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Expressed Emotion in Families of Children With and Without Autism Spectrum Disorder, Cerebral Palsy and Down Syndrome: Relations with Parenting Stress and Parenting Behaviors

Abstract

This study examined the family emotional climate as assessed by Five Minute Speech Samples and the relation with parenting stress and parenting behaviors among parents of children (6–17 years, 64.7% boys) with autism spectrum disorder, cerebral palsy, Down syndrome, and without any known disability (n = 447). The large majority of parents (79%) showed low levels of Expressed Emotion, an indicator of a positive family climate. In all groups, more Emotional Over-involvement, more Criticism and fewer expressions of Warmth were associated with higher levels of parenting stress. Across groups, Emotional Over-involvement was related to more autonomy-supportive parenting, Criticism to more psychologically controlling and overreactive parenting, and Warmth was associated with more responsive and less psychologically controlling and overreactive parenting.

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References

  • Abidin, R. R. (1986). Parenting Stress Index: Test manual. Pediatric Psychology Press.

    Google Scholar 

  • Achenbach, T. M. (2001). Manual for the child behavior Checklist/6-18 and 2001 profile. University of Vermont.

    Google Scholar 

  • APA. (2000). Diagnostic and statistical manual of mental disorders. (4th ed.). American Pschycological Press.

    Google Scholar 

  • Arnold, D. S., O’Leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The parenting scale: A measure of dysfunctional parenting in discipline situations. Psychological Assessments, 5, 137–144.

    Article  Google Scholar 

  • Baker, J. K., Smith, L. E., Greenberg, J. S., Seltzer, M. M., & Taylor, J. L. (2011). Change in maternal criticism and behavior problems in adolescents and adults with autism across a 7-year period. Journal of Abnormal Psychology, 120(2), 465–475. https://doi.org/10.1037/a0021900

    Article  PubMed Central  PubMed  Google Scholar 

  • Barber, B. K. (1996). Parental psychological control: Revisiting a neglected construct. Child Development, 67, 3296–3319. https://doi.org/10.1111/j.1467-8624.1996.tb01915

    Article  PubMed  Google Scholar 

  • Beasley, T. M., & Schumacker, R. E. (1995). Multiple regression approach to analyzing contingency tables: Post Hoc and planned comparison procedures. The Journal of Experimental Education, 64(1), 79–93. https://doi.org/10.1080/00220973.1995.9943797

    Article  Google Scholar 

  • Beck, A., Daley, D., Hastings, R. P., & Stevenson, J. (2004). Mothers’ expressed emotion towards children with and without intellectual disabilities. Journal of Intellectual Disability Research, 48(7), 628–638. https://doi.org/10.1111/j.1365-2788.2003.00564.x

    Article  PubMed  Google Scholar 

  • Belsky, J. (1984). The determinants of parenting: A process model. Child Development, 55(1), 83–96. https://doi.org/10.2307/1129836

    Article  PubMed  Google Scholar 

  • Benson, P. R., Daley, D., Karlof, K. L., & Robison, D. (2010). Assessing expressed emotion in mothers of children with autism: The autism-specific five minute speech sample. Autism, 15(1), 65–82. https://doi.org/10.1177/1362361309352777

    Article  PubMed  Google Scholar 

  • Boger, K. D., Tompson, M. C., Briggs-Gowan, M. J., Pavlis, L. E., & Carter, A. S. (2008). Parental expressed emotion toward children: Prediction from early family functioning. Journal of Family Psychology, 22(5), 784–788. https://doi.org/10.1037/a0013251

    Article  PubMed Central  PubMed  Google Scholar 

  • Boonen, H., van Esch, L., Lambrechts, G., Maljaars, J., Zink, I., Van Leeuwen, K. G., et al. (2015). Mothers’ parenting behaviors in families of school-aged children with autism spectrum disorder: An observational and questionnaire study. Journal of Autism and Developmental Disorders, 45(11), 3580–3593. https://doi.org/10.1007/s10803-015-2506-6

    Article  PubMed  Google Scholar 

  • Constantino, J., & Gruber, C. (2005). The Social responsiveness scale manual. Western Psychological Services.

