A review of executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder

Social motor synchrony in autism spectrum conditions: A systematic review

LAY ABSTRACT

When two people interact, they often fall into sync with one another by moving their bodies at the same time. Some say autistic people are not as good as non-autistic people at moving at the same time as a partner. This has led some researchers to ask whether measuring synchrony might help diagnose autism. We reviewed the research so far to look at differences in Social Motor Synchrony (SMS) (the way we move together) between autistic people and people they interact with. The research suggests that interactions involving an autistic partner (either two autistic partners, or an autistic and non-autistic partner) show lower synchrony than a non-autistic pair. However, we recognised elements in the research so far that may have affected SMS in interactions involving an autistic person. One way SMS may have been affected in research so far might be the way interactions have been set up in the research studies. Few papers studied interactions between two autistic people or looked at synchrony in comfortable environments with autistic-preferred tasks. The studies also do not explain why synchrony might be different, or weaker, in pairs involving autistic partners. We use these limitations to suggest improvements for future research.

A transdiagnostic examination of cognitive heterogeneity in children and adolescents with neurodevelopmental disorders

Children and adolescents with neurodevelopmental disorders demonstrate extensive cognitive heterogeneity that is not adequately captured by traditional diagnostic systems, emphasizing the need for alternative assessment and classification techniques. Using a transdiagnostic approach, a retrospective cohort study of cognitive functioning was conducted using a large heterogenous sample (n = 1529) of children and adolescents 7 to 18 years of age with neurodevelopmental disorders. Measures of short-term memory, verbal ability, and reasoning were administered to participants with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), comorbid ADHD/ASD, and participants without neurodevelopmental disorders (non-NDD) using a 12-task, web-based neurocognitive testing battery. Unsupervised machine learning techniques were used to create a self-organizing map, an artificial neural network, in conjunction with k-means clustering to identify data-driven subgroups. The study aims were to: 1) identify cognitive profiles in the sample using a data-driven approach, and 2) determine their correspondence with traditional diagnostic statuses. Six clusters representing different cognitive profiles were identified, including participants with varying forms of cognitive impairment. Diagnostic status did not correspond with cluster-membership, providing evidence for the application of transdiagnostic approaches to understanding cognitive heterogeneity in children and adolescents with neurodevelopmental disorders. Additionally, the findings suggest that many typically developing participants may have undiagnosed learning difficulties, emphasizing the need for accessible cognitive assessment tools in school-based settings.

Symptoms of ADHD and Autism Spectrum Disorder Interactively Predict Children's Verbal Fluency

OBJECTIVE

Verbal fluency, the capacity to generate words from a designated category, predicts myriad cognitive and life outcomes. The study investigated verbal fluency in children with ADHD, autism spectrum disorder (ASD), and comorbid ADHD and ASD, to understand how ADHD- and ASD-related symptoms individually and jointly predict verbal fluency, and the underlying linguistic and cognitive substrates.

METHOD

Thirty-three school-aged children with ADHD, 27 with ASD, 25 with comorbid ADHD and ASD, and 39 with typical development, were assessed for ADHD and ASD symptoms and completed a semantic verbal fluency task.

RESULTS

Findings indicated that ADHD and ASD symptoms, especially ADHD hyperactivity-impulsivity symptoms and language-related ASD symptoms, interactively predicted verbal fluency across diagnostic groups.

CONCLUSION

The study implicated the potential cognitive and linguistic mechanisms underlying verbal fluency differences in ADHD and/or ASD, and clinical practices on enhancing verbal fluency in these clinical groups.

Using Dispositions to Understand Otherwise Intractable Causal Pathways to Psychological Problems During Childhood and Adolescence

Studies of the genetic and environmental factors that make children more or less likely to develop distressing and impairing psychological problems, and studies of the psychobiological pathways through which these causal factors operate, have the goal of improving our understanding of the basic nature of psychological problems to develop better methods of prevention and treatment. For this reason, we have long had our eye on the prize of discovering the causes and psychobiological mechanisms underlying each dimension of psychological problems. There are compelling reasons, however, to seek a different and more achievable prize to understand psychological problems. Dimensions of psychological problems are both far too heterogeneous and too highly correlated to line up with distinct causal pathways. In contrast, a small number of orthogonal cognitive and socioemotional dispositional dimensions are correlated with psychological problems in revealing cross-cutting patterns. Each of these dispositions shares its independent causal pathways with psychological problems and help us understand the complex shared and heterogeneous nature of their causal processes. I outline a strategy for understanding the causes and mechanisms of psychological problems using studies of independently measured dispositions.

