Intelligence levels and autistic severity are important contributors of adaptive functioning and cognitive-adaptive functioning gaps in school-aged children with ASD

Intelligence levels and autistic severity are important contributors of adaptive functioning and cognitive-adaptive functioning gaps in school-aged children with ASD | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Intelligence levels and autistic severity are important contributors of adaptive functioning and cognitive-adaptive functioning gaps in school-aged children with ASD Wen-Yuan Jin, Chao Song, Yan-Yan Wang, Xiao-Lin Liu, Wen-Hao Li, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5771996/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Children with autism spectrum disorder (ASD) frequently presented weaker adaptive functioning compared with typically developing children. Multiple affecting factors of adaptive functioning in ASD individuals had been explored in previous studies. Methods Data of age, gender, parental education, place of residence, behavioral intervention, attention deficit hyperactivity disorder comorbidity, Wechsler Intelligence Scale for Children (WISC) scores and Autism Diagnostic Observation Schedule (ADOS) scores were collected in 107 school-aged children with ASD. Adaptive functioning of ASD subjects were evaluated through Adaptive Behavior Assessment System (ABAS). Spearman correlation analyses were applied to investigate the associations between intelligence quotient (IQ) scores, ASD related symptoms and adaptive functioning and cognitive-adaptive functioning gaps. Hierarchical regressions were performed in sequence to examine the effects of gender, age, parental education, intelligence, autistic severity and behavioral factors on General Adaptive Composite (GAC) in children with ASD. Results Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI) of WISC were positively correlated with Conceptual domain, Social domain and GAC ( P < 0.01). There were positive correlations between VCI, PRI and PSI and Practical domain ( P < 0.01). Positive associations were discovered between full-scale IQ (FSIQ) and the three domains and GAC in ABAS ( P < 0.01). Social Affect (SA), Restricted and Repetitive Behavior (RRB) and Total scores of ADOS were negatively correlated with Conceptual, Social and Practical domains ( P < 0.05). Comparison Scores were negatively correlated with Conceptual domain and Social domain ( P < 0.05). Negative correlations were found between SA, RRB, Total scores, Comparison Scores and GAC ( P < 0.05). VCI, PRI, WMI, PSI and FSIQ were positively correlated with FSIQ-Conceptual, FSIQ-Social, FSIQ-Practical and FSIQ-GAC gaps ( P < 0.01). SA was inversely correlated with FSIQ-Conceptual and FSIQ-Practical gaps ( P < 0.05). Total scores were inversely correlated with FSIQ-Conceptual, FSIQ-Practical and FSIQ-GAC gaps ( P < 0.05). FSIQ was positively correlated with GAC in the total model (β= 0.25, P = 0.015). There were significant inverse associations between RRB and GAC in the total model (β=−0.28, P = 0.014). Conclusions Intelligence levels and autistic severity were important contributors of adaptive functioning in school-aged children with ASD. IQ and ASD symptoms were also crucial factors affecting the cognitive-adaptive functioning gaps in ASD. Autism spectrum disorder Adaptive functioning Cognitive-adaptive functioning gap Intelligence quotient Autistic severity Background Adaptive functioning describes how well an individual manage the demands of daily life independently, including requirements in socialization, communication, home living, self-care, leisure and community participation [ 1 ]. Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by impaired social interaction, restricted and repetitive patterns of behaviors [ 2 ]. Children with ASD frequently display weak adaptive behavior functions compared with typically developing children [ 3 – 5 ]. Although some ASD individuals have high intelligence quotient (IQ) and gifted in reasoning and mechanical memory (especially for high-functioning ASD), they still have difficulties in developing their adaptive functioning. Previous research discovered significant discrepancies between IQ scores and adaptive functioning scores in children with ASD, particularly in those autistic individuals without intellectual disabilities [ 4 – 7 ]. The gap can be observed both in ASD males and females, starts from toddlerhood and persists into young adulthood [ 7 – 9 ]. This phenomenon suggests that autistic individuals have challenges in translating their intellectual potentials into capabilities of independent living. Several studies have explored underlying factors influencing adaptive functioning of children with ASD. It has been discovered that adaptive functioning is negatively associated with severity of autistic symptoms. That means more severe social deficits and repetitive stereotyped behaviors predict poorer adaptive functioning of ASD individuals [ 10 ]. However, a population-based cohort study investigated 421 preschool children with ASD, and revealed the cross-trajectory overlap between autistic symptom severity and adaptive functioning was relative low [ 11 ]. Another large cohort study surveyed 2538 school-aged children with ASD and discovered poor associations between adaptive behavior scores and ASD severity [ 12 ]. Research from Lee et al. [ 13 ] found different temperaments (‘even’ and ‘reacitve’) might influence the relationship between symptom severity and adaptive behavior functions as a mediator. IQ is another important determinant in the development of adaptive functioning for children with ASD. It has been reported that IQ scores are positively correlated with communication skills, social skills and global adaptive behaviors [ 3 , 10 ]. Worse intellectual performance, especially in verbal comprehension and working memory, significantly impacts adaptive functioning [ 14 ]. Additionally, evidence from previous studies convinced early intensive behavioral intervention (EIBI) effectively improved adaptive behavior skills in young ASD individuals, including daily living skills and motor skills [ 15 – 17 ]. If ASD coexisted with attention deficit hyperactivity disorder (ADHD), the symptoms of ADHD aggravated adaptive functioning impairments [ 18 – 19 ]. Furthermore, sex differences of adaptive behaviors were demonstrated in children with ASD. Two studies discovered females with ASD performed worse social functions, executive functions and daily living skills than male counterparts [ 20 – 21 ]. Socioeconomic status was found to be associated with domain-specific communication skills and global adaptive functioning when compared with basic demographic factors alone (such as age and gender) [ 22 ]. Additionally, psychiatric co-morbidities including depression and anxiety were negatively correlated with adaptive behavior functions in adults with ASD without intellectual disability [ 9 ]. Adaptive functioning is a critical determinant of outcomes in autistic children (i.e. academic performance, employment, self-care, prosocial behaviors and community integration in the adolescence and adulthood). Exploring influencing factors involving in the development of adaptive functioning is of great importance. Our study attempt to further investigate the roles of different influencing factors involve in the development of adaptive functioning in school-aged children with ASD. Methods Participants Between January 2019 and 2022, 107 school-aged outpatients (6-16 years old) visited the Department of Developmental Behavioral Pediatrics, Children’s Hospital, Zhejiang University School of Medicine and diagnosed with ASD were invited to participate in our study. Children with ASD were diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) results and determined by two professionally qualified developmental behavioral pediatricians. The exclusion criteria were consisted of congenital malformations, inherited metabolic diseases and special chromosome abnormalities. Information about age, gender, place of residence, grade, sibling, parental education background, behavioral intervention was collected through questionnaires. Our study was approved by our hospital’s Clinical Research Ethics Committee. Informed consents were acquired from parents or caregivers of every participant. Adaptive Behavior Assessment System, Second Edition Adaptive Behavior Assessment System, Second Edition (ABAS-II) was applied to comprehensively and psychometrically evaluate the adaptive behavior functions of children with ASD in our study. The standardized Chinese version of ABAS-II was comparable to the US version in reliability and validity. ABAS-II was comprised of a General Adaptive Composite (GAC) score, three domain scores (Conceptual, Social and Practical) and ten skill area scores (Communication, Functional Academics, Self-Direction, Social, Leisure, Community Use, Home Living, Health and Safety, Self-Care and Work) [23]. Since our participants were under 17 years old and did not have any work experience, Work skill score was not contained in our ABAS-II scale. The Conceptual domain included Communication, Functional Academics and Self-Direction; the Social domain included Social and Leisure; the Practical domain included Community Use, Home Living, Health and Safety and Self-Care. All the ABAS-II questionnaires were finished by parents or caregivers of the subjects. Autism Diagnostic Observation Schedule, Second Edition Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) was a semi-structured, standardized assessment of communication, social interaction, play/imaginative use of materials, and restricted and repetitive behaviors for individuals who were suspected of ASD. It provided examiners with opportunities to observe behaviors which were directly relevant to the diagnosis of ASD at different developmental levels and chronological ages. It had been regarded as a ‘gold standard’ assessment of ASD diagnosis across the world [24]. The Overall total score of ADOS-2 was the sum of two algorithm domains: Social Affect (SA) and Restricted and Repetitive Behavior (RRB). The SA domain included items pertaining to ‘Communication’ and ‘Reciprocal Social Interaction’, and the RRB domain included items pertaining to ‘Restricted and Repetitive Behaviors’. Comparison Scores in the ADOS-2 (obtained from Overall Total score and age) were applied to indicate the level of autism spectrum-related symptomatology when compared children with ASD of the same chronological age and language level. Comparison Scores ranged from 1 to 10. Comparion Scores in the 8-to-10 range indicated the individual displayed a high level of ASD related symptoms. Comparison Scores in the 5-to-7 range indicated the individual displayed a moderate level of ASD related symptoms. Comparion Scores in the 3-to-4 range indicated the individual showed a relatively low level of ASD related symptoms. Comparion Scores in the 1-to-2 range indicated the individual showed minimal-to-no evidence of ASD related symptoms. Wechsler Intelligence Scale for Children, Fourth Edition Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) was used to evaluate intellectual abilities of our participants. It was a widely applied measurement of IQ with good reliability and validity, which was consisted of four index scores: Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI). WISC-IV had ten core subtests and five supplemental subtests. The VCI contained Vocabulary, Similarity, Comprehension, Information and Word Reasoning subtests; the PRI contained Block Design, Picture Concept, Matrix Reasoning and Picture Completion subtests; the WMI contained Digit Span, Letter-Number Sequencing and Arithmetic subtests; the PSI contained Coding, Symbol Search and Cancellation subtests. Full-scale IQ (FSIQ) was calculated on the basis of VCI, PRI, WMI and PSI [25]. WISC-IV was conducted for every subject in our study by trained pediatricians. Statistical Analysis Characteristics such as age, gender, parental education, place of residence, behavioral factors, WISC-IV scores and ADOS-2 scores in our study were displayed as mean±SD, median (interquartile range, IQR) or N(%). Mann-Whitney U-test was used to explore the differences of adaptive functioning between male and female participants. Spearman correlation analyses were applied to investigate the associations between IQ scores (WISC-IV results), ASD related symptoms (ADOS-2 results) and adaptive functioning (ABAS-II results). Spearman