A Multi-Method Approach for the Identification of Social Functioning Profiles in Autistic Adolescents and Young Adults Without Intellectual Disability.

Small sample size (49 autistic participants) limits the stability of the identified profiles and requires replication in larger independent samples. The sample consisted mainly of adolescents and young adults with late diagnoses, which may skew results due to increased masking behaviors and does not generalize to those diagnosed early in childhood. Cultural and contextual factors may influence parent-report interpretations, as standardized scales were used in a Swiss/French context. The study is cross-sectional, so it cannot determine whether mental health difficulties cause the social profile differences or vice versa. Self-reported interaction levels were based on a single EMA item, which may not fully capture the complexity of social engagement.

The study was funded by the University of Geneva. No other conflicts of interest were reported.

Do not assume that autistic patients who appear socially capable in clinical settings or self-reports have no social functioning difficulties. The study found that two distinct profiles were indistinguishable on self-report and observer measures but differed significantly on parent-report, with one profile having worse adaptive skills and more mental health comorbidities. Relying solely on patient presentation or standardized tests may miss those who need support.