Adaptive functioning, or the suite of skills essential for real-world, day-to-day functioning, includes daily living, communication, and socialization abilities. Even in the absence of co-occurring intellectual disability (IQ < 70), difficulties in adaptive functioning are prominent in autism spectrum disorder (ASD). Further, ASD individuals without co-occurring intellectual disability (ID) demonstrate a gap between IQ and adaptive functioning, which widens with age. Existing studies of IQ-adaptive functioning discrepancies have characterized predominantly male ASD samples; thus, whether the gap is demonstrated in ASD females is unknown. To probe sex- versus diagnosis-specific differences in adaptive functioning in ASD, we characterized adaptive functioning using the Vineland Adaptive Behavior Scales, Second Edition in 177 non-ID (IQ > 70) ASD (females = 75, males = 102), and 178 typically developing (TD) (females = 87, males = 91) youth, aged 8–17 years. We examined whether each group evidenced a gap between full-scale IQ and adaptive skills and its associations with age. ASD youth evinced significantly lower adaptive skills and a significantly greater IQ-adaptive functioning gap than their same-sex TD peers. In this cross-sectional sample, the increase in the IQ-adaptive functioning gap with age was of similar magnitude for ASD males and females, but only reached statistical significance in males. We discuss unique implications the profound IQ-socialization skills gap in particular may have for ASD females.

Lay abstract

Adaptive functioning refers to skills that are vital to success in day-to-day life, including daily living (e.g. grocery shopping, food preparation, transportation use), communication (e.g. verbal expression of needs), and socialization skills (e.g. interpersonal skills, including expressing and recognizing emotions, and understanding turn-taking in conversation). Among autistic individuals without intellectual disability, adaptive functioning is not commensurate with intellectual ability (IQ), and instead a gap exists between these individuals’ intellectual ability and their adaptive skills. Further, these autistic individuals show a widening of this gap with increasing age. Existing studies of the gap between IQ and adaptive functioning have studied predominantly male samples. Thus, we do not know if the gap also exists in autistic females. We therefore looked at adaptive functioning and the gap between IQ and adaptive functioning in a large sample of autistic girls and boys without intellectual disability. To disentangle effects of group (autistic vs typically developing) from effects of sex (girls vs boys), we compared autistic girls and boys to one another as well as to their same-sex typically developing peers. Analyses took into consideration differences in IQ between autistic and typically developing youth. We found autistic girls, like autistic boys, show lower adaptive functioning than their same-sex typically developing peers. Results underscore the need to evaluate adaptive functioning in autistic individuals without intellectual disability and to provide necessary supports. The large gap between intellectual ability and socialization skills, in particular, may be of critical importance in improving our understanding of outcomes and mental health difficulties among autistic females.

中文翻译：

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自闭症谱系障碍的智商和适应性功能之间的差距：解开诊断和性别差异

适应性功能，或对现实世界的日常功能至关重要的一整套技能，包括日常生活、沟通和社交能力。即使没有同时发生的智力障碍（IQ < 70），自闭症谱系障碍（ASD）中适应功能的困难也很突出。此外，没有同时发生智力障碍 (ID) 的 ASD 个体表现出智商和适应功能之间的差距，这种差距随着年龄的增长而扩大。现有的智商适应性功能差异研究主要以男性 ASD 样本为特征。因此，这种差距是否在 ASD 女性中表现出来是未知的。为了探究 ASD 中适应性功能的性别与诊断特异性差异，我们使用 Vineland 适应性行为量表第二版在 177 个非 ID（智商 > 70) ASD（女性 = 75，男性 = 102）和 178 名典型发育（TD）（女性 = 87，男性 = 91）青年，年龄在 8-17 岁。我们检查了每组是否证明了全面智商和适应技能之间的差距及其与年龄的关系。与同性 TD 同龄人相比，ASD 青年的适应技能显着降低，IQ 适应功能差距显着增大。在这个横截面样本中，ASD 男性和女性的智商适应性功能差距随年龄增长的幅度相似，但仅在男性中达到统计学意义。我们讨论了深刻的智商社交技能差距可能对 ASD 女性产生的独特影响。我们检查了每组是否证明了全面智商和适应技能之间的差距及其与年龄的关系。与同性 TD 同龄人相比，ASD 青年的适应技能显着降低，IQ 适应功能差距显着增大。在这个横截面样本中，ASD 男性和女性的智商适应性功能差距随年龄增长的幅度相似，但仅在男性中达到统计学意义。我们讨论了深刻的智商社交技能差距可能对 ASD 女性产生的独特影响。我们检查了每组是否证明了全面智商和适应技能之间的差距及其与年龄的关系。与同性 TD 同龄人相比，ASD 青年的适应技能显着降低，IQ 适应功能差距显着增大。在这个横截面样本中，ASD 男性和女性的智商适应性功能差距随年龄增长的幅度相似，但仅在男性中达到统计学意义。我们讨论了深刻的智商社交技能差距可能对 ASD 女性产生的独特影响。ASD 男性和女性的智商适应功能差距随年龄增长的幅度相似，但仅在男性中达到统计学意义。我们讨论了深刻的智商社交技能差距可能对 ASD 女性产生的独特影响。ASD 男性和女性的智商适应功能差距随年龄增长的幅度相似，但仅在男性中达到统计学意义。我们讨论了深刻的智商社交技能差距可能对 ASD 女性产生的独特影响。

抽象

适应性功能是指对日常生活成功至关重要的技能，包括日常生活（例如杂货店购物、食物准备、交通使用）、沟通（例如需求的口头表达）和社交技能（例如人际交往能力、包括表达和识别情绪，以及理解谈话中的轮换）。在没有智力障碍的自闭症个体中，适应性功能与智力（IQ）不相称，相反，这些个体的智力能力和他们的适应性技能之间存在差距。此外，随着年龄的增长，这些自闭症个体表现出这种差距的扩大。现有的关于智商和适应性功能之间差距的研究主要研究了男性样本。因此，我们不知道自闭症女性是否也存在这种差距。因此，我们研究了大量没有智力障碍的自闭症女孩和男孩的适应性功能以及智商和适应性功能之间的差距。为了区分群体（自闭症与典型发育）的影响与性别（女孩与男孩）的影响，我们将自闭症女孩和男孩彼此以及与同性发育的同龄人进行了比较。分析考虑了自闭症和正常发育青年之间的智商差异。我们发现自闭症女孩和自闭症男孩一样，表现出比同性发育中的同龄人更低的适应性功能。结果强调需要评估没有智力障碍的自闭症患者的适应性功能并提供必要的支持。智力能力和社交能力之间的巨大差距，尤其是，