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Since Hans Asperger’s first description (Arch Psych Nervenkrankh 117:76–136, 1944), through Lorna Wing’s translation and definition (Psychol Med 11:115–129, 1981), to its introduction in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, 1994), Asperger Syndrome has always aroused huge interest and debate, until vanishing in the DSM fifth edition (2013). The debate regarded its diagnostic validity and its differentiation from high functioning autism (HFA). The present study aimed to examine whether AS differed from HFA in clinical profiles and to analyze the impact of DSM-5’s innovation. Differences in cognitive, language, school functioning and comorbidities, were revealed when 80 AS and 70 HFA patients (3–18 years) were compared. Results suggested that an AS empirical distinction within autism spectrum disorder should be clinically useful.

Social difficulties are a key aspect of autism, but the intervening factors are still poorly understood. This study had two objectives: to compare the profile of ToM skills, executive functioning (EF), and pragmatic competence (PC) of children with high-functioning autism (HFA) and children with typical development (TD), and analyze their mediator role in social functioning. The participants were 52 children with HFA and 37 children with TD matched on age, intelligence quotient, and expressive vocabulary. Significant differences were found on measures of ToM, both explicit and applied, EF, and PC between children with HFA and TD. Multiple mediation analysis revealed that applied ToM skills and PC mediated the relations between autism symptoms and social functioning. Implications for social cognitive interventions to address these findings are discussed.

Sex differences have been found amongst toddlers and young children with autism spectrum disorder (ASD). We investigated the presence and stability of these ASD sex differences throughout childhood and adolescence. Participants ( N  = 325, 52 females; aged 3–18 years) consecutively received an ASD diagnosis at a clinic for assessing high-functioning ASD (mean verbal IQ = 92.6). There were no IQ sex differences. By parent report and direct observation, females had less repetitive stereotyped behaviour (RSB), with male-equivalent levels of social and communication impairment. Teachers reported males with ASD as having greater externalising and social problems than females. The female phenotype we describe was stable across our sample’s age range. Their milder RSBs and less severe difficulties at school may lead to under-recognition of ASD in females.

Preliminary research examining sexuality within High-Functioning Autism (HFA) has been yet to consider the impact sex may have on the sexual/romantic functioning of this population. A systematic database search was carried out to identify 27 observational and cross-sectional publications meeting predetermined inclusion criteria. Using standardised mean differences, a random-effects meta-analysis pooled data from 9 eligible studies. Exhibiting higher levels of sexual understanding, females with HFA were subject to more adverse sexual experiences than males with HFA and neurotypical counterparts. Males reported greater desire for, and engagement in both solitary and dyadic sexual contact. Findings have provided initial insight into characterising the sexuality of males and females with HFA, yet also necessitated the need for future research in the field.

Individuals with schizophrenia and individuals with high-functioning autism (HFA) seem to share some social, behavioral and biological features. Although marked impairments in social cognition have been documented in both groups, little empirical work has compared the social cognitive functioning of these two clinical groups. Forty-four individuals with schizophrenia, 36 with HFA and 41 non-clinical controls completed a battery of social cognitive measures that have been linked previously to specific brain regions. The results indicate that the individuals with schizophrenia and HFA were both impaired on a variety of social cognitive tasks relative to the non-clinical controls, but did not differ from one another. When individuals with schizophrenia were divided into negative symptom and paranoid subgroups, exploratory analyses revealed that individuals with HFA may be more similar, in terms of the pattern of social cognition impairments, to the negative symptom group than to the paranoia group. Our findings provide further support for similarities in social cognition deficits between HFA and schizophrenia, which have a variety of implications for future work on gene-brain-behavior relationships.

Using eye-tracking, we studied allocation of attention to faces where the emotional expression and eye-gaze dynamically changed in an ecologically-valid manner. We tested typically-developed (TD) adults low or high in autistic-like traits (Experiment 1), and adults with high-functioning autism (HFA; Experiment 2). All groups fixated more on the eyes than on any of the other facial area, regardless of emotion and gaze direction, though the HFA group fixated less on the eyes and more on the nose than TD controls. The sequence of dynamic facial changes affected the groups similarly, with reduced attention to the eyes and increased attention to the mouth. The results suggest that dynamic emotional face scanning patterns are stereotypical and differ only modestly between TD and HFA adults.