correlation analyses were also used to investigate the associations between IQ, autistic symptoms and cognitive-adaptive functioning gaps. Hierarchical regressions were performed in sequence to examine the effects of gender, age, parental education, intelligence, ASD severity and behavioral factors on General Adaptive Composite (ABAS-II results) in children with ASD. All the analyses were performed through IBM SPSS statistics 25.0 version (SPSS Inc, Chicago, USA). P -values <0.05 were defined as statistically significant. Results Demographic characteristics of participants Table 1 presented basic demographic characteristics of our participants. The average age of participants was 7.45±1.28 years old. 86.0% of the ASD subjects were male. Majority (69.2%) of our subjects live in city. 65.4% of the fathers and 53.3% of the mothers received university or higher education. Approximately 20% of the fathers and mothers had an education background of high school or even lower. More than half (57.9%) of our ASD subjects were complicated with ADHD. However, only 31.8% of our participants had a record of EIBI. Most of the EIBI persisted less than two years. The highest FSIQ in subjects with ASD was 146 and the lowest FSIQ was 49. Subjects with ASD had advantages in PRI with median (IQR) score at 98 (82-108). But they had disadvantages in VCI with median (IQR) score at 81 (72-99). The median (IQR) of SA and RRB scores in ADOS-2 were respectively 10 (8-12) and 2 (1-3). The median (IQR) of Comparison Score was 6 (4-8). Table 1 Demographic characteristics of participants Characteristics Mean±SD or Median(IQR) or N(%) Age 7.45±1.28 Gender Male 92 (86.0%) Female 15 (14.0%) Place of residence City 74 (69.2%) Town/Country 33 (30.8%) Paternal education ≥University 70 (65.4%) Junior college 16 (15.0%) High school 12 (11.2%) ≤Junior school 9 (8.4%) Maternal education ≥University 57 (53.3%) Junior college 30 (28.0%) High school 11 (10.3%) ≤Junior school 9 (8.4%) Siblings None 57 (53.3%) One or more 50 (46.7%) Complicated with ADHD Yes 62 (57.9%) No 45 (42.1%) EIBI Yes 34 (31.8%) No 73 (68.2%) WISC-IV VCI 81 (72-99) PRI 98 (82-108) WMI 88 (77-97) PSI 86 (74-98) FSIQ 84 (74-99) ADOS-2 SA 10 (8-12) RRB 2 (1-3) Total Score 12 (9-14) Comparison Score 6 (4-8) ADHD , attention deficit hyperactivity disorder; EIBI , early intensive behavioral intervention; VCI , Verbal Comprehension Index; PRI , Perceptual Reasoning Index; WMI , Working Memory Index; PSI , Processing Speed Index; FSIQ , Full-scale intelligence quotient; ADOS-2 , Autism Diagnostic Observation Schedule, Second Edition; SA , Social Affect; RRB , Restricted and Repetitive Behavior. Adaptive functioning profile of children with ASD Table 2 demonstrated adaptive functioning profile of children with ASD and compared the differences between male and female subjects. The median (IQR) GAC of our subjects was 82 (74-96). Children with ASD obtained the lowest scores in Social and Self-Direction, and obtained the highest score in Community Use. Among the three domains, children with ASD had the lowest score in Social domain and the highest score in Practical domain. Boys were characterized with better performance in Community Use than girls ( P =0.021). However, there were no significant differences between male and female ASD individuals in other adaptive behavior skills. There were no remarkable sexual difference in the three domains, either. Table 2 Adaptive functioning profile of children with ASD Adaptive functioning Total Male Female Male vs. Female P value Communication 8 (6-9) 8 (6-9) 6 (4-9) 0.178 Functional Academics 8 (6-10) 8 (7-10) 8 (5-9) 0.054 Self-Direction 6 (5-8) 6 (5-8) 6 (4-7) 0.251 Social 5 (4-8) 5 (4-8) 6 (4-8) 0.606 Leisure 7 (5-9) 7 (5-9) 7 (4-9) 0.554 Community Use 9 (6-11) 9 (6-12) 7 (6-8) 0.021* Home Living 8 (6-10) 8 (6-10) 8 (6-9) 0.314 Health and Safety 8 (6-10) 8 (6-11) 8 (6-10) 0.486 Self-Care 7 (5-9) 7 (5-9) 7 (5-8) 0.661 Conceptual domain 83 (75-94) 83 (77-96) 81 (70-85) 0.079 Social domain 77 (65-89) 77 (65-89) 77 (65-93) 0.993 Practical domain 87 (79-98) 88 (79-102) 85 (78-91) 0.245 GAC 82 (74-96) 82 (74-98) 81 (71-87) 0.258 * P <0.05, ** P <0.01. GAC , General Adaptive Composite. Associations between intelligence, ASD severity and adaptive functioning in children with ASD Table 3 showed associations between intelligence levels and adaptive functioning in children with ASD. VCI, PRI, WMI and PSI of WISC-IV were positively correlated with Conceptual domain, Social domain and GAC ( P <0.01). There were positive correlations between VCI, PRI and PSI of WISC-IV and Practical domain ( P <0.01). WMI had weak association with Practical domain without statistical significance. Furthermore, positive associations were discovered between FSIQ and Conceptual domain, Social domain, Practical domain and GAC ( P <0.01). Table 3 Associations between intelligence levels and adaptive functioning in children with ASD IQ Conceptual domain Social domain Practical domain GAC VCI 0.394** 0.371** 0.255** 0.342** PRI 0.439** 0.334** 0.315** 0.372** WMI 0.352** 0.308** 0.172 0.280** PSI 0.379** 0.436** 0.305** 0.369** FSIQ 0.464** 0.414** 0.297** 0.395** * P <0.05, ** P <0.01. IQ , intelligence quotient; VCI , Verbal Comprehension Index; PRI , Perceptual Reasoning Index; WMI , Working Memory Index; PSI , Processing Speed Index; FSIQ , Full-scale intelligence quotient; GAC , General Adaptive Composite. Table 4 displayed associations between ADOS-2 scores and adaptive functioning in children with ASD. SA scores, RRB scores and Total scores of ADOS-2 were negatively correlated with Conceptual, Social and Practical domain ( P <0.05). Comparison Scores of ADOS-2 were negatively correlated with Conceptual domain and Social domain except for Practical domain ( P <0.05). In addition, negative correlations were found between SA, RRB, Total scores and Comparison Scores of ADOS-2 and GAC ( P <0.05). Table 4 Associations between ADOS-2 scores and adaptive functioning in children with ASD ADOS-2 Conceptual domain Social domain Practical domain GAC SA -0.297** -0.348** -0.215* -0.290** RRB -0.335** -0.314** -0.293** -0.308** Total Score -0.366** -0.399** -0.289** -0.350** Comparison Score -0.228* -0.261** -0.183 -0.218* * P <0.05, ** P <0.01. ADOS-2 , Autism Diagnostic Observation Schedule, Second Edition; SA , Social Affect; RRB , Restricted and Repetitive Behavior; GAC , General Adaptive Composite. Associations between IQ, ADOS-2 scores and cognitive-adaptive functioning gaps in children with ASD Table 5 demonstrated associations between IQ and cognitive-adaptive functioning gaps in children with ASD. VCI, PRI, WMI and PSI of WISC-IV were positively correlated with FSIQ-Conceptual skills, FSIQ-Social skills, FSIQ-Practical skills and FSIQ-GAC gaps ( P <0.01). Besides, FSIQ itself was positively associated with cognitive-adaptive functioning gaps ( P <0.01). These outcomes reflected that cognitive-adaptive functioning gaps gradually increased with the elevation of IQ. Table 5 Associations between IQ and cognitive-adaptive functioning gaps in children with ASD IQ FSIQ-Conceptual FSIQ-Social FSIQ-Practical FSIQ-GAC VCI 0.658** 0.575** 0.663** 0.642** PRI 0.585** 0.580** 0.604** 0.578** WMI 0.542** 0.518** 0.592** 0.549** PSI 0.509** 0.388** 0.493** 0.467** FSIQ 0.712** 0.647** 0.732** 0.700** * P <0.05, ** P <0.01. IQ , intelligence quotient; VCI , Verbal Comprehension Index; PRI , Perceptual Reasoning Index; WMI , Working Memory Index; PSI , Processing Speed Index; FSIQ , Full-scale intelligence quotient; GAC , General Adaptive Composite. Table 6 showed associations between ADOS-2 scores and cognitive-adaptive functioning gaps in children with ASD. SA of ADOS-2 was inversely correlated with FSIQ-Conceptual skills and FSIQ-Practical skills gaps ( P <0.05). Total scores of ADOS-2 were inversely correlated with FSIQ-Conceptual skills, FSIQ-Practical skills and FSIQ-GAC gaps ( P <0.05). These results indicated that cognitive-adaptive functioning gaps gradually decreased with the exacerbation of autistic severity. Table 6 Associations between ADOS-2 scores and cognitive-adaptive functioning gaps in children with ASD ADOS-2 FSIQ-Conceptual FSIQ-Social FSIQ-Practical FSIQ-GAC SA -0.203* -0.097 -0.233* -0.184 RRB -0.079 -0.093 -0.106 -0.093 Total Score -0.206* -0.119 -0.235* -0.194* Comparison Score -0.147 -0.065 -0.164 -0.128 * P <0.05, ** P <0.01. ADOS-2 , Autism Diagnostic Observation Schedule, Second Edition; SA , Social Affect; RRB , Restricted and Repetitive Behavior; FSIQ , Full-scale intelligence quotient; GAC , General Adaptive Composite. Effects of demographic characteristics, intelligence, ASD severity and behavioral factors on adaptive functioning in children with ASD Table 7 presented effects of gender, parental education, intelligence, ASD severity and behavioral factors on overall adaptive functioning (GAC) in children with ASD. Demographic characteristics including gender, age, paternal education and maternal education did not have significant associations with GAC in step 1, step 2, step 3 and the total model (all P >0.05). FSIQ was an important contributor to overall adaptive functioning in step 2 (β= 0.38 , P <0.001), step 3 (β= 0.25, P =0.014) and the total model (β= 0.25, P =0.015), which indicated that FSIQ was positively correlated with GAC. There were significant inverse associations between RRB and GAC in step 3 (β= -0.27, P =0.017) and the total model (β= -0.28, P =0.014). However, behavioral factors including ADHD complication and EIBI did not have significant correlations with GAC in the total model (all P >0.05). Table 7 Effects of demographic characteristics, intelligence, ASD severity and behavioral factors on overall adaptive functioning in children with ASD B SE β t P Step 1 Gender -5.22 3.86 -0.13 -1.35 0.179 Age 1.06 1.07 0.10 0.99 0.327 Paternal education -2.70 1.89 -0.20 -1.43 0.155 Maternal education 1.10 1.98 0.08 0.56 0.580 Step 2 Gender -4.52 3.59 -0.11 -1.26 0.211 Age 0.88 1.00 0.08 0.88 0.379 Paternal education -1.20 1.79 -0.09 -0.67 0.504 Maternal education 0.34 1.85 0.02 0.19 0.853 FSIQ 0.28 0.07 0.38 4.16 0.000 Step 3 Gender -3.50 3.65 -0.09 -0.96 0.340 Age 0.72 1.00 0.07 0.72 0.475 Paternal education -1.53 1.77 -0.11 -0.86 0.391 Maternal education 0.25 1.81 0.02 0.14 0.891 FSIQ 0.18 0.07 0.25 2.50 0.014 SA -1.12 0.76 -0.23 -1.47 0.144 RRB -3.18 1.31 -0.27 -2.43 0.017 Comparison Score 1.49 1.66 0.15 0.90 0.372 Step 4 - Total model Gender -3.58 3.68 -0.09 -0.97 0.334 Age 0.71 1.01 0.07 0.70 0.486 Paternal education -1.65 1.80 -0.12 -0.92 0.362 Maternal education 0.39 1.85 0.03 0.21 0.834 FSIQ 0.19 0.08 0.25 2.47 0.015 SA -1.14 0.78 -0.23 -1.47 0.146 RRB -3.33 1.34 -0.28 -2.50 0.014 Comparison Score 1.61 1.69 0.17 0.95 0.344 Complicated with ADHD -1.91 2.51 -0.07 -0.76 0.450 EIBI -0.05 2.78 0.00 -0.02 0.987 Hierarchical regressions were performed in sequence to examine the effects of demographic characteristics, intelligence, ASD severity and behavioral factors on General Adaptive Composite. FSIQ , Full-scale intelligence quotient; SA , Social Affect; RRB , Restricted and Repetitive Behavior; ADHD , attention deficit hyperactivity disorder; EIBI , early intensive behavioral intervention. Additionally, we explored the effects of demographic characteristics, intelligence, ASD severity and behavioral factors on Conceptual, Social and Practical domain. In the total model, FSIQ had a positive correlation with Conceptual domain (β= 0.34, P =0.001), whereas RRB had a negative correlation with Conceptual domain (β= -0.26, P =0.016). There was a positive correlation between FSIQ and Social domain (β= 0.23, P =0.024), but a negative correlation between RRB and Social domain (β= -0.23, P =0.047). Moreover, there was an inverse correlation between RRB and Practical domain (β= -0.35, P =0.004). Discussion Adaptive functioning of ASD subjects were affected by multiple factors in previous studies. Our study discovered intelligence levels and severity of autistic symptoms were important contributors to adaptive functioning of children with ASD, whether ASD subjects complicated with or without intellectual disabilities. There existed significantly positive correlations between intelligence levels (including verbal comprehension, perceptual reasoning, working memory, processing speed and FSIQ) and adaptive functioning (including Conceptual domain, Social domain, Practical domain and GAC). Whereas remarkably negative correlations were found between severity of autistic symptoms (including social