Parent Reports of Executive Function Associated with Functional Communication and Conversational Skills Among School Age Children With and Without Autism Spectrum Disorder

A follow-up study of peer relationships in autistic and non-autistic youths: Mediating effects from autistic, emotional and behavioral symptoms

BACKGROUND

Little is known about how clinical features prospectively influence peer relationships in autistic populations.

AIMS

This study investigated the clinical symptoms mediating the link between autism spectrum disorder (ASD) diagnosis and peer relationships at follow-up, i.e. the second time evaluation of this study.

METHODS

The sample consisted of 366 autistic youths and 134 non-autistic comparisons. The autistic traits and emotional/behavioral problems were measured at baseline by Social Responsiveness Scale (SRS) and Child Behavior Checklist (CBCL). The interactions and problems with peers were assessed by the Social Adjustment Inventory for Children and Adolescents (SAICA) at follow-up.

RESULTS

Each subscore of SRS and CBCL showed significant mediation effects. Multiple mediation analyses showed atypical social communication, social awareness problems, and delinquent behaviors mediated the link from ASD to less active peer interactions after controlling for sex, age, and IQ. Moreover, atypical social communication, social-emotional problems, and attention difficulties predicted problems with peers. After considering these mediation effects, the diagnosis of ASD still demonstrated a significantly direct effect on peer relationships at follow-up.

CONCLUSIONS AND IMPLICATIONS

Our findings support that social-related autistic features, attention problems, and delinquent behaviors mediated a link between ASD and peer relationships. These mediators are potential measures for improving interactions and decreasing difficulties with peers in the autistic population.

The mediators for the link between autism and real-world executive functions in adolescence and young adulthood

LAY ABSTRACT

Childhood factors that predict real-world executive function in autism spectrum disorder during the transition into adulthood are largely unknown. This study aimed to identify the predictors for the behavioral and cognitive aspects of real-world executive function in late adolescent and young adult autistic populations. We followed up 289 autistic youth (mean age 11.6 years) and 203 non-autistic controls (10.7 years) to their ages of 16.9 and 15.8, respectively. The Behavior Rating Inventory of Executive Function scale was used to measure the real-world executive function at late adolescence and young adulthood at follow-up. Potential predictors such as autistic symptoms, inattention or hyperactivity symptoms, peer relationship, emotional symptoms, and parenting styles were assessed in childhood at first enrollment. The results showed that childhood inattention, withdrawn behaviors, social communication difficulties, and child-reported emotion and inattention/hyperactivity may predict real-world lower executive function in late adolescence and young adults with autism. When separating executive function into behavioral and cognitive aspects, we found that oppositional behaviors and peer problems were specific predictors for behavioral regulation and cognitive function, respectively. Our findings suggested that treating common predictors in childhood, such as inattention, may potentially improve real-world executive function in autism during the transition into adulthood.

Use of the Weekly Calendar Planning Activity to Assess Executive Function in Adolescents With Autism Spectrum Disorder

IMPORTANCE

Youths with autism spectrum disorder (ASD) have challenges with executive function (EF). However, there are few measures to objectively assess EF, such as time management and prioritization. The Weekly Calendar Planning Activity (WCPA) is a promising performance-based EF measure that has rarely been used with youths with ASD.

OBJECTIVE

To characterize the performance of youths with ASD on the WCPA and the association of WCPA performance with caregiver-rated EF.

DESIGN

Observational and summary data obtained during a baseline evaluation for a research study.

SETTING

Middle school.

PARTICIPANTS

Thirty-nine adolescents with ASD and without an intellectual disability.

METHOD

Youth were administered the WCPA; caregivers completed EF ratings. Descriptive statistics characterized WCPA performance. Correlations between WCPA scores and age, IQ, and EF ratings were computed.

RESULTS

The majority of youth performed poorly on the WCPA and lacked insight into their poor performance. Many struggled to enter appointments. Appointment accuracy was <30%. The most common errors were location errors. Appointment accuracy and planning time were moderately associated with IQ but not with caregiver-rated EF or age.

