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Raising a child with autism spectrum disorder (ASD) can be a very stressful experience, impacting parents and their ability to take care of their child. We examined the relationship between parenting stress and child, and parent and contextual factors in a sample of 61 families of children with ASD recruited in a centre for ASD assessment and treatment. Results showed that mothers had a higher level of stress related to their parental role when compared to fathers. Data also showed the importance of considering the specific role of parental emotion regulation, family functioning and educational level in influencing maternal stress and the specific role of couple adjustment in influencing fathers’ parental distress. This study pointed out the importance of employing a vision that embraces different domains of family life in cases of children with ASD and in parents’ intervention programmes because these factors may contribute to parental stress.

Purpose The assessment of Autism Spectrum Disorders (ASD) in childhood has two essential aspects: the identification of the risk (under 30 months of age) and the definition of a diagnosis that takes into account its core areas as well as further non-specific aspects. The purpose of this paper is to present an approach that considers the combination of clinical evaluation with the use of tools that analyse the various levels of the child’s functioning as fundamental. Design/methodology/approach The comprehensive assessment at the Institute of Ortofonologia in Rome provides the ADOS-2 and the Leiter-R for the evaluation of the symptomatology, the severity level, the non-verbal cognitive functioning and the fluid reasoning; the TCE and the UOI are used to identify, respectively, the child’s emotional skills and the ability to understand the intentions of others, as precursors of the theory of mind. Within this assessment, the Brief-P, the Short Sensory Profile and the RBS are also included for the evaluation of executive functions, sensory pattern and of restricted and repetitive behaviours, as observed by parents. Findings How to define a reliable development profile, which allows to plan a specific intervention calibrated on the potential of the child and on his development trajectory, is described. Two clinical cases are also presented. Originality/value The entire process is aimed both at a detailed assessment of the child’s functioning and at identifying a specific therapeutic project and predictive factors for achieving an optimal outcome.

Based on cross-sectional research linking poor reflective functionining (RF) to eating disorders, the current follow-up study tested whether maternal RF would explain the variance of mothers' and children's weight beyond the effects of maternal emotional dysregulation. During pregnancy (Time 1 [T1]), 51 women were administered the Difficulties in Emotion Regulation Scale (DERS) and interviewed using the Adult Attachment Interview (AAI). Seven months after delivery (Time 2 [T2]), mother-baby dyads who remained in the study (n = 44) were videotaped (Feeding Scale) during their feeding interaction. Last (Time 3 [T3]), the weight of the 34 children who were still in the study was collected at 3 years of age. Maternal AAI-RF at T1 did not correlate with the DERS at T1 nor with the quality of the feeding interacions at T2. However, it correlated, significantly, with maternal body mass index (BMI) at T1, r = -.298, P = .034, and marginally significantly with baby's BMI at T3, r = -.296, P = .089. Moreover, multiple regression models showed a trend indicating that maternal AAI-RF might explain the variance of mothers' and