deficits and repetitive stereotyped behaviors) and adaptive functioning. These discoveries were consistent with the findings of previous studies and provided convincing evidence supporting them [ 3 , 10 – 14 ]. It was worth noting that past studies mostly applied Vinland Adaptive Behavior Scales (VABS) as the assessment tool of adaptive functioning [ 11 – 14 ]. We drew the same conclusions using ABAS as the assessment tool. As we all knew, both VABS and ABAS were extensively used scales for evaluating adaptive behaviors of children with ASD. They had different emphases and presented strengths and weaknesses of children with ASD in different fields [ 26 ]. Our study further confirmed the strong relationships between intelligence, autistic symptoms and adaptive functioning of ASD individuals. Additionally, we found cognitive-adaptive functioning gaps were influenced by intelligence levels and autistic severity. The gaps between IQ and adaptive behaviors were positively associated with cognitive abilities, but inversely associated with ASD severity in our study. Previous research found the discrepancies existed both in ASD males and females, started from toddlerhood and persisted into young adulthood [ 7 – 9 ]. Our results discovered the gaps between IQ and adaptive functioning in children with ASD, which were in accord with previous studies. We further explored the underlying influencing factors of cognitive-adaptive functioning gaps, which was a noteworthy highlight of our study. Our study found the discrepancies between cognitive abilities and adaptive functioning gradually enlarged with the increase of IQ, implying children with ASD had difficulties in transforming their intelligence into adaptive functioning. Social deficits and repetitive stereotyped behaviors hindered the development of daily living skills, both in autistic children with or without intellectual disabilities. For those high-functioning autistic individuals, the development of adaptive functioning was seriously affected by emotions. It has been revealed that the gaps between intelligence and adaptive behaviors in autism persisted to young adulthood was linked to psychiatric co-morbidities, including anxiety and depression [ 9 ]. In a recent study, reduced executive functions were discovered to be consistently correlated with a greater cognitive-adaptive gaps in socialization domains for both preschool and school-aged autistic children [ 27 ]. Moreover, cognitive-adaptive functioning gaps gradually narrowed with the exacerbation of social-communication symptoms in our study, suggesting children with severe autistic symptoms always performed weak cognitive abilities and adaptive functioning. Severe social deficits and repetitive stereotyped behaviors also hampered the development of intellectual abilities to some extent. In the research of Tillmann J et al. [ 28 ], higher IQ scores and heavier social-communication symptoms were associated with greater IQ-adaptive functioning gaps. By contrast, sensory ASD symptoms, ADHD symptoms and psychiatric co-morbidities including anxiety and depression were not associated with IQ-adaptive functioning discrepancies. These findings suggested more studies concerning the underlying influencing factors of cognitive-adaptive functioning gaps were needed in the future. There were still some controversial consequences in our research. Evidence from previous studies revealed that EIBI could effectively promote the development of adaptive behavior skills for ASD individuals [ 15 – 17 ]. But our results did not provide sufficient evidence supporting the viewpoint. Lack of long-term, sustained and effective interventions was speculated to be the predominant reason leading to the inconsistent conclusion. Unfortunately, most of our subjects received intermittent professional interventions less than two years, which was frequently restricted to limited parental awareness of ASD and heavy financial burdens of ASD family [ 29 – 30 ]. It has been reported that ADHD coexistence aggravated the impairments in adaptive functioning of ASD individuals [ 18 – 19 , 31 ]. Our study verified the executive function deficits of ASD combined with ADHD subjects, for they presented weaker performance in working memory and processing speed than ASD subjects without ADHD. But the differences did not reach statistical significance. As well, we did not find significant differences of adaptive functioning in ASD accompanied by ADHD or not. It has been debated in literature that the attentional impairment reported among autistic children might be a distinct characteristic of ASD—joint attention deficit, rather than an ADHD attention deficit [ 32 – 33 ]. Attention deficits in ASD was prone to be the “not listening” and “difficulty shifting focus” type than the “short attention span” and “excessive distractibility” type [ 32 ]. There was a possibility that some children diagnosed with ASD and ADHD did not really have ADHD. Whether ADHD coexistence aggravated the impairments of adaptive functioning in ASD still deserve further study and discussion. Furthermore, sexual differences of adaptive functioning were investigated in our study. There were no significant differences in adaptive functioning except for community use between male and female ASD subjects in the present study. Results of hierarchical regressions showed gender was not a predominant contributor to overall adaptive functioning in ASD. Whereas White EI et al. [ 21 ] reported that females with ASD performed relative worse executive functions and daily living skills than male counterparts. Mahendiran T et al. [ 20 ] found female ASD individuals obtained lower scores compared to males in communication, leisure and social skill areas at older ages, despite females performing better at younger ages. It was speculated that sexual differences of adaptive functioning in ASD individuals might be affected by complicated confounding factors, such as age and early developmental trajectories. There existed some limitations that could not be ignored in our study. Firstly, our sample size was not big enough. Given the huge population gross of China, a multicenter study with larger sample size could be more representative. Secondly, the amount of female ASD subjects was limited in our study. Although the prevalence of ASD was significantly higher in boys than in girls, we still need a sex-matched study to better analyse other potential affecting factors. Thirdly, ABAS-II questionnaire was self-reported in our study. We could not rule out the possibility of reporting bias. Our findings were vulnerable to over-evaluation of adaptive behavior scores, as the caregivers of ASD subjects were more likely to report what they could perform, rather than what they did perform independently without support. Fourthly, emotion regulation was a crucial mediating factor which always affected adaptive functioning of children with ASD. It has been discovered that psychiatric complications such as depression and anxiety were negatively correlated with adaptive behavior skills in young adulthood with ASD [ 9 ]. Adding emotion-related scales into our study would be helpful for further investigating multiple influencing factors of adaptive functioning. Conclusions Intelligence levels and autistic severity were important contributors to adaptive functioning of school-aged children with ASD. IQ and ASD symptoms were also crucial factors affecting the cognitive-adaptive functioning gaps in ASD. Adaptive functioning was a determinant of long-term outcomes for autistic children. Exploring influencing factors of adaptive functioning was of great importance to improve quality of life for ASD individuals. Abbreviations ABAS-II - Adaptive Behavior Assessment System, Second Edition ADHD - attention deficit hyperactivity disorder ADOS-2 - Autism Diagnostic Observation Schedule, Second Edition ASD - autism spectrum disorder DSM-5 - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition EIBI - early intensive behavioral intervention FSIQ - full-scale intelligence quotient GAC - General Adaptive Composite IQ - intelligence quotient IQR - interquartile range PRI - Perceptual Reasoning Index PSI - Processing Speed Index RRB - Restricted and Repetitive Behavior SA - Social Affect VABS - Vinland Adaptive Behavior Scales VCI - Verbal Comprehension Index WISC-IV - Wechsler Intelligence Scale for Children, Fourth Edition WMI - Working Memory Index Declarations Acknowledgements We are grateful for all the researchers from Department of Developmental Behavioral Pediatrics, Children’s Hospital, Zhejiang University School of Medicine in the data acquisition. We also thankful to all the subjects for their participation in our study. Authors’ contributions JWY participated in study design, data acquisition, literature review and manuscript writing. SC participated in study design, data acquisition and literature review. WYY, LXL and LWH participated in data collection and statistical analysis. WLL and ZZW participated in study design and funds collection. All the authors read and approved the final manuscript. Funding This study was funded by the Natural Science Foundation of Zhejiang Province (LGF20H090015). Availability of data and materials The raw data generated and analyzed in this study are not publically available due to the appropriate protection of the personal protection of children and adolescents but are available from the corresponding authors on a reasonable request. Clinical trial number Not applicable. Ethics approval and consent to participate Our research was conducted in accordance with the Declaration of Helsinki. Our study was approved by Clinical Research Ethics Committee of Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health (No. 2022-IRB-099). Informed consents were acquired from parents or caregivers of every participant. Consent for publication Not applicable. Competing interests The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. References Chandler S, Carter Leno V, White P, Yorke I, Hollocks MJ, Baird G, et al. Pathways to adaptive functioning in autism from early childhood to adolescence. Autism Res. 2022;15:1883-93. doi: 10.1002/aur.2785. Hodges H, Fealko C, Soares N. Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr. 2020;9(Suppl 1):S55-S65. doi: 10.21037/tp.2019.09.09. Jin WY, Wu LL, Hu LF, Li WH, Song C, Wang YY, et al. 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Developmental trajectories of symptom severity and adaptive functioning in an inception cohort of preschool children with autism spectrum disorder. JAMA Psychiatry. 2015;72:276-83. doi: 10.1001/jamapsychiatry.2014.2463. Pathak M, Bennett A, Shui AM. Correlates of adaptive behavior profiles in a large cohort of children with autism: The autism speaks Autism Treatment Network registry data. Autism. 2019;23:87-99. doi: 10.1177/1362361317733113. Lee V, Duku E, Zwaigenbaum L, Bennett T, Szatmari P, Elsabbagh M, et al. Temperament influences the relationship between symptom severity and adaptive functioning in children with autism spectrum disorder. Autism. 2020;24:2057-70. doi: 10.1177/1362361320933048. Rosa M, Puig O, Lázaro L, Vallés V, Lera S, Sánchez-Gistau V, et al. Broad Cognitive Profile in Children and Adolescents with HF-ASD and in Their Siblings: Widespread Underperformance and its Clinical and Adaptive Correlates. J Autism Dev Disord. 2017;47:2153-62. doi: 10.1007/s10803-017-3137-x. Reichow B, Hume K, Barton EE, Boyd BA. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2018;5:CD009260. doi: 10.1002/14651858.CD009260.pub3. Daniolou S, Pandis N, Znoj H. The Efficacy of Early Interventions for Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. J Clin Med. 2022;11:5100. doi: 10.3390/jcm11175100. MacDonald R, Parry-Cruwys D, Dupere S, Ahearn W. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism. Res Dev Disabil. 2014;35:3632-44. doi: 10.1016/j.ridd.2014.08.036. Liu Y, Wang L, Xie S, Pan S, Zhao J, Zou M, et al. Attention Deficit/Hyperactivity Disorder Symptoms Impair Adaptive and Social Function in Children With Autism Spectrum Disorder. Front Psychiatry. 2021;12:654485. doi: 10.3389/fpsyt.2021.654485. Yerys BE, Bertollo JR, Pandey J, Guy L, Schultz RT. Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated With Lower Adaptive Behavior Skills in Children With Autism. J Am Acad Child Adolesc Psychiatry. 2019;58:525-33.e3. doi: 10.1016/j.jaac.2018.08.017. Mahendiran T, Dupuis A, Crosbie J, Georgiades S, Kelley E, Liu X, et al. Sex Differences in Social Adaptive Function in Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder. Front Psychiatry. 