Investigating the factors underlying adaptive functioning in autism in the EU-AIMS Longitudinal European Autism Project.
Julian Tillmann, Antonia San José Cáceres, Chris H Chatham and 14 others
PMID 30741482WHAT IT FOUND
For autistic people aged 6 to 31, parent-reported social difficulties were linked to poorer everyday adaptive skills and bigger gaps between IQ and daily functioning.
Repetitive behaviours, sensory symptoms, anxiety, depression, and ADHD were not linked when other factors were considered.
Key findings
01Parent-reported social difficulties, measured by the Social Responsiveness Scale, were associated with lower adaptive functioning scores across Vineland domains and the composite score.
02Adaptive functioning was impaired across all Vineland domains, with socialization most impaired, then daily living, and communication least impaired.
03In the discrepancy analyses, older age and higher parent-reported social difficulties were associated with larger IQ-adaptive gaps; psychiatric symptoms were not.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The data are cross-sectional, so the study cannot show that age, IQ, or social difficulties cause poorer adaptive functioning. Age differences may reflect sampling differences across ages rather than true change over time. The sample excluded many people with severe intellectual disability and had higher IQs than the broader population of people with ASD, so it may not apply to lower-ability autistic people. Parent-reported social difficulties and parent-reported adaptive functioning may share reporting method, which could inflate their association. The Social Responsiveness Scale overlaps with Vineland social skills, so the measures are not fully independent. The study did not measure services or interventions received, which could affect adaptive functioning. It did not use a wider biopsychosocial model or patient-nominated outcomes such as quality of life. Analyses used different numbers because some measures were missing; discrepancy analyses used 369 participants, not the full 417.
Declared interests
The paper reports research support, non-U.S. government. Tobias Banaschewski declared advisory, consultancy, speaker, clinical trial, and royalty relationships with several companies and publishers, and states the present work is unrelated to them. Sven Bölte declared royalties for manuals and adaptations of ADI-R, ADOS, and SRS, and author, consultant, or lecturer relationships with several companies and publishers. Jan Buitelaar declared past consultancy, advisory, or speaker work for several pharmaceutical companies, but said he is not employed by them, holds no shares, and has no other financial support.
The easy way to misread this
Do not conclude that treating social communication difficulties will improve adaptive functioning. The study is cross-sectional and did not test any intervention.