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Adaptive Behavior and Its Differences between Children with Autism Spectrum Disorder and Social Communication Disorder

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Title: Adaptive Behavior and Its Differences between Children with Autism Spectrum Disorder and Social Communication Disorder
Language: English
Authors: Deepika Jain (ORCID 0009-0007-4583-4649), Kawaljit Singh Multani, Anjali Dodiya, Urva Benani, Anand Iyer (ORCID 0000-0002-3932-4729)
Source: Autism: The International Journal of Research and Practice. 2025 29(4):829-837.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 9
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Descriptors: Autism Spectrum Disorders, Children, Communication Disorders, Interpersonal Communication, Child Behavior, Socialization, Age Differences, Adjustment (to Environment), Neurodevelopmental Disorders, Foreign Countries, Symptoms (Individual Disorders)
Geographic Terms: India
Assessment and Survey Identifiers: Vineland Adaptive Behavior Scales
DOI: 10.1177/13623613251317787
ISSN: 1362-3613
1461-7005
Abstract: Adaptive behavior is paramount for independent living and is varyingly impaired in different neurodevelopmental disorders. This study aimed to investigate differences in adaptive behavior between children with autism spectrum disorder and social communication disorder, two conditions characterized by deficits in social communication. Data from 232 children with autism spectrum disorder and 90 children with social communication disorder were analyzed. Adaptive behavior was assessed using the Vineland Adaptive Behavior Scale--III. Diagnoses were made independently using the Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria and the AIIMS Modified INCLEN Diagnostic Tool--autism spectrum disorder Diagnostic Evaluation for autism spectrum disorder. Statistical analyses included non-parametric tests and generalized linear models to account for age and sex differences. The results showed that children with social communication disorder exhibited better adaptive behavior than those with autism spectrum disorder across all domains (p < 0.001). The most significant differences were observed in the Vineland Adaptive Behavior Scale-III standard scores in communication (autism spectrum disorder: 50.40 ± 15.51; social communication disorder: 70.53 ± 9.69) and socialization (autism spectrum disorder: 69.46 ± 8.77; social communication disorder: 80.07 ± 6.16) domains. Age and overall adaptive behavior scores correlated well with group membership (p < 0.001). These findings emphasize the importance of distinguishing between autism spectrum disorder and social communication disorder in clinical practice. The results support the use of adaptive behavior assessments in diagnostic evaluations, highlighting the need for tailored interventions.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1466235
Database: ERIC
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  Value: &lt;anid&gt;AN0184233771;f9d01apr.25;2025Apr08.02:17;v2.2.500&lt;/anid&gt; &lt;title id=&quot;AN0184233771-1&quot;&gt;Adaptive behavior and its differences between children with autism spectrum disorder and social communication disorder&#160;&lt;/title&gt; &lt;p&gt;Adaptive behavior is paramount for independent living and is varyingly impaired in different neurodevelopmental disorders. This study aimed to investigate differences in adaptive behavior between children with autism spectrum disorder and social communication disorder, two conditions characterized by deficits in social communication. Data from 232 children with autism spectrum disorder and 90 children with social communication disorder were analyzed. Adaptive behavior was assessed using the Vineland Adaptive Behavior Scale-III. Diagnoses were made independently using the Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria and the AIIMS Modified INCLEN Diagnostic Tool-autism spectrum disorder Diagnostic Evaluation for autism spectrum disorder. Statistical analyses included non-parametric tests and generalized linear models to account for age and sex differences. The results showed that children with social communication disorder exhibited better adaptive behavior than those with autism spectrum disorder across all domains (p &amp;lt; 0.001). The most significant differences were observed in the Vineland Adaptive Behavior Scale-III standard scores in communication (autism spectrum disorder: 50.40 &#177; 15.51; social communication disorder: 70.53 &#177; 9.69) and socialization (autism spectrum disorder: 69.46 &#177; 8.77; social communication disorder: 80.07 &#177; 6.16) domains. Age and overall adaptive behavior scores correlated well with group membership (p &amp;lt; 0.001). These findings emphasize the importance of distinguishing between autism spectrum disorder and social communication disorder in clinical practice. The results support the use of adaptive behavior assessments in diagnostic evaluations, highlighting the need for tailored interventions. This study compared adaptive behavior skills between children with autism spectrum disorder and social communication disorder using the Vineland Adaptive Behavior Scale-III. The researchers analyzed data from 232 children with autism spectrum disorder and 90 with social communication disorder. Key findings showed that children with social communication disorder demonstrated significantly better adaptive functioning across all areas compared to those with autism spectrum disorder. The largest differences were seen in communication and social skills. However, both groups still showed impairments compared to typical development, especially in expressive language. The study also found that younger children with lower overall adaptive behavior scores were more likely to be diagnosed with autism spectrum disorder. In addition, there was a higher proportion of males in the social communication disorder group than the autism spectrum disorder group. These results highlight important differences between autism spectrum disorder and social communication disorder, supporting their classification as distinct disorders. The findings emphasize the need for comprehensive adaptive behavior assessment during diagnosis and tailored interventions for each condition. Early identification and targeted support may be particularly crucial for children with autism spectrum disorder.&lt;/p&gt; &lt;p&gt;Keywords: adaptive behavior; autism spectrum disorder; neurodevelopmental disorders; social communication disorder; Vineland Adaptive Behavior Scale-III&lt;/p&gt; &lt;hd id=&quot;AN0184233771-2&quot;&gt;Introduction&lt;/hd&gt; &lt;p&gt;Adaptive behavior refers to an individual&#39;s ability to achieve a set of age-related skills that enable them to achieve independence ([&lt;reflink idref=&quot;bib2&quot; id=&quot;ref1&quot;&gt;2&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib6&quot; id=&quot;ref2&quot;&gt;6&lt;/reflink&gt;]). Deficits in adaptive behavior restrict individuals in a wide range of ways including limiting basic personal autonomy and self-sustainability ([&lt;reflink idref=&quot;bib6&quot; id=&quot;ref3&quot;&gt;6&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib11&quot; id=&quot;ref4&quot;&gt;11&lt;/reflink&gt;]). This is reflected in an individual&#39;s social and practical competence to meet the demands of everyday living and remain self-sufficient throughout life. Deficits in adaptive functioning are common across several neurodevelopmental disorders, particularly autism spectrum disorder (ASD).