2019;10:607. doi: 10.3389/fpsyt.2019.00607. White EI, Wallace GL, Bascom J, Armour AC, Register-Brown K, Popal HS, et al. Sex differences in parent-reported executive functioning and adaptive behavior in children and young adults with autism spectrum disorder. Autism Res. 2017;10:1653-62. doi: 10.1002/aur.1811. Hodge MA, Boulton KA, Sutherland R, Barnett D, Bennett B, Chan E, et al. Predictors of adaptive functioning in preschool aged children with autism spectrum disorder. Autism Res. 2021;14:1444-55. doi: 10.1002/aur.2501. Harrison PL, Oakland T. Adaptive behavior assessment system, second edition. San Antonio, TX: Harcourt Assessment, Inc (2003). Lord C, Rutter M, DiLavore PC, et al. Autism Diagnostic Observation Schedule Manual-2. Los Angeles, CA: Western Psychological Services (2012) . Wechsler D. The Wechsler Intelligence Scale for Children-Fourth Edition. San Antonio, TX: The Psychological Corporation (2003). Tamm L, Day HA, Duncan A. Comparison of Adaptive Functioning Measures in Adolescents with Autism Spectrum Disorder Without Intellectual Disability. J Autism Dev Disord. 2022;52:1247-56. doi: 10.1007/s10803-021-05013-9. Braverman Y, Edmunds SR, Hastedt I, Faja S. Mind the Gap: Executive Function Is Associated with the Discrepancy Between Cognitive and Adaptive Functioning in Autistic Children Without Cognitive Delay. J Autism Dev Disord. 2024 May 23. doi: 10.1007/s10803-024-06354-x. Tillmann J, San José Cáceres A, Chatham CH, Crawley D, Holt R, Oakley B, et al. Investigating the factors underlying adaptive functioning in autism in the EU-AIMS Longitudinal European Autism Project. Autism Res. 2019;12:645-57. doi: 10.1002/aur.2081. Horlin C, Falkmer M, Parsons R, Albrecht MA, Falkmer T. The cost of autism spectrum disorders. PLoS One. 2014;9:e106552. doi: 10.1371/journal.pone.0106552. Singh JKA, Ling WH, Sivanesom RS, Huay CCS, Lan ACS. Age at autism spectrum disorder diagnosis and its association with child and family characteristics in a tertiary care hospital in Malaysia. Autism Res. 2024;17:637-49. doi: 10.1002/aur.3106. Chandler S, Carter Leno V, White P, Yorke I, Hollocks MJ, Baird G, et al. Pathways to adaptive functioning in autism from early childhood to adolescence. Autism Res. 2022;15:1883-93. doi: 10.1002/aur.2785. Hours C, Recasens C, Baleyte JM. ASD and ADHD Comorbidity: What Are We Talking About? Front Psychiatry. 2022:13:837424. doi: 10.3389/fpsyt.2022.837424. Gargaro BA, Rinehart NJ, Bradshaw JL, Tonge BJ, Sheppard DM. Autism and ADHD: how far have we come in the comorbidity debate? Neurosci Biobehav Rev. 2011;35:1081-8. doi: 10.1016/j.neubiorev.2010.11.002. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5771996","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":399907266,"identity":"cc9236d9-2376-4933-9a24-cf5812b87e02","order_by":0,"name":"Wen-Yuan Jin","email":"","orcid":"","institution":"Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Wen-Yuan","middleName":"","lastName":"Jin","suffix":""},{"id":399907267,"identity":"bad54f32-4c42-447c-ada0-085985841b0c","order_by":1,"name":"Chao Song","email":"","orcid":"","institution":"Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Chao","middleName":"","lastName":"Song","suffix":""},{"id":399907268,"identity":"fc7085c3-a705-47c5-bbac-b0e53eda33ec","order_by":2,"name":"Yan-Yan Wang","email":"","orcid":"","institution":"Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Yan-Yan","middleName":"","lastName":"Wang","suffix":""},{"id":399907269,"identity":"a062ccc3-3a17-43f5-ad54-ef70c9ccba01","order_by":3,"name":"Xiao-Lin Liu","email":"","orcid":"","institution":"Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Xiao-Lin","middleName":"","lastName":"Liu","suffix":""},{"id":399907270,"identity":"a2ec745d-121c-46a9-91b3-f27cbf85cee9","order_by":4,"name":"Wen-Hao Li","email":"","orcid":"","institution":"Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Wen-Hao","middleName":"","lastName":"Li","suffix":""},{"id":399907271,"identity":"a2ed596d-a348-4c89-9f53-5aebebe26563","order_by":5,"name":"Ling-Ling Wu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzUlEQVRIiWNgGAWjYDACCQYzIGkhw8/AkABkMBOtRYJHsoFkLQYHwFwitPDPbt72uLBNgsf4/IFnEgwV1okN7GcP4LfkzrFy45lALWYHDqRJMJxJT2zgyUvAq8VAIsdMmncbUMvBhjQJxrbDiQ1ARxKnxbiZAajlHylaDNhAWhqI0CJxIw3ol38SPBJnGJItEo6lG7fx5ODXwj8jedvjgjM2cvz9ZxJvfKixlu1nP4NfCwhA44InARyZbATVI7SwHyBG8SgYBaNgFIxAAAB1OjwDj6XFCgAAAABJRU5ErkJggg==","orcid":"","institution":"Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":true,"prefix":"","firstName":"Ling-Ling","middleName":"","lastName":"Wu","suffix":""},{"id":399907272,"identity":"ac6675de-9159-4b18-89e8-85ddc8280fec","order_by":6,"name":"Zhi-Wei Zhu","email":"","orcid":"","institution":"Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health","correspondingAuthor":false,"prefix":"","firstName":"Zhi-Wei","middleName":"","lastName":"Zhu","suffix":""}],"badges":[],"createdAt":"2025-01-06 08:23:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5771996/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5771996/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":73656085,"identity":"ba06c889-7751-4672-bf70-5e394ea528d1","added_by":"auto","created_at":"2025-01-13 10:23:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1540921,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5771996/v1/eeb58da3-3c1d-4ed4-8166-2355a0102278.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Intelligence levels and autistic severity are important contributors of adaptive functioning and cognitive-adaptive functioning gaps in school-aged children with ASD","fulltext":[{"header":"Background","content":"\u003cp\u003eAdaptive functioning describes how well an individual manage the demands of daily life independently, including requirements in socialization, communication, home living, self-care, leisure and community participation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by impaired social interaction, restricted and repetitive patterns of behaviors [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Children with ASD frequently display weak adaptive behavior functions compared with typically developing children [\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Although some ASD individuals have high intelligence quotient (IQ) and gifted in reasoning and mechanical memory (especially for high-functioning ASD), they still have difficulties in developing their adaptive functioning. Previous research discovered significant discrepancies between IQ scores and adaptive functioning scores in children with ASD, particularly in those autistic individuals without intellectual disabilities [\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The gap can be observed both in ASD males and females, starts from toddlerhood and persists into young adulthood [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. This phenomenon suggests that autistic individuals have challenges in translating their intellectual potentials into capabilities of independent living.\u003c/p\u003e \u003cp\u003eSeveral studies have explored underlying factors influencing adaptive functioning of children with ASD. It has been discovered that adaptive functioning is negatively associated with severity of autistic symptoms. That means more severe social deficits and repetitive stereotyped behaviors predict poorer adaptive functioning of ASD individuals [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. However, a population-based cohort study investigated 421 preschool children with ASD, and revealed the cross-trajectory overlap between autistic symptom severity and adaptive functioning was relative low [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Another large cohort study surveyed 2538 school-aged children with ASD and discovered poor associations between adaptive behavior scores and ASD severity [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Research from Lee et al. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] found different temperaments (\u0026lsquo;even\u0026rsquo; and \u0026lsquo;reacitve\u0026rsquo;) might influence the relationship between symptom severity and adaptive behavior functions as a mediator. IQ is another important determinant in the development of adaptive functioning for children with ASD. It has been reported that IQ scores are positively correlated with communication skills, social skills and global adaptive behaviors [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Worse intellectual performance, especially in verbal comprehension and working memory, significantly impacts adaptive functioning [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Additionally, evidence from previous studies convinced early intensive behavioral intervention (EIBI) effectively improved adaptive behavior skills in young ASD individuals, including daily living skills and motor skills [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. If ASD coexisted with attention deficit hyperactivity disorder (ADHD), the symptoms of ADHD aggravated adaptive functioning impairments [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Furthermore, sex differences of adaptive behaviors were demonstrated in children with ASD. Two studies discovered females with ASD performed worse social functions, executive functions and daily living skills than male counterparts [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Socioeconomic status was found to be associated with domain-specific communication skills and global adaptive functioning when compared with basic demographic factors alone (such as age and gender) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Additionally, psychiatric co-morbidities including depression and anxiety were negatively correlated with adaptive behavior functions in adults with ASD without intellectual disability [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdaptive functioning is a critical determinant of outcomes in autistic children (i.e. academic performance, employment, self-care, prosocial behaviors and community integration in the adolescence and adulthood). Exploring influencing factors involving in the development of adaptive functioning is of great importance. Our study attempt to further investigate the roles of different influencing factors involve in the development of adaptive functioning in school-aged children with ASD.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBetween January 2019 and 2022, 107 school-aged outpatients (6-16 years old) visited the Department of Developmental Behavioral Pediatrics, Children\u0026rsquo;s Hospital, Zhejiang University School of Medicine and diagnosed with ASD were invited to participate in our study. Children with ASD were diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) results and determined by two professionally qualified developmental behavioral pediatricians. The exclusion criteria were consisted of congenital malformations, inherited metabolic diseases and special chromosome abnormalities. Information about age, gender, place of residence, grade, sibling, parental education background, behavioral intervention was collected through questionnaires. Our study was approved by our hospital\u0026rsquo;s Clinical Research Ethics Committee. Informed consents were acquired from parents or caregivers of every participant. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdaptive Behavior Assessment System, Second Edition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdaptive Behavior Assessment System, Second Edition (ABAS-II) was applied to comprehensively and psychometrically evaluate the adaptive behavior functions of children with ASD in our study. The standardized Chinese version of ABAS-II was comparable to the US version in reliability and validity. ABAS-II was comprised of a General Adaptive Composite (GAC) score, three domain scores (Conceptual, Social and Practical) and ten skill area scores (Communication, Functional Academics, Self-Direction, Social, Leisure, Community Use, Home Living, Health and Safety, Self-Care and Work) [23]. Since our participants were under 17 years old and did not have any work experience, Work skill score was not contained in our ABAS-II scale. The Conceptual domain included Communication, Functional Academics and Self-Direction; the Social domain included Social and Leisure; the Practical domain included Community Use, Home Living, Health and Safety and Self-Care. All the ABAS-II questionnaires were finished by parents or caregivers of the subjects.