Association of cognitive and adaptive skills with internalizing and externalizing problems in autistic children and adolescents.
Teaching social and daily living skills cuts anxiety and behavior problems in autistic kids, while high-IQ youth need extra internalizing screening.
01Research in Context
What this study did
Donoso et al. (2024) asked how thinking skills and daily-life skills relate to anxiety and behavior problems in autistic youth.
They measured IQ, adaptive skills, and parent reports of worry and acting-out in children and teens with autism.
What they found
Stronger daily-life skills, especially socialization, predicted fewer anxiety and behavior problems across all IQ levels.
Surprise: youth without intellectual disability who had higher IQ scores showed more internalizing problems.
How this fits with other research
The finding builds on Richman et al. (2001) and Hogg et al. (1995), who first showed adaptive skills lag behind IQ in autism. Javiera et al. extend that work by proving these skill gaps now forecast mental-health risk.
Myers et al. (2018) and Moya et al. (2022) add the ‘how’: metacognitive executive function links social skills to daily self-management, explaining why boosting socialization lowers both anxiety and acting-out.
Chang et al. (2013) profiled the social-adaptive gap in high-functioning Taiwanese kids; the new study shows the same gap predicts later anxiety, turning a description into a warning.
Why it matters
You can’t assume bright autistic clients are mentally healthy. Screen for worry even when IQ is average or above, and target socialization and daily-life skills early—those lessons double as mental-health prevention.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a socialization target to the next BIP and run a quick anxiety checklist for high-functioning clients.
02At a glance
03Original abstract
The presence of an intellectual disability (ID) alongside autism is considered to increase the risk for mental health and behavior problems in children and adolescents. Existing evidence is restricted by looking at ID as a categorical classification. The study aimed to examine the association of cognitive and adaptive behavior skills with internalizing and externalizing problems in a large sample of autistic children and adolescents, across a wide range of cognitive skills. Participants were 2759 children and adolescents aged between 4 and 18 years recruited as part of the Simons Simplex Collection (SSC), of whom 709 (approximately 25%) had ID. Multiple regression models examined associations of internalizing and externalizing problems with cognitive and adaptive skills (communication, daily living, and socialization skills). Cognitive skills were not associated with externalizing problems but were associated with more internalizing problems in autistic children without ID (Cog β: 0.126). All adaptive skill domains were inversely associated with externalizing (Communication β: -0.145; Daily-Living β: -0.132; Socialization β: -0.289) and internalizing problems (Communication β: -0.074; Daily-Living β: -0.064; Socialization β: -0.213) in those without ID. Daily living (β: -0.158) and socialization skills (β: -0.104) were inversely correlated with externalizing problems in autistic children with ID, while only socialization problems (β: -0.099) were associated with internalizing problems in this group. Socialization skills were systematically associated with internalizing and externalizing problems across all levels of cognitive functioning. Supporting social skills development may benefit all aspects of child mental health, while recognizing that children with higher cognitive skills are more vulnerable to internalizing problems might assist with earlier identification of these problems.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3056