The Relationship Between Social Cognition and Social Functioning in Individuals with Autism Spectrum Disorder

Background:  Individuals with autism spectrum disorder (ASD) categorically experience marked challenges with social-cognitive and social functioning. Specifically, they have difficulty understanding the intentions, desires, and beliefs of others. They exhibit poor social awareness, social interaction skills, and adaptive behaviors. However, the association between social-cognitive and social functioning across the life course has not been adequately addressed. We hypothesize that social-cognitive functioning positively predicts social functioning, after controlling for demographic factors and intelligence.

Objectives:  Examine the relationship between social cognition and social functioning composite scores in verbal individuals (n=130) with ASD and without intellectual disability.

Methods:  Cross-sectional data were collected from 130 individuals with ASD who were participants in two separate studies conducted in the University of Pittsburgh’s Center For Autism Research. The hypothesis was tested by creating standardized (z-metric) composite indices of social-cognitive and social functioning, based on theory of mind (Sally-Anne, John and Mary, and preference judgment tasks) and social functioning (the Social Responsiveness Scale, the Child Behavior Checklist, and the Vineland Adaptive Behavior Scales) measures, respectively. Average age was 11.8. Average Performance Intelligence quotient (PIQ) was 106. Males accounted for 90.0% (n=117) of the sample. A series of general linear models were constructed to predict social functioning from cognitive functioning, gender, age, and PIQ.

Results:  As expected, results indicated that there was a significant prediction of social functioning by social-cognitive functioning, gender, age, and PIQ, F(4,125)=3.790, p=.006, R²=.108, adjusted R²=.080. Both social-cognitive functioning (B=.200, t(125)=3.005, p=.003, sr²=.065) and age (B=-.046, t(125)=-2.507, p=.013, sr²=.045) contributed significantly to the prediction of social functioning. There was no significant prediction of social functioning by gender (B=.015, t(125)=.096, p=.923, sr²=.000) or PIQ (B=.001, t(125)=.393, p=.695, sr²=.001).

Conclusions:  Findings indicate that social cognition and age predict social functioning in individuals with ASD. These findings highlight the role of social cognition in social functioning. Results also indicate that younger participants with ASD function better socially which may reflect better intervention or conditions in which younger individuals have more structure and support for positive social functioning than adults. These results highlight the importance of a developmental perspective on the deficits that emerge in social cognition and social functioning as individuals with ASD age and cognitive demands associated with the social environment become more complex. The lack of difference in ability and function between males and females may reflect the comparable IQ and language levels of both genders participating in these research studies in contrast to studies of representative samples which may reveal that females with ASD are often more severely affected on average than males with ASD. These findings suggest the important impact of evolving community intervention programs, especially early interventions, and the considerable need to build interventions for adults with ASD which have been seriously neglected in the longstanding focus on “early” intervention. The lifelong plasticity of the brain and the far greater portion of life spent in adulthood support the need for an equal focus on intensive cognitive interventions for adults with ASD.