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAutism Diagnostic Observation Schedule, Second Edition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAutism Diagnostic Observation Schedule, Second Edition (ADOS-2) was a semi-structured, standardized assessment of communication, social interaction, play/imaginative use of materials, and restricted and repetitive behaviors for individuals who were suspected of ASD. It provided examiners with opportunities to observe behaviors which were directly relevant to the diagnosis of ASD at different developmental levels and chronological ages. It had been regarded as a \u0026lsquo;gold standard\u0026rsquo; assessment of ASD diagnosis across the world [24]. The Overall total score of ADOS-2 was the sum of two algorithm domains: Social Affect (SA) and Restricted and Repetitive Behavior (RRB). The SA domain included items pertaining to \u0026lsquo;Communication\u0026rsquo; and \u0026lsquo;Reciprocal Social Interaction\u0026rsquo;, and the RRB domain included items pertaining to \u0026lsquo;Restricted and Repetitive Behaviors\u0026rsquo;. Comparison Scores in the ADOS-2 (obtained from Overall Total score and age) were applied to indicate the level of autism spectrum-related symptomatology when compared children with ASD of the same chronological age and language level. Comparison Scores ranged from 1 to 10. Comparion Scores in the 8-to-10 range indicated the individual displayed a high level of ASD related symptoms. Comparison Scores in the 5-to-7 range indicated the individual displayed a moderate level of ASD related symptoms. Comparion Scores in the 3-to-4 range indicated the individual showed a relatively low level of ASD related symptoms. Comparion Scores in the 1-to-2 range indicated the individual showed minimal-to-no evidence of ASD related symptoms. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWechsler Intelligence Scale for Children, Fourth Edition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) was used to evaluate intellectual abilities of our participants. It was a widely applied measurement of IQ with good reliability and validity, which was consisted of four index scores: Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI). WISC-IV had ten core subtests and five supplemental subtests. The VCI contained Vocabulary, Similarity, Comprehension, Information and Word Reasoning subtests; the PRI contained Block Design, Picture Concept, Matrix Reasoning and Picture Completion subtests; the WMI contained Digit Span, Letter-Number Sequencing and Arithmetic subtests; the PSI contained Coding, Symbol Search and Cancellation subtests. Full-scale IQ (FSIQ) was calculated on the basis of VCI, PRI, WMI and PSI [25]. WISC-IV was conducted for every subject in our study by trained pediatricians. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCharacteristics such as age, gender, parental education, place of residence, behavioral factors, WISC-IV scores and ADOS-2 scores in our study were displayed as mean\u0026plusmn;SD, median (interquartile range,\u0026nbsp;IQR) or N(%). Mann-Whitney U-test was used to explore the differences of adaptive functioning between male and female participants. Spearman correlation analyses were applied to investigate the associations between IQ scores (WISC-IV results), ASD related symptoms (ADOS-2 results) and adaptive functioning (ABAS-II results). Spearman correlation analyses were also used to investigate the associations between IQ, autistic symptoms and cognitive-adaptive functioning gaps. Hierarchical regressions were performed in sequence to examine the effects of gender, age, parental education, intelligence, ASD severity and behavioral factors on General Adaptive Composite (ABAS-II results) in children with ASD. All the analyses were performed through IBM SPSS statistics 25.0 version (SPSS Inc, Chicago, USA). \u003cem\u003eP\u003c/em\u003e-values \u0026lt;0.05 were defined as statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eDemographic characteristics of participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003epresented basic demographic characteristics of our participants. The average age of participants was 7.45\u0026plusmn;1.28 years old. 86.0% of the ASD subjects were male. Majority (69.2%) of our subjects live in city. 65.4% of the fathers and 53.3% of the mothers received university or higher education. Approximately 20% of the fathers and mothers had an education background of high school or even lower. More than half (57.9%) of our ASD subjects were complicated with ADHD. However, only 31.8% of our participants had a record of EIBI. Most of the EIBI persisted less than two years. The highest FSIQ in subjects with ASD was 146 and the lowest FSIQ was 49. Subjects with ASD had advantages in PRI with median (IQR) score at 98 (82-108). But they had disadvantages in VCI with median (IQR) score at 81 (72-99). The median (IQR) of SA and RRB scores in ADOS-2 were respectively 10 (8-12) and 2 (1-3). The median (IQR) of Comparison Score was 6 (4-8). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1 Demographic characteristics of participants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"352\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u0026plusmn;SD or Median(IQR) or N(%)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e7.45\u0026plusmn;1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e92 (86.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e15 (14.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eCity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e74 (69.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eTown/Country\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e33 (30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternal education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026ge;University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e70 (65.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eJunior college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e16 (15.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e12 (11.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026le;Junior school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e9 (8.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026ge;University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e57 (53.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eJunior college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e30 (28.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e11 (10.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u0026le;Junior school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e9 (8.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSiblings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e57 (53.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eOne or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e50 (46.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComplicated with ADHD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e62 (57.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e45 (42.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEIBI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e34 (31.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e73 (68.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWISC-IV\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eVCI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e81 (72-99)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003ePRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e98 (82-108)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eWMI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e88 (77-97)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003ePSI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e86 (74-98)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eFSIQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e84 (74-99)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eADOS-2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e10 (8-12)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eRRB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e2 (1-3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eTotal Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e12 (9-14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003eComparison Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 158px;\"\u003e\n \u003cp\u003e6 (4-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003cem\u003eADHD\u003c/em\u003e, attention deficit hyperactivity disorder; \u003cem\u003eEIBI\u003c/em\u003e, early intensive behavioral intervention; \u003cem\u003eVCI\u003c/em\u003e, Verbal Comprehension Index; \u003cem\u003ePRI\u003c/em\u003e, Perceptual Reasoning Index; \u003cem\u003eWMI\u003c/em\u003e, Working Memory Index; \u003cem\u003ePSI\u003c/em\u003e, Processing Speed Index; \u003cem\u003eFSIQ\u003c/em\u003e, Full-scale intelligence quotient; \u003cem\u003eADOS-2\u003c/em\u003e, Autism Diagnostic Observation Schedule, Second Edition; \u003cem\u003eSA\u003c/em\u003e, Social Affect; \u003cem\u003eRRB\u003c/em\u003e, Restricted and Repetitive Behavior.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdaptive functioning profile of children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e demonstrated adaptive functioning profile of children with ASD and compared the differences between male and female subjects. The median (IQR) GAC of our subjects was 82 (74-96). Children with ASD obtained the lowest scores in Social and Self-Direction, and obtained the highest score in Community Use. Among the three domains, children with ASD had the lowest score in Social domain and the highest score in Practical domain. Boys were characterized with better performance in Community Use than girls (\u003cem\u003eP\u003c/em\u003e=0.021). However, there were no significant differences between male and female ASD individuals in other adaptive behavior skills. There were no remarkable sexual difference in the three domains, either. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Adaptive functioning profile of children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"628\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdaptive functioning\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale vs. Female\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eCommunication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (4-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.178\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eFunctional Academics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (7-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (5-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSelf-Direction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (5-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (5-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (4-7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.251\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSocial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (4-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e5 (4-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e6 (4-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eLeisure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (5-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (5-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (4-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.554\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eCommunity Use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e9 (6-11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e9 (6-12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (6-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.021*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eHome Living\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.314\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eHealth and Safety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e8 (6-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSelf-Care\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (5-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (5-9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e7 (5-8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.661\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eConceptual domain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e83 (75-94)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e83 (77-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e81 (70-85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eSocial domain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e77 (65-89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e77 (65-89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e77 (65-93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.993\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003ePractical domain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e87 (79-98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e88 (79-102)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e85 (78-91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.245\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eGAC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e82 (74-96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e82 (74-98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e81 (71-87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 147px;\"\u003e\n \u003cp\u003e0.258\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05, **\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01. \u003cem\u003eGAC\u003c/em\u003e, General Adaptive Composite.