children's weight beyond the effects of maternal emotional dysregulation. These findings suggest that working on maternal mentalization might contribute to helping prevent childhood obesity from pregnancy.Objetivo: con base en la investigación de naturaleza transversal que conecta el pobre funcionamiento con reflexión (RF) con los trastornos de alimentación, el presente estudio de seguimiento examinó si el RF materno podría explicar la variación del peso de las madres y de los niños más allá de los efectos de la desregulación emocional materna. Método: durante el embarazo (T1), a 51 mujeres se les administró la Escala de Regulación de las Dificultades en la Emoción (DERS) y se les entrevistó usando la Entrevista de la Afectividad Adulta (AAI). Siete meses después del parto (T2), las díadas mamá-bebé que permanecían en el estudio (n = 44) fueron grabadas en video (Escala de Alimentación) durante su interacción de alimentación. Por último (T3), se determinó el peso de los 34 niños que aún estaban en el estudio a los tres años de edad. Resultados: la información materna de AAI-RF al T1 no se correlacionó con DERS al T1, ni tampoco con la calidad de las interacciones de alimentación al T2. Sin embargo, sí se correlacionó, significativamente, con BMI materno al T1 (r = −.298, p = .034), y marginalmente significativo, con el BMI del bebé al T3 (r = −.296, p = .089). Es más, los modelos de regresión múltiple mostraron una tendencia indicando que la AAI-RF materna pudiera explicar la variación del peso de las madres y de los niños más allá de los efectos de la desregulación emocional materna. Conclusiones: estos resultados sugieren que trabajar en la mentalización materna pudiera contribuir a ayudar a prevenir la obesidad en la niñez desde el embarazo.Objectif: Se basant sur des recherches transversales liant un faible fonctionnement de réflexion (RF) aux troubles du comportement alimentaire, cette étude de suivi a testé si le RF maternel pouvait ou non expliquer la variance des poids des mères et des enfants au-delà des effets de la dysrégulation émotionnelle maternelle. Méthode: Durant la grossesse (T1), 51 femmes ont reçu l'Echelle de Difficultés de Régulation de l'Emotion (en anglais Difficulties in Emotion Regulation Scale, soit la DERS) et ont passé un entretien utilisant l'Entretien d'Attachement Adulte (Adult Attachment Interview, AAI). Sept mois après l'accouchement (T2), les dyades mère-bébé encore dans l’étude (n = 44) ont été filmées (Echelle d'Alimentation) durant leur interaction alimentaires. Enfin (T3), le poids des 34 enfants étant encore dans l’étude a été pris à l’âge de trois ans. Résultats: Le RF-AAI maternel au T1 n’était pas en corrélation avec la DERS au T1, ni avec la qualité des interactions alimentaires au T2. Cependant, il était corrélé, et de manière importante, avec l'IMC maternel au T1 (r = −,298, p = ,034), et de manière marginalement importante, avec l'IMC du bébé au T3 (r = −,296, p = ,089). De plus plusieurs modèles de régression ont montré une tendance indiquant le le RF-AAI maternel pourrait expliquer la variance des poids des mères et des enfants au delà des effets de la dysrégulation émotionnelle maternelle. Conclusions: Ces résultats suggèrent que le fait de travailler sur la mentalisation maternelle peut contribuer à aider à prévenir l'obésité de l'enfance dès la grossesse.Der Einfluss mütterlicher Reflexionsfähigkeit auf das Gewicht von Mutter und Kind: eine Follow-Up Studie Ziel: Basierend auf Querschnittsuntersuchungen, die geringe Reflexionsfähigkeit (poor reflective functioning; RF) mit Essstörungen in Zusammenhang gebracht haben, untersuchte die vorliegende Follow-Up Studie, ob durch mütterliche RF eine Varianzaufklärung