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Research Insights: Autistic children’s mental health affected by the quality of their parents’ romantic relationships, mental health — and vice versa

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A note on language: There is not a consensus on what terms to use when talking about autism (also called autism spectrum disorder). This interview will use identity-first language (i.e. “autistic child”) as this is often voiced as the preferred term by self-advocates. When working with individuals and families it is always best to ask about their preference.

Brianna Piro-Gambetti, who received her PhD in Human Development & Family Studies (HDFS) in 2023, is the lead author of a recently published study that examined how the mental health of autistic children is connected with the mental health and romantic relationship quality of their parents. She is now a research scientist at the Waisman Center, a research center on the UW–Madison campus that studies human development, developmental disabilities and neurodegenerative diseases.

In this Q&A, Piro-Gambetti talks through the results of her research, which she conducted alongside HDFS professors Sigan Hartley and Lauren Papp and two other co-authors.

What did this study find?

We know that autistic children experience a high rate of mental health conditions like depression, inattention and anxiety relative to neurotypical children. Little is known, though, about how these mental health conditions are related to family dynamics like parent mental health and the quality of the parent-couple relationship. We do know that the family environment is one of the most influential environments for a child and that the well-being of the child is often very closely connected to the well-being of the parents.

With this study, we wanted to understand how autistic children’s mental health is related to parent mental health and parents’ marital or couple relationship across time. Through four study visits conducted over three years, 188 autistic children and their parents came to our lab at UW–Madison and completed questionnaires and interacted with one another while being observed by researchers. We found strong connections between parent mental health and the quality of their parent-couple relationship and the autistic child’s mental health, with effects going in both directions. More specifically, across the three years, increases in depression symptoms in mothers and fathers predicted a decrease in parent-couple relationship satisfaction, and these decreases predicted increases in the autistic child’s mental health conditions. In the other direction, increases in the autistic child’s mental health conditions predicted decreases in parent-couple relationship satisfaction, which in turn, predicted an increase in parents’ depression symptoms, which we saw particularly in fathers.

One interesting pattern we picked up on is that mothers’ depression symptoms appeared to be more directly affected by the child’s mental health conditions, but fathers’ depression symptoms seemed more sensitive to changes in the parent-couple relationship.

Why does this matter?

The focus of autism services tends to be on treating the child, but this study shows it’s crucial to provide support for the whole family. A lot of times when we think of early intervention, there’s a strong focus on behavior modifications for the child and teaching parents how to help their child self-regulate, which is very important. But our study suggests families may also benefit from resources aimed at helping parents with their own mental health and couple relationship needs.

The experiences of family members are interwoven. Parent and child mental health and the quality of the parent-couple relationship are connected in feedback loops across time. By understanding how these dynamics work, we can better tailor interventions to meet the needs of families.

What action should be taken?

Programs and interventions should take a family-wide perspective that addresses the mental health needs of both parents and children as well as the needs of the parent-couple relationship. For example, it could be beneficial to incorporate mental health and parent-couple relationship support into early autism interventions. It’s also important to remember that there’s no one-size-fits-all intervention or program or resource that will work for every autistic child and every family.

What follow-up research is being done?

For this study, we collected mental health data about the child only from their parents, but in future research, it is also important to capture mental health as reported by the autistic child themselves. I also believe collecting these data from teachers is important because it’s a perspective outside of the home.

For our ongoing research, we are looking at other family dynamics, such as the sibling relationship and the quality of the parent-child relationship. We’re trying to explore a variety of familial dynamics in order to understand strategies to promote positive outcomes across different family members.

This study, titled “Parent-couple satisfaction, parent depression, and child mental health in families with autistic children,” was published Jan. 10, 2024 in Frontiers in Psychiatry.