Executive Function and Social Cognition Performance Predicts Social Difficulty for Autistic Adults

There has been limited research aimed at understanding the cognitive features that predict outcomes in autistic adults. Difficulties in social cognition and executive function (EF) processes have been proposed as important cognitive components underlying social functioning outcomes. In this study, 305 autistic adults were administered a battery of social cognition, EF, and social functioning assessments to determine the degree to which social cognition and EF factors predicted outcomes. For social cognition, hierarchical regressions showed that EF explained neither theory of mind scores nor emotion recognition scores. We then ran several mediation models to determine whether EF explained social functioning independently of social cognition. These exploratory analyses show that poorer performance-based EF and social cognition both predicted more clinician-observed social challenges, while poorer self-reported EF and social cognition predicted more self-reported social challenges. Effects on outcomes were independent of each other. Our results highlight the potential of bot EF and social cognition measures to provide clinically meaningful markers for social functioning, but via separate pathways. This study supports the utility of targeting EF and social cognition processes in autistic adults in assessment and support pathways.