Skip to main content
SpringerLink
Log in

Effects of Anxiety Disorder Severity on Social Functioning in Children with Autism Spectrum Disorders

  • Original Article
  • Published:
Journal of Developmental and Physical Disabilities Aims and scope Submit manuscript

Abstract

Maladaptive social functioning is a core deficit in children with autism spectrum disorders (ASD). However, few studies have explicitly examined the linkage between anxiety and the degree of social functioning impairment in children with ASD. This study examines several types of anxiety and their covariation with social functioning deficits in children with ASD. Participants were 53 children with ASD who met criteria for at least one anxiety disorder. Within this sample of children, social anxiety disorder was the most common anxiety disorder. Results indicated that a greater severity of social anxiety disorder was associated with a higher level of social functioning deficits for elementary school aged children with ASD. Specifically, exploratory analyses revealed that higher levels of social anxiety disorder predicted lower assertive and responsible social skills. Social anxiety may increase the barriers to social engagement and thus serve as a risk factor for increased social deficits in youth with ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Albano, A. M., & Silverman, W. K. (1996). Anxiety disorders interview schedule for DSM-IV: child version: clinician manual. San Antonio: The Psychological Corporation.

    Google Scholar 

  • Alfano, C. A., Beidel, D. C., & Turner, S. M. (2006). Cognitive correlates of social phobia among children and adolescents. Journal of Abnormal Child Psychology, 34(2), 189–201. doi:10.1007/s10802-005-9012-9.

    Article  PubMed  Google Scholar 

  • Baron-Cohen, S., O’Riordan, M., Stone, V., Jones, R., & Plaisted, K. (1999). Recognition of faux pas by normally developing children with asperger syndrome or high-functioning autism. Journal of Autism and Developmental Disorders, 29(5), 407–418.

    Article  PubMed  Google Scholar 

  • Bauminger, N., & Kasari, C. (2000). Loneliness and friendship in high-functioning children with autism. Child Development, 71(2), 447–456.

    Article  PubMed  Google Scholar 

  • Bauminger, N., Solomon, M., Aviezer, A., Heung, K., Gazit, L., Brown, J., et al. (2008). Children with autism and their friends: a multidimensional study of friendship in high-functioning autism spectrum disorder. Journal of Abnormal Child Psychology, 36(2), 135–150. doi:10.1007/s10802-007-9156-x.

    Article  PubMed  Google Scholar 

  • Beidel, D. C., Turner, S. M., & Morris, T. L. (1999). Psychopathology of childhood social phobia. Journal of the American Academy of Child and Adolescent Psychiatry, 38(6), 643–650.

    Article  PubMed  Google Scholar 

  • Bellini, S. (2004). Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19(2), 78–86.

    Article  Google Scholar 

  • Capps, L., Sigman, M., & Yirmiya, N. (1995). Self-competence and emotional understanding in high-functioning children with autism. Development and Psychopathology. Special Issue: Emotions in developmental psychopathology, 7(1), 137–149.

    Google Scholar 

  • Cath, D., Ran, N., Smit, J., van Balkom, A., & Comijs, H. (2008). Symptom overlap between autism spectrum disorder, generalized social anxiety disorder and obsessive-compulsive disorders in adults: a preliminary case-controlled study. Psychopathology, 41, 101–110. doi:10.1159/000111555.

    Article  PubMed  Google Scholar 

  • Davila, J., & Beck, J. G. (2002). Is social anxiety associated with impairment in close relationships? A preliminary investigation. Behavior Therapy, 33(3), 427–446.

    Article  Google Scholar 

  • de Bruin, E. I., Ferdinand, R. F., Meester, S., de Nijs, P. F. A., & Verheij, F. (2007). High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders, 37(5), 877–886. doi:10.1007/s10803-006-0215-x.

    Article  PubMed  Google Scholar 

  • DiPerna, J. C., & Volpe, R. J. (2005). Self-report on the social skills rating system: analysis of reliability and validity for an elementary sample. Psychology in the Schools, 42(4), 345–354.

    Article  Google Scholar 

  • Erath, S. A., Flanagan, K. S., & Bierman, K. L. (2007). Social anxiety and peer relations in early adolescence: behavioral and cognitive factors. Journal of Abnormal Child Psychology, 35(3), 405–416. doi:10.1007/s10802-007-9099-2.

