The Use of Social Observation in Predicting Variation in Outcome among Adolescents with High-Functioning Autism

Background: All individuals who are diagnosed with autism exhibit deficits in social and communication skills, and exhibit restricted repetitive behaviors. However, the adaptive life outcomes achieved by individuals with autism are extremely varied (Sigman & Ruskin, 1999). The modifier model of High-Functioning Autism (HFA; Mundy, Henderson, Inge, & Coman, 2007) suggests that studying non-syndrome specific constructs, which vary among all individuals regardless of diagnosis, provides insight into the processes by which some individuals with HFA succeed in leading independent lives while others require constant care and supervision.

Objectives: This study used a novel observational measure of social behavior as an outcome assessment, while also collecting information regarding temperament, symptoms, and social-emotional functioning, through observation and parent- and self-report measures, to examine individual variability in outcome.

Methods: A total of 58 participants (29 HFA, 29 Control) were seen as part of a larger longitudinal study examining motivation, self-monitoring, and family processes in higher functioning children with autism. Each group was composed of 5 females and 24 males. Each participant completed the self-report short form of the Early Adolescent Temperament Questionnaire- Revised (Ellis & Rothbart, 2001), which assesses temperament along 12 dimensions. The 12 dimensions are combined to form 4 overarching factors: Surgency (i.e., surgency/high intensity pleasure, shyness-reverse scored, fear-reverse scored), Effortful Control (i.e., attention, inhibitory control, activation control), Affiliativeness (i.e., affiliation, perceptual sensitivity, pleasure sensitivity), Negative Affectivity (i.e., frustration, depressive mood, aggression). In addition, each child in the HFA group was paired with a child in the control group and completed a dyadic social interaction. This interaction was composed of tasks such as an unstructured conversation in which participants were instructed to get to know one another, a teaching task in which each participants were given the opportunity to teach their peer how to complete a task, and a task in which participants were instructed to work together to make a list of the top ten movies ever made. From these tasks, measures of approach tendencies, social self-monitoring, and social skills were obtained. Parent-report of social-emotional functioning was also obtained on the Behavioral Assessment System for Children (Reynolds & Kamphaus, 2004).

Results: Results indicated that the HFA group self-reported higher levels of negative affect, F(1, 52)=10.27, p<.01,  and lower levels of Surgency, F(1, 52)=5.58, p=.022,  and were observed to exhibit higher levels of approach tendencies, F(1, 56)=6.41, p=.014,  and lower levels of social skills, F(1, 56)=16.14, p<.001, compared with the control group. Across all participants, higher levels of Effortful Control, composed of self-report of effortful control and observed social self-monitoring, was predictive of more adaptive social skills, F(5, 50)=6.57, p< .001, and surprisingly, higher levels of observed approach behavior were predictive of higher levels of anxiety, F(5, 52)=5.58, p< .001.

Conclusions: These results will be discussed in relation to the variability in outcomes seen among individuals with autism.  Strengths and limitations of the current observational paradigm and coding will be discussed as well as the importance of targeting self-regulatory skills (i.e., effortful control and social self-monitoring) in interventions for children and adolescents with autism.