Introduction: Autistic adolescents often experience a lower social and overall quality of life (QoL), primarily due to challenges in daily life arising from limited social skills and behavioral challenges. Their awareness of these social limitations, along with frequent social anxiety, may further exacerbate these challenges. However, the specific roles that these factors play in affecting QoL remain underexplored.
Objective: We examined how social skills, challenging behaviors, social anxiety and self-perceived social competence are associated with social and overall QoL in autistic adolescents.
Methods: 117 intellectually able autistic adolescents (101 males, 12.6 ± 2.2 years) completed the Pediatric Quality of Life Inventory, the Social Anxiety Scale for Adolescents, and the Social Competence Subscale of the Self-Perception Profile for Children/Adolescents. Caregivers evaluated their social skills and challenging behaviors using the Social Skills Improvement System Rating Scales. Linear regressions were used for analysis.
Results: After controlling for age and sex, higher social anxiety and lower perceived social competence were significantly associated with reduced social QoL (β = -.79, 10.26, ps < 0.5). Further, higher social anxiety, lower perceived social competence, and more challenging behaviors were significantly associated with decreased overall QoL (β = -.46, -.26, 5.42, ps < 0.5). These factors explained 47.4% of the variance in social and 41.7% in overall QoL.
Conclusion: These findings highlight the importance of addressing social anxiety and enhancing self-perceived social competence to improve the social and overall QoL for autistic adolescents. Additionally, managing challenging behaviors is crucial for promoting their overall QoL.