While lower-functioning children and adolescents show a moderate relationship between social skills measured by the Vineland Adaptive Behavior Scales (VABS) and social disability as measured by the ADOS (Klin et al. 2006), high-functioning individuals do not (Anderson et al. 2009). Thus, the relationship between social skills and autistic symptoms may vary with level of functioning.
Objectives: To identify continuity and change in autistic symptoms and adaptive behaviors of autistic individuals from middle childhood through adolescence and into adulthood, and to ascertain the relationships between these constructs.
Methods: Participants were 20 individuals with autism, first observed in early childhood (M= 3.9 yrs, SD= 1.1yrs). Using repeated measures ANOVAs, we assessed change on the VABS and the ADI-R from middle childhood (M=11.2 yrs, SD= 3.2 yrs), through adolescence (M=17.7 yrs, SD= 3.8 yrs), and into adulthood (M=26.5 yrs, SD=3.8 yrs). Correlations were evaluated between adaptive abilities measured by the VABS and autistic symptoms reported on the ADI-R. Applying a rating of adaptive social functioning (Howlin et al., 2004), participants’ outcomes in adulthood were classified as “Fair/Good” (N=9) or “Poor” (N=11). Using T-tests, we compared VABS and ADI-R scores between outcome groups at all three time points.
Results: While symptoms of autism in nonverbal communication and repetitive behavior did not change significantly from adolescence to adulthood, social symptoms on the ADI-R improved from middle childhood (M=19.0) to adolescence (M=13.5) only to worsen from adolescence to adulthood (M=15.5) (p<.001). While adaptive social skills did not improve from adolescence to adulthood, daily living skills (p<.001) and communication skills (p<0.05) continued to improve from early childhood (M(DLS)=69.2; M(CS)= 68.0) into adolescence (M(DLS)=96.9; M(CS)=83.9) and adulthood (M(DLS)=121.6; M(CS)=95.0). Groups formed on the basis of social-functioning outcome differed at the 0.05 level on all sub-domains of the VABS at each time point, with the “Fair/Good” group reporting higher adaptive skills than the “Poor” group. At all time points, social skills and social symptoms were strongly correlated (p values < 0.001): middle childhood (r= -.809), adolescence (r= -.812), and adulthood (r= -.806).
Conclusions: Results suggest that daily living and communication skills in people with autism improve from middle childhood to adulthood. Social skills did not improve across these stages. Autistic symptomatology increased from adolescence to adulthood. VABS scores and social sub-domain scores on the ADI-R in middle childhood and adolescence were related to adaptive social functioning in adulthood. Regardless of social functioning rating in adulthood, all participants demonstrated a lack of development in adaptive social skills and an increase in autistic social symptomatology from adolescence to adulthood. These findings suggest a need for additional social skills training/intervention during this period of development.