Skip to main content
Log in

A PROMIS®ing New Measure for Quantifying Emotion Dysregulation in Toddlers and Preschoolers: Development of the Emotion Dysregulation Inventory-Young Child

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

The Emotion Dysregulation Inventory (EDI) was designed and validated to quantify emotion dysregulation (ED) in school-age children, with a particular emphasis on capturing ED in youth with ASD. We saw a need to adapt the EDI for use in young children (ages 2–5) given early childhood is a formative time for emotion regulation development. The present study discusses the adaptation process for the EDI-Young Child (EDI-YC), including item refinement/generation and cognitive interviews (N = 10 with ASD), consistent with the Patient-Reported Outcomes Measurement Information System (PROMIS®) methodology. The item bank was piloted in a sample of 2-year-olds with and without ASD (N = 31), which provided initial support for the EDI-YC as a valid and reliable measure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Achenbach, T., & Rescorla, L. (2000). Manual for the ASEBA preschool forms & profiles. University of Vermont, Research Center for Children, Youth, and Families.

  • Adrien, J. L., Lenoir, P., Martineau, J., Perrot, A., Hameury, L., Larmande, C., & Sauvage, D. (1993). Blind ratings of early symptoms of autism based upon family home movies. Journal of the American Academy of Child & Adolescent Psychiatry, 32(3), 617–626.

  • Alwin, D. F., & Krosnick, J. (1991). The reliability of survey attitude measurement: The influence of question and respondent attributes. Sociological Methods & Research, 20(1), 139–181. https://doi.org/10.1177/0049124191020001005

    Article  Google Scholar 

  • Berkovits, L., Eisenhower, A., & Blacher, J. (2016). Emotion regulation in young children with autism spectrum disorders. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-016-2922-2

    Article  Google Scholar 

  • Blackwell, C. K., Wakschlag, L., Krogh-Jespersen, S., Buss, K. A., Luby, J., Bevans, K., Lai, J. S., Forrest, C. B., & Cella, D. (2020). Pragmatic health assessment in early childhood: The PROMIS® of developmentally based measurement for pediatric psychology. Journal of Pediatric Psychology, 45(3), 311–318. https://doi.org/10.1093/jpepsy/jsz094

    Article  PubMed  Google Scholar 

  • Blair, B. L., Perry, N. B., O'Brien, M., Calkins, S. D., Keane, S. P., & Shanahan, L. (2015). Identifying developmental cascades among differentiated dimensions of social competence and emotion regulation. Developmental Psychology, 51(8), 1062–1073. https://doi.org/10.1037/a0039472

  • Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., Amtmann, D., Bode, R., Buysse, D., Choi, S., Cook, K., DeVellis, R., DeWalt, D., Fries, J. F., Gershon, R., Hahn, E. A., Lai, J.-S., Pilkonis, P., Revicki, D., & Hays, R. (2010). The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. Journal of Clinical Epidemiology, 63(11), 1179–1194. https://doi.org/10.1016/j.jclinepi.2010.04.011

    Article  PubMed  PubMed Central  Google Scholar 

  • Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Ader, D., Fries, J. F., Bruce, B., & Rose, M. (2007). The Patient-Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH roadmap cooperative group during its first two years. Medical Care, 45(5 Suppl 1), 3. https://doi.org/10.1097/01.MLR.0000258615.42478.55

    Article  Google Scholar 

  • Cibralic, S., Kohlhoff, J., Wallace, N., McMahon, C., & Eapen, V. (2019). A systematic review of emotion regulation in children with Autism Spectrum Disorder. Research in Autism Spectrum Disorders, 68, 101422. https://doi.org/10.1016/j.rasd.2019.101422

    Article  Google Scholar 

  • Clifford, S. M., Hudry, K., Elsabbagh, M., Charman, T., & Johnson, M. H. (2013). Temperament in the first 2 years of life in infants at high-risk for autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(3), 673–686.

  • Cole, P. M., Michel, M. K., & O’Donnell Teti, L. (1994). The development of emotion regulation and dysregulation: A clinical perspective. Monographs of the Society for Research in Child Development, 59(2/3), 73–100.

    Article  PubMed  Google Scholar 

  • Conner, C. M., Golt, J., Shaffer, R., Righi, G., Siegel, M., & Mazefsky, C. A. (2021). Emotion dysregulation is substantially elevated in autism compared to the general population: Impact on psychiatric services. Autism Research, 14, 169–181. https://doi.org/10.1002/aur.2450

  • Croen, L. A., Najjar, D. V., Ray, G. T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118(4), e1203–e1211.

