Many children and adults with CdLS have some difficulties in understanding and using the ‘tools’ for social interaction. These ‘tools’ include the use of eye contact, facial expression, following another’s gaze and other skills including showing, pointing, giving and gesturing. Children and adults with CdLS are often extremely ‘passive’ during social interaction with both familiar and unfamiliar people, and rarely initiate interaction with other people. Some individuals might find social interaction very anxiety provoking and prefer very small groups or even one to one interaction, rather than big group events and activities. They may also take a long time to feel comfortable in a social situation or activity.
These difficulties in social interaction skills are similar to those observed in individuals with autism spectrum disorder (ASD). While individuals with CdLS have been found to share a number of characteristics with individuals with ASD, further research is required to determine the extent of these similarities.
It is important to ensure that professionals working with individuals with CdLS are aware of these difficulties and take these into account when designing and implementing educational and leisure time programmes for individuals.