Sage Journals: Discover world-class research

Abstract

High Functioning Autism Spectrum Disorder (HFASD) describes individuals who lack intellectual disability but show deficits in communication and social interaction. The double empathy problem (DEP) suggests that social miscommunication involves differences in communication and understanding emotions between individuals with and without autism. This qualitative study examines social difficulties faced by HFASD youths in Malaysia, gathering perspectives from the youths, parents, and experts. Interviews with 26 participants, including 13 HFASD youths, 7 parents, and 6 healthcare experts in Kuala Lumpur, reveal various insights. HFASD youths struggle with non-verbal cues, language barriers, and initiating conversations, with varying motivation levels. Parents highlight their children's rigid interests, insecurities, and lack of self-awareness. Healthcare experts stress deficiencies in perspective-taking and understanding pragmatics, noting high anxiety as a significant social barrier. Understanding these challenges from multiple perspectives can inform effective social skills interventions for HFASD youths.

Keywords

high functioning autism spectrum disorder social skills difficulties perspectives communication social interaction

Get full access to this article

View all access options for this article.

References

Ahmad Basri

M. A. F.

Wan Ismail

W. S.

Kamal Nor

Mohd Tohit

Ahmad

M. N.

Mohamad Aun

N. S.

Mohd Daud

T. I.

(2024). Validation of key components in designing a social skills training content using virtual reality for high functioning autism youth—A fuzzy delphi method. PLoS ONE, 19(4), e0301517. https://doi.org/10.1371/journal.pone.0301517

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Archibald

M. M.

Ambagtsheer

R. C.

Casey

M. G.

Lawless

(2019). Using Zoom videoconferencing for qualitative data collection: Perceptions and experiences of videoconferencing for qualitative data collection: Perceptions and experiences of researchers and participants. International Journal of Qualitative Methods, (18), 1–8. https://doi.org/10.1177/1609406919874596

Bal

V. H.

Farmer

Thurm

(2017). Describing function in ASD: Using the DSM-5 and other methods to improve precision. Journal of Autism and Developmental Disorders, 47(9), 2938–2941. https://doi.org/10.1007/s10803-017-3204-3

Baron-Cohen

(1997). Mindblindness: An essay on autism and theory of mind. MIT Press.

Baron-Cohen

Leslie

A. M.

Frith

(1985). Does the autistic child have a ‘theory of mind’? Cognition, 21(1), 37–46. https://doi.org/10.1016/0010-0277(85)90022-8

Beebe-Frankenberger

Lane

K. L.

Bocian

K. M.

Gresham

F. M.

MacMillan

D. L.

(2005). Students with or at risk for problem behavior: Betwixt and between teacher and parent expectations. Preventing School Failure: Alternative Education for Children and Youth, 49(2), 10–17. https://doi.org/10.3200/PSFL.49.2.10-17

Berenguer

Miranda

Colomer

Baixauli

Roselló

(2018). Contribution of theory of mind, executive functioning, and pragmatics to socialization behaviours of children with high-functioning autism. Journal of Autism and Developmental Disorders, 48(2), 430–441. https://doi.org/10.1007/s10803-017-3349-0

Berliner

D. C.

(2004). Describing the behavior and documenting the accomplishments of expert teachers. Bulletin of Science, Technology & Society, 24(3), 200–212. https://doi.org/10.1177/0270467604265535

10.

Blacher

Cohen

Azad

(2014). In the eye of the beholder: Reports of autism symptoms by anglo and latino mothers. Research in Autism Spectrum Disorders, 8(12), 1648–1656. https://doi.org/10.1016/j.rasd.2014.08.017

11.

Blais

Jack

R. E.

Scheepers

Fiset

Caldara

(2008). Culture shapes how we look at faces. PLoS ONE, 3(8), e3022. https://doi.org/10.1371/journal.pone.0003022

12.

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

13.