&lt;/p&gt; &lt;p&gt;The Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (&lt;emph&gt;DSM&lt;/emph&gt;-5) defines ASD as impairments in social communication and social reciprocity, coupled with the presence of restricted interests and repetitive behaviors ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref5&quot;&gt;1&lt;/reflink&gt;]). Social communication disorder (SCD), a new diagnostic category introduced in &lt;emph&gt;DSM&lt;/emph&gt;-5, is characterized by a primary deficit in the social use of nonverbal and verbal communication ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref6&quot;&gt;1&lt;/reflink&gt;]). While both ASD and SCD share deficits in social communication skills, individuals with SCD do not exhibit restricted interests, repetitive behaviors, insistence on sameness, or sensory abnormalities. Individuals with SCD exhibit difficulty using language for social purposes, appropriately matching communication to the social context, following rules of the communication context, understanding nonliteral language and integrating language with nonverbal communicative behaviors ([&lt;reflink idref=&quot;bib14&quot; id=&quot;ref7&quot;&gt;14&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;The estimated prevalence of ASD is approximately 1:100, according to the World Health Organization (WHO) database ([&lt;reflink idref=&quot;bib15&quot; id=&quot;ref8&quot;&gt;15&lt;/reflink&gt;]). In contrast, data on SCD prevalence are limited. A study on Dutch preschoolers reported an estimate of 7.5% for &quot;pragmatic language impairment&quot; without autism ([&lt;reflink idref=&quot;bib3&quot; id=&quot;ref9&quot;&gt;3&lt;/reflink&gt;]), while another study found that 8% of children referred for autism evaluation met the inclusion criteria for SCD ([&lt;reflink idref=&quot;bib9&quot; id=&quot;ref10&quot;&gt;9&lt;/reflink&gt;]). Adaptive behavior, being an easily measurable positive outcome, is often linked to training and intervention programs aimed at enhancing independent living ([&lt;reflink idref=&quot;bib4&quot; id=&quot;ref11&quot;&gt;4&lt;/reflink&gt;]; [&lt;reflink idref=&quot;bib7&quot; id=&quot;ref12&quot;&gt;7&lt;/reflink&gt;]). Therefore, evaluating adaptive behavior has become the norm in the comprehensive diagnostic evaluation for children with neurodevelopmental disorders.&lt;/p&gt; &lt;p&gt;Standard scales for adaptive behavior assessment, such as the Vineland Adaptive Behavior Scales (VABS-III), provide measures of adaptive behaviors from birth up to adulthood across various developmental domains. Studies among children with autism using the VABS-II have depicted deficits in communication, socialization, daily living skills, and motor skills ([&lt;reflink idref=&quot;bib12&quot; id=&quot;ref13&quot;&gt;12&lt;/reflink&gt;]). However, to our knowledge, no study has assessed the adaptive level in children with SCD or compared it with those with ASD using the VABS-III.&lt;/p&gt; &lt;p&gt;This study seeks to examine differences in adaptive levels between children with ASD and SCD using the VABS-III assessment. We analyze overall adaptive level, communication, daily living skills, socialization, and motor domains, as well as adaptive-level differences in receptive and expressive language, interpersonal relationships, and play-leisure subdomains. In addition, we explore the influence of age and sex on these differences.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-3&quot;&gt;Methods&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0184233771-4&quot;&gt;Participants&lt;/hd&gt; &lt;p&gt;The study included data from 232 children diagnosed with ASD (mean age = 3.18 &#177; 1.10 years) and 90 with SCD (mean age = 3.66 &#177; 1.25 years) using the &lt;emph&gt;DSM&lt;/emph&gt;-5 criteria. The participants were prospectively recruited from February 2020 to February 2022 at a single child development center in Ahmedabad, India.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-5&quot;&gt;Diagnostic procedures&lt;/hd&gt; &lt;p&gt;Diagnosis of ASD and SCD were made independently by a developmental pediatrician using the &lt;emph&gt;DSM&lt;/emph&gt;-5 criteria and verified by a pediatric neurologist with expertise in neurodevelopmental disorders. The diagnostic process included the use of the AIIMS-Modified INDT-ASD (INCLEN Diagnostic Tool for Autism Spectrum Disorder) Diagnostic Evaluation for ASD. It is also important to note that the VABS-III information was not used to inform diagnosis in our study. The VABS-III was administered after the diagnosis was established for further insights.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-6&quot;&gt;Instruments and measures&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0184233771-7&quot;&gt;Diagnostic criteria for ASD&lt;/hd&gt; &lt;p&gt;According to the &lt;emph&gt;DSM&lt;/emph&gt;-5, a child with ASD must have persistent deficits in social communication and social interaction across multiple contexts, such as social-emotional reciprocity; nonverbal communicative behaviors used for social interaction; and developing, maintaining, and understanding relationships. Other criteria include restricted, repetitive patterns of behavior, interests, or activities, such as stereotyped or repetitive motor movements, use of objects, or speech; insistence on sameness, inflexible adherence to routines; highly restricted, fixated interests that are abnormal in intensity or focus; and hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref14&quot;&gt;1&lt;/reflink&gt;]).&lt;/p&gt; &lt;hd id=&quot;AN0184233771-8&quot;&gt;AIIMS-Modified INDT-ASD (INCLEN Diagnostic Tool for ASD)&lt;/hd&gt; &lt;p&gt;This Diagnostic Tool is a structured, &lt;emph&gt;DSM&lt;/emph&gt;-5-aligned instrument validated for diagnosing ASD in children aged 1–14 years within the Indian context. The tool consists of two sections: Section A with 28 structured questions across 7 subdomains assessing social interaction, communication deficits, and restrictive/repetitive behaviors, and Section B serving as a diagnostic checklist validating &lt;emph&gt;DSM&lt;/emph&gt;-5 criteria. The tool demonstrates strong psychometric properties with 98.4% sensitivity, 91.7% specificity, and excellent internal consistency (Cronbach&#39;s) alpha = 0.92) and inter-rater reliability (Kappa = 0.95). A cut-off score of 10 indicates ASD diagnosis, with scores ⩾14 corresponding to severe ASD ([&lt;reflink idref=&quot;bib5&quot; id=&quot;ref15&quot;&gt;5&lt;/reflink&gt;]).&lt;/p&gt; &lt;hd id=&quot;AN0184233771-9&quot;&gt;Diagnostic criteria for social (pragmatic) communication disorder&lt;/hd&gt; &lt;p&gt;According to the &lt;emph&gt;DSM&lt;/emph&gt;-5, a child with SCD must have persistent difficulties in the social use of verbal and nonverbal communication, as manifested by all of the following: deficits in using communication for social purposes; impairment in the ability to change communication to match context or the needs of the listener; difficulties following rules for conversation and storytelling; and difficulties understanding what is not explicitly stated and nonliteral or ambiguous meanings of language ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref16&quot;&gt;1&lt;/reflink&gt;]).&lt;/p&gt; &lt;hd id=&quot;AN0184233771-10&quot;&gt;Vineland-III&lt;/hd&gt; &lt;p&gt;The Vineland-III (Vineland Adaptive Behavior Scales, third edition) was used to measure participants&#39; levels of adaptive skills. This semi-structured interview assesses an individual&#39;s adaptive behaviors based on a caregiver&#39;s report in four domains: Communication, Daily Living Skills, Socialization, and Motor Skills. The Vineland-III has been shown to have a high degree of test–retest reliability, and the subdomains have demonstrated an acceptable level of internal consistency ([&lt;reflink idref=&quot;bib13&quot; id=&quot;ref17&quot;&gt;13&lt;/reflink&gt;]). Two types of norm-referenced scores are available on the Vineland-III: standard scores for each domain (&lt;emph&gt;M&lt;/emph&gt; = 100, &lt;emph&gt;SD&lt;/emph&gt; = 15, range = 20–140) and v-scale scores for each subdomain (&lt;emph&gt;M&lt;/emph&gt; = 15, &lt;emph&gt;SD&lt;/emph&gt; = 3, range = 0–24). The written communication, domestic, and community ADL skills scores were not included in our analysis, as these subscales are only applicable for children 3 years of age and older ([&lt;reflink idref=&quot;bib13&quot; id=&quot;ref18&quot;&gt;13&lt;/reflink&gt;]). Both quantitative (standard and v-scale scores) and qualitative (low, moderately low, adequate, high, moderately high) scores were derived for each child.