Hoe jij en ik samen vorm krijgen. Observaties van moeder-kind interacties in de context van autisme

Children develop in close interaction with their environments. During the first years of life, important environmental aspects are a child's interactions with their parents. To better understand the development of young children at elevated likelihood (EL) of autism, this doctoral project aimed to shed more light on how interactions between these children at EL of autism and their parents take shape. This doctoral project is part of the TIARA study (Tracking Infants at Raised likelihood of Autism), which tracked children at EL of autism from the ages of 5 to 36 months. Specifically, we investigated children with an older autistic sibling and children who were born very preterm. To investigate PCIs, we applied the theoretical framework of the bioecological model, as described by Bronfenbrenner and Morris (1998). Although this theory was already formulated in the previous century, and has been widely accepted, the basic principles posed by this model have been little reflected in autism research. The bioecological model states that parent-child interactions (PCIs) are shaped by the context wherein they take place. Yet, in autism research, PCIs are almost exclusively studied during a free play context. In manuscript 1, we compared PCIs during free play and goal-directed play when children were 24 months. We noted that mothers showed more sensitive-responsive and positive behaviors, and less negative behaviors during free play compared to goal-directed play contexts. Furthermore, our results indicated that the relationship between mothers' and children's negativity only became apparent during goal-directed play, but not free play. The bioecological model also emphasizes bidirectionality, meaning that both interaction partners mutually shape each other. In the autism field, the potential impact of parents' behaviors on child development has been rigorously studied, but little is known about the potential impact of child characteristics parents' PCI-behaviors. In manuscript 2, we investigated the latter. We zoomed in on a specific type of parenting behaviors: the degree to which parents synchronize their verbalizations to match with the child's focus of attention. Previous studies indicated that this parenting behavior is beneficial for children's subsequent language development. Our results indicated that children's early language abilities (10 months) were predictive for parents' subsequent synchronized verbalizations (14 months). Other child characteristics, such as early cognitive abilities or autism diagnosis, did not add predictive value beyond language abilities. Thirdly, this model emphasizes that PCIs change throughout time, and encourages investigating PCIs using longitudinal designs. In manuscript 3, we observed PCIs at the ages of 5, 10, 14, 24, and 36 months. Based on trajectories of PCI-behaviors, we identified three subgroups of mother-child dyads: (a) dyads wherein children showed the most social-communicative behaviors, and mothers showed the most supportive behaviors across the first three years of life, (b) dyads wherein children initially showed the least social-communicative behaviors, and parents the least supportive behaviors, but both increased throughout time, and (c) dyads who showed notably more negativity in interactions, and wherein mothers showed the least supportive behaviors. Our results confirmed that PCIs change throughout time, and indicate that the course of PCI-trajectories relate to children's social-communicative behaviors and negative affectivity. The course of PCI-trajectories did not relate to children's research diagnoses of autism or parent-rated signs of internalizing or externalizing distress. This doctoral project suggests that the principles of the bioecological model may apply to parent-child interactions in light of emerging autism, and encourages further investigation. In this thesis, we share critical reflections on our work and discuss clinical implications that can be drawn from this project.