CONCLUSIONS AND RELEVANCE

Overall, the WCPA was cognitively demanding for youths with ASD without an intellectual disability. These results have implications for using evidence-based strategies to teach adolescents with ASD how to manage their time and plan and prioritize homework assignments, upcoming tests or quizzes, and extracurricular activities. Plain-Language Summary: Youths with autism spectrum disorder have significant problems with executive function, particularly organization, prioritization, time management, and planning. There are few objective, performance-based measures of executive function, especially those that can be used with autistic youths. To our knowledge, this study is the first to use the Weekly Calendar Planning Activity (WCPA) with autistic adolescents who do not have an intellectual disability. The WCPA captured their deficits related to executive function and could be a useful tool for assessment and treatment planning.

The Relation between Cognitive and Emotional Processes in Children and Adolescents with Neurodevelopmental Disorders-A Meta-Analysis

BACKGROUND

Up to 80% of children with autism spectrum disorders (ASDs) have mental health issues-either emotional or behavioral problems. The underlying mechanisms are still unknown, even if emotional regulation (ER) is considered to play a major role in child and adolescent psychopathology. Several studies link the ability to regulate the intensity and quality of emotions with executive functioning. Therefore, we aimed to investigate the association between executive functions (EFs) and ER and affective problems in children with ASD.

METHODS

This meta-analysis is based on a literature search of peer-reviewed journals from the following databases: Scopus, ProQuest, Ebsco, Science Direct, Springer Link and Clarivate. We analyzed 15 studies that investigated the link between EF, ER or affective problems (APs) in children and adolescents with ASD aged between 2 and 18 y with ASD. To assess the effect size of the relationship between EF and ER, and EF and AP, 15 studies comprising 54 effect sizes were analyzed.

RESULTS

Our findings revealed a small effect size regarding the association between EF and ER, r = 0.331, p = 0.034, and a small effect size regarding the association between EF and AP, r = -0.213, p = 0.024. No significant moderators were found. The results are presented in regard to the two analyses developed, as well as a short review of the studies included in the meta-analysis.

CONCLUSION

Even if there are several limitations of this study, especially considering the small number of studies included, the results suggest that it is worth considering EF as an underlying mechanism for the appearance of emotional or behavioral problems in children with ASD. These findings have important implications for the development of ASD intervention plans, as well as for increasing awareness among specialists about the importance of executive functions in school adjustment and social functioning.

The Association of Autistic Traits on Cognitive Emotion Regulation Strategies in a Non-clinical Sample

Individuals with high autistic traits have difficulty in regulating their negative emotions. However, few studies clarify the relationship between autistic traits and cognitive emotion regulation strategies. This study examined the association between adaptive and maladaptive strategies in cognitive emotion regulation and autistic traits using a non-clinical sample. Two hundred and thirty-four participants completed the Japanese version of the Social Responsiveness Scale-2 (Adult Self-Report version) and the Japanese version of the Cognitive Emotion Regulation Questionnaire. The results showed that autistic traits were negatively associated with the use of adaptive subordinate strategies for cognitive emotion regulation. By contrast, autistic traits were positively associated with the use of maladaptive subordinate strategies of cognitive emotion regulation. The cognitive and emotional characteristics of autism spectrum disorder, such as perspective taking and executive function, contextualize these results. These findings can help guide not only our understanding of the relationship between autistic traits and cognitive emotion regulation but also develop interventions aimed at facilitating the use of adaptive cognitive emotion regulation strategies and preventing the use of maladapted strategies in individuals with high autistic traits.

