The Relationship Between Socialization Skills and Externalizing Problems in Autism Spectrum Disorder

Background: Although not a core symptom of Autism Spectrum Disorders (ASD), externalizing symptoms such as aggression and behavior problems are common and have the potential to negatively impact daily functioning and academic achievement (Klin & Volkmar, 2000; Volker et al., 2010).  Klin & Volkmar (2010) suggested that externalizing behaviors associated with ASD may be a function of social difficulties (Klin & Volkmar, 2000). Specifically, it has been suggested that individuals with ASD engage in problem behaviors to achieve desired social responses as a result of difficulties adjusting to social demands in socially appropriate ways (Macintosh & Disssanayake, 2006).  Despite this suggestion, there has been no empirical assessment of this postulated relationship.

Objectives: The goals of this study were to (a) provide empirical evidence to support the relationship between socialization and behavior problems, (b) and to investigate whether this relationship is unique to individuals with ASD. 

Methods: Participants in this study included 20 children with ASD and 34 typically developing (TD) children.  Participants with ASD met diagnostic criteria for ASD as determined by the Autism Diagnostic Observation Schedule, Second Edition, Autism Diagnostic Interview-Revised, and clinical judgment based on DSM-5 criteria.  All participants were administered the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II; Wechsler, 2011).  Parents of participants completed the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II; Sparrow, Cicchetti, & Balla, 2005) and the Behavioral Assessment System for Children, Second Edition (BASC-2; Reynolds & Kamphaus, 2004).  Of interest to the present study were the Externalizing Problems Domain on the BASC-2 and the Socialization domain on the Vineland-II.  Participant’s ages and IQ scores are presented in Table 1.  There was a significant difference in Full Scale and Verbal IQ (but not in the Perceptual Reasoning Index) between the typically developing and ASD groups, however IQ was not significantly correlated with the relevant Vineland or BASC-2 scales for either of the two groups.

 

Results: Linear regressions were run separately for the ASD group and the TD group to predict Socialization scores on the Vineland-II from the Externalizing Problems scores on the BASC-2.   Externalizing problems predicted social functioning in the expected direction for the individuals with an ASD F(1,18) = 9.96, p = .005, with an R² of .356, but not for the TD participants F(1,32) = 1.745, p = .196, with an R²= .052.

Conclusions: These findings support the relationship between socialization and behavior problems in ASD, specifically that children with more socialization difficulties have more behavior problems. Further, this relationship might be unique to individuals with an ASD, though this specification requires further study. 

(Table 1 is uploaded as an image)