Good social skills despite poor theory of mind: exploring compensation in autism spectrum disorder.
Autism spectrum disorder
adaptation
camouflaging
compensation
compensatory mechanisms
executive function
remediation
theory of mind
Journal
Journal of child psychology and psychiatry, and allied disciplines
ISSN: 1469-7610
Titre abrégé: J Child Psychol Psychiatry
Pays: England
ID NLM: 0375361
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
accepted:
26
01
2018
pubmed:
28
3
2018
medline:
10
4
2020
entrez:
28
3
2018
Statut:
ppublish
Résumé
It is proposed that some individuals with Autism Spectrum Disorder (ASD) can 'compensate' for their underlying difficulties (e.g. in theory of mind; ToM), thus demonstrating relatively few behavioural symptoms, despite continued core cognitive deficits. The mechanisms underpinning compensation are largely unexplored, as is its potential impact on mental health. This study aimed to estimate compensation patterns in ASD, by contrasting overt social behaviour with ToM task performance, in order to compare the characteristics of 'Low' and 'High' Compensators. A total of 136 autistic adolescents, from the ongoing Social Relationships Study, completed a range of cognitive tasks, the Autistic Diagnostic Observation Schedule (ADOS) and a self-report anxiety questionnaire. Participants were assigned compensation group status; High Compensators demonstrated good ADOS scores despite poor ToM performance, while Low Compensators demonstrated similarly poor ToM, accompanied by poor ADOS scores. High Compensators demonstrated better IQ and executive function (EF), but greater self-reported anxiety, compared with Low Compensators. Such differences were not found when comparing individuals who had good versus poor ADOS scores, when ToM performance was good. Other core autistic characteristics (weak central coherence, nonsocial symptoms) did not differentiate the High and Low Compensators. IQ, EF and anxiety appear to be implicated in the processes by which certain autistic young people can compensate for their underlying ToM difficulties. This tendency to compensate does not appear to reflect the severity of 'hit' for ASD per se, suggesting that well-compensated individuals are not experiencing a milder form of ASD. The construct of compensation in ASD has implications for research and clinical practice.
Sections du résumé
BACKGROUND
It is proposed that some individuals with Autism Spectrum Disorder (ASD) can 'compensate' for their underlying difficulties (e.g. in theory of mind; ToM), thus demonstrating relatively few behavioural symptoms, despite continued core cognitive deficits. The mechanisms underpinning compensation are largely unexplored, as is its potential impact on mental health. This study aimed to estimate compensation patterns in ASD, by contrasting overt social behaviour with ToM task performance, in order to compare the characteristics of 'Low' and 'High' Compensators.
METHODS
A total of 136 autistic adolescents, from the ongoing Social Relationships Study, completed a range of cognitive tasks, the Autistic Diagnostic Observation Schedule (ADOS) and a self-report anxiety questionnaire. Participants were assigned compensation group status; High Compensators demonstrated good ADOS scores despite poor ToM performance, while Low Compensators demonstrated similarly poor ToM, accompanied by poor ADOS scores.
RESULTS
High Compensators demonstrated better IQ and executive function (EF), but greater self-reported anxiety, compared with Low Compensators. Such differences were not found when comparing individuals who had good versus poor ADOS scores, when ToM performance was good. Other core autistic characteristics (weak central coherence, nonsocial symptoms) did not differentiate the High and Low Compensators.
CONCLUSIONS
IQ, EF and anxiety appear to be implicated in the processes by which certain autistic young people can compensate for their underlying ToM difficulties. This tendency to compensate does not appear to reflect the severity of 'hit' for ASD per se, suggesting that well-compensated individuals are not experiencing a milder form of ASD. The construct of compensation in ASD has implications for research and clinical practice.
Identifiants
pubmed: 29582425
doi: 10.1111/jcpp.12886
pmc: PMC6334505
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
102-110Subventions
Organisme : Medical Research Council
ID : G0500870
Pays : United Kingdom
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2018 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
Références
J Autism Dev Disord. 2015 Jun;45(6):1579-87
pubmed: 25398602
Autism. 2014 Jan;18(1):17-30
pubmed: 24126870
Behav Res Ther. 2000 Aug;38(8):835-55
pubmed: 10937431
Neuropsychol Rev. 2011 Dec;21(4):360-89
pubmed: 21989834
Trends Cogn Sci. 2012 Sep;16(9):454-7
pubmed: 22835639
Neuropsychologia. 1994 Apr;32(4):477-92
pubmed: 8047253
J Autism Dev Disord. 1994 Oct;24(5):659-85
pubmed: 7814313
J Autism Dev Disord. 2017 Aug;47(8):2519-2534
pubmed: 28527095
Curr Opin Psychiatry. 2017 Mar;30(2):69-76
pubmed: 28067726
Clin Psychol Rev. 2014 Feb;34(1):73-86
pubmed: 24424351
J Autism Dev Disord. 2000 Jun;30(3):205-23
pubmed: 11055457
JAMA Psychiatry. 2015 May;72(5):415-23
pubmed: 25738232
Biometrics. 2000 Jun;56(2):645-6
pubmed: 10877330
Psychol Med. 2011 Mar;41(3):619-27
pubmed: 21272389
Dev Psychopathol. 2015 May;27(2):425-42
pubmed: 25997763
Autism. 2017 Aug;21(6):678-689
pubmed: 27899709
J Child Psychol Psychiatry. 2015 Aug;56(8):893-902
pubmed: 25418509
Cognition. 2013 Nov;129(2):410-7
pubmed: 23994318
J Child Psychol Psychiatry. 2013 Feb;54(2):195-205
pubmed: 23320807
Child Neuropsychol. 2016;22(2):220-37
pubmed: 25506753
Autism. 2017 Aug;21(6):690-702
pubmed: 27899710
PLoS One. 2012;7(2):e30320
pubmed: 22312423
Philos Trans R Soc Lond B Biol Sci. 2003 Feb 28;358(1430):387-92
pubmed: 12639335
J Autism Dev Disord. 2016 Jan;46(1):74-82
pubmed: 26210519
Science. 2009 Aug 14;325(5942):883-5
pubmed: 19608858
Neurosci Biobehav Rev. 2017 Sep;80:729-742
pubmed: 28642070
J Child Psychol Psychiatry. 1996 Feb;37(2):229-36
pubmed: 8682904
Twin Res Hum Genet. 2013 Feb;16(1):117-25
pubmed: 23110994
Neurosci Biobehav Rev. 2015 Apr;51:205-22
pubmed: 25597655
J Exp Child Psychol. 2010 Dec;107(4):377-93
pubmed: 20655060
J Child Psychol Psychiatry. 2013 Nov;54(11):1176-85
pubmed: 24273800
J Autism Dev Disord. 2017 May;47(5):1369-1379
pubmed: 28213839
J Child Psychol Psychiatry. 2001 Feb;42(2):241-51
pubmed: 11280420