Associations between executive function and attention abilities and language and social communication skills in young autistic children

LAY ABSTRACT

Executive functioning describes a set of cognitive processes that affect thinking and behavior. Past research has shown that autistic individuals often have delays in the acquisition of executive function abilities. Our study explored how differences in executive function and attention abilities relate to social abilities and communication/language in 180 young autistic children. Data were gathered via caregiver report (questionnaires/interviews) and an assessment of vocabulary skills. The ability to sustain attention to a dynamic video was measured via eye tracking. We found that children with higher levels of executive function skills demonstrated lower levels of social pragmatic problems, a measure of having difficulties in social contexts. Furthermore, children who were able to sustain their attention longer to the video displayed higher levels of expressive language. Our results emphasize the importance of executive function and attention skills across multiple areas of functioning in autistic children, in particular those that involve language and social communication.

Child Attachment Representations and Parenting Stress in Mothers and Fathers of School-Age Children with a Diagnosis of Autism Spectrum Disorder: A Pilot Cross-Sectional Study

Mothers and fathers of autistic children (ASD) tend to report elevated levels of parenting stress. Thus, it is critically important to understand which factors contribute to an imbalance between the perceived demands of parenting and the available psychological resources. To date, little is known about the association between child attachment representations and parenting stress. In this study, we first examined group differences in parenting stress levels based on child diagnosis and parents' gender. Second, we explored the predictive role of child diagnosis, autism severity, and child attachment representations on parenting stress. The study involved 23 school-age children with ASD (IQ > 70), 27 without ASD (7-13 years), and their mothers (n = 50) and fathers (n = 50). Data were collected from 2017 to 2020. Parents completed the Social Responsiveness Scale 2 and the Parenting Stress Index-Short Form, while the children's attachment representations were assessed using the School-age Assessment of Attachment. Parents of children with ASD reported higher stress compared with controls. No differences were found between mothers and fathers. Implicit attachment representations have been found to be associated with parenting stress only in mothers, while the severity of social impairment showed a significant effect on parenting stress in both parents. These findings revealed the potential benefit of adaptive attachment representations not only for children themselves but also for mothers and the family system, suggesting the bidirectional nature of parent-child relationships in the context of ASD. The uniqueness of maternal and paternal parenting experiences should be considered when parenting stress is addressed.

A new acquisition protocol for conducting studies with children: The science camp research experience

In the last 50 years, the study of brain development has brought major discoveries to education and medicine, changing the lives of millions of children and families. However, collecting behavioral and neurophysiological data from children has specific challenges, such as high rates of data loss and participant dropout. We have developed a science camp method to collect data from children using the benefits of positive peer interactions and interactive and engaging activities, to allow researchers to better collect data repeatedly and reliably from groups of children. A key advantage of this approach is that by increasing participant engagement, attention is also increased, thereby increasing data quality, reducing data loss, and lowering attrition rates. This protocol describes the step-by-step procedure for facilitation of a science camp, including behavioral, electrophysiological, and participatory engagement activities. As this method is robust but also flexible, we anticipate that it can also be applied to different demographics and research needs.

Developmental competencies, temperament, parenting practices and psychosocial adversities in children with internalising disorders - A pilot study

Research on the aetiology of internalising disorders has focussed on biological and environmental factors, however, the role of developmental competencies that a child acquires has not been explored much. The current report aimed to understand the association among the developmental competencies, temperament, parenting practices and psychosocial adversities in internalising disorders. The sample consisted of 30 children and adolescents with internalising disorders belonging to the age group of six to 18, and one of their parents. All the participants were assessed for functional impairment, temperament, interpersonal competence, emotion regulation, executive function, self-concept, adaptive behaviour, parenting practices, life events and family environment using standardised tools. The findings revealed that positive parenting shares a negative relationship with functional impairment(ρ=-0.62; p <.001). On comparison with non-clinical samples in previous studies, interpersonal competence and self-concept were found to be at lower levels in the current sample. In conclusion, the current study indicates that children with internalising disorders differ from control groups in specific developmental competences. These findings have specific implications for intervention and research in the area of internalising disorders in children and adolescents.

