Social skills and associated psychopathology in children with chromosome 22q11.2 deletion syndrome: implications for interventions.
In 22q11DS, social struggles come from anxiety and ADHD, not low IQ—treat those first.
01Research in Context
What this study did
The team compared kids with 22q11.2 deletion syndrome to same-age peers. They gave quick tests of facial emotion reading and asked parents and teachers to rate everyday social skills.
They also looked at IQ scores, anxiety checklists, and ADHD scales to see what best predicted the social gaps.
What they found
Children with 22q11DS read faces worse and were rated as less socially skilled than controls.
Surprise: IQ did not explain the gap. Instead, higher anxiety and ADHD symptoms lined up with poorer social scores.
How this fits with other research
Potter et al. (2013) followed the same syndrome one year later. They saw IQ drop in a third of teens while behavior problems moved on a separate track. Together the two papers show you cannot use IQ as a stand-in for social risk in 22q11DS.
Honigfeld et al. (2012) and van Rijn et al. (2008) mapped social deficits in sex-chromosome disorders. Their pattern—extra Y chromosomes carry heavier social cost—mirrors the 22q11DS finding that specific gene changes create distinct social profiles.
Guy et al. (2020) studied fragile X and also found social attention gaps. Across syndromes, the message is the same: look at social attention and emotional control, not just mental age.
Why it matters
If you serve a child with 22q11DS, screen for anxiety and ADHD even when IQ looks decent. Treating worry and impulsivity first may open the door to better peer interaction. Track these behaviors each visit; they shift independently of cognitive scores.
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02At a glance
03Original abstract
BACKGROUND: Although distinctive neuropsychological impairments have been delineated in children with chromosome 22q11 deletion syndrome (22q11DS), social skills and social cognition remain less well-characterised. OBJECTIVE: To examine social skills and social cognition and their relationship with neuropsychological function/behaviour and psychiatric diagnoses in children with 22q11DS. METHODS: Sixty-six children with 22q11DS and 54 control participants underwent neuropsychological testing and were administered the Diagnostic Analysis of Non-Verbal Accuracy (DANVA) for face and auditory emotion recognition, a measure of social cognition: their parents/guardians were administered the Social Skills Rating System (SSRS) - parent version, Child Behavior Checklist (CBCL) - parent version and the Computerised Diagnostic Interview Schedule for Children (C-DISC). RESULTS: The 22q11DS group exhibited significantly lower social skills total score and more problem social behaviours, lower neurocognitive functioning, higher rates of anxiety disorders and more internalising symptoms than the control group. Participants with 22q11DS also exhibited significant deficits in their ability to read facial expressions compared with the control group, but performed no differently than the control participants in the processing of emotions by tone of voice. Within the 22q11DS group, higher social competency was correlated with higher global assessment of functioning and parental socio-economic status. Social competency was worse in those with anxiety disorders, attention deficit hyperactivity disorder, more than two psychiatric diagnoses on the C-DISC and higher internalising symptoms. No significant correlations of SSRS scores were seen with IQ, executive functions, attention, or verbal learning and memory. No correlations were found between social cognition and social skill scores. CONCLUSION: Our results indicate that social skills in children with 22q11DS are associated with behaviour/emotional functioning and not with neurocognition. Thus, treating the behaviour or emotional problems such as attention deficit hyperactivity disorder and anxiety disorders may provide a pathway for improving social skills in these children.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01477.x