    Google Scholar 

  • Cruise, R. C., Sheeber, L. B., & Tompson, M. C. (2011). Behavioral correlates of maternal expressed emotion in interaction tasks. Journal of Family Psychology: Journal of the Division of Family Psychology of the American Psychological Association, 25(5), 781–784. https://doi.org/10.1037/a0024699

    Article  Google Scholar 

  • Daley, D., & Benson, P. R. (2008). Manual for coding expressed emotion in parents of children with autism spectrum disorders: The autism-specific five minute speech sample. Center for Social Development and Education, University of Massachusetts Boston.

    Google Scholar 

  • Datta, S. S., Russell, P. S. S., & Gopalakrishna, S. C. (2002). Burden among the caregivers of children with intellectual disability: associations and risk factors. Journal of Learning Disabilities, 6(4), 337–350. https://doi.org/10.1177/146900470200600401

    Article  Google Scholar 

  • De Brock, A. A. J. L., Vermulst, A. A., Gerris, J. R. M., & Abidin, R. R. (1992). Nijmeegse Ouderlijke Stress Index. Lisse.

    Google Scholar 

  • de Falco, S., Venuti, P., Esposito, G., & Bornstein, M. H. (2011). Maternal and paternal pragmatic speech directed to young children with Down syndrome and typical development. Infant Behavior & Development, 34(1), 161–169. https://doi.org/10.1016/j.infbeh.2010.12.002

    Article  Google Scholar 

  • De Pauw, S. S. W. (2010). The contribution of temperament and personality to problem behavior in children and adolescents. Ghent University.

    Google Scholar 

  • Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268. https://doi.org/10.1207/S15327965PLI1104_01

    Article  Google Scholar 

  • Delvecchio, E., Di Riso, D., Chessa, D., Salcuni, S., Mazzeschi, C., & Laghezza, L. (2014). Expressed emotion, parental stress, and family dysfunction among parents of nonclinical Italian children. Journal of Child and Family Studies, 23(6), 989–999. https://doi.org/10.1007/s10826-013-9754-x

    Article  Google Scholar 

  • Dieleman, L. M., De Pauw, S. S. W., Soenens, B., Beyers, W., & Prinzie, P. (2017). Examining bidirectional relationships between parenting and child maladjustment in youth with autism spectrum disorder: A 9-year longitudinal study. Development and Psychopathology, 29(4), 1199–1213. https://doi.org/10.1017/s0954579416001243

    Article  PubMed  Google Scholar 

  • Dieleman, L. M., De Pauw, S. S. W., Soenens, B., Mabbe, E., Campbell, R., & Prinzie, P. (2018). Relations between problem behaviors, perceived symptom severity and parenting in adolescents and emerging adults with ASD: The mediating role of parental psychological need frustration. Research in Developmental Disabilities, 73, 21–30. https://doi.org/10.1016/j.ridd.2017.12.012

    Article  PubMed  Google Scholar 

  • Dieleman, L. M., Moyson, T., De Pauw, S. S. W., Prinzie, P., & Soenens, B. (2018). Parents’ need-related experiences and behaviors when raising a child with autism spectrum disorder. Journal of Pediatric Nursing: Nursing Care of Children and Families, 42, e26–e37. https://doi.org/10.1016/j.pedn.2018.06.005

    Article  Google Scholar 

  • Dieleman, L. M., Soenens, B., Prinzie, P., De Clercq, L., Ortibus, E., & De Pauw, S. S. W. (2020). Daily parenting of children with cerebral palsy: The role of daily child behavior, parents’ daily psychological needs, and mindful parenting. Development and Psychopathology. https://doi.org/10.1017/S0954579419001688

    Article  Google Scholar 

  • Dieleman, L. M., Van Vlaenderen, R., Prinzie, P., & De Pauw, S. S. W. (2019). Parents’ need-related experiences when raising an adolescent with cerebral palsy. Advances in Neurodevelopmental Disorders, 3(2), 204–219. https://doi.org/10.1007/s41252-019-00111-3

    Article  Google Scholar 

  • Meta-Analysis Fixed effect vs. random effects (2007). Retrieved July 15, 2020, from https://www.meta-analysis.com/downloads/M-a_f_e_v_r_e_sv.pdf.