Undiagnosed Autism Spectrum Disorder in a Child With Chronic Pain: A Case Report

The literature acknowledges the presence of psychiatric comorbidities in pediatric chronic pain populations. Few studies have focused on comorbidity with autism spectrum disorders. We describe the case of a 10-year-old patient at the onset of his care by the chronic pain team. This boy had been experiencing refractory multifocal chronic pain for three years and had undergone multiple medical examinations that had not identified the cause of the pain or provided sufficient pain relief. During our consultations, the behavioral peculiarities (averted gaze, inhibition), the atypical description of this boy's pain (pain in the hair), and sensory peculiarities (intolerance to noise) led us to suspect an autism spectrum disorder. A multidisciplinary approach, including a thorough developmental history and evaluation by an autism resource center, confirmed this suspicion. The diagnosis of an underlying autism spectrum disorder allowed us to guide our management by integrating the specific sensory aspects of this boy. Concurrently, we facilitated the family's better understanding of the young boy's issues and addressed his social and communication difficulties. Through multidisciplinary care and the integration of these various aspects, our patient's clinical situation improved. Multidisciplinary management is essential in chronic pain teams.

Predictors of Health-Related Quality of Life in Neurodivergent Children: A Systematic Review

Health-related Quality of Life (HRQoL) is a multi-faceted construct influenced by a myriad of environmental, demographic, and individual characteristics. Our understanding of these influencers remains highly limited in neurodevelopmental conditions. Existing research in this area is sparse, highly siloed by diagnosis labels, and focused on symptoms. This review synthesized the evidence in this area using a multi-dimensional model of HRQoL and trans-diagnostically across neurodevelopmental conditions. The systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Checklist, was completed in June 2023 using Medline, PsycInfo, Embase, PubMed, and Cochrane Library. Our search revealed 78 studies that examined predictors of HRQoL in neurodevelopmental conditions. The majority of these studies focused on autism and ADHD with a paucity of literature in other conditions. Cross-diagnosis investigations were limited despite the fact that many of the examined predictors transcend diagnostic boundaries. Significant gaps were revealed in domains of biology/physiology, functioning, health perceptions, and environmental factors. Very preliminary evidence suggested potentially shared predictors of HRQoL across conditions including positive associations between HRQoL and adaptive functioning, male sex/gender, positive self-perception, physical activity, resources, and positive family context, and negative associations with diagnostic features and mental health symptoms. Studies of transdiagnostic predictors across neurodevelopmental conditions are critically needed to enable care models that address shared needs of neurodivergent individuals beyond diagnostic boundaries. Further understanding of HRQoL from the perspective of neurodivergent communities is a critical area of future work.

Validating the International Classification of Functioning, Disability and Health Core Sets for Autism in a Sample of Australian School-Aged Children on the Spectrum

Assessing functioning of children on the autism spectrum is necessary to determine the level of support they require to participate in everyday activities across contexts. The International Classification of Functioning, Disability and Health (ICF) is a comprehensive biopsychosocial framework recommended for classifying health-related functioning in a holistic manner, across the components of body functions, activities and participation, and environmental factors. The ICF Core Sets (ICF-CSs) are sub-sets of relevant codes from the broader framework that provide a basis for developing condition-specific measures. This study combined the ICF-CSs for autism, attention deficit hyperactivity disorder (ADHD) and cerebral palsy (CP) to validate the ICF-CSs for autism in an Australian sample of school-aged children. This cross-sectional study involved caregivers of school-aged children on the spectrum (n = 70) completing an online survey and being visited in their homes by an occupational therapist to complete the proxy-report measure based on the ICF-CSs for autism, ADHD and CP. Absolute and relative frequencies of ratings for each of the codes included in the measure were calculated and reported, along with the number of participants who required clarification to understand the terminology used. Findings indicate that the body functions and activities and participation represented in the ICF-CSs for autism were the most applicable for the sample. However, findings relating to environmental factors were less conclusive. Some codes not currently included in the ICF-CSs for autism may warrant further investigation, and the language used in measures based on the ICF-CSs should be revised to ensure clarity.

