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A Comparison on How ASD and FASD Affect the Socialization of Children

Although Autism Spectrum Disorder (ASD) is characterized by difficulties in social interaction, ASD cannot solely be diagnosed on type and quality of social interaction, as children diagnosed with other disorders may also show similar difficulties socializing. Fetal Alcohol Spectrum Disorder (FASD) seen in children exposed to alcohol prenatally can cause difficulty in reading social cues, which may lead children with FASD to have trouble creating long-lasting social bonds with friends. Despite the difficulties that both ASD and FASD can create for children in social situations, it has been unclear how each disorder affects children’s social behaviors and if children experience the same behavioral changes with both ASD and FASD. 

In order to investigate the differences in how ASD and FASD affect children’s social behavior, 29 families of children with clinically diagnosed autism and 29 families of children with clinically diagnosed FASD took the Autism Diagnostic Interview‐Revised and a child assessment, including Differential Ability Scales (DAS), and The Autism Diagnostic Observation Schedule (ADOS) (Figure 1). These examinations detail different types of verbal and non-verbal actions from cues in different social situations, displaying how ASD and FASD individuals may act and react differently in the same environment. These examinations suggested that ASD individuals were more likely to show more behavioral abnormalities than FASD individuals in respect to communication and social domains. However, half of the children with ASD and FASD showed abnormalities in 11 out of the 36 behavior types examined. Furthermore, similar behaviors tied to difficulties in social awareness, cooperating and compromising with peers were observed in both groups at 50%. While both children with ASD and FASD demonstrated significant social difficulties (>50%), 68% of children with FASD demonstrated these social abnormalities while 100% of children with ASD demonstrated social abnormalities. However, because FASD can include very mild, non-neurological symptoms, it is possible that children who were observed to have less social abnormalities may have had lower morbidity on the FASD spectrum compared to ASD. 

Figure 1. ADOS Diagnostic Checklist

Although the observed quality of interaction between children and their peers with FASD and ASD were observed to be similar despite ASD presenting some additional behavior difficulties, children with FASD were observed to initiate social interactions more often than children with ASD. Due to the differences in social initiation, it could be suggested perhaps the additional behavioral abnormalities seen in individuals with ASD may make children feel additionally isolated, discouraging them from initiating social interactions with others. These key differences from FASD in certain behaviors particularly in communication may provide key insights into ASD and loneliness, and how to maximize interaction for children that desire to be more social.

Bishop, S., Gahagan, S., & Lord, C. (2007). Re‐examining the core features of autism: a comparison of autism spectrum disorder and fetal alcohol spectrum disorder. Journal of Child Psychology and Psychiatry, 48(11), 1111-1121.

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