Peer Problems and Prosocial Behavior Among Icelandic Children and Adolescents with ADHD and/or Autism: Gender and Age Differences.
Young girls with autism or both autism and ADHD face the steepest peer problems, so catch and treat social deficits early.
01Research in Context
What this study did
Researchers asked teachers and parents across Iceland to rate kids with ADHD, autism, or both. They wanted to know who had the most trouble with peers and who showed the least kindness.
The sample included children and teens. The team looked at age and gender to see if younger girls faced extra social hurdles.
What they found
Kids with autism or both autism and ADHD scored worse on peer problems and prosocial behavior than kids with ADHD alone.
Girls with autism or the dual diagnosis had the hardest time. Teachers reported the youngest girls showed the steepest social gaps.
How this fits with other research
Sedgewick et al. (2019) saw a similar pattern in the UK. They found autistic girls had more friendship conflict than neurotypical girls, even though the friendships looked alike on the surface. The new Icelandic data extend that finding by showing the conflict starts earlier and is worse for girls with both autism and ADHD.
Eussen et al. (2016) reported that early-adolescent autistic girls carry higher depression risk. The current study adds peer rejection as a likely driver of that mood load.
Germani et al. (2014) found no gender gap in core autism traits over one year. The 2024 survey agrees on core traits but shows a clear gender gap in real-world social life, pointing to camouflaging or missed cues rather than different autism severity.
Why it matters
Screen social skills early and often in girls with autism or combined ADHD/autism. Add friendship groups, conflict-resolution scripts, and peer coaching before middle school. Track progress monthly and adjust supports as girls age.
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02At a glance
03Original abstract
Children with neurodevelopmental disorders tend to have more social difficulties than typically developing children. The aim of the current study was to examine parent and teacher-reported effects of age and gender on social functioning in a large clinical sample of children and adolescents with ADHD, autism, or co-occurring ADHD and autism using a cross-sectional study design. This nationwide clinical sample included 2132 Icelandic children and adolescents (35% girls, 65% boys) aged 5-18 years referred for a neurodevelopmental diagnostic assessment (ADHD and/or autism) in Iceland. Social functioning was measured using the Prosocial behavior and Peer problem subscales on the Strengths and Difficulties Questionnaire (SDQ) completed by parents and teachers. Results revealed that autistic youth and youth with co-occurring ADHD and autism experienced more peer problems and showed less prosocial behavior than youth with ADHD only. According to parents and teachers, girls were found to experience more social difficulties compared to boys. Interaction for age and gender, although only significant for teacher reports, indicated that younger girls with neurodevelopmental disorders experience more peer problems and show less prosocial behavior than older girls. In contrast, boys with neurodevelopmental disorders experience similar issues at all ages. The results suggest different patterns of social difficulties for boys and girls with neurodevelopmental disorders. Future research should examine different developmental pathways of social challenges for boys and girls. Implications for developing and providing clinical interventions appropriate developmental stages are discussed.
Journal of autism and developmental disorders, 2024 · doi:10.1111/ped.14105