    Article  PubMed  Google Scholar 

  • Farrugia, S., & Hudson, J. (2006). Anxiety in adolescents with asperger syndrome: negative thoughts, behavioral problems, and life interference. Focus on Autism and Other Developmental Disabilities, 21(1), 25–35. doi:10.1177/10883576060210010401.

    Article  Google Scholar 

  • Frankel, F., & Wood, J. (2012). Social skills success for students with autism/aspergers. United States: Wiley, Inc.

    Google Scholar 

  • Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high-functioning children with autism. Autism, 5(3), 277–286.

    Article  PubMed  Google Scholar 

  • Ginsburg, G. S., La Greca, A. M., & Silverman, W. K. (1998). Social anxiety in children with anxiety disorders: relation with social and emotional functioning. Journal of Abnormal Child Psychology, 26(3), 175–185.

    Article  PubMed  Google Scholar 

  • Green, J., Gilchrist, A., Burton, D., & Cox, A. (2000). Social and psychiatric functioning in adolescents with asperger syndrome compared with conduct disorder. Journal of Autism and Developmental Disorders, 30(4), 279–293.

    Article  PubMed  Google Scholar 

  • Gresham, F. M., & Elliott, S. N. (1990). Social skills rating system manual. Circle Pines: American Guidance Service.

    Google Scholar 

  • Kaland, N., Callesen, K., Moller-Nielsen, A., Mortensen, E. L., & Smith, L. (2008). Performance of children and adolescents with asperger syndrome or high-functioning autism on advanced theory of mind tasks. Journal of Autism and Developmental Disorders, 38(6), 1112–1123. doi:10.1007/s10803-007-0496-8.

    Article  PubMed  Google Scholar 

  • Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and asperger syndrome. Autism, 4(2), 117–132.

    Article  Google Scholar 

  • Kuusikko, S., Pollock-Wurman, R., Jussila, K., Carter, A., Mattila, M., Ebeling, H., Pauls, D., & Moilanen, I. (2008). Social anxiety in high-functioning children and adolescents with autism and asperger syndrome. Journal of Autism and Developmental Disorders, 38, 1697–1709. doi:10.1007/s10803-008-0555-9.

    Article  PubMed  Google Scholar 

  • La Greca, A. M., & Lopez, N. (1998). Social anxiety among adolescents: linkages with peer relations and friendships. Journal of Abnormal Child Psychology, 26(2), 83–94.

    Article  PubMed  Google Scholar 

  • Lang, R., Regester, A., Lauderdale, S., Ashbaugh, K., & Haring, A. (2010). Treatment of anxiety in autism spectrum disorders using cognitive behavior therapy: a systematic review. Developmental Neurorehabilitation, 13, 53–63.

    Article  PubMed  Google Scholar 

  • Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861. doi:10.1007/s10803-006-0123-.

    Article  PubMed  Google Scholar 

  • Little, L. (2002). Middle-class mothers’ perceptions of peer and sibling victimization among children with Asperger’s syndrome and noverbal learning disorders. Issues in Comprehensive Pediatric Nursing, 25, 43–57.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview–revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule–generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P., & Risi, S. (2001). Autism diagnostic observation schedule. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Meyer, J. A., Mundy, P. C., van Hecke, A. V., & Durocher, J. S. (2006). Social attribution processes and comorbid psychiatric symptoms in children with asperger syndrome. Autism, 10(4), 383–402. doi:10.1177/1362361306064435.

    Article  PubMed  Google Scholar 

  • Muris, P., Steerneman, P., Merckelbach, H., Holdrinet, I., & Meesters, C. (1998). Comorbid anxiety symptoms in children with pervasive developmental disorders. Journal of Anxiety Disorders, 12(4), 387–393.

    Article  PubMed  Google Scholar 

  • Puliafico, A., & Kendall, P. (2006). Threat-related attentional bias in anxious youth: a review. Clinical Child and Family Psychology Review, 9, 162–180.

    Article  PubMed  Google Scholar 

  • Rao, P. A., Beidel, D. C., Turner, S. M., Ammerman, R. T., Crosby, L. E., & Sallee, F. R. (2007). Social anxiety disorder in childhood and adolescence: descriptive psychopathology. Behaviour Research and Therapy, 45(6), 1181–1191.