  • Day, T. N., Mazefsky, C. A., & Wetherby, A. M. (in press). Characterizing difficulties with emotion regulation in toddlers with autism spectrum disorder. Research in Autism Spectrum Disorders.

  • Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20, 775–803. https://doi.org/10.1017/S0954579408000370

    Article  PubMed  Google Scholar 

  • Dow, D., Day, T. N., Kutta, T. J., Nottke, C., & Wetherby, A. M. (2020). Screening for autism spectrum disorder in a naturalistic home setting using the systematic observation of red flags (SORF) at 18–24 months. Autism Research, 13(1), 122–133. https://doi.org/10.1002/aur.2226

    Article  PubMed  Google Scholar 

  • Garon, N., Zwaigenbaum, L., Bryson, S., Smith, I. M., Brian, J., Roncadin, C., Vaillancourt, T., Armstrong, V., Sacrey, L.-A.R., & Roberts, W. (2016). Temperament and its association with autism symptoms in a high-risk population. Journal of Abnormal Child Psychology, 44(4), 757–769. https://doi.org/10.1007/s10802-015-0064-1

    Article  PubMed  Google Scholar 

  • Goldsmith, H. H. (1996). Studying temperament via construction of the toddler behavior assessment questionnaire. Child Development, 67(1), 218–235. https://doi.org/10.1111/j.1467-8624.1996.tb01730.x

    Article  PubMed  Google Scholar 

  • Herring, S., Gray, K., Taffe, J., Tonge, B., Sweeney, D., & Einfeld, S. (2006). Behaviour and emotional problems in toddlers with pervasive developmental disorders and developmental delay: Associations with parental mental health and family functioning. Journal of Intellectual Disability Research, 50(12), 874–882.

  • Hofstra, M. B., Van Der Ende, J. A. N., & Verhulst, F. C. (2002). Child and adolescent problems predict DSM-IV disorders in adulthood: A 14-year follow-up of a Dutch epidemiological sample. Journal of the American Academy of Child & Adolescent Psychiatry, 41(2), 182–189.

  • Irwin, D. E., Varni, J. W., Yeatts, K., & DeWalt, D. A. (2009). Cognitive interviewing methodology in the development of a pediatric item bank: A patient reported outcomes measurement information system (PROMIS) study. Health and Quality of Life Outcomes, 7(1), 1–10. https://doi.org/10.1186/1477-7525-7-3/TABLES/5

    Article  Google Scholar 

  • Jahromi, L. B., Meek, S. E., & Ober‐Reynolds, S. (2012). Emotion regulation in the context of frustration in children with high functioning autism and their typical peers. Journal of Child Psychology and Psychiatry, 53(12), 1250–1258.

  • Kim-Cohen, J., Caspi, A., Moffitt, T. E., Harrington, H., Milne, B. J., & Poulton, R. (2003). Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Archives of General Psychiatry, 60(7), 709–717. https://doi.org/10.1001/archpsyc.60.7.709

  • Kasari, C., Gulsrud, A. C., Wong, C., Kwon, S., & Locke, J. (2010). Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. Journal of Autism and Developmental Disorders, 40(9), 1045–1056.

  • Konstantareas, M. M., & Stewart, K. (2006). Affect regulation and temperament in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 36(2), 143–154. https://doi.org/10.1007/s10803-005-0051-4

    Article  PubMed  Google Scholar 

  • Kopp, C. B. (1989). Regulation of distress and negative emotions: A developmental view. Developmental Psychology, 25(3), 343–354. https://doi.org/10.1037/0012-1649.25.3.343

    Article  Google Scholar 

  • Luyster, R., Gotham, K., Guthrie, W., Coffing, M., Petrak, R., Pierce, K., Bishop, S., Esler, A., Hus, V., Oti, R., Richler, J., Risi, S., & Lord, C. (2009). The autism diagnostic observation schedule—Toddler Module : A new module of a standardized diagnostic measure for Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 39, 1305–1320. https://doi.org/10.1007/s10803-009-0746-z

    Article  PubMed  PubMed Central  Google Scholar 

  • Macari, S. L., DiNicola, L., Kane-Grade, F., Prince, E., Vernetti, A., Powell, K., Fontenelle, S., & Chawarska, K. (2018). Emotional expressivity in toddlers with Autism Spectrum Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 57(11), 828–836. https://doi.org/10.1016/j.jaac.2018.07.872