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-11&quot;&gt;Statistical analysis&lt;/hd&gt; &lt;p&gt;Statistical analyses were performed using SPSS version 26.0. Normality tests were conducted for all subgroups as defined by VABS-III. As the data were not normally distributed, non-parametric tests (Mann–Whitney &lt;emph&gt;U&lt;/emph&gt; test) were used for group comparisons. Chi-square tests or Fisher&#39;s exact tests were used for categorical variables.&lt;/p&gt; &lt;p&gt;To examine the relationship between age, overall adaptive behavior score, and group membership (ASD vs SCD), we employed a generalized linear model (GLM) with a binomial distribution and a logit link function. The model included age, overall score, and their interaction as predictors.&lt;/p&gt; &lt;p&gt;Effect sizes were calculated using point-biserial correlation for continuous variables and Cramer&#39;s V for categorical variables. The significance level was set at p &amp;lt; 0.05 for all analyses.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-12&quot;&gt;Results&lt;/hd&gt; &lt;p&gt;Quantitative data were expressed as mean and standard deviation (&lt;emph&gt;SD&lt;/emph&gt;), and qualitative data (low, moderately low, adequate, moderately high, high) were expressed as percentages. The data were tested for normality using multiple tests including measures of Skewness, Kurtosis Interpretations, and the Shapiro–Wilk&#39;s Test which were analyzed together. Since the results of these tests were negative, and the data were not normally distributed (as supported by Appendices 1 and 2) the Mann–Whitney &lt;emph&gt;U&lt;/emph&gt; test, a non-parametric statistical test, was used to compare the mean and standard deviation of quantitative scores between the ASD and SCD groups.&lt;/p&gt; &lt;p&gt;The key from the Vineland-III scale was used to quantify the statistical significance of the differences in means obtained between the two groups.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-13&quot;&gt;Domains and subdomains in VABS-III&lt;/hd&gt; &lt;p&gt;Table 1 presents the mean scores and standard deviations for the VABS-III domains and subdomains for both groups, as well as the resulting p value from the Mann–Whitney &lt;emph&gt;U&lt;/emph&gt; analysis. Adapted from Pearson&#39;s Vineland-III ([&lt;reflink idref=&quot;bib13&quot; id=&quot;ref19&quot;&gt;13&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Table 1. VABS-III domain and subdomain scores.&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Domain/subdomain&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD (mean &amp;amp;#177; &amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;)&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD (mean &amp;amp;#177; &amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;)&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;&amp;lt;italic&amp;gt;P&amp;lt;/italic&amp;gt; value&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Overall score&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;66.03 &amp;amp;#177; 8.54&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;76.57 &amp;amp;#177; 4.83&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Communication&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;50.40 &amp;amp;#177; 15.51&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;70.53 &amp;amp;#177; 9.69&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Daily living skills&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;78.42 &amp;amp;#177; 10.68&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;85.62 &amp;amp;#177; 8.40&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Socialization&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;69.46 &amp;amp;#177; 8.77&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;80.07 &amp;amp;#177; 6.16&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Motor skills&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;83.14 &amp;amp;#177; 10.26&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;89.51 &amp;amp;#177; 9.55&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Receptive&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6.01 &amp;amp;#177; 3.40&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10.18 &amp;amp;#177; 2.29&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Expressive&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.46 &amp;amp;#177; 2.56&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6.38 &amp;amp;#177; 2.82&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Written&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10.89 &amp;amp;#177; 4.58&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;12.79 &amp;amp;#177; 2.34&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.005&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Personal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;9.31 &amp;amp;#177; 3.00&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;11.48 &amp;amp;#177; 2.52&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Domestic&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;12.86 &amp;amp;#177; 1.74&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;14.59 &amp;amp;#177; 1.85&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Community&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;9.96 &amp;amp;#177; 2.39&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;11.51 &amp;amp;#177; 1.44&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Interpersonal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8.19 &amp;amp;#177; 2.03&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10.94 &amp;amp;#177; 1.69&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Play and leisure&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8.85 &amp;amp;#177; 2.23&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;11.04 &amp;amp;#177; 1.57&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Coping&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10.86 &amp;amp;#177; 1.61&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;12.31 &amp;amp;#177; 1.37&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Gross motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;12.68 &amp;amp;#177; 2.18&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13.72 &amp;amp;#177; 1.58&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Fine motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;11.14 &amp;amp;#177; 2.70&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13.14 &amp;amp;#177; 2.02&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;Key for VABS-III.