Cappiello

M. M.

Gahagan

(2009). Early child development and developmental delay in indigenous communities. Pediatric Clinics of North America, 56(6), 1501–1517. https://doi.org/10.1016/j.pcl.2009.09.017

14.

Cassidy

Bradley

Shaw

Baron-Cohen

(2018). Risk markers for suicidality in autistic adults. Molecular Autism, 9(1). https://doi.org/10.1186/s13229-018-0226-4

15.

Cassidy

S. A.

Gould

Townsend

Pelton

Robertson

A. E.

Rodgers

(2020). Is camouflaging autistic traits associated with suicidal thoughts and behaviours? Expanding the interpersonal psychological theory of suicide in an undergraduate student sample. Journal of Autism and Developmental Disorders, 50(10), 3638–3648. https://doi.org/10.1007/s10803-019-04323-3

16.

Cederlund

Hagberg

Gillberg

(2010). Asperger syndrome in adolescent and young adult males: Interview, self- and parent assessment of social, emotional, and cognitive problems. Research in Developmental Disabilities, 31(2), 287–298. https://doi.org/10.1016/j.ridd.2009.09.006

17.

Chevallier

Kohls

Troiani

Brodkin

E. S.

Schultz

R. T.

(2012). The social motivation theory of autism. Trends in Cognitive Sciences, 16(4), 231–239. https://doi.org/10.1016/j.tics.2012.02.007

18.

Conner

C. M.

White

S. W.

Scahill

Mazefsky

C. A.

(2020). The role of emotion regulation and core autism symptoms in the experience of anxiety in autism. Autism, 24(4), 931–940. https://doi.org/10.1177/1362361320904217

19.

Constantino

J. N.

Gruber

C. P.

(2012). Social Responsiveness Scale–Second Edition (SRS-2). WPS Publication.

20.

Creswell

J. W.

Creswell

J. D.

(2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Sage.

21.

Davis

Crompton

C. J.

(2021). What do new findings about social interaction in autistic adults mean for neurodevelopmental research? Perspectives on Psychological Science, 16(3), 649–653. https://doi.org/10.1177/1745691620958010

22.

De Leeuw

Happé

Hoekstra

R. A.

(2020). A conceptual framework for understanding the cultural and contextual factors on autism across the globe. Autism Research, 13(7), 1029–1050. https://doi.org/10.1002/aur.2276

23.

De Los Reyes

Lerner

M. D.

Thomas

S. A.

Daruwala

Goelep

(2013). Discrepancies between parent and adolescent beliefs about daily life topics and performance on an emotion recognition task. Journal of Abnormal Child Psychology, 41(6), 971–982. https://doi.org/10.1007/s10802-013-9733-0

24.

Dyches

T. T.

Wilder

L. K.

Sudweeks

R. R.

Obiakor

F. E.

Algozzine

(2004). Multicultural issues in autism. Journal of Autism and Developmental Disorders, 34(2), 211–222. https://doi.org/10.1023/b:jadd.0000022611.80478.73

25.

Factor

R. S.

Moody

C. T.

Sung

K. Y.

Laugeson

E. A.

(2022). Improving social anxiety and social responsiveness in autism spectrum disorder through PEERS®. Evidence-Based Practice in Child and Adolescent Mental Health, 7(1), 142–159. https://doi.org/10.1080/23794925.2021.2013138

26.

Frey

J. R.

Elliott

S. N.

Kaiser

A. P.

(2014). Social skills intervention planning for preschoolers: Using the SSiS-rating scales to identify target behaviors valued by parents and teachers. Assessment for Effective Intervention, 39(3), 182–192. https://psycnet.apa.org/doi/10.1177/1534508413488415 https://doi.org/10.1177/1534508413488415

27.

Goddard

Cook

(2022). “I spent most of freshers in my room”—A qualitative study of the social experiences of university students on the autistic spectrum. Journal of Autism and Developmental Disorders, 52(6), 2701–2716. https://doi.org/10.1007/s10803-021-05125-2

28.

