Theory suggests that symptoms of Attention-deficit Hyperactivity Disorder (ADHD; e.g., hyperactivity and impulsivity) may be associated with social cognition deficits characterised by fast but erroneous processing of social cues. Despite this, prior research has provided mixed evidence for (a) deficits in social cognition skills and (b) a link between such deficits and poor social outcomes among children with ADHD. We sought to clarify this ambiguity by (a) exploring variation in social cognition skills across a mixed clinical and normative population and (b) examining the demographic, clinical, and dimensional symptom profiles of children presenting with reduced social cognition skills characterised by fast but erroneous processing.

Participants were children and adolescents (N = 1,097) aged 4–18 years (M = 9.02, SD = 2.72) assessed using the Paediatric Evaluation of Emotions Relationships and Socialisation (PEERS), a child-direct, ecologically sensitive measure of social cognition. Latent profile analysis of standardised social cognition scores and response times for incorrect encoding of social cues (error-response times) was used to identify social cognition profiles. Differences between each profile in terms of demographics, clinical profiles, symptom dimensions, and social outcomes were explored.

Four social cognition profiles were identified. Two profiles were identified as being of particular interest: one which captured typically developing children (TDC; n = 727), and another which was characterised by lower social cognition scores and faster error-response times (impulsive responding; n = 201). The remaining profiles captured the response styles of younger participants (n = 152) and children with more pervasive social cognition deficits (n = 17). Comparison of the two profiles of interest revealed a number of statistically significant differences (p < .05). Compared to the TDC group, the impulsive responding group had: higher SDQ scores for hyperactivity, conduct, emotional, and peer problems; lower IQ and prosocial scores, and; greater parent-perceived social function deficits. Children in this group were also more likely to be male and from a lower SES background. Clinically, 18% of children in the impulsive responding group had an ADHD diagnosis, and 14% had at lease one mental health diagnosis other than ADHD.

A large minority of children (~18%) demonstrate social cognition deficits characterised by fast but erroneous processing of social cues. Although the explorative nature of this study does not allow conclusions to be made about the causes of such deficits, it is reasonable to conclude that they are not reducible to clinically significant symptoms of hyperactivity-impulsivity — less than 1/5 of the children in this group had an ADHD diagnosis, and 2/3 of children in this group had no mental health diagnosis at all. Child-direct tools designed to detect individual differences in social cognition skills may be beneficial in identifying individuals who will benefit from social support or interventions aimed at reducing social cognition deficits despite being missed by more traditional screening measures (e.g., clinical diagnoses). Future work should focus on understanding the causal relationships between symptoms of hyperactivity-impulsivity, fast but erroneous processing of social cues, social cognition skills, and social outcomes for this group of children.