An Analysis of Social Competence in Individuals with Autism Spectrum Disorder and Co-Occurring Conduct Problems

Background: A core diagnostic feature of Autism Spectrum Disorder (ASD) is impairments in social competence (APA, 2013). Deficits in social competence have meaningful implications for individuals with ASD, including social isolation, co-occurring internalizing conditions, and poorer overall quality of life (White, 2007). There is also high co-occurrence between ASD and conduct problems (CP), such as Conduct Disorder (Sipes, 2011). However, little is known about the effects of co-occurring CP on social competence in individuals with ASD.

Objectives: In the current study, we compared social competence in individuals with ASD both with (ASD+CP) and without (ASD-CP) co-occurring CP. It was hypothesized that individuals with ASD+CP would have greater social deficits than individuals with ASD only.

Methods: Participants include 31 children and adolescents with ASD (with language impairment = 4, with intellectual impairment = 6; male = 25, female = 6) between the ages of 6 and 18 years from the southwest Virginia area. Families seeking an ASD assessment visited the university clinic and research center for a diagnostic evaluation and were asked to complete several measures. The Social Responsiveness Scale - 2nd Edition (SRS-2) measures overall ASD symptomology, as well as Social Awareness (SA), Social Cognition (SC), Social Motivation (SM) and Social Communication (SCM). Co-occurring CP was determined by scores above the clinical cutoff on the Conduct Problems subscale of the Child Behavior Checklist. An independent samples t-tests were used to compare ASD+CP (n=13) with ASD-CP (n=14) on parent reports of SA, SC, SM, SCM, and total ASD severity.

Results: The research indicated that individuals with ASD+CP have greater ASD severity than individuals with ASD-CP as measured by the SRS-2 total score (M=83.31, SD=7.016, M=72.29,SD=8.145; t(25)= -3.583, p<.001). Additionally, individuals with ASD+CP have greater deficits that individuals with ASD-CP on measures of SA (M=78.85, SD=5.60, M=68.21, SD=6.23, respectively; t(25)= -4.65, p<0.001), SC (M=81.08, SD=6.28,M=72.64, SD=9.71, respectively; t(25)= -2.66, p = 0.014), SM (M=73.92, SD=12.24, M=63.71, SD=11.52, respectively; t(24) = -2.19, p= 0.039), and SCM (M=71.36;SD=8.46,M=81.54, SD=6.70; t(25)= -3.44, p= .002).

Conclusions: These findings help to better understand the impact that co-occurring CP can have on core ASD symptomology (i.e., social competence), such that individuals with co-occurring CP had more severe impairments with regard to social motivation, cognition, and awareness. These findings can inform the prognosis of children with ASD and co-occurring disruptive behavior concerns, specifically with respect to social outcomes. Additionally, these findings support the importance of social competence instruction, especially in cognition, awareness, and motivation, for individuals with ASD and co-occurring CP.