  • Foody, C., James, J. E., & Leader, G. (2015). Parenting stress, salivary biomarkers, and ambulatory blood pressure: a comparison between mothers and fathers of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 45(4), 1084–1095. https://doi.org/10.1007/s10803-014-2263-y

    Article  PubMed  Google Scholar 

  • (2018). Retrieved April 29, 2020 from https://www.statistiekvlaanderen.be/nl/bevolking-naar-onderwijsniveau-scholingsgraad.

  • Glenn, S., Dayus, B., Cunningham, C., & Horgan, M. (2001). Mastery motivation in children with Down syndrome. Down’s Syndrome, Research and Practice: the Journal of the Sarah Duffen Centre, 7(2), 52–59. https://doi.org/10.3104/reports.114

    Article  Google Scholar 

  • Greenberg, J. S., Seltzer, M. M., Hong, J., & Orsmond, G. I. (2006). Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with autism. American Journal on Mental Retardation, 111(4), 229–249.

    Article  PubMed  Google Scholar 

  • Griffith, G. M., Hastings, R. P., Petalas, M. A., & Lloyd, T. J. (2015). Mothers’ expressed emotion towards children with autism spectrum disorder and their siblings. Journal of Intellectual Disability Research, 59(6), 580–587. https://doi.org/10.1111/jir.12178

    Article  PubMed  Google Scholar 

  • Grolnick, W. S., Ryan, R. M., & Deci, E. L. (1991). Inner resources for school achievement: Motivational mediators of children’s perceptions of their parents. Journal of Educational Psychology, 83(4), 508–517. https://doi.org/10.1037/0022-0663.83.4.508

    Article  Google Scholar 

  • Hastings, R. P., Daley, D., Burns, C., & Beck, A. (2006). Maternal distress and expressed emotion: Cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities. American Journal on Mental Retardation, 111(1), 48–61.

    Article  PubMed  Google Scholar 

  • Hastings, R. P., & Lloyd, T. (2007). Expressed emotion in families of children and adults with intellectual disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 13(4), 339–345. https://doi.org/10.1002/mrdd.20173

    Article  PubMed  Google Scholar 

  • Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(3), 629–642. https://doi.org/10.1007/s10803-012-1604-y

    Article  PubMed  Google Scholar 

  • Hickey, E. J., Hartley, S. L., & Papp, L. (2020). Psychological well-being and parent-child relationship quality in relation to child autism: An actor-partner modeling approach. Family Process, 59(2), 636–650. https://doi.org/10.1111/famp.12432

    Article  PubMed  Google Scholar 

  • Hickey, E. J., Nix, R. L., & Hartley, S. L. (2019). Family Emotional climate and children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(8), 3244–3256. https://doi.org/10.1007/s10803-019-04037-6

    Article  PubMed Central  PubMed  Google Scholar 

  • Hodapp, R. M. (2007). Families of persons with Down syndrome: New perspectives, findings, and research and service needs. Mental Retardation and Developmental Disabilities Research Reviews, 13(3), 279–287. https://doi.org/10.1002/mrdd.20160

    Article  PubMed  Google Scholar 

  • Hodapp, R. M., Casale, E. G., & Sanderson, K. A. (2019). Parenting children with intellectual disabilities. In M. Bornstein (Ed.), Handbook of parenting: Volume I: Children and parenting. (3rd ed.). Routeledge.

    Google Scholar 

  • Kim Park, I. J., Garber, J., Ciesla, J. A., & Ellis, B. J. (2008). Convergence among multiple methods of measuring positivity and negativity in the family environment: Relation to depression in mothers and their children. Journal of Family Psychology, 22(1), 123–134. https://doi.org/10.1037/0893-3200.22.1.123

    Article  PubMed  Google Scholar 

  • Kubicek, L. F., Riley, K., Coleman, J., Miller, G., & Linder, T. (2013). Assessing the emotional quality of parent-child relationships involving young children with special needs: applying the constructs of emotional availability and expressed emotion. Infant Mental Health Journal, 34(3), 242–256. https://doi.org/10.1002/imhj.21384

    Article  Google Scholar 

  • Laghezza, L., Mazzeschi, C., Di Riso, D., Chessa, D., & Buratta, L. (2010). The Five Minute Speech Sample as a measure of parental Expressed Emotion in the field of disability. Life Span and Disability, 2, 169–186.