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssociations between intelligence, ASD severity and adaptive functioning in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u003c/strong\u003e showed associations between intelligence levels and adaptive functioning in children with ASD. VCI, PRI, WMI and PSI of WISC-IV were positively correlated with Conceptual domain, Social domain and GAC (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01). There were positive correlations between VCI, PRI and PSI of WISC-IV and Practical domain (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01). WMI had weak association with Practical domain without statistical significance. Furthermore, positive associations were discovered between FSIQ and Conceptual domain, Social domain, Practical domain and GAC (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Associations between intelligence levels and adaptive functioning in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"650\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIQ\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConceptual domain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003edomain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractical domain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGAC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.394**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.371**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.255**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.342**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePRI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.439**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.334**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.315**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.372**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWMI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.352**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.308**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.280**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePSI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.379**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.436**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.305**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.369**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.464**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.414**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.297**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 149px;\"\u003e\n \u003cp\u003e0.395**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05, **\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01. \u003cem\u003eIQ\u003c/em\u003e, intelligence quotient; \u003cem\u003eVCI\u003c/em\u003e, Verbal Comprehension Index; \u003cem\u003ePRI\u003c/em\u003e, Perceptual Reasoning Index; \u003cem\u003eWMI\u003c/em\u003e, Working Memory Index; \u003cem\u003ePSI\u003c/em\u003e, Processing Speed Index; \u003cem\u003eFSIQ\u003c/em\u003e, Full-scale intelligence quotient; \u003cem\u003eGAC\u003c/em\u003e, General Adaptive Composite. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u003c/strong\u003e displayed associations between ADOS-2 scores and adaptive functioning in children with ASD. SA scores, RRB scores and Total scores of ADOS-2 were negatively correlated with Conceptual, Social and Practical domain (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). Comparison Scores of ADOS-2 were negatively correlated with Conceptual domain and Social domain except for Practical domain (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). In addition, negative correlations were found between SA, RRB, Total scores and Comparison Scores of ADOS-2 and GAC (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Associations between ADOS-2 scores and adaptive functioning in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"659\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eADOS-2\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConceptual domain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003edomain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractical domain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGAC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.297**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.348**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.215*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.290**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRRB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.335**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.314**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.293**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.308**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.366**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.399**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.289**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.350**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComparison Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.228*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.261**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.183\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e-0.218*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05, **\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01. \u003cem\u003eADOS-2\u003c/em\u003e, Autism Diagnostic Observation Schedule, Second Edition; \u003cem\u003eSA\u003c/em\u003e, Social Affect; \u003cem\u003eRRB\u003c/em\u003e, Restricted and Repetitive Behavior; \u003cem\u003eGAC\u003c/em\u003e, General Adaptive Composite.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssociations between IQ, ADOS-2 scores and cognitive-adaptive functioning gaps in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5\u0026nbsp;\u003c/strong\u003edemonstrated associations between IQ and cognitive-adaptive functioning gaps in children with ASD. VCI, PRI, WMI and PSI of WISC-IV were positively correlated with FSIQ-Conceptual skills, FSIQ-Social skills, FSIQ-Practical skills and FSIQ-GAC gaps (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01). Besides, FSIQ itself was positively associated with cognitive-adaptive functioning gaps (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01). These outcomes reflected that cognitive-adaptive functioning gaps gradually increased with the elevation of IQ.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Associations between IQ and cognitive-adaptive functioning gaps in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"670\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIQ\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-Conceptual\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-Social\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-Practical\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-GAC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.658**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.575**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.663**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.642**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePRI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.585**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.580**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.604**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.578**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWMI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.542**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.518**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.592**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.549**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePSI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.509**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.388**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.493**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.467**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.712**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.647**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.732**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e0.700**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05, **\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01. \u003cem\u003eIQ\u003c/em\u003e, intelligence quotient; \u003cem\u003eVCI\u003c/em\u003e, Verbal Comprehension Index; \u003cem\u003ePRI\u003c/em\u003e, Perceptual Reasoning Index; \u003cem\u003eWMI\u003c/em\u003e, Working Memory Index; \u003cem\u003ePSI\u003c/em\u003e, Processing Speed Index; \u003cem\u003eFSIQ\u003c/em\u003e, Full-scale intelligence quotient; \u003cem\u003eGAC\u003c/em\u003e, General Adaptive Composite. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6\u003c/strong\u003e showed associations between ADOS-2 scores and cognitive-adaptive functioning gaps in children with ASD. SA of ADOS-2 was inversely correlated with FSIQ-Conceptual skills and FSIQ-Practical skills gaps (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). Total scores of ADOS-2 were inversely correlated with FSIQ-Conceptual skills, FSIQ-Practical skills and FSIQ-GAC gaps (\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05). These results indicated that cognitive-adaptive functioning gaps gradually decreased with the exacerbation of autistic severity. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Associations between ADOS-2 scores and cognitive-adaptive functioning gaps in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"706\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eADOS-2\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-Conceptual\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-Social\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-Practical\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFSIQ-GAC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSA\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.203*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.233*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.184\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRRB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.206*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.235*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.194*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComparison Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.065\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e-0.128\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eP\u003c/em\u003e\u0026lt;0.05, **\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01. \u003cem\u003eADOS-2\u003c/em\u003e, Autism Diagnostic Observation Schedule, Second Edition; \u003cem\u003eSA\u003c/em\u003e, Social Affect; \u003cem\u003eRRB\u003c/em\u003e, Restricted and Repetitive Behavior; \u003cem\u003eFSIQ\u003c/em\u003e, Full-scale intelligence quotient; \u003cem\u003eGAC\u003c/em\u003e, General Adaptive Composite.