Social cognition as a predictor of functional and social skills in autistic adults without intellectual disability.

Abstract

Autistic adults, including those without intellectual disability, commonly experience poor social and functional outcomes. Although reduced social cognitive ability in autism is often theorized as a mechanism of these poor outcomes, there has been surprisingly little empirical work testing this assumption. Here, 103 autistic adults without intellectual disability completed a comprehensive battery that included eight social cognitive tasks psychometrically validated for use with this population (e.g., emotion recognition and theory of mind), five tasks assessing neurocognitive abilities (e.g., processing speed and working memory), performance-based measures of their functional skills, and a standardized assessment of their social skills. Collectively, the combination of demographic variables, IQ, neurocognitive performance, and social cognitive performance accounted for 49% of the variance in functional skills and 33% of the variance in social skills. For functional skills, demographic variables, and general and neurocognition independently accounted for a significant portion of the variance, but social cognition did not. Social cognition did, however, significantly mediate the effect of neurocognition on functional skills. Social cognition also accounted for significant proportion in the variance in social skills above and beyond the relatively large contribution of neurocognition. Taken together, findings indicate that social cognitive ability contributes to functional and social skills in autistic adults without intellectual disability, but this contribution may be more limited and indirect than commonly assumed. Autism Res 2020, 13:259-270. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Many social programs for autistic adults presume that improving social cognition will translate to better life outcomes. In this study of 103 autistic adults without intellectual disability, we found that social cognitive abilities do contribute to real-world social and daily living skills, but this contribution is small and indirect once general-cognitive abilities are taken into account. Although results substantiate social cognition as an independent cognitive capacity in autism spectrum disorder, its unique contribution to functional and social outcomes may be more limited than previously assumed.