    Article  PubMed  PubMed Central  Google Scholar 

  • Macari, S. L., Koller, J., Campbell, D. J., & Chawarska, K. (2017). Temperamental markers in toddlers with autism spectrum disorder. Journal of Child Psychology and Psychiatry and Allied Disciplines, 58(7), 819–828. https://doi.org/10.1111/jcpp.12710

    Article  PubMed  Google Scholar 

  • Madden, J. M., Lakoma, M. D., Lynch, F. L., Rusinak, D., Owen-Smith, A. A., Coleman, K. J., Quinn, V. P., Yau, V. M., Qian, Y. X., & Croen, L. A. (2017). Psychotropic medication use among insured children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 47(1), 144–154.

  • Mazefsky, C. A., Borue, X., Day, T. N., & Minshew, N. J. (2014). Emotion regulation patterns in adolescents with high-functioning autism spectrum disorder: Comparison to typically developing adolescents and association with psychiatric symptoms. Autism Research, 7(3), 344–354. https://doi.org/10.1002/aur.1366

    Article  PubMed  PubMed Central  Google Scholar 

  • Mazefsky, C. A., Conner, C. M., Breitenfeldt, K., Leezenbaum, N., Chen, Q., Bylsma, L. M., & Pilkonis, P. (2021). Evidence base update for questionnaires of emotion regulation and reactivity for children and adolescents. Journal of Clinical Child & Adolescent Psychology, 50(6), 683–707. https://doi.org/10.1080/15374416.2021.1955372

    Article  Google Scholar 

  • Mazefsky, C. A., Day, T. N., Siegel, M., White, S. W., Yu, L., & Pilkonis, P. A. (2018a). Development of the emotion dysregulation inventory: A PROMIS®ing method for creating sensitive and unbiased questionnaires for Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 48(11), 3736–3746. https://doi.org/10.1007/s10803-016-2907-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Mazefsky, C. A., Yu, L., White, S. W., Siegel, M., & Pilkonis, P. A. (2018b). The emotion dysregulation inventory: Psychometric properties and item response theory calibration in an autism spectrum disorder sample. Autism Research, 11(6), 928–941. https://doi.org/10.1002/aur.1947

    Article  PubMed  PubMed Central  Google Scholar 

  • Mazefsky, C. A., Yu, L., & Pilkonis, P. A. (2020). Psychometric properties of the emotion dysregulation inventory in a nationally representative sample of youth. Journal of Clinical Child & Adolescent Psychology. https://doi.org/10.1080/15374416.2019.1703710

    Article  Google Scholar 

  • Mullen, E. (1995). Mullen scales of early learning. American Guidance Service.

    Google Scholar 

  • Nuske, H. J., Hedley, D., Tseng, C. H., Begeer, S., & Dissanayake, C. (2018). Emotion regulation strategies in preschoolers with autism: Associations with parent quality of life and family functioning. Journal of Autism and Developmental Disorders, 48(4), 1287–1300.

  • Nuske, H. J., Hedley, D., Woollacott, A., Thomson, P., Macari, S. L., & Dissanayake, C. (2017). Developmental delays in emotion regulation strategies in preschoolers with autism. Autism Research, 10(11), 1808–1822. https://doi.org/10.1002/aur.1827

    Article  PubMed  Google Scholar 

  • Pilkonis, P. A., Choi, S. W., Reise, S. P., Stover, A. M., Riley, W. T., & Cella, D. (2011). Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS®): Depression, anxiety, and anger. Assessment, 18(3), 263–283. https://doi.org/10.1177/1073191111411667

    Article  PubMed  PubMed Central  Google Scholar 

  • PROMIS® Validity Standards Committee on behalf of the PROMIS® Network. (2013). PROMIS® Instrument Development and Validation Scientific Standards, Version 2.0, (revised May 2013). http://www.nihpromis.org/science/methodology?AspxAutoDetectCookieSupport=1.