Association of sugar-sweetened beverages with executive function in autistic children

The association between sugar-sweetened beverages (SSBs) consumption and executive function (EF) among typically developing (TD) children has been investigated in previous studies but with inconsistent results. Furthermore, this relationship has been less investigated among autistic children who perform worse in EF compared with TD children. In this study, we aimed to investigate the association between SSB consumption and EF in autistic children, and whether the association between SSB and EF in autistic children is different from that in TD children. We recruited 106 autistic children and 207 TD children aged 6–12 years in Guangzhou, China. Children’s EF was assessed by using the Chinese version of parent-reported Behavior Rating Inventory of Executive Function, Stroop Color–Word Test, and working memory subscales of the Chinese version of Wechsler Intelligence Scale for children, Fourth edition. Meanwhile, we assessed children’s dietary intake and SSB consumption with a validated Food Frequency Questionnaire. In this study, 70 (66.0%) autistic children consumed SSB and 20 (18.9%) of them consumed more than two servings SSB a week. Among autistic children, over two servings per week SSB consumption was associated with poorer performance in emotional control [β = 7.20, 95% confidence interval (CI): 0.94–13.46] and plan/Organize (β = 6.45, 95% CI: 0.27–12.63). The association between over two servings/week SSB consumption and emotional control among autistic children was significantly different from that among TD children (β_ASD = 7.20; β_TD = −3.09, Z = 2.72, p = 0.006). Results of this study show that SSB consumption was associated with an impairment in some subscales of EF in autistic children. Furthermore, the association between SSB and EF in autistic children might be different from that in TD children.

Elevated symptoms of executive dysfunction predict lower adaptive functioning in 3-year-olds with autism spectrum disorder

Executive functioning (EF) deficits co-occur frequently with autism spectrum disorder (ASD) and have a long-term detrimental impact on quality of life of children and their families. Timely identification of risk for EF vulnerabilities may hasten access to early intervention and alleviate their long-term consequences. This study examines (1) if EF deficits are elevated in toddlers with ASD compared to nonautistic siblings of children with ASD, typically developing (TYP) toddlers, and toddlers with atypical developmental presentation; and (2) if EF deficits have a detrimental effect on adaptive functioning in ASD. Participants were recruited between September 2014 and October 2019 and included 73 toddlers with ASD, 33 nonautistic siblings of children with ASD, 35 toddlers with atypical development, and 28 TYP toddlers matched on chronological age (M = 39.01 months, SD = 3.11). EF deficits were measured using the BRIEF-P; adaptive skills were measured using the VABS-II. Whenever appropriate, analyses were controlled for MSEL verbal and nonverbal developmental quotient, ADOS-2 autism severity scores, and sex. Analyses revealed that toddlers with ASD exhibited elevated BRIEF-P scores across all domains compared to each of the three comparison groups. Higher BRIEF-P scores were associated with lower adaptive social, communication, and daily living skills while controlling for symptom severity, verbal and nonverbal functioning, and sex. In conclusion, marked vulnerabilities in EF are already present in 3-year-old toddlers with ASD and are predictive of the level of adaptive functioning in ASD. EF vulnerabilities in toddlers should be targeted for intervention to improve long-term outcomes in ASD. LAY SUMMARY: Many children with autism experience vulnerabilities in executive functioning (EF), which may include challenges with inhibition, working memory, cognitive flexibility, and planning. The study shows that these vulnerabilities can already be detected at age three and that their presence is linked with lower social, communication, and daily living skills. Screening children with ASD for EF challenges and helping those who have difficulties may improve their long-term outcomes.

Executive Functions in Children and Adolescents with Autism Spectrum Disorder in Family and School Environment

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by the presence of difficulties in communication and social interaction, often associated with deficits in executive functions (EF). The EF correct development is related to a more effective functioning in all its daily activities, while being associated with more efficient social relations. The objective of this research is to analyze the level of development of EF in children and adolescents with ASD in school and at home. This is a descriptive, cross-sectional, and multicenter study with 102 participants selected by non-probabilistic sampling, 32 parents of children with ASD, and 70 professionals in the field of education of students with ASD. The study confirms that although children and adolescents with ASD have problems in executive functioning, the perception of informants, parents, and education professionals is similar but not the same in the different contexts: school and home.