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEffects of demographic characteristics, intelligence, ASD severity and behavioral factors on adaptive functioning in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7\u0026nbsp;\u003c/strong\u003epresented effects of gender, parental education, intelligence, ASD severity and behavioral factors on overall adaptive functioning (GAC) in children with ASD. Demographic characteristics including gender, age, paternal education and maternal education did not have significant associations with GAC in step 1, step 2, step 3 and the total model (all \u003cem\u003eP\u003c/em\u003e\u0026gt;0.05). FSIQ was an important contributor to overall adaptive functioning in step 2 (\u0026beta;= 0.38\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cem\u003eP\u003c/em\u003e\u0026lt;0.001), step 3 (\u0026beta;= 0.25, \u003cem\u003eP\u003c/em\u003e=0.014) and the total model (\u0026beta;= 0.25, \u003cem\u003eP\u003c/em\u003e=0.015), which indicated that FSIQ was positively correlated with GAC. There were significant inverse associations between RRB and GAC in step 3 (\u0026beta;= -0.27, \u003cem\u003eP\u003c/em\u003e=0.017) and the total model (\u0026beta;= -0.28, \u003cem\u003eP\u003c/em\u003e=0.014). However, behavioral factors including ADHD complication and EIBI did not have significant correlations with GAC in the total model (all \u003cem\u003eP\u003c/em\u003e\u0026gt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7 Effects of demographic characteristics, intelligence, ASD severity and behavioral factors on overall adaptive functioning in children with ASD\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"642\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSE\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStep 1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-5.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.327\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003ePaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-2.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStep 2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-4.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e3.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.379\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003ePaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.504\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.853\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eFSIQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e4.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStep 3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-3.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e3.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.340\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.475\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003ePaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.391\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.891\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eFSIQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.144\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eRRB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-3.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-2.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eComparison Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.372\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStep 4 - Total model\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-3.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e3.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003ePaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.362\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eMaternal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.834\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eFSIQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.146\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eRRB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-2.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eComparison Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.344\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eComplicated with ADHD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.450\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 248px;\"\u003e\n \u003cp\u003eEIBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e-0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.987\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eHierarchical regressions were performed in sequence to examine the effects of demographic characteristics, intelligence, ASD severity and behavioral factors on General Adaptive Composite.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFSIQ\u003c/em\u003e, Full-scale intelligence quotient;\u003cem\u003e\u0026nbsp;SA\u003c/em\u003e, Social Affect; \u003cem\u003eRRB\u003c/em\u003e, Restricted and Repetitive Behavior; \u003cem\u003eADHD\u003c/em\u003e, attention deficit hyperactivity disorder; \u003cem\u003eEIBI\u003c/em\u003e, early intensive behavioral intervention.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAdditionally, we explored the effects of demographic characteristics, intelligence, ASD severity and behavioral factors on Conceptual, Social and Practical domain. In the total model, FSIQ had a positive correlation with Conceptual domain (\u0026beta;= 0.34, \u003cem\u003eP\u003c/em\u003e=0.001), whereas RRB had a negative correlation with Conceptual domain (\u0026beta;= -0.26, \u003cem\u003eP\u003c/em\u003e=0.016). There was a positive correlation between FSIQ and Social domain (\u0026beta;= 0.23, \u003cem\u003eP\u003c/em\u003e=0.024), but a negative correlation between RRB and Social domain (\u0026beta;= -0.23, \u003cem\u003eP\u003c/em\u003e=0.047). Moreover, there was an inverse correlation between RRB and Practical domain (\u0026beta;= -0.35, \u003cem\u003eP\u003c/em\u003e=0.004).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAdaptive functioning of ASD subjects were affected by multiple factors in previous studies. Our study discovered intelligence levels and severity of autistic symptoms were important contributors to adaptive functioning of children with ASD, whether ASD subjects complicated with or without intellectual disabilities. There existed significantly positive correlations between intelligence levels (including verbal comprehension, perceptual reasoning, working memory, processing speed and FSIQ) and adaptive functioning (including Conceptual domain, Social domain, Practical domain and GAC). Whereas remarkably negative correlations were found between severity of autistic symptoms (including social deficits and repetitive stereotyped behaviors) and adaptive functioning. These discoveries were consistent with the findings of previous studies and provided convincing evidence supporting them [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR11 CR12 CR13\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. It was worth noting that past studies mostly applied Vinland Adaptive Behavior Scales (VABS) as the assessment tool of adaptive functioning [\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. We drew the same conclusions using ABAS as the assessment tool. As we all knew, both VABS and ABAS were extensively used scales for evaluating adaptive behaviors of children with ASD. They had different emphases and presented strengths and weaknesses of children with ASD in different fields [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Our study further confirmed the strong relationships between intelligence, autistic symptoms and adaptive functioning of ASD individuals.\u003c/p\u003e \u003cp\u003eAdditionally, we found cognitive-adaptive functioning gaps were influenced by intelligence levels and autistic severity. The gaps between IQ and adaptive behaviors were positively associated with cognitive abilities, but inversely associated with ASD severity in our study. Previous research found the discrepancies existed both in ASD males and females, started from toddlerhood and persisted into young adulthood [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Our results discovered the gaps between IQ and adaptive functioning in children with ASD, which were in accord with previous studies. We further explored the underlying influencing factors of cognitive-adaptive functioning gaps, which was a noteworthy highlight of our study. Our study found the discrepancies between cognitive abilities and adaptive functioning gradually enlarged with the increase of IQ, implying children with ASD had difficulties in transforming their intelligence into adaptive functioning. Social deficits and repetitive stereotyped behaviors hindered the development of daily living skills, both in autistic children with or without intellectual disabilities. For those high-functioning autistic individuals, the development of adaptive functioning was seriously affected by emotions. It has been revealed that the gaps between intelligence and adaptive behaviors in autism persisted to young adulthood was linked to psychiatric co-morbidities, including anxiety and depression [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. In a recent study, reduced executive functions were discovered to be consistently correlated with a greater cognitive-adaptive gaps in socialization domains for both preschool and school-aged autistic children [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Moreover, cognitive-adaptive functioning gaps gradually narrowed with the exacerbation of social-communication symptoms in our study, suggesting children with severe autistic symptoms always performed weak cognitive abilities and adaptive functioning. Severe social deficits and repetitive stereotyped behaviors also hampered the development of intellectual abilities to some extent. In the research of Tillmann J et al. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], higher IQ scores and heavier social-communication symptoms were associated with greater IQ-adaptive functioning gaps. By contrast, sensory ASD symptoms, ADHD symptoms and psychiatric co-morbidities including anxiety and depression were not associated with IQ-adaptive functioning discrepancies. These findings suggested more studies concerning the underlying influencing factors of cognitive-adaptive functioning gaps were needed in the future.\u003c/p\u003e \u003cp\u003eThere were still some controversial consequences in our research. Evidence from previous studies revealed that EIBI could effectively promote the development of adaptive behavior skills for ASD individuals [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. But our results did not provide sufficient evidence supporting the viewpoint. Lack of long-term, sustained and effective interventions was speculated to be the predominant reason leading to the inconsistent conclusion. Unfortunately, most of our subjects received intermittent professional interventions less than two years, which was frequently restricted to limited parental awareness of ASD and heavy financial burdens of ASD family [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. It has been reported that ADHD coexistence aggravated the impairments in adaptive functioning of ASD individuals [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Our study verified the executive function deficits of ASD combined with ADHD subjects, for they presented weaker performance in working memory and processing speed than ASD subjects without ADHD. But the differences did not reach statistical significance. As well, we did not find significant differences of adaptive functioning in ASD accompanied by ADHD or not. It has been debated in literature that the attentional impairment reported among autistic children might be a distinct characteristic of ASD\u0026mdash;joint attention deficit, rather than an ADHD attention deficit [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Attention deficits in ASD was prone to be the \u0026ldquo;not listening\u0026rdquo; and \u0026ldquo;difficulty shifting focus\u0026rdquo; type than the \u0026ldquo;short attention span\u0026rdquo; and \u0026ldquo;excessive distractibility\u0026rdquo; type [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. There was a possibility that some children diagnosed with ASD and ADHD did not really have ADHD. Whether ADHD coexistence aggravated the impairments of adaptive functioning in ASD still deserve further study and discussion. Furthermore, sexual differences of adaptive functioning were investigated in our study. There were no significant differences in adaptive functioning except for community use between male and female ASD subjects in the present study. Results of hierarchical regressions showed gender was not a predominant contributor to overall adaptive functioning in ASD. Whereas White EI et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] reported that females with ASD performed relative worse executive functions and daily living skills than male counterparts. Mahendiran T et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] found female ASD individuals obtained lower scores compared to males in communication, leisure and social skill areas at older ages, despite females performing better at younger ages. It was speculated that sexual differences of adaptive functioning in ASD individuals might be affected by complicated confounding factors, such as age and early developmental trajectories.