Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: Social impairments and internalizing symptoms
Abstract
Sluggish cognitive tempo (SCT) was introduced in 1980s in the field of attention deficit hyperactivity disorder (ADHD). Studies indicate that symptoms of SCT are separate from symptoms of ADHD and independently associated with multiple domains of functioning in clinical groups and in typical development. We assessed whether similar pattern would apply to higher functioning autism spectrum disorders (ASD). Children with higher functioning ASD (N = 55; 5-15 years) were divided into the ASD+High SCT (n = 17), the ASD+Medium SCT (n = 18) and the ASD+Low SCT (n = 20) groups based on parent-rated daydreaming and slowness on the Five to Fifteen questionnaire (FTF). The groups were compared on SCT-related impairments found in previous studies: social skills, academic functioning, psychiatric symptoms, and processing speed. Assessment methods were the FTF, the Development and Well-Being Assessment, and the Coding subtest of the WISC-III. The ADHD symptoms were statistically controlled due to the overlap between SCT and ADHD. The ASD+High SCT and ASD+Medium SCT groups were significantly more likely to have the most pronounced social impairments, and the ASD+High SCT group had significantly higher rate of internalizing disorders compared to the ASD+Low SCT group. Our results suggest that children with higher functioning ASD and high or medium levels of SCT symptoms could be at higher risk for psychosocial impairments than children with higher functioning ASD with low levels of SCT symptoms. Co-occurring ADHD symptoms do not explain the finding. Recognizing SCT symptoms in higher functioning ASD would be important to targeting preventive support.
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13-16% of children with high CDS symptoms also meet criteria for an autism diagnosis, while 30-49% of children with autism present with elevated CDS symptoms.
“Studies indicate that 13-16% of children with high CDS symptoms also meet the criteria for an autism diagnosis, while 30-49% of children with autism present with elevated CDS symptoms [62-65].”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [62]
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
Hu, R. J. (2003) · Elsevier eBooks · doi:10.1016/b0-12-226870-9/01070-4 · Cited by 9,167 · see citing works
Lord, C., Rutter, M., & Le Couteur, A. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172145 · Cited by 9,065 · see citing works
(1991) · Medical Entomology and Zoology · Cited by 8,071 · see citing works
Goodman, R., Ford, T., Richards, H., Gatward, R., & Meltzer, H. (2000) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2000.tb02345.x · Cited by 1,755 · see citing works
Anxiety Disorders in Children and Adolescents with Autistic Spectrum Disorders: A Meta-Analysis
van Steensel, F. J. A., Bögels, S. M., & Perrin, S. (2011) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-011-0097-0 · Cited by 1,463 · see citing works
Perfectionism as a transdiagnostic process: A clinical review
Egan, S. J., Wade, T. D., & Shafran, R. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.04.009 · Cited by 961 · see citing works
Fabiano, G. A., Pelham, W. E., Waschbusch, D. A., Gnagy, E. M., Lahey, B. B., Chronis, A. M., Onyango, A. N., Kipp, H., Lopez-Williams, A., & Burrows-MacLean, L. D. (2006) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3503_3 · Cited by 673 · see citing works
Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder
Rommelse, N. N. J., Franke, B., Geurts, H. M., Hartman, C. A., & Buitelaar, J. K. (2010) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-010-0092-x · Cited by 564 · see citing works
Comorbidity of Asperger syndrome: a preliminary report
Ghaziuddin, M., Weidmer‐Mikhail, E., & Ghaziuddin, N. (1998) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.1998.tb01647.x · Cited by 414 · see citing works
Atypical attentional networks and the emergence of autism