&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Adaptive level&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;V-Scale score&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Standard score&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;High&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;21&amp;amp;#8211;24&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;130&amp;amp;#8211;140&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Moderately high&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;18&amp;amp;#8211;20&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;115&amp;amp;#8211;129&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Adequate&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13&amp;amp;#8211;17&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;86&amp;amp;#8211;114&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Moderately low&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10&amp;amp;#8211;12&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;71&amp;amp;#8211;85&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Low&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;amp;#8211;9&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;20&amp;amp;#8211;70&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;Children with SCD demonstrated significantly higher scores across all domains and subdomains of the VABS-III compared to children with ASD, as shown in Graph 1. The largest differences were observed in the Communication and Socialization domains. The overall mean standard score and the mean standard scores for the communication and socialization domains were in the low range for ASD children and moderately low for SCD children. In the daily living skills and motor domains, the mean standard score was moderately low for ASD children and adequate for SCD children. In the subdomains, the mean adaptive level was low in receptive language, personal daily living skills, interpersonal relationships, and play and leisure skills for the ASD group and moderately low for the SCD group. Expressive language adaptive level was low, and coping skills were moderately low for both ASD and SCD children. Gross motor skills were adequate for both groups, and fine motor skills were moderately low for ASD children and adequate for SCD children.&lt;/p&gt; &lt;p&gt;Graph: Graph 1. Graph shows the VABS-III domain scores obtained from participant assessments in this study.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-14&quot;&gt;Demographic characteristics&lt;/hd&gt; &lt;p&gt;Table 2 presents the demographic characteristics of the ASD and SCD groups. The mean age of children in the ASD group (3.18 &#177; 1.10 years) was significantly lower than that of the SCD group (3.66 &#177; 1.25 years) (p &amp;lt; 0.001). When categorized into age groups, the majority of children in both groups fell into the 2–4 years category (ASD: 82.8%, SCD: 73.3%), followed by the 4–6 years category (ASD: 14.7%, SCD: 20.0%), with the smallest proportion in the &amp;gt;6 years category (ASD: 2.6%, SCD: 6.7%). However, the overall distribution of age groups between ASD and SCD was not statistically significant (p = 0.092). Regarding sex distribution, both groups had a higher proportion of males, but this proportion was significantly higher in the SCD group (88.9%) compared to the ASD group (77.6%) (p = 0.021). These demographic differences, particularly in age and sex distribution, are important considerations when interpreting the results of adaptive behavior assessments between the two groups.&lt;/p&gt; &lt;p&gt;Table 2. Demographic characteristics.&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Characteristic&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD (&amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; = 232)&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD (&amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; = 90)&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;&amp;lt;italic&amp;gt;P&amp;lt;/italic&amp;gt; value&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age (years), mean &amp;amp;#177; &amp;lt;italic&amp;gt;SD&amp;lt;/italic&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.18 &amp;amp;#177; 1.10&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.66 &amp;amp;#177; 1.25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age groups, &amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; (%)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;0.092&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;2&amp;amp;#8211;4 years&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;192 (82.8%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;66 (73.3%)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;4&amp;amp;#8211;6 years&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;34 (14.7%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;18 (20.0%)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#62;6 years&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6 (2.6%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6 (6.7%)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Sex, &amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; (%)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td&amp;gt;0.021&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Male&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;180 (77.6%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;80 (88.9%)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Female&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;52 (22.4%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10 (11.1%)&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;hd id=&quot;AN0184233771-15&quot;&gt;Age and overall score as predictors of group membership&lt;/hd&gt; &lt;p&gt;A GLM was used to examine the relationship between age, overall adaptive behavior score, and group membership (ASD vs SCD), as shown in Table 3. The model demonstrated good fit (χ&#178; = 144.695, df = 5, p &amp;lt; 0.001).&lt;/p&gt; &lt;p&gt;Table 3. Parameter estimates from the regression analysis examining the relationship between age and overall scores..&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot; rowspan=&quot;2&quot;&amp;gt;Parameter&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot; rowspan=&quot;2&quot;&amp;gt;B&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot; rowspan=&quot;2&quot;&amp;gt;Std. error&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot; colspan=&quot;2&quot;&amp;gt;95% Wald confidence interval&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot; colspan=&quot;3&quot;&amp;gt;Hypothesis test&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Lower&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Upper&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Wald chi-square&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;df&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Sig.&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;(Intercept)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5.455&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4.7926&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;3.938&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;14.849&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.296&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.255&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;[age = 1]&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;17.903&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5.7917&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6.551&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;29.254&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;9.555&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.002&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;[age = 2]&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;17.834&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8.4956&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.183&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;34.486&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4.407&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.036&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;[age = 3]&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;xref ref-type=&quot;table-fn&quot; rid=&quot;tfn2&quot;&amp;gt;a&amp;lt;/xref&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;overall score&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.080&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.0693&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.216&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.056&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.338&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.247&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;[age = 1] * overall