  • Rescorla, L. A., Winder-Patel, B. M., Paterson, S. J., Pandey, J., Wolff, J. J., Schultz, R. T., & Piven, J. (2017). Autism spectrum disorder screening with the CBCL/1½–5: Findings for young children at high risk for autism spectrum disorder. Autism. https://doi.org/10.1177/1362361317718482

    Article  PubMed  PubMed Central  Google Scholar 

  • Rieffe, C., Oosterveld, P., Terwogt, M. M., Mootz, S., van Leeuwen, E., & Stockmann, L. (2011). Emotion regulation and internalizing symptoms in children with autism spectrum disorders. Autism, 15(6), 655–670. https://doi.org/10.1177/1362361310366571

    Article  PubMed  Google Scholar 

  • Samson, A. C., Hardan, A. Y., Lee, I. A., Phillips, J. M., & Gross, J. J. (2015). Maladaptive behavior in autism spectrum disorder: The role of emotion experience and emotion regulation. Journal of Autism and Developmental Disorders, 45(11), 3424–3432. https://doi.org/10.1007/s10803-015-2388-7

    Article  PubMed  Google Scholar 

  • Samson, A. C., Phillips, J. M., Parker, K. J., Shah, S., Gross, J. J., & Hardan, A. Y. (2014). Emotion dysregulation and the core features of autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(7), 1766–1772. https://doi.org/10.1007/s10803-013-2022-5

    Article  PubMed  Google Scholar 

  • Scarpa, A., & Reyes, N. M. (2011). Improving emotion regulation with CBT in young children with high functioning autism spectrum disorders: A pilot study. Behavioral and Cognitive Psychotherapy, 39(4), 495–500.

  • Soke, G. N., Maenner, M. J., Christensen, D., Kurzius-Spencer, M., & Schieve, L. (2018). Prevalence of co-occurring medical and behavioral conditions/symptoms among 4-and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. Journal of Autism and Developmental Disorders, 48(8), 2663–2676.

  • Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A. (2016). Vineland adaptive behavior scales (3rd ed.). Psychological Corporation.

    Google Scholar 

  • Thompson, R. A., & Goodman, M. (2010). Development of emotion regulation: More than meets the eye. In Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment (pp. 38–58). The Guilford Press.

  • Weiss, J. A., Riosa, P. B., Mazefsky, C. A., & Beaumont, R. (2017). Emotion regulation in autism spectrum disorder in emotion regulation and psychopathology in children and adolescents (pp. 235–258).

  • Werner, E., Dawson, G., Osterling, J., & Dinno, N. (2000). Brief report: Recognition of autism spectrum disorder before one year of age: A retrospective study based on home videotapes. Journal of Autism and Developmental Disorders, 30(2), 157.

  • Whalen, D. J., Sylvester, C. M., & Luby, J. L. (2017). Depression and anxiety in preschoolers: A review of the past 7 years. In Child and Adolescent Psychiatric Clinics of North America (Vol. 26, Issue 3, pp. 503–522). https://doi.org/10.1016/j.chc.2017.02.006

Download references

Acknowledgments

This study included a subsample of children from the first author’s dissertation; the project was executed as a side project in collaboration with the senior author. Support for the present study included an internal award from Florida State University (awarded to Taylor N. Day), Eunice Kennedy Shriver National Institute of Child Health & Human Development under Award Number R01HD078410 (PI: Amy M. Wetherby), and Eunice Kennedy Shriver National Institute of Child Health & Human Development under Award Number R01HD079512 (PI: Carla A. Mazefsky). Special acknowledgement belongs to Dr. Wetherby, the first author’s graduate school mentor, as well as Dr. Lan Yu and Dr. Paul Pilkonis who contributed to the development of this measure. An additional thanks to the participating families and staff at FIRST WORDS® Project. During the preparation of this manuscript, Dr. Day was supported by National Institute of Mental Health under Award Number T32MH016804 and Dr. Northrup was supported by National Center for Advancing Translational Sciences under Award Number KL2TR001856.

Author information

Authors and Affiliations

Authors

Contributions

Dr. TND and Dr. CAM co-led the development of the EDI-YC as well as made decisions regarding the modification of the item bank. Dr. TND was responsible for data collection. All authors (TND, JBN, CAM) contributed to the data analysis and the preparation and editing of the manuscript.

Corresponding author

Correspondence to Carla A. Mazefsky.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the Florida State University Institutional Review Board (IRB) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent for Publication

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Day, T.N., Northrup, J.B. & Mazefsky, C.A. A PROMIS®ing New Measure for Quantifying Emotion Dysregulation in Toddlers and Preschoolers: Development of the Emotion Dysregulation Inventory-Young Child. J Autism Dev Disord 53, 2261–2273 (2023). https://doi.org/10.1007/s10803-022-05536-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-022-05536-9

Keywords

Navigation