Identifying cognitive correlates of social interactions in children with Autistic disorder and Asperger syndrome

Abstract

Social interaction deficits are core symptoms of children with autism spectrum disorder (ASD). Reciprocity deficit, one of the social interaction deficits in children with ASD, is the process of collaborative behavior between individuals who perform activities to reach shared goals. The reciprocity and social interaction deficits of children with ASD lead to difficulties in social participation in real-life contexts. Reciprocal behaviors and social interactions depend on the child’s developing cognitive skills and emotional functioning. In previous studies, the brain regions controlling theory of mind (ToM) and executive function (EF) were found to be the neural correlates of reciprocity. However, to date, no behavioral studies have investigated the relations among ToM, EF, and reciprocity in children with ASD. Moreover, the structured computer games used in past studies could not reflect the performance of children with ASD in real life contexts. In addition, ToM and cool EF have been examined to explain the social interaction deficit in children with ASD. However, based on current evidence these two abilities cannot fully explain the social deficits in children with ASD, possibly because the influences of motivation- and emotion-related factors, such as hot EF, were not examined in past studies
To resolve the above gaps, this study aimed to investigate in children with autistic disorder and Asperger’s syndrome (1) the correlates of reciprocity by considering cool EF, hot EF, and ToM; (2) the correlates of social interactions in daily life by considering cool EF, hot EF, and ToM; and (3) the correlation between reciprocity in a laboratory context and social interactions in a real-life context by using a relatively unstructured measure to assess reciprocity.
To fulfill these aims, 59 children with diagnoses of autistic disorder or Asperger’s syndrome according to the Diagnostic and Statistical Manual of Mental Disorders-fourth edition (DSM-IV) and aged from 4 to 12 years were recruited from clinics and hospitals in Tainan, Kaohsiung, and Taipei. Their ToM, hot and cool EF, reciprocity, social interactions, autistic symptom severity, and verbal abilities were examined with the Theory of Mind Task Battery (TOMB), Dimensional Card Change Sort Task (DCCS), Children’s Gambling Task, Interactive Drawing Task (IDT), Vinland Adaptive Behavior Scale (VABS), Social Responsiveness Scale (SRS), Childhood Autism Rating Scale (CARS), and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) or Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV). For the data analysis, (1) descriptive analysis was used to analyze the demographic data of the children; (2) Pearson’s correlation coefficients were used to analyze the correlations among cool EF, hot EF, and ToM to reciprocity and social interaction, respectively; and (3) stepwise regression and hierarchical regression models with a stepwise method were used to examine the predictors of reciprocity in the laboratory context and social interactions in real-life contexts, respectively.
The results of the present study showed the following: (1) Cool EF-single block accuracy (r =.482, p The present study provides further understanding of the relationships among ToM, cool EF, hot EF, reciprocity, and social interaction. The results indicate that children with autistic disorder and Asperger’s syndrome who have better cool and hot EF capacity tend to have better reciprocity capacity, that those who have better ToM and cool EF ability tend to have better social interaction performance, and that better reciprocity capacity has a positive correlation with social interaction. However, the limitations of the present study include the following: (1) The findings cannot be generalized to lower-functioning and non-verbal ASD and children diagnosed with PDD-NOS; (2) ToM ability may have been underestimated due to the verbal demands of the ToM tasks ; (3) social interaction style was not examined, and (4) the VABS-classroom version was reported by caregivers. Therefore, further study is warranted to (1) recruit lower-functioning children with less verbal ability and children diagnosed with PDD-NOS; (2) apply a ToM measurement which is less verbally demanding; (3) add a measure for assessing social interaction styles, and (4) collect VABS-classroom version reports from teachers to better illustrate the cognitive correlates in social interactions. The results of the present study should help clinicians to identify the cognitive correlates of reciprocity and social interactions in children with autistic disorder and Asperger’s syndrome, which can be the basis of clinical interventions for reducing children’s social interactions deficits and improving their social participations in daily life. In addition, the results may also serve as a foundation for further studies to identify the correlates of social interactions in children with ASD.

Date of Award	2016
Original language	English
Supervisor	Kuan-Lin Chen (Supervisor)