score&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.226&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.0819&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.387&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.066&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7.622&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.006&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;[age = 2] * overall score&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.238&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.1190&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.472&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;.005&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4.016&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.045&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;[age = 3] * overall score&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;xref ref-type=&quot;table-fn&quot; rid=&quot;tfn2&quot;&amp;gt;a&amp;lt;/xref&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;(Scale)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;xref ref-type=&quot;table-fn&quot; rid=&quot;tfn3&quot;&amp;gt;b&amp;lt;/xref&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;1 Dependent variable: group. Model: (intercept), age, overall score, age * overall score.&lt;/p&gt; &lt;ulist&gt; &lt;item&gt;2 Set to zero because this parameter is redundant.&lt;/item&gt; &lt;item&gt;3 Fixed at the displayed value.&lt;/item&gt; &lt;/ulist&gt; &lt;p&gt;The inclusion of age and adaptive behavior interactions in the GLM was based on evidence that these factors differentially impact diagnostic outcomes in ASD and SCD. Research indicates that adaptive behavior profiles can vary significantly across age and sex in neurodevelopmental disorders ([&lt;reflink idref=&quot;bib8&quot; id=&quot;ref20&quot;&gt;8&lt;/reflink&gt;]). Specifically, studies have shown that females with ASD may exhibit better social communication skills in early childhood but experience more challenges in adolescence, while males show more consistent profiles across development. In addition, evidence suggests that the relationship between adaptive functioning and diagnosis may vary with age, as social demands and expectations increase throughout development ([&lt;reflink idref=&quot;bib10&quot; id=&quot;ref21&quot;&gt;10&lt;/reflink&gt;]). Therefore, examining the interaction between age and adaptive behavior provides crucial insights into how these factors jointly influence diagnostic group membership.&lt;/p&gt; &lt;p&gt;Significant effects were found for age (χ&#178; = 10.105, df = 2, p = 0.006), overall score (χ&#178; = 30.973, df = 1, p &amp;lt; 0.001), and the interaction between age and overall score (χ&#178; = 8.166, df = 2, p = 0.017).&lt;/p&gt; &lt;p&gt;The Wald chi-square test for individual model effects demonstrated significant contributions from age (χ&#178; = 10.105, df = 2, p = 0.006), overall score (χ&#178; = 30.973, df = 1, p &amp;lt; 0.001), and the interaction between age and overall score (χ&#178; = 8.166, df = 2, p = 0.017), suggesting that these variables play a significant role in predicting the likelihood of ASD compared to SCD.&lt;/p&gt; &lt;p&gt;Specifically, parameter estimates revealed that younger children (2–4 years) had significantly higher odds of being diagnosed with ASD compared to SCD (B = 17.903, p = 0.002), and this likelihood decreased as the overall score increased, particularly in the younger age groups (B = −0.226, p = 0.006 for 2−4 years; B = -−.238, p = 0.045 for 4–6 years). These findings suggest that the interaction between age and overall score is crucial in differentiating between ASD and SCD in pediatric patients, highlighting the importance of early assessment and intervention based on these predictors.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-16&quot;&gt;Sex differences&lt;/hd&gt; &lt;p&gt;A significant association was found between sex and group membership (χ&#178; = 5.328, p = 0.021) via a chi-squared test. As shown in Graph 2, SCD group had a higher proportion of males (88.9%) compared to the ASD group (77.6%). The odds ratio for males being in the SCD group versus the ASD group was 2.31 (95% CI: 1.12–4.78).&lt;/p&gt; &lt;p&gt;Graph: Graph 2. Graph shows data on intergroup sex differences obtained from participant assessments in this study.&lt;/p&gt; &lt;p&gt;Around 77.6% of the participants in the group ASD were male while 22.4% were female. In the group SCD, 88.9% of the participants were male and 11.1% of the participants were female.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-17&quot;&gt;Discussion&lt;/hd&gt; &lt;p&gt;This study provides novel insights into the differences in adaptive behavior between children diagnosed with ASD and SCD. Notably, it underscores the relative advantages in adaptive functioning experienced by children with SCD compared to those with ASD. These findings stress the importance of differentiating between the two disorders, as the specific nature and degree of deficits in communication, socialization, motor, and daily living skills are critical factors in devising individualized interventions that can optimize outcomes for affected children.&lt;/p&gt; &lt;p&gt;Our findings demonstrate that children with SCD exhibit better adaptive functioning across all domains assessed by the VABS-III, with the most pronounced differences in communication and socialization skills. However, it is important to note that both groups showed impairments in expressive language skills relative to normative data, with mean scores falling in the &quot;low&quot; range for both ASD and SCD groups. In all other domains assessed, while SCD children had better adaptive levels than ASD children, their performance was still below age expectations.&lt;/p&gt; &lt;p&gt;Children with SCD performing better in the communication domain aligns with the diagnostic criteria that differentiate SCD from ASD. While both conditions involve social communication deficits, children with SCD typically have better structural language skills and do not display the restricted and repetitive behaviors characteristic of ASD ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref22&quot;&gt;1&lt;/reflink&gt;]). Our results provide some quantitative support for this clinical distinction.&lt;/p&gt; &lt;p&gt;The significant differences observed in the socialization domain are also of note. Despite their social communication challenges, children with SCD in our sample demonstrated better skills in interpersonal relationships, play and leisure activities, and coping behaviors compared to children with ASD. This suggests that the absence of restricted and repetitive behaviors in SCD may allow for greater flexibility in social interactions and activities.&lt;/p&gt; &lt;p&gt;For daily living skills and motor domain, both the quantitative and qualitative scores were better in SCD children as compared to ASD children. In sub-scales, barring expressive language adaptive skills which were low in both ASD and SCD groups, coping skills which were moderately low, and gross motor skills which were adequate in both groups, in all other domains assessed (receptive, daily living skills, interpersonal relationship, play &amp;amp; leisure, fine motor) SCD children had better adaptive level then ASD children.&lt;/p&gt; &lt;p&gt;This would imply that children with ASD may require more specific interventions targeting the motor and daily living activities along with interventions in the communication and socialization domain. The comparatively milder impairments in children with SCD highlight the importance of early identification and targeted interventions to foster the development of communication and social skills within this population. Future research could investigate the effectiveness of tailored intervention strategies for children with SCD, such as social skills training, language therapy, or parent-mediated interventions.