Relationship Between Individual Differences in Social Motivation and Autism Symptom Severity

Background: Children with ASDs demonstrate deficits in social relatedness, or the inherent drive to connect with others and share complementary feeling states (Rogers & Benneto, 2000).  Researchers argue that autism may involve a failure to assign reward value to social stimuli (Dawson, Toth, Abbott, Osterling, Munson, Estes, et al., 2004). Failure to orient to social stimuli reflects a disturbance in the motivational mechanisms that normally draw an infant’s attention to social stimuli such as faces and voices (Dawson et. al, 2004).  The Autism Diagnostic Observation Schedule (ADOS) is a standardized protocol for observation of social and communicative behavior associated with autism (Lord et al., 1989).  Recent additions to the ADOS have been made in an attempt to standardize scores to approximate an autism severity metric, allowing for documentation of severity as part of clinical assessment and comparisons in scores across time (Gotham, Pickles, & Lord, 2008).

Objectives: The purpose of this study is to examine the relationship between symptom severity in children with ASDs and their social motivation (or preference for adult attention).  It was expected that there would be a negative correlation between ADOS severity scores and the duration of time spent interacting with the examiner in a preference for adult attention assessment (based on Dube et al., 2004).

Methods: Participants included 30 children from Miami-Dade or Broward County, FL between the ages of 2 and 5. 
All children had a previous diagnosis of an ASD and met cutoffs for ASD or Autism on the ADOS and were part of a larger study on the effectiveness of an intervention targeting initiating joint attention skills.  Procedures included the severity score metric of the Autism Diagnostic Observation Schedule (ADOS) and the Forced Choice Preference Assessment for Adult Attention (FC-AAR, Split Room).  In the Split Room procedure, a room is divided in half with tape placed on the ground and identical toys on each side.  On the attention side, an experimenter interacts with the child.  On the non-attention side, an experimenter pretends to be occupied with another task (reading a book) and does not interact with the child.  The child is force-exposed to each side separately for one minute; following this, the child is free to move between both sides for a five minute time period.  Scoring is based on duration of time spent engaged with the examiners during the last five minutes. 

Results: Results indicated a significant negative relationship between overall ADOS severity scores and duration of time engaged with adult examiners (r= - 0.478, p= 0.010). 

Conclusions: As expected, children with greater symptom severity demonstrated a lesser preference for adult attention than children with less severe symptoms, and vice versa.  These findings indicate that social motivation may play an important role in autism symptom severity and have implications for clinical practice and future intervention-based research.   Quantitative measures of social motivation (e.g., preference for adult attention) may be useful in identifying individual differences which may serve as predictors of positive outcomes.