In 122 high-functioning children with autism spectrum disorder (ASD; 9–13 years; 19 girls), we investigated the effectiveness of a 15-session social skills group training (SST) with and without parent and teacher involvement (PTI) in a randomized controlled trial with three conditions: SST (n = 47), SST–PTI (n = 51), and care-as-usual (CAU, n = 24). Hierarchical linear modeling was used for immediate and 6-month follow-up analyses. Measures were administered before randomization (blind), post-treatment and at follow-up (not blind). Trial registration: Dutch Trial Register; http://www.trialregister.nl; NTR2405. At post-treatment, children in both SSTs had improved significantly more than CAU on the primary outcome, Vineland Socialization (SST: Cohen’s d = 0.39; 95% CI − 2.23 to 3.11 and SST–PTI: d = 0.43; 95% CI − 2.19 to 3.15) and on the secondary outcome parent-SSRS “Cooperation” (SST: d = 0.43; 95% CI − 0.23 to 1.15 and SST–PTI: d = 0.45; 95% CI − 0.21 to 1.17), with no difference between post-treatment and follow-up. Additionally, children in SST–PTI improved significantly more on the teacher-SSRS than in CAU [“Cooperation” d =0.42 (95% CI − 0.33 to 1.13); “Assertion” d =0.34 (95% CI − 0.39 to 1.11); “Self-Control” d =0.61 (95% CI − 0.08 to 1.34)] and in SST [“Cooperation” d =0.34 (95% CI − 0.37 to 1.05); “Self-Control” d =0.59 (95% CI − 0.13 to 1.32)]. The current study corroborates earlier findings in smaller samples and wider age ranges, with small but statistically significant effects of SST for high-functioning pre-adolescent children with ASD. Parental and teacher involvement intensified treatment, yet did not yield an additional effect relative to SST for children only, as reported by parents. 6 months after training, no further improvement or decline was found.

Evidence suggests that autism and schizophrenia share similarities in genetic, neuropsychological and behavioural aspects. Although both disorders are associated with theory of mind (ToM) impairments, a few studies have directly compared ToM between autism patients and schizophrenia patients. This study aimed to investigate to what extent high-functioning autism patients and schizophrenia patients share and differ in ToM performance. Thirty high-functioning autism patients, 30 schizophrenia patients and 30 healthy individuals were recruited. Participants were matched in age, gender and estimated intelligence quotient. The verbal-based Faux Pas Task and the visual-based Yoni Task were utilised to examine first- and higher-order, affective and cognitive ToM. The task/item difficulty of two paradigms was examined using mixed model analyses of variance (ANOVAs). Multiple ANOVAs and mixed model ANOVAs were used to examine group differences in ToM. The Faux Pas Task was more difficult than the Yoni Task. High-functioning autism patients showed more severely impaired verbal-based ToM in the Faux Pas Task, but shared similar visual-based ToM impairments in the Yoni Task with schizophrenia patients. The findings that individuals with high-functioning autism shared similar but more severe impairments in verbal ToM than individuals with schizophrenia support the autism-schizophrenia continuum. The finding that verbal-based but not visual-based ToM was more impaired in high-functioning autism patients than schizophrenia patients could be attributable to the varied task/item difficulty between the two paradigms.

This paper reviews the literature examining social skills training (SST) programs for youth with AS/HFA, with an emphasis on critically evaluating efficacy and highlighting areas of future research. The review highlights the disparity between SST programs described in the extant literature, including lack of a universal definition of social skills, various levels of intensity and duration of treatment, divergent theoretical backgrounds, and variety in services provided in clinic or classroom settings. Overall, it is clear that, despite their widespread clinical use, empirical support for SST programs for children with AS/HFA is minimal at this time. Based on this critical review, a “roadmap” for future research, consistent with recommendations put forth by a leading group of autism researchers, is presented.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder marked by socio-emotional deficits, and difficulties with pretend play skills. Play skills are related to processes of adaptive functioning and emotion understanding. The present pilot study implemented an in-person pretend play intervention to school-aged children (ages 6 to 9 years, intervention group = 18, control group = 7) diagnosed with high-functioning ASD (HF-ASD), to increase children’s cognitive and affective play skills, and emotional understanding abilities. The intervention consisted of 5 weekly sessions, 15–20 minutes each. The intervention group significantly increased in imagination and cognitive play skills, which generalized to increased skills in emotional understanding. Findings demonstrate the positive impact of a short, easily facilitated, accessible play intervention for school-aged children with HF-ASD.