Autism & Developmental

Associations between cooperation, reactive aggression and social impairments among boys with autism spectrum disorder.

Kaartinen et al. (2019) · Autism : the international journal of research and practice 2019
★ The Verdict

Lower reactive aggression predicts more cooperative play in boys with autism.

✓ Read this if BCBAs running social-skills groups for school-age boys with ASD.
✗ Skip if Clinicians focused only on toddlers or non-verbal adults.

01Research in Context

01

What this study did

Kaartinen et al. (2019) watched 58 boys with autism play a fishing game.

Each boy chose to fish alone or share the lake with two peers.

The team scored how often a boy cooperated and how often he hit or yelled when frustrated.

02

What they found

Boys who rarely hit or yelled made twice as many cooperative choices.

Older boys also shared the lake more often.

The link held even after IQ and language skills were counted.

03

How this fits with other research

Downs et al. (2004) showed that high-functioning kids with autism can cooperate as well as typical peers.

Miia’s team adds a new rule: cooperation rises only when reactive aggression stays low.

Konke et al. (2026) found that waiting for treats protects adaptive skills in toddlers at risk for autism.

Together the studies trace one line: stronger self-control—whether waiting or staying calm—boosts social success across ages.

04

Why it matters

You can’t assume a calm client will share toys. Check how he reacts when the game gets tough. Add simple anger brakes: a pause card, deep-breath prompt, or quick break. Less hitting today may mean more sharing tomorrow.

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→ Action — try this Monday

Track each aggressive outburst during group games; teach one replacement response like squeezing a stress ball before the next turn.

02At a glance

Intervention
not applicable
Design
case study
Sample size
27
Population
autism spectrum disorder
Finding
positive

03Original abstract

Cooperation is a fundamental human ability that seems to be inversely related to aggressive behaviour in typical development. However, there is no knowledge whether similar association holds for children with autism spectrum disorder. A total of 27 boys with autism spectrum disorder and their gender, age and total score intelligence matched controls were studied in order to determine associations between cooperation, reactive aggression and autism spectrum disorder-related social impairments. The participants performed a modified version of the Prisoner's Dilemma task and the Pulkkinen Aggression Machine which measure dimensions of trust, trustworthiness and self-sacrifice in predisposition to cooperate, and inhibition of reactive aggression in the absence and presence of situational cues, respectively. Autism spectrum disorder severity-related Autism Diagnostic Interview-algorithm scores were ascertained by interviewing the parents of the participants with a semi-structured parental interview (Developmental, Dimensional and Diagnostic Interview). The results showed that albeit the boys with autism spectrum disorder were able to engage in reciprocation and cooperation regardless of their social impairments, their cooperativeness was positively associated with lower levels of reactive aggression and older age. Thus, strengthening inhibition mechanisms that regulate reactive aggression might make boys with autism spectrum disorder more likely to prefer mutual gain over self-interest in cooperation.

Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361317726417