Category: Autism Spectrum and Developmental Disorders
Autism spectrum disorder (ASD) is well-known for its phenotypic heterogeneity. In addition to ASD itself presenting in a variety of ways, individuals with ASD commonly experience comorbid difficulties that go above and beyond their autism symptomatology (Simonoff et al., 2008). In their study, Joshi et al. (2010) found that 95% of their sample of over 2,000 participants carried three or more psychiatric disorders, in addition to ASD. No known study to date has examined the influence of a psychiatric or medical diagnosis on response to a well-validated social skills intervention.
One-hundred thirty-six adolescents with ASD participated in this study. Autism was confirmed using the ADOS-G (Lord et al., 2002) and IQ (≥ 70) was assessed with the KBIT-2 (Kaufman & Kaufman, 2004). Participants were randomly assigned to experimental (EXP; n = 66) or waitlist control (WL; n = 70) groups and received the Program for the Education and Enrichment of Relational Skills (PEERS®). Parents completed a demographic form prior to the intervention, which asked about comorbid diagnoses, and the Social Responsiveness Scale (SRS; Constantino et al., 2003) before and after the intervention. Binary codes were created for: 1) Any comorbid diagnosis, 2) Presence of each anxiety, ADHD, Learning Disability (LD), depression/mood, aggression, and 3) Any medical diagnosis.
Linear univariate and multivariate regression analyses were conducted for the SRS separately for each group to examine if a comorbid diagnosis predicted intervention outcome above and beyond each measure prior to the intervention. Results indicated that the only comorbid diagnosis that influenced treatment outcome was an LD. Those in the EXP group with an LD scored -19.86 points lower on the SRS at post-test (b = -19.86, t(63) = -2.23 p = .03), controlling for levels at pre-test and all other comorbid diagnoses. Overall, the model explained 34.6 % of the variance in outcome on the SRS F(6, 60) = 6.34, p < .001.
Findings from the present study indicate that the presence of a comorbid LD, but no other psychiatric or medical diagnosis, had an influence on receipt of the PEERS® intervention. These results demonstrate that having a comorbid LD was indicative of greater gains over the course of the intervention than those without an LD. There is surprisingly little research examining the comorbidity of LD in ASD. One recent study found that differences in reading ability were positively related to autism severity (McIntyre et al., 2017); however, it did not account for the presence or absence of LD. Further research is needed to elucidate the relationship between LD and ASD, especially in the context of social skills interventions with a didactic component.
Alana McVey– Marquette University
Hillary Schiltz– Marquette University
Angela Haendel– Marquette University
Bridget Dolan– Marquette University
Sheryl Pleiss– University of Minnesota
Audrey Carson– Texas Children's
Elisabeth Vogt– Marquette University
Amy Van Hecke– Marquette University