    Google Scholar 

  • Lancaster, R. L., Balling, K., Hastings, R., & Lloyd, T. J. (2014). Attributions, criticism and warmth in mothers of children with intellectual disability and challenging behaviour: a pilot study. Journal of Intellectual Disability Research, 58(11), 1060–1071. https://doi.org/10.1111/jir.12029

    Article  PubMed  Google Scholar 

  • Landis, J. R., & Koch, G. G. (1977). The Measurement of Observer Agreement for Categorical Data. Biometrics, 33(1), 159–174. https://doi.org/10.2307/2529310

    Article  PubMed  Google Scholar 

  • Loane, M., Morris, J. K., Addor, M.-C., Arriola, L., Budd, J., Doray, B., et al. (2013). Twenty-year trends in the prevalence of Down syndrome and other trisomies in Europe: impact of maternal age and prenatal screening. European Journal of Human Genetics, 21(1), 27–33. https://doi.org/10.1038/ejhg.2012.94

    Article  PubMed  Google Scholar 

  • Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 56(6), 466–474. https://doi.org/10.1016/j.jaac.2017.03.013

    Article  PubMed  Google Scholar 

  • Magaña-Amato, A. B. (1993). Manual for coding Expressed Emotion from the Five Minute Speech Sample UCLA: Family Project. UCLA.

    Google Scholar 

  • Magaña-Amato, A. B., Goldstein, J. M., Karno, M., Miklowitz, D. J., Jenkins, J., & Falloon, I. R. (1986). A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Research, 17(3), 203–212. https://doi.org/10.1016/0165-1781(86)90049-1

    Article  Google Scholar 

  • Maljaars, J., Boonen, H., Lambrechts, G., Van Leeuwen, K. G., & Noens, I. (2014). Maternal parenting behavior and child behavior problems in families of children and adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(3), 501–512. https://doi.org/10.1007/s10803-013-1894-8

    Article  PubMed  Google Scholar 

  • McCarty, C. A., Lau, A. S., Valeri, S. M., & Weisz, J. R. (2004). Parent–Child interactions in relation to critical and emotionally overinvolved expressed emotion (EE): Is EE a proxy for behavior? Journal of Abnormal Child Psychology, 32(1), 83–93. https://doi.org/10.1023/B:JACP.0000007582.61879.6f

    Article  PubMed Central  PubMed  Google Scholar 

  • McCauley, J. B., Mundy, P., & Solomon, M. (2019). Parenting and autism spectrum disorder. In M. H. Bornstein (Ed.), Handbook of parenting Vol. I: Children and Parenting. (3rd ed.). New York: Routledge.

    Google Scholar 

  • Orsmond, G. I., Seltzer, M. M., Greenberg, J. S., & Krauss, M. W. (2006). Mother–child relationship quality among adolescents and adults with autism. American Journal on Mental Retardation, 111(2), 121–137.

    Article  PubMed  Google Scholar 

  • Palisano, R. J., Rosenbaum, P., Bartlett, D., & Livingston, M. H. (2008). Content validity of the expanded and revised gross motor function classification system. Developmental Medicine & Child Neurology, 50(10), 744–750. https://doi.org/10.1111/j.1469-8749.2008.03089.x

    Article  Google Scholar 

  • Peer, J. W., & Hillman, S. B. (2014). Stress and resilience for parents of children with intellectual and developmental disabilities: A review of key factors and recommendations for practitioners. Journal of Policy and Practice in Intellectual Disabilities, 11(2), 92–98. https://doi.org/10.1111/jppi.12072

    Article  Google Scholar 

  • Peris, T. S., & Miklowitz, D. J. (2015). Parental expressed emotion and youth psychopathology: New directions for an old construct. Child Psychiatry and Human Development, 46(6), 863–873. https://doi.org/10.1007/s10578-014-0526-7

    Article  PubMed Central  PubMed  Google Scholar 

  • Peris, T. S., & Piacentini, J. (2013). Optimizing treatment for complex cases of childhood obsessive compulsive disorder: A preliminary trial. Journal of Clinical Child & Adolescent Psychology, 42(1), 1–8. https://doi.org/10.1080/15374416.2012.673162