Keehn, B., Müller, R.-A., & Townsend, J. (2013) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2012.11.014 · Cited by 412 · see citing works
Barkley, R. A. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.734259 · Cited by 398 · see citing works
Mattila, M., Hurtig, T. M., Haapsamo, H., Jussila, K. K., Kuusikko‐Gauffin, S., Kielinen, M., Linna, S., Ebeling, H. E., Bloigu, R., Joskitt, L., et al. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-0958-2 · Cited by 392 · see citing works
Hinshaw, S. P. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.70.5.1086 · Cited by 379 · see citing works
Green, J., Gilchrist, A., Burton, D., & Cox, A. (2000) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1005523232106 · Cited by 378 · see citing works
Becker, S. P., Leopold, D. R., Burns, G. L., Jarrett, M. A., Langberg, J. M., Marshall, S. A., McBurnett, K., Waschbusch, D. A., & Willcutt, E. G. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2015.12.006 · Cited by 368 · see citing works
Carlson, C. L., & Mann, M. (2002) · Journal of Clinical Child & Adolescent Psychology · doi:10.1207/s15374424jccp3101_14 · Cited by 342 · see citing works
Dimensions and types of attention deficit disorder
LAHEY, B. B., PELHAM, W. E., SCHAUGHENCY, E. A., ATKINS, M. S., MURPHY, H. A., HYND, G., RUSSO, M., HARTDAGEN, S., & LORYS-VERNON, A. (1988) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198805000-00011 · Cited by 313 · see citing works
Distinguishing Sluggish Cognitive Tempo from Attention-Deficit/Hyperactivity Disorder in Adults
Barkley, R. A. (2012) · Journal of Abnormal Psychology · doi:10.1037/a0023961 · Cited by 279 · see citing works
Hinshaw, S. P. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.5.1086 · Cited by 274 · see citing works
Estes, A. M., Rivera, V., Bryan, M. J., Cali, P., & Dawson, G. (2010) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-010-1127-3 · Cited by 269 · see citing works
DSM-IV Field Trials for the Disruptive Behavior Disorders: Symptom Utility Estimates
Frick, P. J., LAHEY, B. B., Applegate, B. E., KERDYK, L., Ollendick, T. H., Hynd, G. W., Garfinkel, B. D., Greenhill, L. L., Biederman, J., Barkley, R. A., et al. (1994) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199405000-00011 · Cited by 263 · see citing works
Kadesj�, B., Janols, L., Korkman, M., Mickelsson, K., Strand, G., Trillingsgaard, A., & Gillberg, C. (2004) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-004-3002-2 · Cited by 250 · see citing works
Penny, A. M., Waschbusch, D. A., Klein, R. M., Corkum, P., & Eskes, G. (2009) · Psychological Assessment · doi:10.1037/a0016600 · Cited by 241 · see citing works
The Internal and External Validity of Sluggish Cognitive Tempo and its Relation with DSM–IV ADHD
Willcutt, E. G., Chhabildas, N., Kinnear, M., DeFries, J. C., Olson, R. K., Leopold, D. R., Keenan, J. M., & Pennington, B. F. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9800-6 · Cited by 224 · see citing works
Three Diagnostic Approaches to Asperger Syndrome: Implications for Research
Klin, A., Pauls, D. L., Schultz, R. J., & Volkmar, F. R. (2005) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-004-2001-y · Cited by 216 · see citing works
Barkley, R. A. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9824-y · Cited by 208 · see citing works
Lee, S., Burns, G. L., Snell, J., & McBurnett, K. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9714-3 · Cited by 200 · see citing works
Defining the Intellectual Profile of Asperger Syndrome: Comparison with High-Functioning Autism
Ghaziuddin, M., & Kimchi-Mountain, K. (2004) · Journal of Autism and Developmental Disorders · doi:10.1023/b:jadd.0000029550.19098.77 · Cited by 199 · see citing works
Bauermeister, J. J., Barkley, R. A., Bauermeister, J. A., Martínez, J. V., & McBurnett, K. (2012) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-011-9602-7 · Cited by 195 · see citing works