&lt;/p&gt; &lt;p&gt;Our findings highlight important age and sex-related patterns in ASD and SCD diagnoses. Children diagnosed with ASD were generally younger and had lower overall adaptive behavior scores, emphasizing the importance of early assessment and intervention. While our cross-sectional data suggest age-related patterns in adaptive behavior differences between ASD and SCD groups, longitudinal studies would be needed to definitively characterize how these differences evolve over time.&lt;/p&gt; &lt;p&gt;The demographic composition of our groups also revealed notable patterns. The ASD group had a higher percentage of girls and younger children compared to the SCD group, suggesting that children with ASD may present with more significant deficits at earlier ages, leading to earlier identification and diagnosis. These earlier and more pronounced difficulties are reflected in their lower adaptive skills scores. While our GLM analysis accounted for age and sex effects, the observed group differences in adaptive functioning remained significant, suggesting that the distinctions between ASD and SCD extend beyond demographic factors.&lt;/p&gt; &lt;p&gt;The higher proportion of males in the SCD group is particularly intriguing and warrants further investigation as it may reflect genuine differences in disorder prevalence or could be influenced by diagnostic practices and referral patterns. Future research with age- and sex-matched samples would be valuable to validate these findings and determine whether these adaptive differences persist when controlling for demographic variables&lt;/p&gt; &lt;p&gt;Several limitations of this study should be noted. First, the cross-sectional design limits our ability to draw conclusions about developmental trajectories. Longitudinal studies are needed to better understand how adaptive behavior profiles in ASD and SCD may change over time. Second, our sample was drawn from a single clinical center, which may limit generalizability—future research should aim to include more diverse and representative samples.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-18&quot;&gt;Conclusion&lt;/hd&gt; &lt;p&gt;Our study provides evidence for significant differences in adaptive behavior profiles between children with ASD and SCD. Children with SCD consistently demonstrated better adaptive functioning across all domains assessed by the VABS-III, with the most pronounced differences in communication and socialization skills. These findings support the distinction between ASD and SCD as separate diagnostic categories and highlight the importance of comprehensive adaptive behavior assessment in the diagnostic process for neurodevelopmental disorders.&lt;/p&gt; &lt;p&gt;The results emphasize the need for tailored interventions that address the specific adaptive functioning deficits associated with each disorder. For children with ASD, interventions may need to focus more intensively on building basic communication skills and fostering social interactions. In contrast, interventions for children with SCD might emphasize more advanced communication skills and strategies for navigating complex social situations.&lt;/p&gt; &lt;p&gt;Our findings also illuminate the importance of considering age and sex in the assessment and treatment of these disorders. The age-related differences in adaptive behavior profiles suggest that early identification and intervention may be particularly crucial for children with ASD. The observed sex differences warrant further investigation and may have implications for screening and diagnostic practices, although further research is needed here.&lt;/p&gt; &lt;p&gt;In conclusion, the study has important clinical implications. The clear differences in adaptive behavior profiles between ASD and SCD support the validity of SCD as a distinct diagnostic category and underscore the importance of comprehensive adaptive behavior assessment in the diagnostic process. Furthermore, these findings can inform the development of tailored interventions that target specific areas of adaptive functioning in each disorder.&lt;/p&gt; &lt;hd id=&quot;AN0184233771-19&quot;&gt;Appendix 1&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Variable&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD skewness&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD skewness interpretation&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD Kurtosis&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD Kurtosis interpretation&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD Shapiro&amp;amp;#8211;Wilk&#39;s test&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD Shapiro&amp;amp;#8211;Wilk&#39;s test interpretation&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD number of criteria for normality met&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD is unimodal&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;ASD final impression&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age (years)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2.17&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7.13&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Overall score&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;1.01&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2.96&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Yes&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Communication&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.14&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.71&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.006&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;ADL&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.73&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.55&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Social&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;1.27&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6.25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.03&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.4&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.016&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Receptive&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;1.11&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Expressive&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.05&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.13&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Written&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.26&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.011&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Personal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.62&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.92&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Domestic&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.57&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.75&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Community&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.96&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.17&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Interpersonal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.52&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.69&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Play and leisure&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.73&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2.12&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Coping&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.95&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Gross motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.12&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.85&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Fine motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.03&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.27&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.013&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;hd id=&quot;AN0184233771-20&quot;&gt;Appendix 2&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;p&gt;Graph&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;colgroup&amp;gt;&amp;lt;col align=&quot;left&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;col align=&quot;char&quot; char=&quot;.