beim Gewicht von Mutter und Kind möglich ist, unabhängig von mütterlicher emotionaler Dysregulation. Methode: 51 Frauen füllten während der Schwangerschaft (T1) die Difficulties in Emotion Regulation Scale (DERS) aus und durchliefen das Adult Attachment Interview (AAI). Sieben Monate nach der Geburt (T2) wurden die in der Studie verbleibenden Mutter-Kind-Dyaden (n = 44) beim Füttern gefilmt (Feeding Scale). Zuletzt (T3) wurde das Gewicht der 34 in der Studie verbleibenden Kinder im Alter von drei Jahren erhoben. Ergebnisse: Die mütterliche AAI-RF zum Zeitpunkt T1 wies weder zum DERS zu T1 noch zur Qualität der Fütterungsinteraktionen zu T2 Zusammenhänge auf. Allerdings zeigte ich ein signifikanter Zusammenhang zwischen AAI-RF und dem mütterlichen BMI zu T1 (r = −.298, p = .034) und ein marginal signifikanter Zusammenhang mit dem BMI des Babys zu T3 (r = −.296, p = .089). Außerdem zeigten multiple Regressionsmodelle Trends, die darauf schließen lassen, dass mütterliche AAI-RF die Varianz im Gewicht von Mutter und Kind, jenseits der Effekte von emotionaler Dysregulation, erklären könnte. Fazit: Diese Ergebnisse legen nahe, dass die Arbeit an mütterlicher Mentalisierungsfähigkeit seit der Schwangerschaft dazu beitragen könnte, Fettleibigkeit im Kindesalter vorzubeugen.母親の内省機能が母親と子どもの体重に与える影響: フォローアップ研究 目的: 内省機能(RF)の乏しさと摂食障害を結びつけた横断研究を基にして、本研究では、その追跡調査として、母親の内省機能が、母親の感情調節不全の影響を越えて、母親と子どもの体重の変化を説き明かすかどうかを調べた。 方法: 妊娠中(T1)、51人の女性が、感情制御困難性尺度(DERS)を行い、成人愛着面接法(AAI)で面接を受けた。出産後 7 か月目に(T2)、研究に残った乳幼児親子 (n = 44) の食事中の交流を撮影した（摂食尺度）。最後に、3 歳時に(T3)、研究に残っている 34 人の子どもたちの体重を調査した。 結果: T1 時の母親の成人愛着面接−内省機能は、T1 時の感情制御困難性尺度と関連がなく、T2 時の食事中の交流の質とも関連がなかった。しかしながら、それは T1 時の母親の BMI と有意に関連があり (r = −.298, p = .034)、T3 時の幼児の BMI とも有意傾向に関連があった (r = −.296, p = .089)。その上、重回帰モデルは、母親の成人愛着面接-内省機能は、母親の感情調節不全の影響を超えて、母親と子どもの体重の変化を説き明かしている可能性を示唆する傾向を示していた。 結論: これらの調査結果は、母親のメンタライゼーションに働きかけることは、妊娠期から幼児期の肥満を防止するのに役に立つかもしれないことを示している。.母親反思功能對母親和兒童體重的影響:後續研究 目的: 根據將低反思功能 （RF） 與飲食失調聯繫起來的橫斷面研究， 本後續研究測試母親 RF 是否可以解釋母親和兒童體重的變化， 超出母體情緒失調對體重的影響。 方法: 在懷孕期間 （T1）， 51名婦女填寫情緒調節困難量表 （DERS）， 並接受成人依附訪談 （AAI）。分娩後 7 個月 （T2）， 留在研究中的母嬰二人組合 （n = 44） 在餵食期間進行了視頻錄像 （餵食量表）。最後 （T3）， 仍然參與的 34 名兒童， 研究在其 3 歲時收集體重數據。 結果: T1 母親的 AAI-RF 與 T1 DERS 無關， 也與 T2 的進食互動作用質量無關。然而， 它顯著與 T1 母親的 BMI 相關 （r = −.298， p = .034）， 並與嬰兒 T3 的 BMI 顯著相關 （r = −.296， p = .089）。此外， 多元回歸模型顯示一個趨勢， 表明母親 AAI-RF 可能解釋母親和孩子的體重， 超出母親情緒失調對體重的影響。 結論: 這些研究結果表明， 從懷孕開始， 從事母親心理化工作可能有助於預防兒童肥胖。.تأثير الأداء التأملي للأمهات على وزن الأمهات والأطفال: دراسة متابعة الهدف: استنادا إلى البحوث الشاملة التي تربط ضعف الأداء التأملي (RF) باضطرابات الأكل، اختبرت دراسة المتابعة الحالية ما إذا كان الأداء التأملي للأمهات يفسر الفرق في وزن الأمهات والأطفال بما يتجاوز آثار خلل التنظيم العاطفي الأمومي. منهج البحث: أثناء الحمل (T1)، تم إعطاء 51 امرأة مقياس الصعوبات في تنظيم العاطفة (DERS) وأجريت مقابلات باستخدام مقابلة تعلق الكبار (AAI). بعد سبعة أشهر من الولادة (T2)، تم مقابلة ثنائيات الأم والطفل الذين بقوا في الدراسة (ن = 44) وتسجيلهم بالفيديو (مقياس التغذية) أثناء تفاعلهم وقت الإطعام. وأخيراً (T3)، تم رصد وزن الأطفال الـ 34 الذين كانوا لا يزالون في الدراسة في سن الثالثة. النتائج: لم يظهر ارتباط بين الأداء التأملي للأمهات في مقابلة التعلق للكبار AAI-RF في T1 مع مقياس صعوبات تنظيم العاطفة DERS في T1، ولا مع نوعية تفاعلات التغذية في T2. ومع ذلك، فإنه يرتبط، بشكل ملحوظ، مع مؤشر كثافة الجسم الأمومي في T1 (r = -.298، p = 0.034)، وبشكل هامشي، مع مؤشر كتلة الجسم للطفل في T3 (r = -296، p = 0.089). وعلاوة على ذلك، أظهرت نماذج الانحدار المتعدد اتجاها يشير إلى أن الأداء التأملي للأمهات قد يفسر التباين في وزن الأمهات والأطفال بغض النظر عن آثار خلل التنظيم العاطفي الأمومي. الاستنتاجات: تشير هذه النتائج إلى أن التأمل الذهني الأمومي قد يسهم في المساعدة على الوقاية من السمنة في مرحلة الطفولة منذ الحمل.

