Social Skills as a Predictor of Mental Health Trajectories among Autistic Youth and Youth with ADHD during the COVID-19 Pandemic

Neurodiverse youth face increased mental health risks, which may make them particularly vulnerable to the effects of the pandemic. Given high rates of co-occurrence between autism and attention-deficit/hyperactivity disorder (ADHD), it is valuable to identify shared risk factors for poor mental health. The present study investigated mental health trajectories among autistic youth and youth with ADHD from Spring 2020-Spring 2023 and explored how parent-reported youth social skills predicted these trajectories. Participants included 272 youth (autism = 143, ADHD = 129) aged 8–18. Social skills were assessed in Spring 2020. Youth- and parent-reported youth anxiety and depressive symptoms were assessed at six timepoints. Results from growth mixture modelling suggest there were different mental health trajectories during the pandemic. Trajectories of increasing, decreasing, and stable scores emerged for youth- and parent-reported youth anxiety, and parent-reported youth depression. For youth-reported depression scores, only an elevated-stable trajectory emerged. Autistic youth with better social skills were more likely to have high and increasing, and medium and stable parent-reported youth anxiety over the pandemic. Additionally, autistic youth with better social skills had lower youth-reported depression scores at the start of the pandemic. For both autistic youth and youth with ADHD, higher levels of social skills were associated with a greater probability of having low and stable parent-reported youth depression scores over the pandemic. Findings provide insight into the mental health trajectories among neurodiverse youth for the entire duration of the pandemic. Results suggest that social skills may be a valuable intervention target, especially for autistic youth.