&quot; /&amp;gt;&amp;lt;/colgroup&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;Variable&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD skewness&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD skewness interpretation&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD Kurtosis&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD Kurtosis interpretation&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD Shapiro&amp;amp;#8211;Wilk&#39;s test&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD Shapiro&amp;amp;#8211;Wilk&#39;s test interpretation&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD number of criteria for normality met&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD is unimodal&amp;lt;/th&amp;gt;&amp;lt;th align=&quot;left&quot;&amp;gt;SCD final impression&amp;lt;/th&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age (years)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.72&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.47&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Yes&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Overall score&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.01&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.734&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Communication&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.55&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.53&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.002&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Yes&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;ADL&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.18&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.19&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.451&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Social&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.8&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.97&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.003&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.52&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.85&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.039&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Receptive&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.72&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.53&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Expressive&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.32&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.37&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.002&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Written&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.45&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.19&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.039&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Personal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.24&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.05&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.054&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Domestic&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.29&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.7&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.014&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Community&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.39&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.23&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.003&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Interpersonal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.29&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2.49&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Play and leisure&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.14&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.05&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.002&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Coping&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.54&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.19&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#60;0.001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Gross motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.17&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.19&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.003&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Fine motor&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;&amp;amp;#8211;0.04&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.13&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.025&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Not normal&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;The authors thank Hiya Jain for editing the paper. Special thanks to all the children and their families who consented for their data to be anonymized and included in the study.&lt;/p&gt; &lt;ref id=&quot;AN0184233771-21&quot;&gt; &lt;title&gt; References &lt;/title&gt; &lt;blist&gt; &lt;bibl id=&quot;bib1&quot; idref=&quot;ref5&quot; type=&quot;bt&quot;&gt;1&lt;/bibl&gt; &lt;bibtext&gt; American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib2&quot; idref=&quot;ref1&quot; type=&quot;bt&quot;&gt;2&lt;/bibl&gt; &lt;bibtext&gt; Ashwood K. L., Tye C., Azadi B., Cartwright S., Asherson P., Bolton P. (2015). Brief report: Adaptive functioning in children with ASD, ADHD and ASD+ADHD. Journal of Autism and Developmental Disorders, 45, 2235–2242.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib3&quot; idref=&quot;ref9&quot; type=&quot;bt&quot;&gt;3&lt;/bibl&gt; &lt;bibtext&gt; Bishop D. V. (1998). 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Development and validation of DSM-5 based diagnostic tool for children with autism spectrum disorder. PLOS ONE, 14(3), Article e0213242.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib6&quot; idref=&quot;ref2&quot; type=&quot;bt&quot;&gt;6&lt;/bibl&gt; &lt;bibtext&gt; Ibrahim N., El-abdeen A. M. Z., Ng F., Zoromba M., Haikal A. (2020). Socio-economic and demographic factors associated with adaptive behaviour among children diagnosed with autism spectrum disorder in Egypt. Middle East Current Psychiatry, 27(1), 1–5.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib7&quot; idref=&quot;ref12&quot; type=&quot;bt&quot;&gt;7&lt;/bibl&gt; &lt;bibtext&gt; Kanne S. M., Gerber A. J., Quirmbach L. M., Sparrow S. S., Cicchetti D. V., Saulnier C. A. (2011). The role of adaptive behavior in autism spectrum disorders: Implications for functional outcome. 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Social (pragmatic) communication disorder: A research review of this new DSM-5 diagnostic category. Journal of Neurodevelopmental Disorders, 6(1), Article 41.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; World Health Organization. (2023, March 29). Autism. https://&lt;ulink href=&quot;http://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders&quot;&gt;www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders&lt;/ulink&gt;&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;ref id=&quot;AN0184233771-22&quot;&gt; &lt;title&gt; Footnotes &lt;/title&gt; &lt;blist&gt; &lt;bibtext&gt; Deepika Jain: Conceptualization; Data curation; Formal analysis; Investigation; Methodology; Project administration; Resources; Software; Supervision; Validation; Visualization; Writing—original draft; Writing—review &amp;amp; editing.Kawaljit Singh Multani: Methodology; Resources; Supervision.Anjali Dodiya: Investigation; Methodology; Resources.Urva Benani: Project administration.Anand Iyer: Data curation; Methodology; Supervision; Validation.