The moderating role of executive functions on longitudinal relationships between anxiety and social communication difficulties in autistic children

Background: Evidence suggests anxiety is associated with greater social communication difficulties among autistic children; however, findings regarding the direction of this relationship are mixed. In addition, it is not yet established whether executive functions (EFs) act as a protective factor, by moderating these relationships. In this study, we examined these associations longitudinally in a community sample of autistic pre-adolescents. In particular, we: (1) investigated whether anxiety predicts greater social communication difficulties over time, or vice versa, and (2) assessed the moderating effect of EF. Methods: Participants were drawn from Pathways, a pan-Canadian, longitudinal cohort study of autistic children (N = 157; 15% female; mean FSIQ = 84.8). We focused on two time points during pre-adolescence (age 9: mean age = 9.7 years, and age 10: mean age = 10.7 years). A cross-lagged panel model tested whether levels of parent-reported anxiety at age 9 predicted teacher-reported social communication difficulties at age 10, and vice versa (cross-lagged pathways). Next, multigroup analyses tested for similarity in cross-lagged pathways across different levels of teacher-reported EF ability. Results: Within our sample, average levels of anxiety were relatively low, and levels of anxiety and social communication difficulties decreased from age 9 to age 10. Analyses in the whole sample indicated that there were no significant longitudinal associations between anxiety and social communication difficulties. However, multi-group analyses revealed that among participants with clinically elevated behavioural dysregulation only, lower age 9 anxiety predicted increased social communication difficulties at age 10. Conclusions: Our findings highlight the importance of considering the potentially beneficial role some anxiety may play in shaping autistic children’s social development. We suggest potential pathways by which anxiety may be associated with emergent social abilities for children with behavioural regulation difficulties. Further multi-method and longitudinal research is required to clarify the mechanisms underlying this relationship, in order to establish the clinical implications of these findings. Such research has the potential to enhance the precision of clinical care for autistic youth, with the ultimate goal of providing more individualized care to support both social and emotional wellbeing.Arts, Faculty ofPsychology, Department ofGraduat