Understanding, Assessing, and Intervening with Emotion Dysregulation in Autism Spectrum Disorder: A Developmental Perspective

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Key points

  • Children and adolescents with autism spectrum disorder (ASD) present with social-communication deficits, restricted interests and repetitive behaviors, and sensory sensitivities, all of which render them more vulnerable to emotion dysregulation (ED).

  • Associated features of ASD also contribute to ED, including difficulties with sleep and feeding, shifting attention appropriately, understanding and expressing emotions, and executive functions.

  • It is essential to assess the timeline of ED throughout

Development of emotion regulation in autism spectrum disorder

Children with ASD have difficulties with both the reactive and regulatory components of ER from birth.1 Core features of ASD, that is, deficits in social and communication functioning and rigid, repetitive behaviors, link to ED.3,4 For example, social-communication deficits reduce a child’s capacity to benefit from caregivers to serve as emotional regulators, in addition to interfering with the child’s ability to understand and express emotions. Restricted and repetitive behaviors are most

Assessing emotion dysregulation

There are several approaches to assessing ER in ASD including parent interview, direct observation, and checklist/rating scales.

A careful history and observation should cover each of the developmental domains associated with ER. In addition to administration of instruments such as the Autism Diagnostic Observation Schedule-2 (ADOS-2)27 and the Autism Diagnostic Interview –Revised (ADI-R),28 routine questions should be asked about the child’s mood, level of irritability, and the frequency,

Treatment of emotion dysregulation in autism spectrum disorder

ED and irritability resulting in aggressive behavior directed at self and/or others is a serious problem, and often a psychiatric emergency. Addressing these behaviors is essential to improving outcomes.

Summary

The ER deficits of children with ASD can be both reactive and regulatory and are often the reason for a family seeking treatment. Such difficulties can be conceptualized as sequelae of the core symptoms of ASD or an independent construct. Understanding the ER in ASD deficits from a developmental perspective provides a context for both assessment and intervention. A detailed assessment of the function and intensity of ER provides the basis for intervention. Evidence-based interventions include

Disclosure

The authors have nothing to disclose.

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