Brief report: Does "healthy" family functioning look different for families who have a child with autism?

Background: For families of typically developing children, extremes of family cohesion (enmeshed and disengaged) and flexibility (rigid and chaotic) are associated with negative outcomes (Olson, 2011). Some work suggests that this may not be true for families of children with autism spectrum disorder (ASD; Altiere & von Kluge 2009). Specifically, regimented daily routines (increased rigidity) and highly involved caregivers (increased enmeshment) might theoretically be associated with positive outcomes.

Objectives: This study examined whether families who have a child with ASD report different family dynamics than families with typically developing children, and if these dynamics are equally predictive of outcomes for both groups.

Method: Regression-based interaction analyses using data from an online survey (n = 235) were used to examine how diagnostic group (typically-developing child or child with ASD) affected the relationships between elements of family functioning and parent outcomes of happiness, depression, and satisfaction with family life.

Results: Higher parent-reported enmeshment was associated with decreased parent-reported happiness in typical families only; these variables were unrelated in families with a child with ASD. In addition, the relationship between disengagement and parent happiness was marginally weaker in the ASD group. Other scales (rigid and chaotic) exhibited similar relationships with family outcomes across both diagnostic groups.

Conclusion: In alignment with previous findings (Altiere & von Kluge 2009), elevated levels of enmeshment were not predictive of poorer outcomes in families of children with ASD. There is a need to critically consider whether behaviors traditionally thought of as "enmeshed" may represent different, more adaptive support strategies for families who have a child with ASD.