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; The author(s) received no financial support for the research, authorship, and/or publication of this article.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; The study was approved by the ethics committee of 11 Air Force Hospital (11 AFH/364/33/Med).&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Deepika Jain&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;https://orcid.org/0009-0007-4583-4649 Anand Iyer&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt;Graph https://orcid.org/0000-0002-3932-4729&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;aug&gt; &lt;p&gt;By Deepika Jain; Kawaljit Singh Multani; Anjali Dodiya; Urva Benani and Anand Iyer&lt;/p&gt; &lt;p&gt;Reported by Author; Author; Author; Author; Author&lt;/p&gt; &lt;/aug&gt; &lt;nolink nlid=&quot;nl1&quot; bibid=&quot;bib11&quot; firstref=&quot;ref4&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl2&quot; bibid=&quot;bib14&quot; firstref=&quot;ref7&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl3&quot; bibid=&quot;bib15&quot; firstref=&quot;ref8&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl4&quot; bibid=&quot;bib12&quot; firstref=&quot;ref13&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl5&quot; bibid=&quot;bib13&quot; firstref=&quot;ref17&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl6&quot; bibid=&quot;bib10&quot; firstref=&quot;ref21&quot;&gt;&lt;/nolink&gt;
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  Data: Adaptive Behavior and Its Differences between Children with Autism Spectrum Disorder and Social Communication Disorder
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  Data: &lt;searchLink fieldCode=&quot;SO&quot; term=&quot;%22Autism%3A+The+International+Journal+of+Research+and+Practice%22&quot;&gt;&lt;i&gt;Autism: The International Journal of Research and Practice&lt;/i&gt;&lt;/searchLink&gt;. 2025 29(4):829-837.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 9
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2025
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles&lt;br /&gt;Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Autism+Spectrum+Disorders%22&quot;&gt;Autism Spectrum Disorders&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Children%22&quot;&gt;Children&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Communication+Disorders%22&quot;&gt;Communication Disorders&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Interpersonal+Communication%22&quot;&gt;Interpersonal Communication&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Child+Behavior%22&quot;&gt;Child Behavior&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Socialization%22&quot;&gt;Socialization&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Age+Differences%22&quot;&gt;Age Differences&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Adjustment+%28to+Environment%29%22&quot;&gt;Adjustment (to Environment)&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Neurodevelopmental+Disorders%22&quot;&gt;Neurodevelopmental Disorders&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Foreign+Countries%22&quot;&gt;Foreign Countries&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Symptoms+%28Individual+Disorders%29%22&quot;&gt;Symptoms (Individual Disorders)&lt;/searchLink&gt;
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22India%22&quot;&gt;India&lt;/searchLink&gt;
– Name: SubjectThesaurus
  Label: Assessment and Survey Identifiers
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;SU&quot; term=&quot;%22Vineland+Adaptive+Behavior+Scales%22&quot;&gt;Vineland Adaptive Behavior Scales&lt;/searchLink&gt;
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1177/13623613251317787
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1362-3613&lt;br /&gt;1461-7005
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Adaptive behavior is paramount for independent living and is varyingly impaired in different neurodevelopmental disorders. This study aimed to investigate differences in adaptive behavior between children with autism spectrum disorder and social communication disorder, two conditions characterized by deficits in social communication. Data from 232 children with autism spectrum disorder and 90 children with social communication disorder were analyzed. Adaptive behavior was assessed using the Vineland Adaptive Behavior Scale--III. Diagnoses were made independently using the Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria and the AIIMS Modified INCLEN Diagnostic Tool--autism spectrum disorder Diagnostic Evaluation for autism spectrum disorder. Statistical analyses included non-parametric tests and generalized linear models to account for age and sex differences. The results showed that children with social communication disorder exhibited better adaptive behavior than those with autism spectrum disorder across all domains (p &lt; 0.001). The most significant differences were observed in the Vineland Adaptive Behavior Scale-III standard scores in communication (autism spectrum disorder: 50.40 &#177; 15.51; social communication disorder: 70.53 &#177; 9.69) and socialization (autism spectrum disorder: 69.46 &#177; 8.77; social communication disorder: 80.07 &#177; 6.16) domains. Age and overall adaptive behavior scores correlated well with group membership (p &lt; 0.001). These findings emphasize the importance of distinguishing between autism spectrum disorder and social communication disorder in clinical practice. The results support the use of adaptive behavior assessments in diagnostic evaluations, highlighting the need for tailored interventions.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2025
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1466235
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1466235
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/13623613251317787
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 9
        StartPage: 829
    Subjects:
      – SubjectFull: Autism Spectrum Disorders
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Communication Disorders
        Type: general
      – SubjectFull: Interpersonal Communication
        Type: general
      – SubjectFull: Child Behavior
        Type: general
      – SubjectFull: Socialization
        Type: general
      – SubjectFull: Age Differences
        Type: general
      – SubjectFull: Adjustment (to Environment)
        Type: general
      – SubjectFull: Neurodevelopmental Disorders
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Symptoms (Individual Disorders)
        Type: general
      – SubjectFull: India
        Type: general
      – SubjectFull: Vineland Adaptive Behavior Scales
        Type: general
    Titles:
      – TitleFull: Adaptive Behavior and Its Differences between Children with Autism Spectrum Disorder and Social Communication Disorder
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Deepika Jain
      – PersonEntity:
          Name:
            NameFull: Kawaljit Singh Multani
      – PersonEntity:
          Name:
            NameFull: Anjali Dodiya
      – PersonEntity:
          Name:
            NameFull: Urva Benani
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            NameFull: Anand Iyer
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          Dates:
            – D: 01
              M: 04
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 1362-3613
            – Type: issn-electronic
              Value: 1461-7005
          Numbering:
            – Type: volume
              Value: 29
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Autism: The International Journal of Research and Practice
              Type: main
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