Parents of children with autism spectrum disorder (ASD) have to address various challenges mainly due to their children’s atypia related to communication, emotion regulation and behaviors, arising also within the relationship with their caregivers. Several studies have pointed out that children with ASD can exhibit many difficulties regarding initiating and maintaining meaningful relationships with others. To date, little research has explored the interactions between children with ASD and their fathers, focusing more on mothers. In the context of parent–child interactions in the presence of autism, recent studies have highlighted the importance of parental attunement but there is little research considering solely the affective-bodily dimension. Therefore, the aim of the present study was to explore the parental attunement in fathers of children with ASD observed during play interactions and to investigate the relationship between paternal attunement and the perception of their psychological characteristics related to care relationships. The results highlight that fathers who describe themselves as better in affective care and sensitivity toward others more likely have an absence of paternal attunement during play interactions. The data presented are discussed in the light of intervention hypotheses, aimed at improving the relationship between fathers and children with autism.

Early parent-child relationships are an important factor influencing many domains of child development, even in the presence of autism. In this study, we investigated the associations between parent-child attunement during play, parental insightfulness, and parental acceptance of their child's diagnosis of an autism spectrum disorder. A sample of 50 parents (26 mothers and 24 fathers) of 26 children aged between 24 and 58 months were videotaped during parent-child play interactions and then interviewed about what they thought had gone through their child's head during the play interaction, and about their feelings and thoughts about their child's diagnosis. Play interactions were evaluated using a coding protocol to assess parental attunement. The results showed that parents who were more able to accept their child's diagnosis and to see things from their child's perspective were more likely to also be attuned during play interactions with their children. These findings highlight the importance of studying the parental ability of insightfulness and acceptance of their child diagnosis of ASD for the implementation of intervention programs for supporting parental attunement and improving the interactions between the parents and the children with autism spectrum disorders.

This paper reports on a long-term follow-up of a longitudinal study conducted in Italy that assessed attachment patterns of late-adopted children (placed between 4 and 8 years old) and their adoptive mothers, in three phases: T1, at placement; T2, in childhood (7 to 8 months after adoption); and T3, in adolescence (current study). The following hypotheses were tested: 1) children’ IWMs will shift from insecurity towards security in a long-term follow-up; and 2) there will be a significant association between adoptees’ and adoptive mothers’ IWMs in adolescence. Participants were 22 late-adopted adolescents (aged 11-16) and their adoptive mothers, all assessed in previous phases. Participants completed several measures of attachment, including the Separation-Reunion Procedure (T1, T2), Manchester Child Attachment Story Task (T2), Friends and Family Interview (T3), and Adult Attachment Interview (T1, T3). Late-adopted adolescents showed both an increase in attachment security and a decrease in disorganized attachment from childhood to adolescence. Adoptive mothers’ (T1 and/or T3?) secure states of mind were associated significantly(?) to their adopted children attachment security in adolescence. These findings reinforce the importance of taking attachment into account for adoptive families from the beginning of adoption.

This study compared an attachment-based coding system for family drawings with narrative and observational attachment measures in adopted children and those living with their natural parents (“community-based”) in Italy. Attachment patterns of 41 children (ages 5–8) were assessed by: a graphic measure, the Family Drawing (FD); a narrative measure, the Manchester Child Attachment Story Task (MCAST); and an observational measure, the Separation-Reunion Procedure (SRP). In the community sample, a significant association emerged between the FD and MCAST disorganized vs. organized classifications, and a number of expected correlations between the FD Global Scales and the MCAST Coherence and Mentalizing continuous scales were found. In the adopted group, some FD Global Scales linked with insecure and disorganized representations revealed negative correlations with the MCAST Mentalizing scale. No correlations were found between the children’s FD and SRP classifications and scales in both groups. The FD attachment-based coding system revealed a particular capacity to assess attachment representations during childhood capturing closely both insecure and disorganized patterns, both in adopted and community children. A special focus was put on the measurement of disorganization, as reflected in one drawing classified as disorganized.