Mikami, A. Y., Huang-Pollock, C. L., Pfiffner, L. J., McBurnett, K., & Hangai, D. (2007) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-007-9108-5 · Cited by 173 · see citing works
Dimensions and Correlates of Attention Deficit/Hyperactivity Disorder and Sluggish Cognitive Tempo
Garner, A. A., Marceaux, J. C., Mrug, S., Patterson, C. S., & Hodgens, B. (2010) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-010-9436-8 · Cited by 168 · see citing works
Asperger Syndrome and Academic Achievement
Griswold, D. E., Barnhill, G. P., Myles, B. S., Hagiwara, T., & Simpson, R. L. (2002) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/10883576020170020401 · Cited by 168 · see citing works
Marshall, S. A., Evans, S. W., Eiraldi, R. B., Becker, S. P., & Power, T. J. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9758-4 · Cited by 161 · see citing works
Becker, S. P., & Langberg, J. M. (2013) · Journal of Attention Disorders · doi:10.1177/1087054711435411 · Cited by 153 · see citing works
Skirbekk, B., Hansen, B. H., Oerbeck, B., & Kristensen, H. (2011) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-011-9488-4 · Cited by 141 · see citing works
Becker, S. P., Marshall, S., & McBurnett, K. (2013) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-013-9825-x · Cited by 133 · see citing works
Leopold, D. R., Christopher, M. E., Burns, G. L., Becker, S. P., Olson, R. K., & Willcutt, E. G. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12505 · Cited by 130 · see citing works
Bauermeister, J. J., Matos, M., Reina, G., Salas, C. C., Martínez, J. V., Cumba‐Avilés, E., & Barkley, R. A. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.00343.x · Cited by 129 · see citing works
Neuropsychological Profiles of Children with Asperger Syndrome and Autism
Manjiviona, J., & Prior, M. R. (1999) · Autism · doi:10.1177/1362361399003004003 · Cited by 128 · see citing works
Becker, S. P., Luebbe, A. M., Fite, P. J., Stoppelbein, L., & Greening, L. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9719-y · Cited by 118 · see citing works
Wåhlstedt, C., & Bohlin, G. (2010) · Child Neuropsychology · doi:10.1080/09297041003671176 · Cited by 115 · see citing works
Barnhill, G. P., Hagiwara, T., Myles, B. S., & Simpson, R. L. (2000) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/108835760001500303 · Cited by 98 · see citing works
International Classification of Diseases (ICD)
M.Mullner, R. (2009) · Encyclopedia of Health Services Research · doi:10.4135/9781412971942.n221 · Cited by 93 · see citing works
Burns, G. L., Servera, M., Bernad, M. D. M., Carrillo, J. M., & Cardo, E. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.838771 · Cited by 86 · see citing works
Bernad, M. D. M., Servera, M., Becker, S. P., & Burns, G. L. (2015) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-015-0066-z · Cited by 79 · see citing works
Becker, S. P. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.02.007 · Cited by 73 · see citing works
Differentiating SCT and inattentive symptoms in ADHD using fMRI measures of cognitive control
Fassbender, C., Krafft, C. E., & Schweitzer, J. B. (2015) · NeuroImage: Clinical · doi:10.1016/j.nicl.2015.05.007 · Cited by 72 · see citing works
Korkman, M., Jaakkola, M., Ahlroth, A., Pesonen, A.-E., & Turunen, M. (2004) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-004-3005-z · Cited by 72 · see citing works
High rates of psychiatric co-morbidity in individuals with Asperger's disorder
Mukaddes, N. M., & Fateh, R. (2009) · The World Journal of Biological Psychiatry · doi:10.1080/15622970902789130 · Cited by 70 · see citing works
Developmental profiles on the basis of the FTF (Five to Fifteen) questionnaire
Trillingsgaard, A., Damm, D., Sommer, S., Jepsen, J. R. M., �stergaard, O., Frydenberg, M., & Thomsen, P. H. (2004) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-004-3006-y · Cited by 70 · see citing works
High rates of psychiatric co-morbidity in individuals with Asperger's disorder
