Social functioning and symptoms of psychopathology in adolescents with autism and asperger’s disorder

Abstract

This thesis project examined the behaviour and emotional problems and social functioning of adolescents with Autistic or Asperger’s Disorder and the relationship between these two factors. Furthermore, associations between these factors and individual characteristics including gender, age, level of cognitive function and Autism Spectrum Disorder (ASD) diagnosis (that is, Autistic or Asperger’s Disorder) were examined. The research project also investigated the level of agreement between ratings of behaviour and emotional problems and social functioning provided by self, parent and teacher report. Forty-five participants aged 12-18 years were recruited from schools from Melbourne and rural Victoria and through organisations such as the Monash University Centre for Developmental Psychiatry & Psychology, Autism Victoria and Interchange. Adolescents, parents and teachers provided report by completing Achenbach System of Empirically Based Assessment, Developmental Behaviour Checklist and Social Skill Rating System questionnaires. Adolescents with Autistic and Asperger’s Disorder were found to present with high rates of a range of comorbid behaviour and emotional problems, including internalising and externalising difficulties. No significant differences were found in the reported rates of behaviour and emotional problems experienced by adolescents with Autistic Disorder and with Asperger’s Disorder. Neither age nor cognitive function were associated with the levels of behaviour and emotional problems reported. Current findings demonstrate that the difficulties associated with ASD are not limited to the core features of the autism spectrum. Significant discrepancy occurred between self, parent and teacher ratings of behaviour and emotional problems and social functioning. Levels of agreement varied according to the informants being compared and phenomena being examined. Less agreement was found between ratings of internalising symptoms, between adolescents and teachers and between parents and teachers. These findings are consistent with previous research in which low levels of inter-rater agreement have generally been found between multiple informants. This may reflect the differing opinions of informants or variations in adolescents’ behaviour across environmental contexts, such as school and home. The level of social functioning exhibited by adolescents with Autistic or Asperger’s Disorder (who have average or above cognitive abilities, or a mild degree of intellectual disability) does not vary according to their ASD diagnosis, age or level of verbal or perceptual cognitive functioning. Associations between low levels of social function and a range of behaviour and emotional problems were found. Such findings are consistent with observations that poor social functioning is associated with higher levels of behaviour and emotional problems. The social impairments that accompany Autistic or Asperger’s Disorder appear to be associated with additional behaviour and emotional problems regardless of age and cognitive function. Together, these findings suggest that health professionals and teachers need to be mindful of the possibility of these comorbid difficulties when working with adolescents with ASD and their families. Information provided by a sole informant should be considered cautiously when assessing young people with ASD and a multi-informant assessment approach is preferable. There is also a clear need for empirically validated interventions to assist adolescents with behaviour and emotional difficulties. Interventions that seek to improve the social skills, competence and outcomes of young people with ASD may also reduce their vulnerability to and experience of additional behaviour and emotional difficulties.