Children with autism spectrum disorder show atypical electroencephalographic response to processing contextual incongruencies

Children with autism spectrum disorder (ASD) experience difficulties with social communication, making it challenging to interpret contextual information that aids in accurately interpreting language. To investigate how the brain processes the contextual information and how this is different in ASD, we compared event-related potentials (ERPs) in response to processing visual and auditory congruent and incongruent information. Two groups of children participated in the study: 37 typically developing children and 15 children with ASD (age range = 6 to 12). We applied a language task involving auditory sentences describing congruent or incongruent images. We investigated two ERP components associated with language processing: the N400 and P600. Our results showed how children with ASD present significant differences in their neural responses in comparison with the TD group, even when their reaction times and correct trials are not significantly different from the TD group.

The link between social communication and mental health from childhood to young adulthood: A systematic review

This systematic review investigates the current state of the literature on the association between social communication (SC) skills and mental health outcomes in children and young adults. We ran searches using terms describing SC and mental health in the following databases: PubMed, the Psychology and Behavioral Sciences Collection, APA PsychInfo, the Education Resource Information Center (ERIC) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). We included studies that both measured SC before age 21 years and assessed a mental health component, such as behavior/conduct problems, anxiety, depression, or emotional problems, before age 30. Only peer-reviewed articles published in or after 2000 were retained. In total, 27 studies were included in the narrative synthesis. Overall, the methodological quality was good. A longitudinal design was used in 12 studies, seven of which sourced data from the Avon Longitudinal Study of Parents and Children. Most studies investigated the broad concept of pragmatic language and its influence on internalizing, externalizing, and peer-relationship problems. The analyzed publications included population-based studies and studies investigating special populations with existing mental health problems or at increased risk of developing them. The population-based cross-sectional studies showed significantly higher rates of SC problems in children with mental health problems while those with a longitudinal design found earlier onset and more persistent mental health problems in children who had the most severe SC difficulties. Studies with special populations confirmed more SC problems as compared to typically developing children and worse mental health outcomes in children with additional SC difficulties. The available literature thus shows consistently significant, mostly moderate associations between SC skills and mental health outcomes. SC difficulties earlier in life can predict mental health problems and impact their trajectories.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=286598], identifier [CRD42022286598].

Sleep disturbances in autism spectrum disorder without intellectual impairment: relationship with executive function and psychiatric symptoms

The autism spectrum disorder (ASD) is a neurodevelopmental condition, frequently accompanied by medical and psychiatric pathology. One of the most commonly found problems associated with ASD is sleep disturbances, which are estimated to affect approximately 80% of the people with ASD, not only during childhood but also in the adolescence and adult stages. Nevertheless, the relationship of these sleep difficulties with autism severity, as well as other associated impairments such as executive functioning and psychiatric disorders (eg, depression), has not yet been widely studied. The main objective of the present study was to explore the relationship between sleep disturbances, subjective measures of executive function, and psychiatric pathology in the ASD population. To reach that goal, a group of 89 participants with ASD (44 children/adolescents and 45 adults) was recruited and evaluated with self-reported measures of executive function performance and psychiatric pathology tests. Multivariate analysis showed a significant association between sleep disturbances and psychiatric symptoms in both ASD groups, with greater sleep disturbances predicting more severe psychiatric pathology. No significant association was found with executive function in any group. Limitations included a small sample size and lack of objective measures. Sleep problems seem to be associated with the severity of psychiatric pathology throughout the lifespan, increasing the chance of developing psychiatric symptoms when they were present. Improving sleep quality in ASD at all ages may result in preventing and/or decreasing psychiatric pathology in this population.

