1. Martha Early, MA, Micah Mazurek, PhD Thompson Center for Autism and Neurodevelopmental Disabilities, University of Missouri, Columbia, MO INTRODUCTION Children with autism spectrum disorders (ASD) are at a high risk of experiencing internalizing problems, including anxiety and depression (Davis et al., 2011; de Bruin et al. 2006; Gillott, Furniss, & Walter, 2001; Simonoff, 2008). One explanation for this high risk may be difficulties with emotion regulation. Emotion regulation (ER) is the ability to alter emotional responses (Cole, Luby, & Sullivan, 2008), and includes skills such as: Emotion recognition Emotion understanding Coping Emotion regulation also helps children adjust to the social world (Nathalie, 2011). Difficulties with emotion regulation have been associated with both internalizing problems and ASD ( Durbin & Shafir, 2008; Gulsrud, Jahromi, & Kasari, 2010; Nathalie, 2011; Southam-Gerow & Kendall, 2002; Suveg & Zeman, 2004; Zeman, Shipman, & Suveg, 2002 ). However, little research has examined whether ER may serve as a common link between internalizing problems and ASD. Ineffective ER may put children with ASD at greater risk for developing internalizing problems. CURRENT STUDY Aims: 1)To examine the relation between ER and internalizing problems in children with ASD. 2)To examine whether ER predicts internalizing symptoms controlling for demographic variables such as IQ, Age, and Gender. 3)To examine interactions between ER and demographic variables in predicting internalizing problems.METHOD Participants 4,000 children (ages 2-17, 84% male) enrolled in the multi-site Autism Treatment Network (ATN) clinical registry. All participants met DSM-IV criteria for an ASD, and were assessed using a standard diagnostic battery. Measures Internalizing Problems Children’s Behavior Checklist (CBCL; Achenbach, 2010 ) Anxious/Depressed, Withdrawn, Somatic Scales (T-Scores) Emotion Regulation Vineland Adaptive Behavior Scales, Second Edition (Vineland-II; 2005) Coping Subscale (Stanine Scores) Full Scale IQ scores were obtained from a variety of measures: SB-V, WISC-IV, WASI, WPPSI, Mullen Scales of Early Learning Standard Scores were used Emotion Regulation in Children with ASD: Risk for Internalizing Problems Gender and Age Distribution Year 1 N=1,825 Subscribers Variable12345678. 1. Emotion Regulation-- 2. Age-0.28-- 3. Gender-0.01-0.02-- 4. Full Scale IQ0.250.18-0.04-- 5. CBCL-Internalizing-0.140.020.010.10 -- 6. CBCL-Anx/Dep-0.080.230.010.21 0.73-- 7. CBCL-Withdrawn-0.130.09-0.060.090.710.42-- 8. CBCL-Somatic-0.100.040.010.100.680.420.34-- N36944329432832413770377115773771 Mean10.395.86n/a76.0562.9658.6564.1259.49 Standard Deviation2.353.48n/a23.969.829.329.168.48 Minimum3.002.00n/a40.002950 Maximum24.0017.00n/a148.0092.00100.0096.00 RESULTS Aim 1: Analyses reveal small yet significant correlations between Emotion Regulation (ER) and Internalizing Problems. Lower ER scores were associated with more internalizing problems in children with ASD (see Table 1). IQ was also a significant predictor of internalizing problems such that children with higher IQ had more internalizing problems. Table 1: Descriptive Statistics and Intercorrelations between Emotion Regulation, Demographic Variables, and Internalizing Problems Aim 2: Hierarchical regressions revealed that ER predicted internalizing problems while controlling for demographic variables (IQ, Age, and Gender). Aim 3: Hierarchical regressions revealed significant ER by IQ and ER by Age interactions in predicting internalizing problems (see figures 1 and 2). DISCUSSION Results Review Aim 1: Children whose ER scores were low tended to have higher internalizing problems. This is consistent with research conducted with typically developing children. Aim 2: Associations between ER and internalizing symptoms were significant after controlling for IQ, Age, and Gender. Aim 3: Hierarchical regressions revealed significant interactions: A significant ER by IQ interaction indicated that children with high IQ and low ER are at increased risk of internalizing problems relative to children with low IQ and low ER. A significant ER by Age interaction revealed younger children with low ER are at increased risk of internalizing problems than older children with low ER. Conclusions Emotion Regulation (ER) appears to be a small but significant piece of the puzzle in helping us understand why children with ASD often struggle with internalizing problems. The results from this study indicate that the relation between ER and internalizing symptoms is strongest for younger children and children with higher IQ. Clinical Implications These results highlight the importance of considering the emotional experience of children with ASD and how it can impact their well-being. Lack of emotional understanding or control appears to put them at risk for anxiety and depression. Providers should consider emotion regulation as an intervention target for children with ASD, particularly for children with co-occurring anxiety or depression diagnoses. Limitations and Future Directions The current measure of ER is very broad, and our study was cross- sectional in design. Future studies should include longitudinal designs as well as more focused assessments of ER and its components (e.g. Emotion Understanding, Emotional Control). Future research should investigate the use of emotion regulation techniques in currently used or novel intervention approaches. SELECTED REFERENCES Davis, T. E., Moree, B. N., Dempsey, T., Reuther, E. T., Fodstad, J. C., Hess, J. A., Jenkins, W. S., Matson, J. L. (2011) The relationship between autism spectrum disorders and anxiety: The moderating effect of communication. Research in Autism Spectrum Disorders, 5, 324-329). Gulsrud, A.C., Jahromi, L. B., Kasari, C. (2010). The co-regulation of emotions between mothers and their children with autism. Journal of Autism and Developmental Disorders, 40, 227-237. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., Baird, G (2008). Psychiatric disorders in children with autism spectrum disorders. 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