Parent-Reported Adjustment in Children and Adolescents with ASD: An Examination of Negative Cognitions, Executive Function, and General Cognitive Abilities

Background: Adjustment problems such as anxiety have been widely reported in individuals with Autism Spectrum Disorders (ASD; Leyfer et al., 2006). In non-ASD community and clinical samples, cognition has been found to play a role in the development and maintenance of internalizing and externalizing problems (Schniering & Rapee, 2002, 2004a, 2004b). Also, in one study with pre-schoolers, executive functions were found to predict with behavioral problems (Kim et al., 2013). However, only one study has reported an association between negative cognitions and anxiety and behavioral problems in adolescents with ASD (Farrugia et al., 2006). Objectives: The goal of this study was to examine the link between anxiety symptoms and behavioral problems and negative thoughts, executive function skills, and general cognitive abilities in youth with ASD. Methods: In this cross-sectional study, 59 school-aged boys (n=23), adolescent boys (n=27), and adolescent girls (n=9) participated in a comprehensive evaluation to assess anxiety and behavioral difficulties, cognitive abilities, and autism symptoms. Both parent and youth self-report measures were used to assess negative thoughts (i.e., Children Autonomic Thoughts; CATS), executive function (i.e., Behavior Rating Inventory of Executive Function; BRIEF), anxiety symptoms (Screen for Child Anxiety and Related Disorders; SCARED), and behavioral problems (Developmental Behaviour Checklist; DBC). Standardized cognitive testing was also completed using the Weschler Scales. Results: Correlations revealed three major findings. First, poor emotional control was associated with behavioral problems in young boys (r = .39), as well as adolescent boys (r = .52) and girls (r = .94). Second, strong associations were found in girls, such that, negative thoughts were linked to panic (r = .85), general anxiety (r = .79), separation anxiety (r = .87) symptoms, and school difficulties (r = .84). Moreover, negative thoughts were linked to behavioral problems in young boys (r = .54) and adolescent boys (r = .37), but not in girls. Finally, general verbal (r = -.51) and non-verbal (r = -.74) cognitive abilities were associated with behavioral problems in adolescent girls only, such that lower general cognitive ability was a risk for more behavioral problems. Conclusions: The findings indicate that cognitions may play a differential role in internalizing and externalizing problems in boys and girls with ASD. Implications of the apparent links between negative cognitions, executive function, overall cognitive ability, and behavioral and emotional difficulties in youth with ASD will be discussed.