Reciprocity in autistic and typically developing children and adolescents with and without mild intellectual disabilities

Abstract

The assessment of autism in individuals with mild intellectual disabilities (MID) is complicated because of the overlap between autistic traits and intellectual limitations. Impaired social emotional reciprocity is a core diagnostic criterion for autism. However, it is unknown whether reciprocal behaviour differs between MID individuals with or without an autism spectrum disorder (ASD). This study explored differences in reciprocal behaviour of 35 children and adolescents with MID (intelligence quotient 50-85): 15 with ASD (ASD-MID) and 20 with typical development (TD-MID) using the Interactive Drawing Test (IDT). ASD-MID participants showed a lower quality of reciprocal behaviour compared with TD-MID participants. The difference in quality of reciprocal behaviour between ASD-MID and TD-MID participants was not significantly related with Peabody Picture Vocabulary Test scores and thus not attributable to verbal capacity. The IDT is likely to reflect the child's inclination to display reciprocal behaviour in everyday situations, as its scale scores were meaningfully associated with the level of social cognition assessed with the Social Responsiveness Scale. Thus, the IDT seems well suited for measuring impairments in reciprocal behaviour in children and adolescents with MID.

A New Real-Life Test for Reciprocity in Autistic Adults: The Interactive Drawing Test

“…Autistic adults were thus less able to ensure an equal balance between drawing together in their own objects and in the objects drawn by the examiner, and consequently showed a lower quality of reciprocity. These findings are in line with the outcome of the IDT studies in autistic children and adolescents ( 3 , 4 ). Similarities in the ability of autistic and non-autistic adults were found in the ability to reciprocate in general (i.e., the quantity of reciprocal interactions irrespective of who initiated the drawing interaction) ( Table 5 ), and in “Turn-taking” and “Reciprocal flexibility.” These findings were in contrast with the outcome of the previous child and adolescent IDT studies and indicate that autistic adults might outperform autistic youngsters on more basic aspects of reciprocal behavior.…”

“…Age and verbal intelligence (measured with the PPVT) were not associated with reciprocal behavior within the adult groups ( Table 3 ), confirming our previous findings in the child and adolescent samples ( 3 , 4 ). Furthermore, even though autistic adults had a higher mean receptive verbal IQ than non-autistic participants, they did not perform better on the IDT even when controlling for verbal intelligence.…”

“…Scales 3 and 4 are considered to reflect more advanced levels of reciprocity, including the flexibility to deal with interfering or complex additions to one's drawing. The scale “Reciprocal interaction in the other's initiative” was the most sensitive outcome in previous studies with children and adolescents with ASD ( 3 , 4 ).…”

De IDT: een nieuwe, interactieve tekentest voor wederkerig gedrag bij kinderen met autisme

“…De IDT is afgenomen bij 225 kinderen en adolescenten met ASS en 109 kinderen en adolescenten met een normale ontwikkeling. Er zijn drie studies gedaan: 1) er is onderzoek gedaan naar de validiteit en betrouwbaarheid van de IDT, 2) er is onderzoek gedaan naar het effect van geslacht en een lichte verstandelijke beperking (lvb) op wederkerig gedrag (Backer van Ommeren et al 2012, 2017b, 2017c, en 3) er is een digitale versie van de IDT (DIDT) ontwikkeld en getest in een aparte onderzoeksgroep van 58 kinderen (6-13 jaar), waarvan 32 met en 26 zonder ASS.…”

“…met ASS en zonder ASSUit de totaalscores van de IDT blijken duidelijke verschillen in wederkerig gedrag tussen jeugdigen met en zonder ASS, ongeacht leeftijd, geslacht of intelligentie. Het gevoeligst voor ASS bleek schaal 3, 'Wederkerige interactie in initiatief ander'(Backer van Ommeren et al 2015;Backer van Ommeren et al 2017b, 2017c.…”