Temperament as a Predictor of Variability in Adjustment among Higher Functioning Children with Autism

Background: Despite a common diagnosis, higher functioning children with autism (HFA) display great variability in emotional symptoms, personal adjustment and adaptive life outcomes. In the modifier model of High-Functioning Autism we propose that studying non-syndrome specific constructs, such as temperament, provides insight into this phenotypic variability. Temperament describes constitutionally-based individual differences in reactivity and self-regulation.  
Objectives: In the current study, we examined the unique and combined influences of Surgency, the tendency to approach high intensity and novel situations, and Effortful Control, the ability to voluntarily regulate attention and inhibit or activate behavior as needed, on Internalizing and Externalizing Behavior Problems and measures of Adaptive Functioning. 
Methods: Preliminary data are presented on thirty-six (30 male) children with HFA, ranging in age from 9 to 16 years (M=12.75 yr, SD=2.33 yr), who completed several self-report measures including the Early Adolescent Temperament Questionnaire (EATQ-R; Ellis & Rothbart, 2001), the Behavior Assessment System for Children (BASC-2; Reynolds & Kamphaus, 2002), and the Loneliness and Social Dissatisfaction Questionnaire (LSDQ, Asher & Wheeler, 1985). Parents completed the parent-report version of the BASC-2.  The independent variables were Surgency and Effortful Control from the EATQ and the dependent variables were composite measures of Internalizing Problems (BASC SRP Internalizing Problems, BASC PRS Internalizing Problems), Externalizing Problems (BASC SRP Inattention/Hyeractivity; BASC PRS Externalizing Problems), Personal Adjustment (BASC SRP Personal Adjustment, BASC PRS Adaptive Skills), and Loneliness (LSDQ total).  A series of hierarchical multiple regression analyses were conducted to examine the effects of Surgency, Effortful Control, and their interaction on each outcome.
Results: Internalizing problems were predicted by Surgency, β=-.42, p=.012; total R² = .17, and Externalizing problems were predicted by Surgency, β=-.37, p=.03 and Effortful Control, β=-.32, p=.05; total R² = .23.  Personal Adjustment was predicted by Effortful Control, β= .46, p=.006, and the interaction of Surgency and Effortful Control, β=-.43, p=.02; total R² = .33. Similarly, the interaction of Surgency and Effortful Control predicted Loneliness, β= .50, p=.03; total R² = .37. Specifically, among children relatively low in Surgency, Effortful Control was positively associated with Personal Adjustment, r(20)=.66, p = .002 and inversely associated with Loneliness, r(13) = -.59, p = .03.  Among children relatively high in Surgency, however, the relations with Effortful Control were nonsignificant.
Conclusions: Surgency and Effortful Control appear to serve as protective factors against behavior problems among children with HFA.  Low levels of Surgency and low levels of Effortful Control predicted particularly poor personal adjustment and high levels of loneliness. These findings nicely parallel findings isolating low levels of behavioral approach and effortful control as risk factors among infant siblings of children with autism and suggest that children with HFA who are low in Surgency may particularly benefit from interventions targeting self-regulatory skills. Results will be discussed in relation to an emerging literature on the importance of basic motivational and self-regulatory processes in the modification of the expression of autism across childhood.