The link between focused attention and emotion regulation ability in children with ASD.

Background: Empirical studies have frequently highlighted the importance of attentional mechanisms in the emotion regulation of people with autism spectrum disorder (ASD). For instance, people with ASD present distinct gaze patterns when looking at emotional stimuli. However, far less research has focused on the link between general attentional capacity and the ability to regulate emotions in people with ASD. In the typically developing (TD) literature it is shown that children’s focused and sustained attention to non-emotional stimuli is related to a better regulation of negative emotions. Therefore, studying this link in ASD can help understand emotional difficulties in children with ASD.
Objectives: The present study aims to analyse the link between sustained attention to non-emotional stimuli and the use of emotion regulation strategies during a frustration-eliciting situation in children with ASD.
Methods: Thirty-seven children previously diagnosed with ASD (5 female) and 41 TD children (9 female) aged 3 to 13 years old participated in the study. Children first took part in a sustained attention task in which they watched a 3-minute slide presentation of 15 pictures of landscapes, animals, and humans. Then, children took part in a frustration-eliciting situation during which they were presented with attractive toys. After 15 seconds playing with the toys those were removed and placed behind a transparent barrier. Both tasks were videotaped and children’s behaviors were coded by two independent observers. In the sustained attention task children were coded regarding the intensity of facial interest (0=not interested, 1=interested, 2=very interested) and the total amount of time in seconds looking at the slide presentation (maximum = 180 seconds). In the frustration-eliciting situation children’s behaviors were coded into 12 categories and then grouped into 3 emotion regulation strategies: disruptive behavior (physical objection, crying/venting, defending, infraction, and verbal objection), passive tolerance (staring, doing nothing, self-distraction, and parent/researcher), and active self-regulation (directing situation, alternating activity, and complying).
Results: Regarding attention, children with ASD displayed less interest in the slide presentation [t(70)=4.118, p<.001, d=0.96] and watched the presentation for less time [t(43)=5.492, p<.001, d=1.33] than TD children. Regarding the use of emotion regulation strategies, a significant effect of group was found [Λ=.71, F(3,74)=10.26, p<.001, η_p^2=.29]. Separate univariate ANOVAs revealed that children with ASD used more disruptive behaviors [F(1,76)=25.24, p<.001, η_p^2=.25] and less passive tolerance behaviors [F(1,76)=11.35, p<.01, η_p^2=.13] than TD children but did not differ regarding active self-regulation behaviors [F(1,76)=2.03, p=.16, η_p^2=.03]. Regression analyses revealed that children’s total duration of look but not the interest during the attention task significantly predicted children’s use of disruptive behavior (β=-1.12, p<.01) and passive tolerance (β=1.26, p<.01) above and beyond ASD diagnosis.
Conclusions: Our results show a significant association between children’s capacity for sustained attention and their use of less disruptive behaviors and more passive tolerance behaviors as emotion regulation strategies. However, mutual influences between sustained attention and emotion regulation can occur and should be taken into consideration when interpreting the results. The present results offer new perspectives on intervention programs for children with ASD with emotional difficulties.