Alexithymia is related to poor social competence in autistic and nonautistic children.
Check for alexithymia—kids who can't name feelings struggle socially, whether or not they have autism.
01Research in Context
What this study did
The team asked parents to fill out three short forms. One form rated how well their child plays with others. Another form rated how well the child notices and names feelings.
Kids were ages 8-14. Some had autism. Some did not. The study checked if trouble naming feelings, called alexithymia, went hand-in-hand with weak social skills.
What they found
Children who scored high on alexithymia also scored low on social competence. This link showed up in both autistic and non-autistic kids.
After the researchers held age, IQ, sex, and autism traits steady, alexithymia still explained about one-sixth of the differences in social skill scores.
How this fits with other research
Storch et al. (2012) already showed that teens who pass advanced "false-belief" tasks have fewer real-world social problems. Adams et al. (2021) now add a new piece: even when kids understand others' thoughts, they may still struggle if they cannot read their own feelings.
Peristeri et al. (2024) report the opposite headline: bilingual autistic children out-perform monolingual peers on second-order Theory-of-Mind tasks. The studies seem to clash, but they measure different things. Eleni looked at language-driven perspective-taking gains, while E et al. looked at emotion-labeling deficits. A bilingual child can grow in perspective-taking yet still have alexithymia; both facts can be true.
Antezana et al. (2023) extend the social-skills story downward to preschoolers. Their PEERS® for Preschoolers program helped about 60% of autistic 3- to 5-year-olds. Combining the two papers suggests screening for alexithymia even in preschool, then layering emotion-labeling lessons onto peer-training curricula.
Why it matters
If a child cannot say "I feel nervous," they are less likely to ask to join a game or negotiate a trade. Quick screeners for alexithymia take five minutes and are free online. When scores are high, add emotion-tacting goals to the BIP before teaching complex peer rituals. Target feeling words first, then social scripts.
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02At a glance
03Original abstract
Alexithymia is characterized by difficulties identifying and describing one's own emotions and the emotions of others. These challenges with understanding emotions in people with alexithymia may give rise to difficulties with social interactions. Given that alexithymia frequently co-occurs with autism spectrum disorder (ASD), and that both populations have difficulties with social interactions, it is of interest to determine whether alexithymia can help to parse some of the heterogeneity in social competence in autistic and nonautistic individuals. The caregivers of 241 children (6-14 years old), including 120 autistic, and 121 nonautistic, rated their child's social competence using the Multidimensional Social Competence Scale (MSCS), autism traits using the Autism Spectrum Quotient (AQ), and alexithymia traits using the Children's Alexithymia Measure (CAM). Regression analyses indicated that age, IQ, sex, AQ, and CAM scores accounted for 40.2% of the variance in autistic children's, and 68.2% of the variance in nonautistic children's, parent-reported social competence. Importantly, after controlling for age, IQ, sex, and AQ scores, CAM scores alone accounted for an additional 16.2% of the variance in autistic children's, and 17.4% of the variance in nonautistic children's social competence. These results indicate that higher alexithymia traits predict lower levels of social competence, suggesting that increased difficulty in identifying and describing one's own emotions and the emotions of others is associated with poorer social competence. Furthermore, CAM scores were found to partially mediate the relationship between autistic traits and social competence, suggesting that comorbid alexithymia traits may be partially responsible for poor social competence in individuals with high autistic traits. This research contributes to the understanding of the factors associated with the development of social competence and highlights alexithymia as a potential target for identification and intervention to improve social competence. LAY SUMMARY: Alexithymia is a condition where people find it hard to think and talk about their (and others') feelings. About 50% of autistic people have alexithymia. This might be why they have social and emotional difficulties. Parents answered questions about alexithymia and social difficulties their children have. Children with more alexithymia problems had poorer social skills. Thus, alexithymia may be related to social problems faced by autistic and nonautistic children.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2485