Social and language skills in adolescent boys with Asperger syndrome

By Koning, C. and Magill-Evans, J. (2001), Autism, 5(1), 23-36.

Twenty-one adolescent boys with Asperger Syndrome and 21 boys matched on age and an estimate of IQ were assessed using standardised measures of social perception (Child and Adolescent Social Perception Measure, CASP), social skills (parent, teacher, and student forms of the Social Skills Rating System, SSRS), number of close friends and frequency of contact (Child Behaviour Checklist) and expressive and receptive language (Clinical Evaluation of Language Fundementals-Revised). There were significant differences between groups on CASP scores, SSRS scores, number of friends, frequency of contact and social competence. There was also a significant difference on receptive language.

To understand more about the specific nature of deficits in Asperger syndrome, the first objective of this study was to provide a standardised measurement of the social interaction deficits of adolescent boys with Asperger syndrome by comparing them with age, gender and vocabulary IQ matched controls. We were particularly interested in measuring social perception and general social skills. The ability to make inferences from social cues such as facial expression, gesture, tone of voice and situational references seems to be a critical deficit in this population. It is also important to know if individuals with Asperger syndrome rely more strongly on cues from one particular domain such as facial expression or tone of voice.

Method
Twenty-one boys aged 12-15 years who met the DSM-IV criteria for Asperger syndrome comprised the Asperger group.

Measures
The Child and Adolescent Social Perception measure (CASP: Magill-Evans et al., 1995) is a standardised, individually administered test designed to assess social perception in children ages 6 to 15 years. The 10 short unrelated video scenes depict children and adolescents in typical social interactions. The scenes are audio filtered (making words unintelligible but retaining vocal tone and prosodic features) so that meaning must be derived from non-verbal and situational cues. After each scene the child describes what happened, how each character was feeling (emotional recognition and labelling), and how they knew the character was feeling that way (cues used to infer the emotion).

The Social Skills Rating System (SSRS: Gresham and Elliot, 1990) is a questionnaire designed to evaluate skills such as empathy, self-control, cooperation and assertiveness. The parent, teacher and student rate specific skills on a scale of 0 to 2 with higher scores indicating greater competence.

The Social Competence Scale (SCS) of the Child Behaviour Checklist (CBCL: Achenbach, 1991) is part of the parent form. Of relevance to this study are the questions about the number of friends and frequency of contact as well as behaviour with others.

Discussion
While individuals with Asperger syndrome may be able to infer the affective state of others when labelling still photographs or matching contextual and facial expressions, difficulties become apparent when dealing with the simultaneous presentation of facial, voice, body and situational cues.

Overall, adolescents with Asperger syndrome reported using fewer of the available cues to infer emotional state than did adolescents in the comparison group. Both groups made frequent use of facial cues, but the Asperger group showed far less use of other cues. Attending only to facial cues would make it very difficult to understand more complex interactions, such as those involving sarcasm.

The significant differences between groups on the CASP scores and on receptive language indicate that at least some adolescents with Asperger syndrome have impairments in their ability to receive and interpret both verbal and non-verbal language, relative to the comparison group.

It is also interesting that the adolescents with Asperger syndrome rated themselves significantly higher than did their teachers and parents on total scores. Thus, while they were aware of their difficulties in assertion they were less aware of difficulties in other areas, and, as a group, were still relatively positive about their general social skills.

Sixteen of the adolescents with Asperger syndrome reported having virtually no friends. This finding is not surprising given their social difficulties with peers and the heavy emphasis on social skills during the adolescent period.