Social Differences of Adolescents with High-Functioning Autism and Asperger’s Syndrome

1. Miranda Clark Advisor: Tina K. Veale, Ph. D. Eastern Illinois University Partial funding for this project was provided by the Honors Council of the Illinois Region Social Differences of Adolescents with High-Functioning Autism and Asperger’s Syndrome

2. Introduction • High-functioning autism (HFA) and Asperger’s Syndrome (AS) are two similar disorders. • Differentiation of HFA and AS is necessary for multiple reasons. • Individuals need a better understanding of their strengths and weaknesses. • Benefits to parents include a greater understanding of their child’s abilities. • Results of this study will add to the knowledge base regarding the basic similarities or differences between these disorders, and will help families and educators to better understand how to help adolescents in the autism spectrum enhance their social skills.

3. Autism • Leo Kanner first described autism in 1943. • Symptoms must be present from three categories: social interaction, communication, and behavior. • Early indicators of autism include: • Dislike of physical contact • Lack of eye contact • Lack of facial expression • These indicators are noticed around two years of age; onset must be prior to age three.

4. High-Functioning Autism • High-functioning autism (HFA) is a term that has become popular to describe a subset of children with autism. • Acquire communication skills that allow them to carry on conversations with others. • Exhibit intellectual skills. • Develop an exceptional vocabulary and learn to read at an early age (Fullerton, 1996; Gillberg & Ehlers, 1998; Seung, 2007). • Conversational topics often revolve around their narrow interests. • Show higher intelligence quotients (IQ).

5. Asperger’s Syndrome • Hans Asperger independently described children similar to those observed by Kanner. • A group of higher functioning individuals with autistic characteristics had been identified.

6. Asperger’s Syndrome • Criteria for AS remains the same as when the disorder was first described, except they present with: • No cognitive deficit • No communication deficit • No speech –language differences in the first three years • Exhibit repetitive behaviors • Show deficits in social interactions • Don’t understand basic pragmatics • Have limited interests focusing on factual information • Children with AS progress differently than typically developing children.

7. Comparing High-Functioning Autism and Asperger’s Syndrome • While HFA and AS share many characteristics, differences between the two disorders have also been cited in the literature. These include variability in: • Motor skills • Cognition • Age of diagnosis • Communication • Limited Interests

8. Social Development of Individuals with Autism Spectrum Disorders • Deficits include problems with: • Eye referencing • Joint attention • Restricted range of communicative functions (Prelock, 2006) • Participating in conversations with others • Diminished social perspective-taking (Scaliatine, 2009) • These issues contribute to problems obtaining jobs and forging new relationships (Landa, 2000).

9. Research Question • Is there a significant difference in the social skills of adolescents with HFA, AS, and neurotypical development? • In social inferencing ability? • In social interpreting ability? • In social-situation-breakdown problem solving? • In interpreting social interaction? • In interpreting ironic statements?

10. Subject Selection • 17 participants ages 12-17 years: • Normal hearing and visual acuity based upon parent report. • Normal to near-normal cognitive ability based upon documentation of average grade-level performance or IQ of >70. • Professional diagnosis of HFA or AS, or parent report of neurotypical development. • Experimental groups: • HFA group included 5 participants. • AS group was comprised of 7 individuals. • Neurotypical group consisted of 5 subjects who had no known disabilities.

11. Procedures • Employed a group comparative design. • Each participant was administered the Social Language Development Test-Adolescent (SLDT-A). • The SLDT-A is comprised of 5 subtests.

12. Social Language Development Test- Adolescent • Making Inferences • Interpreting Social Language • Problem Solving • Social Interaction • Interpreting Ironic Statements

13. Results • Total test scores from the SLDT-A were analyzed using the nonparametric Kruskal-Wallis analysis of variance to address the main research question. • At the .05 level of confidence, there was no significant difference between the three groups in overall performance on this measure of social language abilities (p=0.146).

14. Results

15. Results • At the .05 level of confidence, a significant difference between the three groups in overall performance on this measure of social language abilities was not achieved (p=0.083), yet the difference approached significance.

16. Discussion • As predicted, neither group with autism spectrum disorders performed as well as subjects with neurotypical development. • The neurotypical group scored the highest on four of the five subtests, with the AS group performing less well, and the HFA group performing the worst. • Making Inferences was the only subtest that did not create such a pattern. • The HFA group scored the best. • All groups were between one and two standard deviations below the mean. • Most participants struggled to formulate language to describe what the pictured individuals were thinking, and also had problems naming aspects of the picture that let them know what the person was thinking.

17. Analysis of Results • The HFA group scored below the mean on 3 subtests. • The AS group scored 1 standard deviation below the mean on 1 subtest. • One of the subtests was not understood by any of the participants, including the neurotypical group. • Pattern of findings was consistent across four subtests. • Nonparametric test was used due to the number of subjects in each group, such test is not as powerful in capturing numerical differences as parametric tests.

18. Relation to Past Research • Findings supported: • Macintosh and Dissanayake (2006) • Eisenmajer et al. (1996) • Scaliatine (2009)

19. Strengths & Limitations • Strength • Researcher employed strategies to ensure that data were reliable. • Limitations • Small sample size • Design of the Making Inferences Subtest on the Social Language Development Test-Adolescent

20. Future Research • Replicate with a larger number of adolescents with HFA and AS for generalization of findings. • Evaluate specific social skill deficits of adolescents with HFA and AS. • Consider using different assessment tools to evaluate social behavior that might be more sensitive to discriminating these characteristics for individuals with autism spectrum disorders.

