Social Functioning and Awareness in Adults with Asperger's Syndrome: The Social Stories Task

Background:

Asperger’s Syndrome (AS) is characterised by significant impairment in social functioning and social ability, usually present with average or high cognitive ability. Current intervention techniques tend to focus more on young lower functioning individuals leaving high functioning adults with AS to learn and develop techniques on their own. Klin et al. (2007) found severe impairment in adaptive functioning skills in high functioning individuals with ASD suggesting that high intellect can mask actual ability to effectively navigate the social world. Thus, understanding how such individuals understand everyday social situations is paramount in order to design effective coping strategies.

Objectives:

A social stories task based on real-life scenarios was used to assess social functioning and awareness in adults with AS. Specifically, this research investigates whether individuals with AS understand what is appropriate/inappropriate in contemporary social situations. In addition, this projects looks at how self esteem may relate to social ability.

Methods:

15 adults diagnosed with AS (recruited from the NAS) matched on IQ/chronological age to 15 typically developed adults given the Adult Asperger Assessment (Baron-Cohen et al., 2005 – to confirm a diagnosis), the Vineland Social Maturity Scale (VSMS), a self esteem questionnaire and a Social Stories experimental task (SST) developed from Happe’s (1994) 'Strange Stories'. The SST covers social domains from Happe’s task including Irony, Sarcasm, Lie and four novel domains Rudeness, Morality, Disability, Appearance. The participants were given 40 short scenarios (four in each domain) depicting appropriate/inappropriate social interactions and asked to judge whether the characters did something acceptable/unacceptable. Participants were then asked to justify these responses.

Results:

There was significant difference between groups on measures of self esteem with the AS group affected by feelings of lower self esteem when perceiving themselves rather than how others view them (t = -2.021, p = 0.05). The AS group was significantly impaired on all areas of social functioning task and this impairment highly correlated with social age (from VSMS). The AS group were also more likely to accept the inappropriate response to a story (F(1, 29) = 26.526, p = 0.005), and reject the appropriate. Within the AS group, a significant negative correlation was found between overall understanding of the social scenarios and both rejection of appropriate response (r=.45, p<0.05) and the Autism Quotient gained from the AAA (r=-.45, p=0.05). All four novel domains came out as significantly positively related to overall understanding of the social scenarios. When asked to give justifications the AS group displayed a desire to change original answer suggesting these individuals may consider a social scenario more carefully when asked to reflect upon it.

Conclusions:

This study confirms prior research showing overall deficit in social skills functioning, and importantly extends this finding to novel, ecologically valid, domains. This project also confirms the SST as a relevant and useful tool for assessing current social and adaptive functioning in high functioning adults with AS, and provides an understanding of how individuals with AS understand social situations as appropriate or inappropriate. Thus, these findings have implications for intervention and individual social skills training.