The Influence of clinical and socio-demographic factors on the adaptive behavior patterns of Egyptian children with autism

Adaptive functioning indicates real-life abilities in children with autism spectrum disorder (ASD). It is increasingly used as an outcome measure in intervention research. This study examined the influence of clinical and sociodemographic factors on the adaptive behavior patterns of Egyptian children with ASD. It also compared their adaptive behavior profiles to those of typically developing peers. A case–control study comprised 97 children aged 38–144 months. Fifty-six had ASD diagnosed by DSM-5 criteria and the Childhood Autism Rating Scale (CARS). Forty-one were age- and sex-matched typically developing children. The adaptive behavior was assessed using the Vineland Adaptive Behavior Scales, Second Edition (VABS-II). Clinical characteristics and socioeconomic indicators were obtained through structured interviews with caregivers. Multivariable linear regression analyses identified independent predictors of adaptive behavior outcomes. Children with ASD score significantly lower across all domains of adaptive behavior compared to controls (p<0.001). Mean scores in the ASD group were within the low range (below 70), with relative strengths observed in motor skills, followed by socialization and daily living skills, while communication showed the greatest impairment. Younger age, verbal ability, and higher socioeconomic status emerged as the strongest independent predictors of higher adaptive behavior scores. Egyptian children with ASD show marked deficits in adaptive functioning, with domain-specific patterns influenced by clinical and socio-demographic characteristics. Identifying these adaptive behavior profiles before intervention is essential for tailoring therapeutic strategies and for evaluating intervention outcomes using standardized measures such as the VABS-II.