21. Conclusions • The SLDT-A assessed general social skills a standardized test of social skills development for adolescents. • No significant differences were found. • Total test scores for both the HFA and AS groups were in the impaired range. • Social deficits will impact their success with peers and adults at school, home, and in the community. • Social skills is an area of autism that will require ongoing attention.

22. Selected References • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. • Baker, J. (2004). Social skills training for children and adolescents with Asperger syndrome and social-communication problems. Shawnee Mission, KS: Autism-Asperger Publishing Company. • Bellini, S. (2008). Building social relationships: A systematic approach to teaching social interaction skills to children and adolescents with autism spectrum disorders and other social difficulties. Shawnee Mission, KS: Autism-Asperger Publishing Company. • Bellini, S. (2004). Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus on Autism & Other Developmental Disabilities, 19, 78-86. • Bowers, L., Huisingh, R., & LoGiudice, C. (2010). Social Language Development Test-Adolescent. East Moline, IL: LinguiSystems, Inc. • Eisenmajer, R., Prior, M., Leekam, S., Wing, L., Ong, B., Gould, J., & Welham, M. (1998). Delayed language onset as a predictor of clinical symptoms in pervasive developmental disorders. Journal of Autism and Developmental Disorder, 28, 527-533. doi:10.1023/A:1026004212375 • Eisenmajer, R., Prior, M., Leekam, S., Wing, L., Ong, B., Gould, J., & Welham, M. (1998). Delayed language onset as a predictor of clinical symptoms in pervasive developmental disorders. Journal of Autism and Developmental Disorder, 28, 527-533. doi:10.1023/A:1026004212375 • Frith, U. (1991). Autism and Asperger syndrome. New York: Cambridge University Press. • Fullerton, A. (1996). Who are higher functioning young adults with autism? In A. Fullerton, J. Stratton, P. Coyne, & C. Gray (Eds.), Higher functioning adolescents and young adults with autism (pp. 1-19). Dallas, TX: Pro-Ed

23. Selected References • Gillberg, C., & Ehlers, S. (1998). High-functioning people with autism and Asperger's syndrome: A literature review. In E. Scholpler, G. B. Mesibov, & L. J. Kunce (Eds.), Asperger syndrome or high-functioning autism? (pp. 79-106). New York, NY: Plenum Press. • Happé, F. (1995). Understanding minds and metaphors: Insights from the study of figurative language in autism. Metaphor and Symbolic Activity, 10, 275-295. • Howlin, P. (2003). Outcome in high-functioning adults with autism with and without early language delays: Implications for the differentiation between autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 33, 3-13. doi: 0162-3257/03/0200-0003/0 • Jones, C. D., & Schwartz, I. S. (2009). When asking questions is not enough: An observational study of social communication differences in high functioning children with autism. Journal of Autism and Developmental Disorders, 39, 432- 443. doi: 10.1007/s10803-008-0642-y • Kaderavek, J. (2011). Language disorders in children. New York, New York: Pearson. • Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child,2, 217-250. • Kowalski, T. (2002). The source for Asperger’s syndrome. East Moline, IL: LinguiSystems, Inc. • Kugler, B. (1998). The differentiation between autism and asperger syndrome. Autism, 2, 11-32. doi: 10.1177/1362361398021003. • Kuusikko, S., Poolock-Wurman, R., Jussila, K., Carter, A. S., Mattila, M., Ebeling, H., Pauls, D. L., & Moilanen, I. (2008). Social anxiety in high-functioning children and adolescents with autism and asperger syndrome. Journal of Autism and Developmental Disorders, 38, 1697-1709. doi: 10.1007/s10803-008-0555-9

24. Selected References • Landa, R. (2000). Social language use in Asperger syndrome and high-function autism. In A. Klin, F. R. Volkmar, S. S. Sparrow (Eds.), Aspergersyndrome. (pp. 215-155). New York, NY: Guilford Press. • Prelock, P. (2006). Autism spectrum disorders: Issues in assessment and intervention. Dallas, TX: Pro-Ed. • Scaliatine, C. (2009). Perspective-taking in adolscents with Asperger syndrome and nonverbal learning disorder (Unpublished master’s thesis). Eastern Illinois University, Charleston, IL. • Physical Disabilities, 17, 345-359. doi:10.1007/s10882-005-6618-3 • Seung, H. (2007). Linguistic characteristics of individuals with high functioning autism and Asperger syndrome. Clinical Linguistics and Phonetics, 21, 247-259. doi: 10.1080/02699200701195081 • Tyson, K., & Cruess, D. (2011). Differentiation high-functioning autism and social phobia. Journal of Autism and Developmental Disorders, 1-14 doi: 10.1007/s10803-011-1386-7 • Volkmar, F., Lord, C., Bailey, A., Schultz, R., & Klin, A. (2004). Autism and pervasive developmental disorders. Journal of Child Psychology and Psychiatry, 45, 135-170. doi:10.1046/j.0021-9630.2003.00317.x

25. Thank you! • Dr. Tina Veale • Dr. Angela Anthony • Ms. Jill Fahy • Dr. Gail Richard • Dr. Rebecca Throneburg • The Eastern Illinois University Honors College