Mukaddes, N. M., & Fateh, R. (2010) · The World Journal of Biological Psychiatry · doi:10.3109/15622970902789130 · Cited by 69 · see citing works
Moruzzi, S., Rijsdijk, F., & Battaglia, M. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9725-0 · Cited by 67 · see citing works
Brief report: sluggish cognitive tempo among pediatric survivors of acute lymphoblastic leukemia
Reeves, C. B., Palmer, S., Gross, A. M., Simonian, S. J., Taylor, L., Willingham, E., & Mulhern, R. K. (2007) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsm063 · Cited by 66 · see citing works
Tamm, L., Garner, A. A., Loren, R. E. A., Epstein, J. N., Vaughn, A. J., Ciesielski, H. A., & Becker, S. P. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.05.054 · Cited by 64 · see citing works
Becker, S. P., Garner, A. A., & Byars, K. C. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.03.005 · Cited by 63 · see citing works
Servera, M., Bernad, M. D. M., Carrillo, J. M., Collado, S., & Burns, G. L. (2016) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2015.1004680 · Cited by 58 · see citing works
Burns, G. L., Becker, S. P., Servera, M., Bernad, M. D. M., & García‐Banda, G. (2016) · Psychological Assessment · doi:10.1037/pas0000325 · Cited by 57 · see citing works
Belmar, M., Servera, M., Becker, S. P., & Burns, G. L. (2015) · Journal of Attention Disorders · doi:10.1177/1087054715597470 · Cited by 52 · see citing works
Planche, P., & Lemonnier, É. (2012) · Research in Autism · doi:10.1016/j.rasd.2011.12.009 · Cited by 52 · see citing works
Garner, A. A., Mrug, S., Hodgens, B., & Patterson, C. S. (2012) · Journal of Attention Disorders · doi:10.1177/1087054711431456 · Cited by 44 · see citing works
The relationship between sluggish cognitive tempo and impairment in children with and without ADHD
Watabe, Y., Owens, J. S., Evans, S. W., & Brandt, N. E. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9767-3 · Cited by 42 · see citing works
Lee, S., Burns, G. L., & Becker, S. P. (2016) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2016.1144192 · Cited by 40 · see citing works
Sluggish cognitive tempo and speed of performance
Wood, W. L. M., Potts, H. E., Lewandowski, L. J., & Lovett, B. J. (2017) · Journal of Attention Disorders · doi:10.1177/1087054716666322 · Cited by 33 · see citing works
Khadka, G., Burns, G. L., & Becker, S. P. (2015) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-015-9534-6 · Cited by 31 · see citing works
Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children
Becker, S. P., Withrow, A. R., Stoppelbein, L., Luebbe, A. M., Fite, P. J., & Greening, L. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12580 · Cited by 31 · see citing works
Becker, S. P., Ciesielski, H. A., Rood, J. E., Froehlich, T. E., Garner, A. A., Tamm, L., & Epstein, J. N. (2014) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104514554312 · Cited by 26 · see citing works
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- Authors
- Reinvall, O., Kujala, T., Voutilainen, A., Moisio, A., Lahti‐Nuuttila, P., & Laasonen, M.
- Affiliations
- University of Helsinki (FI)
- Corresponding author
- Reinvall, Outi
- Venue
- Scandinavian Journal of Psychology
- Publisher
- Wiley
- Published
- 2017-08-16
- Volume
- 58
- Issue
- 5
- Pages
- 389-399
- ISSN
- 0036-5564 (ISSN-L)
- 1467-9450
- OpenAlex
- W2749073634
- Cited by
- 36
- References
- 67
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 7 · 2021: 4 · 2020: 6 · 2018: 3
- FWCI
- 1.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- sluggish cognitive tempo, autism spectrum disorder, high-functioning autism, social dysfunction, internalizing problems, daydreaming, slowness, processing speed, academic functioning, ADHD comorbidity, children and adolescents, psychosocial impairment
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Psychology, Adolescent, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Psychology, Child, Cognition, Female, Humans, Male, Neuropsychological Tests
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