Gurbuz

Hanley

Riby

D. M.

(2019). University students with autism: The social and academic experiences of university in the UK. Journal of Autism and Developmental Disorders, 49(2), 617–631. https://doi.org/10.1007/s10803-018-3741-4

29.

Heasman

Gillespie

(2018). Perspective-taking is two-sided: Misunderstandings between people with asperger’s syndrome and their family members. Autism, 22(6), 740–750. https://doi.org/10.1177/1362361317708287

30.

Hill

E. L.

(2004). Executive dysfunction in autism⋆. Trends in Cognitive Sciences, 8(1), 26–32. https://doi.org/10.1016/j.tics.2003.11.003

31.

Hong

DaWalt

L. S.

Taylor

J. L.

Haider

Mailick

(2023). Autism through midlife: Trajectories of symptoms, behavioral functioning, and health. Journal of Neurodevelopmental Disorders, 15(1). https://doi.org/10.1186/s11689-023-09505-w

32.

Kauley

John

Barr

W. T.

Grove

Masi

Eapen

(2024). Predicting communication skills outcomes for preschool children with autism spectrum disorder following early intervention. Neuropsychiatric Disease and Treatment, 20, 35–48. https://doi.org/10.2147/ndt.s435740

33.

Laugeson

(2013). The science of making friends: Helping socially challenged teens and young adults. John Wiley & Sons.

34.

Laugeson

E. A.

Ellingsen

Estabillo

J. A.

(2024). Social skills training for autistic adolescents and adults. In Adolescents and adults with autism spectrum disorders (2nd ed., pp. 75–101). https://doi.org/10.1007/978-3-031-46463-8_4

35.

Maddox

B. B.

Miyazaki

White

S. W.

(2017). Long-term effects of CBT on social impairment in adolescents with ASD. Journal of Autism and Developmental Disorders, 47(12), 3872–3882. https://doi.org/10.1007/s10803-016-2779-4

36.

Maskey

Lowry

Rodgers

McConachie

Parr

J. R.

(2014). Reducing specific phobia/fear in young people with autism spectrum disorders (ASDs) through a virtual reality environment intervention. PLoS ONE, 9(7), e100374. https://doi.org/10.1371/journal.pone.0100374

37.

Mazurek

M. O.

Kanne

S. M.

(2010). Friendship and internalizing symptoms among children and adolescents with ASD. Journal of Autism and Developmental Disorders, 40(12), 1512–1520. https://doi.org/10.1007/s10803-010-1014-y

38.

McMahon

C. M.

Lerner

M. D.

Britton

(2013). Group-based social skills interventions for adolescents with higher-functioning autism spectrum disorder: A review and looking to the future. Adolescent Health, Medicine and Therapeutics, 4, 23–28. https://doi.org/10.2147/AHMT.S25402

39.

McMahon

C. M.

Solomon

(2015). Brief report: Parent–adolescent informant discrepancies of social skill importance and social skill engagement for higher-functioning adolescents with autism Spectrum disorder. Journal of Autism and Developmental Disorders, 45(10), 3396–3403. https://doi.org/10.1007/s10803-015-2494-6

40.

Milton

D. E.

(2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887. https://doi.org/10.1080/09687599.2012.710008

41.

Milton

Gurbuz

López

(2022). The ‘double empathy problem’: Ten years on. Autism, 26(8), 1901–1903. https://doi.org/10.1177/13623613221129123

42.

Mitchell

Sheppard

Cassidy

(2021). Autism and the double empathy problem: Implications for development and mental health. British Journal of Developmental Psychology, 39(1), 1–18. https://doi.org/10.1111/bjdp.12350

43.

Murray

D. S.

Ruble

L. A.

Willis

Molloy

C. A.

(2009). Parent and teacher report of social skills in children with autism spectrum disorders. Language, Speech, and Hearing Services in Schools, 40(2), 109–115. https://doi.org/10.1044/0161-1461(2008/07-0089)

44.

