Reciprocal Associations Between Parental Anxiety/Depression and Emotional/Behavioral Difficulties in Autistic Children Following Their Diagnosis.

There were only two measurement points, three years apart. The authors say long gaps combined with symptoms that are already stable can dampen cross-lagged effects, so this design cannot tell you whether parent and child influence each other over shorter intervals. Drop-out was substantial: 62.2% of mothers and 62.4% of fathers were still in the study at the three-year follow-up, so those with the highest burden may be missing from the results. Families of children with lower IQ were more likely to drop out, and the authors say the findings may not generalise to families of children with intellectual disability. The preregistered models used all the available degrees of freedom, so their fit could not be checked and the authors say those results cannot be generalised beyond this sample. Children moved from one version of the behaviour questionnaire to the other between the two time points, and the authors could not fully rule out that some of the change over time reflects the change of measure rather than real change. Everything was measured by parent-completed questionnaires, and the depression scale used may pick up fewer cases than other scales. With a single three-year interval, other things changing over that period cannot be separated out; the authors note that unmeasured environmental and genetic factors could act on both parents and children at once.

Funded by the French Health Ministry (DGOS, PHRCN 2013, grant 13-0232) and the National Solidarity Fund for Autonomy (grant 030319), with additional support from Montpellier University Hospital. One author held a doctoral scholarship from the University of Versailles Saint-Quentin-en-Yvelines. The authors declare no conflicts of interest.

Do not read this as showing that parents' mental health does not matter for autistic children, or that supporting parents will not help the child. At diagnosis the two were clearly linked, and each stayed stable over the three years on its own. What the study could not show is that one predicts change in the other, and with only two measurement points three years apart it was not well placed to detect that.