    Article  Google Scholar 

  • Phillips, B. A., Conners, F., & Curtner-Smith, M. E. (2017). Parenting children with down syndrome: An analysis of parenting styles, parenting dimensions, and parental stress. Research in Developmental Disabilities, 68, 9–19. https://doi.org/10.1016/j.ridd.2017.06.010

    Article  PubMed  Google Scholar 

  • Pinquart, M. (2018). Parenting stress in caregivers of children with chronic physical condition-A meta-analysis. Stress and Health: Journal of the International Society for the Investigation of Stress, 34(2), 197–207. https://doi.org/10.1002/smi.2780

    Article  Google Scholar 

  • Prinzie, P., Onghena, P., & Hellinckx, W. (2007). Reexamining the PARENTING SCALE: Reliability, factor structure, and concurrent validity of a scale for assessing the discipline practices of mothers and fathers of elementary-school-aged children. European Journal of Psychological Assessment, 23(1), 24–31. https://doi.org/10.1027/1015-5759.23.1.24

    Article  Google Scholar 

  • Rea, H. M., Factor, R. S., Kao, W., & Shaffer, A. (2020). A meta-analytic review of the five minute speech sample as a measure of family emotional climate for youth: relations with internalizing and externalizing symptomatology. Child Psychiatry & Human Development. https://doi.org/10.1007/s10578-020-00964-z

    Article  Google Scholar 

  • Roeyers, H., Thys, M., Druart, C., De Schryver, M., & Schittekatte, M. (2011). Handleiding Screeningslijst voor autismespectrumstoornissen. Hogrefe Uitgevers B.V.

    Google Scholar 

  • Romero-Gonzalez, M., Chandler, S., & Simonoff, E. (2018). The relationship of parental expressed emotion to co-occurring psychopathology in individuals with autism spectrum disorder: A systematic review. Research in Developmental Disabilities, 72, 152–165. https://doi.org/10.1016/j.ridd.2017.10.022

    Article  PubMed  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2017). Self-determination theory: Basic psychological needs in motivation, development and wellness. The Guilford press.

    Book  Google Scholar 

  • Schaefer, E. S. (1965). Children’s reports of parental behavior: An inventory. Child Development, 36, 413–424.

    Article  PubMed  Google Scholar 

  • Seltzer, M. M., Krauss, M. W., Orsmond, G. I., & Vestal, C. (2000). Families of adolescents and adults with autism: Uncharted territory. International review of research in mental retardation . (Vol. 23, pp. 267–294). Cambridge: Academic Press.

    Google Scholar 

  • Sher-Censor, E. (2015). Five minute speech sample in developmental research: A review. Developmental Review, 36, 127–155.

    Article  Google Scholar 

  • Skotko, B. G., Levine, S. P., & Goldstein, R. (2011). Having a son or daughter with Down syndrome: perspectives from mothers and fathers. American Journal of Medical Genetics Part A, 155(10), 2335–2347. https://doi.org/10.1002/ajmg.a.34293

    Article  Google Scholar 

  • Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2014). The family context of autism spectrum disorders: influence on the behavioral phenotype and quality of life. Child and Adolescent Psychiatric Clinics, 23(1), 143–155. https://doi.org/10.1016/j.chc.2013.08.006

    Article  Google Scholar 

  • Smith, L. E., Greenberg, J. S., Seltzer, M. M., & Hong, J. (2008). Symptoms and behavior problems of adolescents and adults with autism: effects of mother-child relationship quality, warmth, and praise. American Journal on Mental Retardation, 113(5), 387–402. https://doi.org/10.1352/2008.113:387-402

    Article  PubMed  Google Scholar 

  • Soenens, B., Deci, E. L., & Vansteenkiste, M. (2017). How parents contribute to children’s psychological health: The critical role of psychological need support. Development of self-determination through the life-course. (pp. 171–187). Springer.

    Chapter  Google Scholar 

  • Soenens, B., Vansteenkiste, M., Luyckx, K., & Goossens, L. (2006). Parenting and adolescent problem behavior: An integrated model with adolescent self-disclosure and perceived parental knowledge as intervening variables. Developmental Psychology, 42(2), 305–318. https://doi.org/10.1037/0012-1649.42.2.305

    Article  PubMed  Google Scholar 

  • Stanley, F., Blair, E., & Alberman, E. (2000). Cerebral palsies: Epidemiology and causal pathways. Mac Keith Press.

