Neuroendocrine and behavioral response to social rupture and repair in preschoolers with autism spectrum disorders interacting with mother and father

Background: Preschoolers with autism spectrum disorder (ASD) exhibit difficulties in handling social stress and utilizing efficient emotion regulation (ER) strategies to manage high arousal. While researchers called to assess ER in ASD, few studies utilized direct observations. We tested children's behavioral and cortisol response to maternal and paternal unavailability and hypothesized that children with ASD will employ less complex ER strategies and their parents would show increased regulation facilitation effort to accommodate their child's difficulties. Methods: Forty preschoolers with ASD were matched with 40 typically developing (TD) preschoolers. Children were seen twice for identical battery with mother or father in the face-to-face-still-face paradigm, a three-episode paradigm where parent-child play (free play (FP)) is interrupted by elimination of communication (still face (SF)) followed by resuming play (reunion (RE)). Micro-coding of parent and child's social behavior and ER strategies was conducted. Parent and child's cortisol was assessed at baseline, following stress, and at recovery. Results: Children with ASD exhibited the typical SF effect, indexed by an increase in negative affect and decrease in positive communications, but employed more simple regulatory behavior (self-soothing, proximity-seeking) and less complex strategies involving attention redirection and substitutive play. Their parents used more regulation-facilitation behavior, both simple and complex. All children showed initial cortisol response to novelty, which declined over time. However, maternal presence suppressed initial cortisol response in children with ASD. Conclusions: Children with ASD form typical expectations of parental availability and their parents increase effort to help repair social rupture. Among children with ASD, maternal presence and regulation facilitation provide social buffering for the child's HPA stress response in a manner similar to mammalian neonates. Results highlight the importance of assessing ER by combining direct observations and physiological measures and including fathers in empirical studies and intervention efforts for children with ASD during sensitive periods for social growth.