Relationship between cognitive disengagement syndrome (CDS) (formerly sluggish cognitive tempo) and social functioning in child autism, ADHD, and elementary school samples

Background and aims: No studies have compared relationships between specific social functioning deficits and cognitive disengagement syndrome/CDS (formerly sluggish cognitive tempo) in autism, ADHD, and general population child samples. Methods: Mothers rated 1177 children with autism, 725 with ADHD-Combined, and 307 with ADHD-Inattentive (4–17 years) and 665 elementary school children (6–12 years) on the Pediatric Behavior Scale. Results: In all four groups, children with CDS had significantly greater frequencies of rejection by peers than children without CDS, and in the three clinical groups, withdrawn/shy behavior was significantly more prevalent in children with CDS. Low prosocial behavior did not differ between children with and without CDS. CDS contributed significantly and independently to predicting withdrawn/shy behavior and peer rejection, although its contribution was small compared with some other psychological problems. Overall, autism symptoms were the most powerful predictors of withdrawn/shy behavior and peer rejection. Conclusions and implications: CDS studies sometimes control for ADHD and other psychopathology in multivariate analyses, but autism is usually overlooked. This is a critical oversight because CDS is as common in autism as in ADHD and because social problems, autism symptoms, and CDS are significantly interrelated.