Journal of Autism and Developmental Disorders

, Volume 48, Issue 11, pp 3668–3677 | Cite as

Problem Behaviors in Autism Spectrum Disorder: Association with Verbal Ability and Adapting/Coping Skills

  • Diane L. Williams
  • Matthew Siegel
  • Carla A. MazefskyEmail author
  • for the Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC)
S.I. : Autism Inpatient Collection - Studying the Severely Affected


Data from the Autism Inpatient Collection was used to examine the relationship between problem behaviors and verbal ability, which have generally, though not universally, been highly associated. In a comparison of 169 minimally-verbal and 177 fluently-verbal 4 to 20-year-old psychiatric inpatients with ASD, the severity of self-injurious behavior, stereotyped behavior, and irritability (including aggression and tantrums) did not significantly differ, when controlling for age and NVIQ. Verbal ability was not strongly related to the severity of problem behaviors. However, lower adapting/coping scores were significantly associated with increasing severity of each type of problem behavior, even when accounting for verbal ability. Interventions to develop adapting/coping mechanisms may be important for mitigation of problem behaviors across the spectrum of individuals with ASD.


Communication Challenging behavior Coping skills Autism spectrum disorder (ASD) Psychiatric inpatients Autism inpatient collection (AIC) 



The ADDIRC is made up of the co-investigators: Matthew Siegel, MD (PI) (Maine Medical Center Research Institute; Tufts University), Craig Erickson, MD (Cincinnati Children’s Hospital; University of Cincinnati), Robin L. Gabriels, PsyD (Children’s Hospital Colorado; University of Colorado), Desmond Kaplan, MD (Sheppard Pratt Health System), Carla Mazefsky, PhD (Western Psychiatric Institute and Clinics; University of Pittsburgh), Eric M. Morrow, MD, PhD (Bradley Hospital; Brown University), Giulia Righi, PhD (Bradley Hospital; Brown University), Susan L. Santangelo, ScD (Maine Medical Center Research Institute; Tufts University), and Logan Wink, MD (Cincinnati Children’s Hospital; University of Cincinnati). Collaborating investigators and staff: Jill Benevides, BS, Carol Beresford, MD, Carrie Best, MPH, Katie Bowen, LCSW, Briar Dechant, BS, Tom Flis, BCBA, LCPC, Holly Gastgeb, PhD, Angela Geer, BS, Louis Hagopian, PhD, Benjamin Handen, PhD, BCBA-D, Adam Klever, BS, Martin Lubetsky, MD, Kristen MacKenzie, BS, Zenoa Meservy, MD, John McGonigle, PhD, Kelly McGuire, MD, Faith McNeil, BS, Joshua Montrenes, BS, Tamara Palka, MD, Ernest Pedapati, MD, Kahsi A. Pedersen, PhD, Christine Peura, BA, Joseph Pierri, MD, Christie Rogers, MS, CCC-SLP, Brad Rossman, MA, Jennifer Ruberg, LISW, Elise Sannar, MD, Cathleen Small, PhD, Nicole Stuckey, MSN, RN, Barbara Tylenda, PhD, Brittany Troen, MA, R-DMT, Mary Verdi, MA, Jessica Vezzoli, BS, Deanna Williams, BA, and Diane Williams, PhD, CCC-SLP. We gratefully acknowledge the contributions of the coordinating site advisory group: Donald L. St. Germain, MD and Girard Robinson, MD, and our scientific advisory group: Connie Kasari, PhD., Bryan King, MD, James McCracken, MD, Christopher McDougle, MD, Lawrence Scahill, MSN, PhD, Robert Schultz, PhD and Helen Tager-Flusberg, PhD, the input of the funding organizations and the families and children who participated.

Author Contributions

MS and CM conceived of the study and participated in its design and coordination; DW and CM performed the statistical analyses and drafted the manuscript; All authors participated in the interpretation of the data and read and approved the final manuscript. All ADDIRC sites participated in data collection.


The Autism Inpatient Collection (AIC) phenotypic database and biorepository is supported by a grant from the Simons Foundation Autism Research Initiative and the Nancy Lurie Marks Family Foundation, (SFARI #296318 to MS). This study was also supported a grant from the National Institute of Child Health and Human Development (R01HD079512 to CM) and Dr. Mazefsky received additional support from NICHD (K23HD060601).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committees where the data was collected and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in this study.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Diane L. Williams
    • 1
  • Matthew Siegel
    • 2
  • Carla A. Mazefsky
    • 3
    Email author
  • for the Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC)
  1. 1.Department of Communication Sciences and DisordersThe Pennsylvania State UniversityUniversity ParkUSA
  2. 2.Maine Medical Center Research InstituteSpring Harbor Hospital, Tufts University School of MedicineWestbrookUSA
  3. 3.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA

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