Social Functioning in Individuals with a History of Autism Spectrum Disorders Who Achieved Optimal Outcomes

Autism spectrum disorders (ASDs) were once considered lifelong disorders, but recent findings indicate that some children with ASDs no longer meet diagnostic criteria for any ASD and reach normal cognitive function. The current study examined social functioning in 24 of these individuals (ages 8-21), called ‘optimal outcome’ (OO), who did not differ on age, sex, and nonverbal IQ to 29 individuals with high-functioning autism (HFA) and 26 typically developing (TD) individuals. The groups were compared on a measure of other psychiatric disorders that have symptoms which may result in social difficulties and on a measure of overall likability. Results indicated that the HFA group scored worse than the OO and TD groups on domains of withdrawal/depression, immaturity, attention problems, and self-control problems. The OO group, in turn, displayed more difficulties with immaturity, attention problems, and self-control problems than the TD group. However, the OO group was rated by peers to be at least as likable as the TD participants, and were even rated as friendlier, warmer, and more approachable. The HFA group, on the other hand, was rated by peers to be less likable in all aspects than the OO and TD participants. These data suggest that OO individuals have no readily observable social skill deficits, at least when interacting with a trained adult. However, the presence of more difficulties with immaturity, attention problems, and self-control problems in the OO adolescents indicate that they are exhibiting mild social difficulties which are more consistent with those seen in attention-deficit/hyperactivity disorder (ADHD) than in autism spectrum disorders (ASDs)

Residual Communication and Social Deficits in Individuals with a History of Autism Spectrum Disorders Who Achieved Optimal Outcomes

Autism spectrum disorders (ASDs) were once considered lifelong disorders, but a small body of research indicates children with ASDs are capable of gaining skills, such that they no longer meet diagnostic criteria for any ASD. These individuals are considered to have achieved an optimal outcome. This study examined communication and social functioning in a group of adolescents with a history of autism spectrum disorders who have achieved optimal outcomes. Thirty-two such individuals between the ages of eight and twenty-one were matched on age, sex, and nonverbal IQ to 33 individuals with high-functioning autism and 25 typically developing adolescents. The groups were compared on measures of autism symptomatology, adaptive functioning, and pragmatic language. Results indicated that the optimal outcome adolescents were functioning quite well in both the communication and social domains. However, some exhibited subtle residual social deficits, including restricted of a range of directed facial expressions, limited insight in social relationships, and poorer quality of rapport, as compared to the typically developing individuals. Importantly, the optimal outcome adolescents performed better than the adolescents with high-functioning autism on all areas assessed. Thus, the optimal outcome individuals were not experiencing any impairing communication or social deficits