Alpha connectivity and inhibitory control in adults with autism spectrum disorder

BACKGROUND

Individuals with autism spectrum disorder (ASD) often report difficulties with inhibition in everyday life. During inhibition tasks, adults with ASD show reduced activation of and connectivity between brain areas implicated in inhibition, suggesting impairments in inhibitory control at the neural level. Our study further investigated these differences by using magnetoencephalography (MEG) to examine the frequency band(s) in which functional connectivity underlying response inhibition occurs, as brain functions are frequency specific, and whether connectivity in certain frequency bands differs between adults with and without ASD.

METHODS

We analysed MEG data from 40 adults with ASD (27 males; 26.94 ± 6.08 years old) and 39 control adults (27 males; 27.29 ± 5.94 years old) who performed a Go/No-go task. The task involved two blocks with different proportions of No-go trials: Inhibition (25% No-go) and Vigilance (75% No-go). We compared whole-brain connectivity in the two groups during correct No-go trials in the Inhibition vs. Vigilance blocks between 0 and 400 ms.

RESULTS

Despite comparable performance on the Go/No-go task, adults with ASD showed reduced connectivity compared to controls in the alpha band (8-14 Hz) in a network with a main hub in the right inferior frontal gyrus. Decreased connectivity in this network predicted more self-reported difficulties on a measure of inhibition in everyday life.

LIMITATIONS

Measures of everyday inhibitory control were not available for all participants, so this relationship between reduced network connectivity and inhibitory control abilities may not be necessarily representative of all adults with ASD or the larger ASD population. Further research with independent samples of adults with ASD, including those with a wider range of cognitive abilities, would be valuable.

CONCLUSIONS

Our findings demonstrate reduced functional brain connectivity during response inhibition in adults with ASD. As alpha-band synchrony has been linked to top-down control mechanisms, we propose that the lack of alpha synchrony observed in our ASD group may reflect difficulties in suppressing task-irrelevant information, interfering with inhibition in real-life situations.

The Association Between Self-Reported Camouflaging of Autistic Traits and Social Competence in Nonautistic Young Adults

Background

Autistic individuals often experience difficulties in social settings. Although autistic individuals may not intuitively know the "typical" way to behave in social settings, many autistic individuals have a desire to fit in so they develop techniques to "camouflage" their autistic traits. Although camouflaging may help individuals to navigate social environments, camouflaging has also been shown to produce negative psychological outcomes. This study aims to explore whether this "camouflaging" strategy is associated with poor social competence, an aspect of the autism diagnosis.

Methods

In this study, 247 nonautistic adults completed the Multidimensional Social Competence Scale (MSCS) to assess their social competence, and the Camouflaging Autistic Traits Questionnaire (CAT-Q) to assess the extent to which they used strategies to compensate or mask behaviors characteristic of autism in social settings.

Results

We found that over and above IQ, gender, and executive functioning scores, social competence (MSCS) scores reliably predicted the extent to which nonautistic individuals camouflaged, accounting for 25% of the variance in CAT-Q scores. Importantly, even when autistic traits were controlled for, social competence was still able to account for additional variance in CAT-Q scores.

Conclusion

These results suggest that low social competency in nonautistic adults predicts camouflaging as a strategy in social situations. Given these camouflaging behaviors are being performed in an attempt to comply with an environmental demand to behave in a particular manner, these results also highlight the importance of conceptualizing the social challenges that autistic and nonautistic individuals face in a bidirectional manner, where the onus is not solely on the individual to comply with social conventions but also on society to accommodate diverse behavioral traits.