Norbury

C. F.

Sparks

(2013). Difference or disorder? Cultural issues in understanding neurodevelopmental disorders. Developmental Psychology, 49(1), 45–58. https://doi.org/10.1037/a0027446

45.

Ohannessian

C. M.

De Los Reyes

(2014). Discrepancies in adolescents’ and their mothers’ perceptions of the family and adolescent anxiety symptomatology. Parenting, 14(1), 1–18. https://doi.org/10.1080/15295192.2014.870009

46.

Pellecchia

Connell

J. E.

Kerns

C. M.

Xie

Marcus

S. C.

Mandell

D. S.

(2016). Child characteristics associated with outcome for children with autism in a school-based behavioral intervention. Autism, 20(3), 321–329. https://doi.org/10.1177/1362361315577518

47.

Rankin

J. A.

Weber

R. J.

Kang

Lerner

M. D.

(2016). Parent- and self-reported social skills importance in autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(1), 273–286. https://doi.org/10.1007/s10803-015-2574-7

48.

Ritchie

Lewis

(2003). Qualitative research practice: A guide for social science students and researchers. Sage.

49.

Sasson

N. J.

Faso

D. J.

Nugent

Lovell

Kennedy

D. P.

Grossman

R. B.

(2017). Neurotypical peers are less willing to interact with those with autism based on thin Slice judgments. Scientific Reports, 7(1). https://doi.org/10.1038/srep40700

50.

Schilbach

(2016). Towards a second-person neuropsychiatry. Philosophical Transactions of the Royal Society B: Biological Sciences, 371(1686), 20150081. https://doi.org/10.1098/rstb.2015.0081

51.

Schiltz

H. K.

McVey

A. J.

Dolan Wozniak

Haendel

A. D.

Stanley

Arias

Gordon

Van Hecke

A. V.

(2021). The role of loneliness as a mediator between autism features and mental health among autistic young adults. Autism, 25(2), 545–555. https://doi.org/10.1177/1362361320967789

52.

Spain

Blainey

S. H.

Vaillancourt

(2017). Group cognitive behaviour therapy (CBT) for social interaction anxiety in adults with autism spectrum disorders (ASD). Research in Autism Spectrum Disorders, 41–42, 20–30. https://doi.org/10.1016/j.rasd.2017.07.005

53.

Spain

Happé

Johnston

Campbell

Sin

Daly

Ecker

Anson

Chaplin

Glaser

Mendez

Lovell

Murphy

D. G.

(2016). Social anxiety in adult males with autism spectrum disorders. Research in Autism Spectrum Disorders, 32, 13–23. https://doi.org/10.1016/j.rasd.2016.08.002

54.

Tantam

(2000). Psychological disorder in adolescents and adults with asperger syndrome. Autism, 4(1), 47–62. https://doi.org/10.1177/1362361300004001004

55.

Van Schalkwyk

Smith

I. C.

Silverman

W. K.

Volkmar

F. R.

(2018). Brief report: Bullying and anxiety in high-functioning adolescents with ASD. Journal of Autism and Developmental Disorders, 48(5), 1819–1824. https://doi.org/10.1007/s10803-017-3378-8

56.

Wright

M. F.

Wachs

(2019). Does peer rejection moderate the associations among cyberbullying victimization, depression, and anxiety among adolescents with autism spectrum disorder? Children, 6(3), 41. https://doi.org/10.3390/children6030041

57.

Yoon

C. D.

Terol

A. K.

Meadan

Lee

J. D.

(2024). Gaze behaviors and social communication skills of young autistic children: A scoping review. Review Journal of Autism and Developmental Disorders, 68(2). https://doi.org/10.1007/s40489-024-00438-1

Exploring Social Skills Difficulties of Youth with High Functioning Autism Spectrum Disorder (HFASD) in Malaysia: Comparison of Perspectives from Youth,Parents and Professionals

Abstract

Keywords

Get full access to this article

References