Social skills deficits and excesses are defining characteristics of intellectual disability (ID). Despite this, there is an unfortunate lack of research on the patterns and profiles of social behavior, particularly with adults who are severely intellectually disabled. This paper provides an analysis of social skill patterns for adults living in residential programs in the southeastern United States using the Matson Evaluation of Social Skills for Individuals with sEvere Retardation (MESSIER) as the dependent variable. A diagnosis of an autism spectrum disorder (ASD) was associated with more serious social disability. Items that were most commonly noted as problematic for individuals with ASD included preferring to be alone, avoiding eye contact, and exhibiting peculiar or odd mannerisms. Additionally, the presence of blindness and motoric impairment was associated with a higher degree of social skills impairment. The implications of these data for assessment, treatment, and future research are discussed. (Contains 5 tables.)