2 - (SYM 35) Emotional Dysregulation in NDBI for Young Autistic Children: Prevalence, Outcomes, and Effects on Implementation

Background: High levels of emotional dysregulation are common among autistic individuals and are related to psychiatric service use. Studies conducted in early childhood demonstrate that responsive caregiving and co-regulation support the development of regulatory skills. Despite the use of naturalistic developmental behavioral interventions (NDBI) that foster responsive, child-led interaction among caregivers and autistic children, it is unclear whether emotion regulation skills change as a result of NDBI. The present study seeks to assess the prevalence, outcomes, and correlates of emotional dysregulation as children with autism (2-5 years) participate in a caregiver mediated NDBI.

Methods: Participants include caregivers and children receiving Project ImPACT within an outpatient clinic (n = 190, M(age) = 35.43 months). Caregivers completed the Emotional Dysregulation Inventory – Young Child and the Perceived Stress Scales at program onset and completion. As families completed the program, clinicians tracked caregiver’s fidelity implementing Project ImPACT intervention strategies and any adaptations that were made (e.g., dropping key program elements, adding other therapeutic content) while implementing the program.

Results: Results show that 45.2% of children presented with significant levels of emotional reactivity at the start of Project ImPACT. A paired t-test demonstrated reductions in child emotional reactivity across intervention (n = 55; t (52) = 1.97, p = 0.05). Results of a linear regressions showed that children’s baseline reactivity significantly predicted clinician reported adaptations across intervention (F (1,119) = 7.04, p < 0.01). Finally, caregiver stress at baseline was examined, and was significantly associated with child emotional reactivity (F (1, 72) = 9.22, p < 0.01).

Discussion: These results indicate that there may be group level reductions in emotional reactivity following the implementation of an NDBI. Child reactivity was associated with greater clinician-reported adaptations to Project ImPACT. Future research is needed to understand whether these adaptations support improved emotion regulation, or whether emotion regulation gains would be observed irrespective of adaptation to NDBI. Finally, it may be important to understand and support caregiver stress in intervention for dysregulation among autistic children. Future analyses will explore the relationships between each of these variables and the observed change in children’s emotional reactivity across intervention.