Lay summary

Why was this study done?: Some autistic individuals try to hide their autistic traits to "fit in" with others, referred to as "camouflaging." Nonautistic adults also report camouflaging, but it is unclear whether this camouflaging is related to social difficulties that are not specific to autism. No research has been conducted to examine the relationship between social competence and camouflaging in nonautistic adults.What was the purpose of this study?: To further understand the factors that are related to camouflaging behaviors. More specifically, whether social abilities, and/or autism characteristics, are related to whether nonautistic adults camouflage.What did the researchers do?: We had 257 nonautistic adults complete various questionnaires, including ones that asked them about their camouflaging behaviors and social abilities. We examined the relationships between the scores from these questionnaires and the influence of other factors such as gender, intelligence, and executive functioning.What were the results of the study?: We found that both social abilities and autistic traits were related to camouflaging behaviors. Indeed, nonautistic adults who had poor social skills, and more autistic traits, engaged in more camouflaging. Social skills were associated with camouflaging even after we considered factors such as gender, intelligence, and executive functioning.What do these findings add to what was already known?: These findings help us understand camouflaging by demonstrating that it may be a common response to social difficulties in nonautistic, as well as autistic, adults. These results also indicate that camouflaging is related to low social competency, not just autism characteristics.What are the potential weaknesses in the study?: The participants in our study completed questionnaires through which they were required to pick from set answers, rather than describe their experiences. We may be missing important qualitative differences in the way nonautistic adults camouflage compared with autistic adults.How will these findings help autistic adults now or in the future?: By comparing what is shared and what is unique with nonautistic people who share traits with autistic people, a more precise definition and study of camouflaging behavior are possible. Rather than see camouflaging as a phenomenon that occurs exclusively in autistic people because of their disability, it may be that both autistic and nonautistic people use camouflaging when they perceive themselves to lack the necessary social competencies that are expected within their social contexts. Because both autistic traits and social competency are related to camouflaging behavior, we can begin to think about how to tease apart which characteristics are more likely to evoke camouflaging in autistic individuals and how this may be similar or different in nonautistic individuals. This knowledge will ultimately contribute to the development of more tailored approaches to prevent and/or reduce the negative impact of camouflaging behaviors for autistic adults.

Adolescents with solid organ transplant: Using the BRIEF2 parent-report and self-report to measure parent-child agreement and everyday executive function

Agreement between parent and adolescent ratings of executive function (EF) is not known in adolescents with solid organ transplant (SOT), even though pressing concerns about EF deficits are being raised in this population. The current study investigated EF in adolescents with SOT using parent and self report. Twenty-five adolescents (M = 15.51 years) with SOT and their parent completed a behavior rating scale assessing EF within everyday context using the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2). Parents and their adolescents demonstrated moderate to excellent agreement across the BRIEF2 clinical and index scores, higher than previous research with a typical sample. Adolescent males had higher agreement with their parents than female adolescents. Both parents and adolescents reported significantly higher mean T scores on various BRIEF2 indices and domains, in addition to higher rates of clinically elevated executive dysfunction than their peers. Assessment of EF and targeting specific EF domains for intervention may be useful in this population.

Metacognition and behavioral regulation predict distinct aspects of social functioning in autism spectrum disorder

Executive function (EF) deficits are common in autism spectrum disorder (ASD), and previous studies suggest that EF may influence or predict social functioning. Thus, EF is a potential treatment target in this population. However, the nature of how specific metacognition and behavioral regulation components of EF may differentially impact social function remains unclear. The goal of the current study was to examine the relationships between sub-components of EF (e.g., working memory, shifting, inhibition, etc.) and social functioning as measured by parent ratings on the Behavior Rating Inventory of Executive Functioning (BRIEF) and the Social Responsiveness Scale (SRS), while controlling for the influence of age, sex, and IQ. A second goal was to examine whether BRIEF scores were predictive of clinician-rated measures of ASD symptoms. Behavioral data were acquired from the Autism Brain Imaging Data Exchange-II database and included 106 children with ASD (ages 5-13). Based on analysis of parent ratings, self-monitoring skills predicted social awareness; shifting ability predicted social cognition; working memory and monitoring skills predicted social communication; initiation predicted social motivation; and shifting ability predicted restrictive and repetitive behaviors among children with ASD. Parent ratings on the BRIEF did not predict clinician-rated measures of ASD symptoms; this requires further study. Overall, the current findings indicate that metacognition and behavioral regulation both contribute to social functioning in ASD, although they each have distinct patterns of influence on different aspects of social functioning. These findings have promising implications for tailoring social interventions for ASD that target specific EF skills.