    Article  PubMed  Google Scholar 

  • Silverman, W. K., Saavedra, L. M., & Pina, A. A. (2001). Test-retest reliability of anxiety symptoms and diagnoses with anxiety disorders interview schedule for DSM-IV: child and parent versions. Journal of the American Academy of Child and Adolescent Psychiatry, 40(8), 937–944.

    Article  PubMed  Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929. doi:10.1097/CHI.0b013e318179964f.

    Article  PubMed  Google Scholar 

  • Spence, S. H., Donovan, C., & Brechman-Toussaint, M. (1999). Social skills, social outcomes, and cognitive features of childhood social phobia. Journal of Abnormal Psychology, 108(2), 211–221.

    Article  PubMed  Google Scholar 

  • Strauss, C. C., Lease, C. A., Kazdin, A. E., Dulcan, M. K., et al. (1989). Multimethod assessment of the social competence of children with anxiety disorders. Journal of Clinical Child Psychology, 18(2), 184–189.

    Article  Google Scholar 

  • Sukhodolsky, D. G., Scahill, L., Gadow, K. D., Arnold, L. E., Aman, M. G., McDougle, C. J., et al. (2008). Parent-rated anxiety symptoms in children with pervasive developmental disorders: frequency and association with core autism symptoms and cognitive functioning. Journal of Abnormal Child Psychology, 36(1), 117–128. doi:10.1007/s10802-007-9165-9.

    Article  PubMed  Google Scholar 

  • van Roekel, E., Scholte, R., & Didden, R. (2010). Bullying among adolescents with autism spectrum disorders: prevalence and perception. Journal of Autism and Developmental Disorders, 40, 63–73.

    Article  PubMed  Google Scholar 

  • Weisbrot, D. M., Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). The presentation of anxiety in children with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15(3), 477–496.

    Article  PubMed  Google Scholar 

  • Wenzel, A., Graff-Dolezal, J., Macho, M., & Brendle, J. R. (2005). Communication and social skills in socially anxious and nonanxious individuals in the context of romantic relationships. Behaviour Research and Therapy, 43(4), 505–519. doi:10.1016/j.brat.2004.03.010.

    Article  PubMed  Google Scholar 

  • Wood, J. (2006). Effect of anxiety reduction on children’s school performance and social adjustment. Developmental Psychology, 42(2), 345–349.

    Article  PubMed  Google Scholar 

  • Wood, J., & Gadow, K. (2010). Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clinical Psychology: Science and Practice, 14(4), 281–292.

    Article  Google Scholar 

  • Wood, J., Piacentini, J., Bergman, R., McCracken, J., & Barrios, V. (2002). Concurrent validity of the anxiety disorders section of the anxiety disorders interview schedule for DSM-IV: child and parent versions. Journal of Clinical Child and Adolescent Psychology, 31, 335–342.

    PubMed  Google Scholar 

  • Wood, J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. (2009). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. Journal of Child Psychology and Psychiatry, 50(3), 224–234. doi:10.1111/j.1469-7610.2008.01948.x.

    Article  PubMed  Google Scholar 

  • Wood, J., Drahota, A., Sze, K., Van Dyke, M., Decker, K., Fujii, C., Bahng, C., Renno, P., Hwang, W., & Spiker, M. (2009). Brief report: effects of cognitive behavioral therapy on parent-reported autism symptoms in school-aged children with high-functioning autism. Journal of Autism and Developmental Disabilities, 39(11), 1608–1612. doi:10.1007/s10803-009-0791-7.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to gratefully acknowledge the hard work and dedication of the families who participated in this study.

This research was supported by Cure Autism Now Foundation and the National Institute of Mental Health (MH075806), Jeff Wood, Principal Investigator. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the NIMH.

Author information

Authors and Affiliations

  1. UCLA, Los Angeles, CA, USA

    Ya-Chih Chang, Jenny Quan & Jeffrey J. Wood

Authors
  1. Ya-Chih Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jenny Quan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeffrey J. Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ya-Chih Chang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chang, YC., Quan, J. & Wood, J.J. Effects of Anxiety Disorder Severity on Social Functioning in Children with Autism Spectrum Disorders. J Dev Phys Disabil 24, 235–245 (2012). https://doi.org/10.1007/s10882-012-9268-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10882-012-9268-2

Keywords

Search

Navigation