(PS2-65) IQ and childhood social/economic neighborhood opportunity are associated with adaptive functioning in autistic youth

Background

Adaptive behaviors (AB), skills aiding in independent functioning, are often impaired in autistic children. Lower IQ can lead to reduced AB in autistic youth, and lower socioeconomic status (SES) is linked with lower IQ and AB. Most studies capture family-level SES, rather than quantifying neighborhood-level social determinants of health (e.g. pollution, poverty rate). The Childhood Opportunity Index (COI) aggregates these determinants into place-based rankings of opportunity in US neighborhoods, based on neighborhood-level resources.

The COI comprises 44 indicators and three subdomains: education (ED), health and environment (HE), and social and economic (SE).

Examining the impact of neighborhood-level inequities may offer new approaches to understanding disparities that affect AB to improve quality of life and independent living skills into adulthood.

Objective

This study explores how COI 3.0 scores relate to AB among autistic youth, and whether IQ scores mediate this relationship.

Methods

The sample included 399 autistic individuals aged 4-21 years recruited from a specialty pediatric neuropsychology clinic in the Washington D.C. metropolitan area. Metro-Normed COI 3.0 total scores and subdomain scores (ED, HE, SE) were compiled for all participants using home addresses. Higher COI scores indicate greater opportunity ranking in relation to distribution of childhood opportunity across the US (i.e., higher availability of resources beneficial for a child’s development in that area).

Adaptive behavior was assessed using the Adaptive Behavior Assessment System or the Vineland Adaptive Behavior Scale. Full Scale IQ (FSIQ) scores were derived from Weschler intelligence tests. Mediation analyses were conducted to examine the effect of FSIQ scores on the relationship between COI scores (total score, ED, HE, SE subscores) and AB.

Results

FSIQ (M: 92.66, 34-153, SD: 20.61) was average; AB (M: 77.42, 41-120, SD: 11.57) was below average. Nearly half (48.7%) lived in high/very high opportunity neighborhoods, 22.1% lived in moderate opportunity neighborhoods, and 29.3% lived in very low/low opportunity neighborhoods.

Only the SE COI subdomain significantly predicted AB (β=0.113, p=0.023). Overall COI scores (β = 0.249, p < 0.001) and all three COI subdomains significantly predicted FSIQ scores (HE: β= 0.160, p < 0.001; SE: β=0.240, p < 0.001; ED: β=0.217, p< 0.001).

FSIQ (β= 0.353, p< 0.001) significantly predicted AB.

In mediation analyses, the indirect effect of the SE COI subdomain on AB through FSIQ was significant (β =0.0346, 95% CI [0.0195, 0.0527]), while the direct effect was non-significant (β =0.0128, 95% CI [-0.0270, 0.0526]). These findings suggest that FSIQ fully explains the relationship between social and economic factors and adaptive functioning in our sample.

Conclusion

This study echoes previous literature linking social/economic factors and FSIQ, and proposes FSIQ as a mechanism through which SE factors affect AB. The results point to a need to address how neighborhood-level social/economic capital, such as employment rates, housing resources, and friendship networks, affect FSIQ and subsequent AB development. Intervention targets can then be identified for autistic youth.