Age-related social communication decline in ASD?

How do the social skills of children with autism spectrum disorder (ASD) change over time? Previous research demonstrates mixed results on social skill stability, depending on what is measured, how, and with what tests. Some studies have found stability or improvement of social skills from early childhood through high school, while others have found decline across these years.
 
In this study of 324 children with autism spectrum disorders (ASD) and 438 typically-developing children (ages 4–29), data were collected from three sources:

  • Autism Diagnostic Interview—Revised (ADI-R), a “parent interview”
  • Autism Diagnostic Observation Schedule—2 (ADOS-2), a “semi-structured” observation
  • the Social Responsiveness Scale (SRS-2), an “informant report”

They found that, “...in parent-reported social–communicative functioning, children, adolescents, and young adults with ASD demonstrated a general pattern of age-related declines in these scores.” Now—could the social skills of children with ASD truly get worse over time? Possibly. However, we can’t quite jump to that conclusion. It could instead be that the older groups in the study had poorer access to early intervention. It could be that higher social expectations are put on older children, particularly in these tests. It could be that parents of typically-developing children over-estimate their child’s social skills, while parents of children with ASD under-estimate. It could be a combination of factors.
 
As clinicians, what this data does tell us is that we need to be particularly attentive to children’s with ASD's social–communicative skills as they grow older even if they’ve previously performed within normal limits (e.g. in the early elementary years). It’s not inconceivable that some of these children may need to come back onto our caseloads later.

Wallace, G.L., Dudley, K., Anthony, L., Pugliese, C.E., Orionzi, B., Clasen, L., ... Kenworthy, L. (2016). Divergence of age-related differences in social-communication: improvements for typically developing youth but declines for youth with autism spectrum disorder. Journal of Autism and Developmental Disorders. Epub ahead of print. doi:10.1007/s10803-016-2972-5.