\u003c/p\u003e \u003cp\u003eThere existed some limitations that could not be ignored in our study. Firstly, our sample size was not big enough. Given the huge population gross of China, a multicenter study with larger sample size could be more representative. Secondly, the amount of female ASD subjects was limited in our study. Although the prevalence of ASD was significantly higher in boys than in girls, we still need a sex-matched study to better analyse other potential affecting factors. Thirdly, ABAS-II questionnaire was self-reported in our study. We could not rule out the possibility of reporting bias. Our findings were vulnerable to over-evaluation of adaptive behavior scores, as the caregivers of ASD subjects were more likely to report what they could perform, rather than what they did perform independently without support. Fourthly, emotion regulation was a crucial mediating factor which always affected adaptive functioning of children with ASD. It has been discovered that psychiatric complications such as depression and anxiety were negatively correlated with adaptive behavior skills in young adulthood with ASD [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Adding emotion-related scales into our study would be helpful for further investigating multiple influencing factors of adaptive functioning.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIntelligence levels and autistic severity were important contributors to adaptive functioning of school-aged children with ASD. IQ and ASD symptoms were also crucial factors affecting the cognitive-adaptive functioning gaps in ASD. Adaptive functioning was a determinant of long-term outcomes for autistic children. Exploring influencing factors of adaptive functioning was of great importance to improve quality of life for ASD individuals.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eABAS-II -\u0026nbsp;Adaptive Behavior Assessment System, Second Edition\u003c/p\u003e\n\u003cp\u003eADHD -\u0026nbsp;attention deficit hyperactivity disorder\u003c/p\u003e\n\u003cp\u003eADOS-2 -\u0026nbsp;Autism Diagnostic Observation Schedule, Second Edition\u003c/p\u003e\n\u003cp\u003eASD - autism spectrum disorder\u003c/p\u003e\n\u003cp\u003eDSM-5 - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition\u003c/p\u003e\n\u003cp\u003eEIBI - early intensive behavioral intervention\u003c/p\u003e\n\u003cp\u003eFSIQ - full-scale\u0026nbsp;intelligence quotient\u003c/p\u003e\n\u003cp\u003eGAC -\u0026nbsp;General Adaptive Composite\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIQ - intelligence quotient\u003c/p\u003e\n\u003cp\u003eIQR - interquartile range\u003c/p\u003e\n\u003cp\u003ePRI -\u0026nbsp;Perceptual Reasoning Index\u003c/p\u003e\n\u003cp\u003ePSI -\u0026nbsp;Processing Speed Index\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRRB -\u0026nbsp;Restricted and Repetitive Behavior\u003c/p\u003e\n\u003cp\u003eSA -\u0026nbsp;Social Affect\u003c/p\u003e\n\u003cp\u003eVABS -\u0026nbsp;Vinland Adaptive Behavior Scales\u003c/p\u003e\n\u003cp\u003eVCI -\u0026nbsp;Verbal Comprehension Index\u003c/p\u003e\n\u003cp\u003eWISC-IV -\u0026nbsp;Wechsler Intelligence Scale for Children, Fourth Edition\u003c/p\u003e\n\u003cp\u003eWMI - Working Memory Index\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful for all the researchers from Department of Developmental Behavioral Pediatrics, Children\u0026rsquo;s Hospital, Zhejiang University School of Medicine in the data acquisition. We also thankful to all the subjects for their participation in our study. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJWY participated in study design, data acquisition, literature review and manuscript writing. SC participated in study design, data acquisition and literature review. WYY, LXL and LWH participated in data collection and statistical analysis. WLL and ZZW participated in study design and funds collection. All the authors read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Natural Science Foundation of Zhejiang Province (LGF20H090015).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe raw data generated and analyzed in this study are not publically available due to the appropriate protection of the personal protection of children and adolescents but are available from the corresponding authors on a reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur research was conducted in accordance with the Declaration of Helsinki. Our study was approved by Clinical Research Ethics Committee of Children\u0026rsquo;s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health (No. 2022-IRB-099). Informed consents were acquired from parents or caregivers of every participant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eChandler S, Carter Leno V, White P, Yorke I, Hollocks MJ, Baird G, et al. 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Front Psychiatry. 2019;10:607. doi: 10.3389/fpsyt.2019.00607.\u003c/li\u003e\n \u003cli\u003eWhite EI, Wallace GL, Bascom J, Armour AC, Register-Brown K, Popal HS,\u0026nbsp;et al. Sex differences in parent-reported executive functioning and adaptive behavior in children and young adults with autism spectrum disorder. Autism Res. 2017;10:1653-62. doi: 10.1002/aur.1811.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eHodge MA, Boulton KA, Sutherland R, Barnett D, Bennett B, Chan E, et al. Predictors of adaptive functioning in preschool aged children with autism spectrum disorder. Autism Res. 2021;14:1444-55. doi: 10.1002/aur.2501.\u003c/li\u003e\n \u003cli\u003eHarrison PL, Oakland T. Adaptive behavior assessment system, second edition. San Antonio, TX: Harcourt Assessment, Inc (2003).\u003c/li\u003e\n \u003cli\u003eLord C, Rutter M, DiLavore PC, et al. Autism Diagnostic Observation Schedule Manual-2. 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Investigating the factors underlying adaptive functioning in autism in the EU-AIMS Longitudinal European Autism Project. Autism Res.\u0026nbsp;2019;12:645-57. doi: 10.1002/aur.2081.\u003c/li\u003e\n \u003cli\u003eHorlin C, Falkmer M, Parsons R, Albrecht MA, Falkmer T. The cost of autism spectrum disorders. PLoS One.\u0026nbsp;2014;9:e106552. doi: 10.1371/journal.pone.0106552.\u003c/li\u003e\n \u003cli\u003eSingh JKA, Ling WH, Sivanesom RS, Huay CCS, Lan ACS. Age at autism spectrum disorder diagnosis and its association with child and family characteristics in a tertiary care hospital in Malaysia. Autism Res. 2024;17:637-49. doi: 10.1002/aur.3106.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eChandler S, Carter Leno V, White P, Yorke I, Hollocks MJ, Baird G, et al. Pathways to adaptive functioning in autism from early childhood to adolescence. Autism Res.\u0026nbsp;2022;15:1883-93. doi: 10.1002/aur.2785.\u003c/li\u003e\n \u003cli\u003eHours C, Recasens C, Baleyte JM. ASD and ADHD Comorbidity: What Are We Talking About? Front Psychiatry. 2022:13:837424. doi: 10.3389/fpsyt.2022.837424.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGargaro BA, Rinehart NJ, Bradshaw JL, Tonge BJ, Sheppard DM. Autism and ADHD: how far have we come in the comorbidity debate? Neurosci Biobehav Rev. 2011;35:1081-8. doi: 10.1016/j.neubiorev.2010.11.002.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Autism spectrum disorder, Adaptive functioning, Cognitive-adaptive functioning gap, Intelligence quotient, Autistic severity","lastPublishedDoi":"10.21203/rs.3.rs-5771996/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5771996/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eChildren with autism spectrum disorder (ASD) frequently presented weaker adaptive functioning compared with typically developing children. Multiple affecting factors of adaptive functioning in ASD individuals had been explored in previous studies.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eData of age, gender, parental education, place of residence, behavioral intervention, attention deficit hyperactivity disorder comorbidity, Wechsler Intelligence Scale for Children (WISC) scores and Autism Diagnostic Observation Schedule (ADOS) scores were collected in 107 school-aged children with ASD. Adaptive functioning of ASD subjects were evaluated through Adaptive Behavior Assessment System (ABAS). Spearman correlation analyses were applied to investigate the associations between intelligence quotient (IQ) scores, ASD related symptoms and adaptive functioning and cognitive-adaptive functioning gaps. Hierarchical regressions were performed in sequence to examine the effects of gender, age, parental education, intelligence, autistic severity and behavioral factors on General Adaptive Composite (GAC) in children with ASD.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eVerbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) and Processing Speed Index (PSI) of WISC were positively correlated with Conceptual domain, Social domain and GAC (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). There were positive correlations between VCI, PRI and PSI and Practical domain (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Positive associations were discovered between full-scale IQ (FSIQ) and the three domains and GAC in ABAS (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). Social Affect (SA), Restricted and Repetitive Behavior (RRB) and Total scores of ADOS were negatively correlated with Conceptual, Social and Practical domains (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Comparison Scores were negatively correlated with Conceptual domain and Social domain (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Negative correlations were found between SA, RRB, Total scores, Comparison Scores and GAC (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). VCI, PRI, WMI, PSI and FSIQ were positively correlated with FSIQ-Conceptual, FSIQ-Social, FSIQ-Practical and FSIQ-GAC gaps (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01). SA was inversely correlated with FSIQ-Conceptual and FSIQ-Practical gaps (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Total scores were inversely correlated with FSIQ-Conceptual, FSIQ-Practical and FSIQ-GAC gaps (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). FSIQ was positively correlated with GAC in the total model (β= 0.25, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.015). There were significant inverse associations between RRB and GAC in the total model (β=\u0026minus;0.28, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.014).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eIntelligence levels and autistic severity were important contributors of adaptive functioning in school-aged children with ASD. IQ and ASD symptoms were also crucial factors affecting the cognitive-adaptive functioning gaps in ASD.\u003c/p\u003e","manuscriptTitle":"Intelligence levels and autistic severity are important contributors of adaptive functioning and cognitive-adaptive functioning gaps in school-aged children with ASD","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-13 09:07:38","doi":"10.21203/rs.3.rs-5771996/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d51eda4f-d02a-45da-90ae-f226a8209c74","owner":[],"postedDate":"January 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-13T10:23:11+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-13 09:07:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5771996","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5771996","identity":"rs-5771996","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}