Family Perspectives on Social-Cognitive Impairment in Verbal Individuals with Autism Spectrum Disorder

Background and Significance: Individuals with autism spectrum disorder (ASD) commonly experience significant impairments in social information processing or social cognition. The presence of these challenges has been extensively documented through the use of well-validated cognitive tests. However, there is evidence to suggest that standardized instruments may not fully capture elements of social-cognitive functioning that are more salient and/or relevant for families of individuals with ASD. A better understanding of social-cognitive impairment from the perspective of family members may provide researchers with a richer understanding of how families perceive some of the more prominent challenges associated with autism. The purpose of this study was to compare family report measures of social cognition with the results of standardized cognitive tests, in an effort to identify the degree to which such tests reflect family perspectives on social cognition in ASD.

Methods: A total of 259 verbal individuals with ASD, aged 2-63, participated in the study. Each participant was administered two widely used and previously validated standardized tests of social cognition that assess theory of mind. One family member of each participant was administered a family-report measure of social cognition and autism symptoms. A series of general linear correlation analysis and independent sample t-tests were used to examine the convergence between standardized cognitive test scores and family ratings of social cognition.  Moderated multiple regression models then examined the consistency of the relationship between family/cognitive test ratings across a wide developmental age range and other demographic characteristics.

Results: Initial correlation analysis indicated that family reports of social cognition were only weakly correlated to social cognition scores across the two standardized cognitive tests (r=-0.16, p<0.05; r=0.11, p=0.16). Subsequent analysis revealed that family members were able to significantly discriminate poor from non-poor scores on one of the social-cognitive tests (t=2.10 p<0.05), but not the other (t=0.67, p=0.50). These findings were not moderated by participant age or gender, and indicated low consistency between family perspectives on social cognition and those identified by standardized theory of mind tests.

Conclusion and Implications: Family members of individuals with ASD may be attuned to social-cognitive challenges that are not detected by commonly used standardized cognitive tests. More research is needed to better understand disparities between family report and performance-based measures, and greater attention should be paid to family reports of social-cognitive impairment in autism research. Increased attention to family report in tandem with standardized measures of impairment can help researchers and clinicians acquire a more comprehensive understanding of the daily impact of ASD and its characteristics on individuals and their families.