility
of recruiting a heterogeneous sample of children with variability in ASD symptom severity, and assessing
children's responses to family interactions. Building on this data, 130 children with ASD and their parents will
participate in a two-wave longitudinal study over 6 months. Teachers will complete an online survey about the
child at each wave. The approach is innovative because it examines heterogeneity in ASD symptom severity
as a key moderating variable for identifying those children with ASD most at risk for elevated comorbid
internalizing symptoms, and in comparison to the status quo of research in this area, the study utilizes a
longitudinal, multi-method, multi-informant design. The proposed research is significant because this
knowledge is expected to have translational importance in the prevention of internalizing symptoms in children
with ASD.
