Social and emotional skills in children with autism spectrum disorders

The number of people diagnosed with autism spectrum disorders has been steadily increasing. Today, I present two studies related to children’s functioning in school. First, Pereira, Hamsho, Susilo, Famolare, Blacher & Eisenhower (2023) published “Longitudinal Associations Between Internalizing Behaviors and Social Skills for Autistic Students During the Early School Years” in School Psychology. Here are the edited abstract and impact statements:

Autistic students experience greater social difficulties and heightened internalizing behaviors (e.g., anxiety, depression, withdrawal) relative to their nonautistic peers, yet little is known about how these domains influence one another over time. This 1.5-year longitudinal study analyzed the associations between teacher-reported social skills and internalizing behaviors across three time points for 177 autistic students aged 4–7 years. Cross-lagged panel analyses indicated an association between earlier internalizing behaviors and later social skills for autistic students, whereby lower internalizing behaviors predicted greater growth in social skills from one school year to the next. These changes in social skills followed children across multiple teachers and classroom contexts. The opposite cross-lagged path was not supported as early social skills did not predict changes in internalizing behaviors over time. Internalizing behaviors showed similar associations with later social skills for autistic students regardless of cognitive ability, for those in general and special education classrooms, and for those whose teachers did and did not have autism-specific training. Findings suggest that promoting students’ early emotional well-being and targeting internalizing behaviors may indirectly enable social development over time. 

This study examined developmental cascades of young autistic students’ social skills and internalizing behaviors (e.g., anxiety, depression, withdrawal) across the early school years. Those with higher internalizing behaviors early in elementary school showed attenuated growth in social skills over 1.5 years relative to children who had fewer early internalizing behaviors. These findings can aid school psychologists efforts to intentionally support young autistic students social–emotional transition to formal schooling. 

I like this study because it emphasizes that internalizing behaviors interfere with the development of social skills in children with autism spectrum disorders. The next study looks at emotion processing. Bothe, Jeffery, Dawel, Donatti-Liddelow & Palermo (2024) published “Autistic Traits Are Associated with Differences in the Perception of Genuineness and Approachability in Emotional Facial Expressions, Independently of Alexithymia” in Emotion. Here’s the abstract:

People with autism and higher levels of autistic traits often have difficulty interpreting facial emotion. Research has commonly investigated the association between autistic traits and expression labeling ability. Here, we investigated the association between two relatively understudied abilities, namely, judging whether expressions reflect genuine emotion, and using expressions to make social approach judgements, in a nonclinical sample of undergraduates at an Australian university (N = 149; data collected during 2018). Autistic traits were associated with more difficulty discriminating genuineness and less typical social approach judgements. Importantly, we also investigated whether these associations could be explained by the co-occurring personality trait alexithymia, which describes a difficulty interpreting one’s own emotions. Alexithymia is hypothesized to be the source of many emotional difficulties experienced by autistic people and often accounts for expression labeling difficulties associated with autism and autistic traits. In contrast, the current results provided no evidence that alexithymia is associated with differences in genuineness discrimination and social approach judgements. Rather, differences varied as a function of individual differences in specific domains of autistic traits. More autistic-like social skills and communication predicted greater difficulty in genuineness discrimination, and more autistic-like social skills and attention to details and patterns predicted differences in approach judgements. These findings suggest that difficulties in these areas are likely to be better understood as features of the autism phenotype than of alexithymia. Finally, results highlight the importance of considering the authenticity of emotional expressions, with associations between differences in approach judgements being more pronounced for genuine emotional expressions. 

These data come from college students but I think the work is important in differentiating alexithymia from the skills necessary to identify genuineness and make judgments about social approach. It also illustrates the limitations of measures that only assess capacity to label emotions. The studies taken together make it clear that we need more sophisticated measures when clients present with autism spectrum symptoms.