Characterizing difficulties with emotion regulation in toddlers with autism spectrum disorder

Abstract

Background: Difficulties with emotion regulation (ER) underlie emotional/behavioral challenges and co-occurring psychiatric symptoms in autism spectrum disorder (ASD), yet very little is known about the early development of emotion dysregulation. The present study aimed to identify differences in positive and negative emotional reactivity and regulation strategies in toddlers with and without ASD.

Method: Nine tasks from the Laboratory Temperament Assessment Battery (Lab-TAB) were completed with 37 toddlers with and without ASD (22-28 months). Video-recordings of these tasks were coded by research assistants using a behavioral coding scheme tapping facial, bodily, and vocal affect and the frequency of ER strategies. Mixed model analyses were performed to examine the mean affect and total regulation strategies across each task and t-tests were conducted to assess the types of ER strategies utilized.

Results: Toddlers with ASD showed significantly less positive affect and greater frustration compared to non-ASD toddlers; reactivity was comparable between the groups for fear. Both groups used ER strategies in a similar pattern across tasks, with the exception that toddlers with ASD more often engaged in distraction to regulate. Effects of age and developmental level are discussed.

Conclusions: Toddlers with ASD were robustly characterized by greater frustration and lower joy despite frequent and age appropriate attempts to regulate their emotions. This study provides preliminary evidence that observable indicators of emotion dysregulation are present by two years of age. Clinical implications and future research directions are discussed.

Keywords: ASD; Autism spectrum disorder; Early childhood; Emotion regulation; Emotional reactivity; Toddlers.

Fig. 1.. Estimated means and standard errors from the mixed model analyses for facial affect, bodily affect, and vocal affect by task type.

The x-axis depicts the name of each task (Frustration: End of the Line, Attractive Toy in a Transparent Box, Gentle Arm Restraint by Parent; Joy: Make That Car Go, Popping Bubbles, Modified Peek-a-Boo; Fear: Stranger Approach, Remote Controlled Spider, Scary Mask) and the y-axis displays the affect rating (ranging from − 3 to + 3 consistent with the coding scheme). The bars are the estimated means by group and the error bars are the standard error from the mixed model analyses without any covariates. Tasks with an asterisk (*) on the x-axis indicate large-sized, significant group differences, p < .05, whereas tasks with a carrot (^) on the x-axis indicate medium-sized group differences that were non-significant.

Fig. 2.. Estimated means and standard errors from the mixed model analysis for total regulation strategies by task type.

The x-axis depicts the name of each task (Frustration: End of the Line, Attractive Toy in a Transparent Box, Gentle Arm Restraint by Parent; Joy: Make That Car Go, Popping Bubbles, Modified Peek-a-Boo; Fear: Stranger Approach, Remote Controlled Spider, Scary Mask) and the y-axis displays the total frequency of regulation strategies. The bars are the estimated means by groups and the error bars are the standard error from the mixed model analysis without any covariates. There were no significant group differences by task, i.e., all p > .05, but the task with a carrot (^) denoted had a medium-sized group difference that was non-significant.