Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder.

Rose et al. (2000) compared teens with Asperger syndrome to teens with conduct disorder. They looked at real-life social skills and any extra mental-health diagnoses.

All teens had normal early language and IQ. Clinicians rated their day-to-day social problems and checked for anxiety, depression, or obsessional disorders.

The Asperger group showed severe social deficits in everyday settings. They also had far more anxiety and obsessional disorders than the conduct-disorder group.

Despite speaking on time and scoring in the average IQ range, these teens struggled to keep friends, join groups, or handle change.

Chen et al. (2001) ran a near-copy study one year later and found the same pattern. Their effect sizes were large, showing the social gap is reliable.

Wilkinson et al. (1998) and Mattila et al. (2010) tracked younger and larger samples. Both reported that about two-thirds to three-quarters of people with Asperger syndrome develop an extra psychiatric disorder, matching the high anxiety rate seen here.

Hurtig et al. (2009) asked teens, teachers, and parents to rate symptoms. Teens reported the highest anxiety and depression levels, proving the problem is real, not just clinician opinion.

If you work with bright teens on the spectrum, do not assume good scores on language or IQ tests mean they are fine. Screen for anxiety and obsessive thinking every reassessment. Add a teen self-report like the Youth Self-Report form. Target social skills in natural peer settings, not just the clinic. Treating anxiety can open the door to better friendship gains.