Associations between autism traits and family functioning over time in autistic and non-autistic children.

This study looked at how families cope when raising children with autism-like behaviors, whether or not the child has an official autism diagnosis. Researchers found that families of children with autism traits but no formal diagnosis struggled more over time compared to families whose children were officially diagnosed with autism. This suggests families without a diagnosis may miss out on important support services that could help them understand and manage their child's needs.

This longitudinal study followed 168 children referred to youth mental health services to examine relationships between autism traits and family functioning over approximately one year. Researchers found that families with children showing fewer autism traits reported better family functioning over time. Surprisingly, this relationship was only significant for children with autism traits who did not receive a clinical autism diagnosis (42% of sample), not for those with formal autism diagnoses (58%). The authors suggest families of children with subclinical autism traits may lack access to specialized support services available to families with diagnosed children, potentially contributing to ongoing family functioning difficulties despite similar behavioral presentations.

Clinicians should consider offering targeted family support to children with subclinical autism traits who don't meet diagnostic criteria. Family interventions should be tailored to underlying difficulties rather than using standard autism-specific approaches. Early identification and support may prevent deterioration in family functioning for this underserved population.

Sample consisted only of children referred to mental health services, limiting generalizability. Causal relationships cannot be established. One-year follow-up period may be insufficient to capture long-term family functioning patterns. The study does not clarify whether differences reflect actual family functioning or access to support services.

Little is known about family functioning over time when raising a child with autism traits, with or without a clinical autism diagnosis. Therefore, we asked caregivers-mostly parents-of a group of 168 children about the family functioning and the child's emotional and behavioral characteristics, as well as autistic traits, twice with about 1 year in between. For numerous reasons, the children were referred to youth mental health care centers, including child and adolescent psychiatric services. Care as usual was offered after the diagnostic assessment if a clinical diagnosis was the assessment outcome.

Caregivers reported less problematic family functioning in children with fewer autism traits over time. The child's additional emotional or behavioral characteristics did not seem to influence this relation. Furthermore, we split the whole group into autistic children with a clinical autism diagnosis (58%) and non-autistic children with autism traits but without a clinical diagnosis (42%) to see whether we would find the same results in both groups. Surprisingly, the relation between family functioning and the level of a child's autism traits only held for the subgroup of non-autistic children with autism traits.

Thus, raising children with autism traits without a clinical diagnosis may affect family functioning over time. We think that families might have difficulty understanding and adjusting to the autism traits of their children but are lacking the support that is exclusively offered to families of children with a clinical autism diagnosis. We must be cautious because we do not know whether there is a causal relation. Although further research is needed to explore and learn to understand this result, clinicians might consider offering support to families of children with subthreshold autism to prevent problems in family functioning.

Because high autism trait levels in non-autistic children may be of a different origin than autism, for example, other neurodevelopmental or mental health problems, family training or support should be tailored to the child's underlying difficulties.