    Google Scholar 

  • Stoneman, Z. (2007). Examining the Down syndrome advantage: mothers and fathers of young children with disabilities. Journal of Intellectual Disability Research, 51(12), 1006–1017. https://doi.org/10.1111/j.1365-2788.2007.01012.x

    Article  PubMed  Google Scholar 

  • Thompson, T., Coleman, J., & Olmos, A. (2018). The expressed emotion of parents of children with developmental disabilities: A meta-analysis. Life Span and Disability, 21(2), 177–189.

    PubMed  PubMed Central  Google Scholar 

  • Valicenti-McDermott, M., Lawson, K., Hottinger, K., Seijo, R., Schechtman, M., Shulman, L., et al. (2015). Parental stress in families of children with autism and other developmental disabilities. Journal of Child Neurology, 30(13), 1728–1735. https://doi.org/10.1177/0883073815579705

    Article  PubMed  Google Scholar 

  • Vansteenkiste, M., & Ryan, R. M. (2013). On psychological growth and vulnerability: Basic psychological need satisfaction and need frustration as a unifying principle. Journal of Psychotherapy Integration, 23(3), 263–280. https://doi.org/10.1037/a0032359

    Article  Google Scholar 

  • Vaughn, C., & Leff, J. (1976). The measurement of expressed emotion in the families of psychiatric patients. British Journal of Clinical Psychology, 15, 157–165.

    Article  Google Scholar 

  • Wamboldt, F. S., O’Connor, S. L., Wamboldt, M. Z., Gavin, L. A., & Klinnert, M. D. (2000). The five minute speech sample in children with asthma: deconstructing the construct of expressed emotion. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 41(7), 887–898. https://doi.org/10.1111/1469-7610.00676

    Article  PubMed  Google Scholar 

  • Whittingham, K., Wee, D., Sanders, M. R., & Boyd, R. (2013). Predictors of psychological adjustment, experienced parenting burden and chronic sorrow symptoms in parents of children with cerebral palsy. Child Care, Health and Development, 39(3), 366–373. https://doi.org/10.1111/j.1365-2214.2012.01396.x

    Article  PubMed  Google Scholar 

  • Woodman, A. C., Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2015). Change in autism symptoms and maladaptive behaviors in adolescence and adulthood: The role of positive family processes. Journal of Autism and Developmental Disorders, 45(1), 111–126. https://doi.org/10.1007/s10803-014-2199-2

    Article  PubMed Central  PubMed  Google Scholar 

  • Yığman, F., Aykın Yığman, Z., & Ünlü Akyüz, E. (2020). Investigation of the relationship between disease severity, caregiver burden and emotional expression in caregivers of children with cerebral palsy. Irish Journal of Medical Science. https://doi.org/10.1007/s11845-020-02214-6

    Article  PubMed  Google Scholar 

  • Yorke, I., White, P., Weston, A., Rafla, M., Charman, T., & Simonoff, E. (2018). The association between emotional and behavioral problems in children with autism spectrum disorder and psychological distress in their parents: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders, 48(10), 3393–3415. https://doi.org/10.1007/s10803-018-3605-y

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This research was supported by a BOF Starting Grant BOFSTA2017004601, by Grant GV/B-202 from the Marguerite-Marie Delacroix Support Fund and Grants FWO 12B4614N and 11X6516N from the Fund for Scientific Research Flanders.

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All authors contributed to the study’s conception and design. FMSS collection and coding were performed by LED and two research assistants. The data analysis was performed by LED and the research findings were discussed with all authors. All authors commented on previous versions of the manuscript, and read and approved the final manuscript.

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Correspondence to Lana E. De Clercq.

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De Clercq, L.E., Prinzie, P., Warreyn, P. et al. Expressed Emotion in Families of Children With and Without Autism Spectrum Disorder, Cerebral Palsy and Down Syndrome: Relations with Parenting Stress and Parenting Behaviors. J Autism Dev Disord 52, 1789–1806 (2022). https://doi.org/10.1007/s10803-021-05075-9

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