Sleep problems in children with autism spectrum disorder and attention-deficit/hyperactivity disorder: A comparative study and effects on communication skills

Sleep disturbances are highly prevalent among children with neurodevelopmental disorders, like Autism Spectrum Disorder (ASD) and Attention-Deficit/Hiperactivity Disorder (ADHD). The first objective of this study is to examine the differences in sleep problems between a group of children with ASD without intellectual disabilities, a group with ADHD and a typically developing (TD) group. A second objective is aimed at analyzing the effects of sleep problems and symptom severity on their communication skills. Participants were 122 children between 7 and 12 years old distributed in three groups: 32 TD children, 47 children with ASD and 43 children with ADHD, matched on age and intelligence. Parents completed different questionnaires that measured sleep disturbances and communication skills. Findings show significant differences between the clinical groups and the TD group in most types of sleep disorders. Moreover, the group with ADHD showed significantly more sleep breathing disorders and hyperhidrosis in comparison with ASD and TD, as well as more total sleep problems. In contrast to ASD, the predictive power of sleep problems on communication difficulties was greater in the group with ADHD. The results of the mediation analysis indicate that in both groups, sleep problems partially mediate the relationship between symptoms and communication. This investigation highlights the need of considering sleep disorders when assessing communication skills in ASD and ADHD, given its indirect influence in this domain. Understanding the sleep dysfunctions of both conditions and their repercussions is crucial to develop adjusted interventions.

Three Virtual Reality Environments for the Assessment of Executive Functioning Using Performance Scores and Kinematics: An Embodied and Ecological Approach to Cognition

Virtual reality (VR) is an attractive technology for cognitive assessment, as it provides a more embodied experience compared with typical test situations, such as those using paper and pencil. In addition, VR can immerse individuals in complex situations similar to real-life ones, thereby improving the ecological validity (i.e., face validity) of the assessment. VR also offers improved scoring of tests as it facilitates the tracking of kinematic information and the temporal tracking of activities. This study assesses the correlation between scores on executive function assessments using standard neuropsychological tasks in paper-and-pencil format, on a tablet, and in three immersive VR environments, each designed to involve specific aspects of executive function. This study also aims to assess the correlation between these performance scores and a set of kinematic measures (speed, duration, and distance traveled by the hand) collected in VR. The outcomes, including performance scores and kinematic measures, correlate both with traditional assessment methods (such as paper and pencil, and computerized 2D tests) and with each other, suggesting their potential usefulness in clinical and research contexts. The discussion focuses on the advantages of embodied, situated, and spatialized tests for cognitive assessment and the benefits of kinematic tracking in VR tests for the quality of this assessment.

Neurophysiological measures and correlates of cognitive load in attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and dyslexia: A scoping review and research recommendations

Working memory is integral to a range of critical cognitive functions such as reasoning and decision-making. Although alterations in working memory have been observed in neurodivergent populations, there has been no review mapping how cognitive load is measured in common neurodevelopmental conditions such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and dyslexia. This scoping review explores the neurophysiological measures used to study cognitive load in these specific populations. Our findings highlight that electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) are the most frequently used methods, with a limited number of studies employing functional near-infrared spectroscopy (fNIRs), magnetoencephalography (MEG) or eye-tracking. Notably, eye-related measures are less commonly used, despite their prominence in cognitive load research among neurotypical individuals. The review also highlights potential correlates of cognitive load, such as neural oscillations in the theta and alpha ranges for EEG studies, blood oxygenation level-dependent (BOLD) responses in lateral and medial frontal brain regions for fMRI and fNIRS studies and eye-related measures such as pupil dilation and blink rate. Finally, critical issues for future studies are discussed, including the technical challenges associated with multimodal approaches, the possible impact of atypical features on cognitive load measures and balancing data richness with participant well-being. These insights contribute to a more nuanced understanding of cognitive load measurement in neurodivergent populations and point to important methodological considerations for future neuroscientific research in this area.

Do ASD and ADHD Have Distinct Executive Function Deficits? A Systematic Review and Meta-Analysis of Direct Comparison Studies

OBJECTIVE

To evaluate if children and adolescents with a diagnosis of ASD or ADHD have distinct executive function (EF) profiles.

METHODS

Peer-reviewed articles comparing ASD, ADHD, and typically developing individuals under 19 years of age were identified. The domains evaluated were: working memory, response inhibition, planning, cognitive flexibility, attention, processing speed, and visuospatial abilities.

RESULTS

Fifty-eight articles met inclusion criteria. Analyses were performed on 45 performance metrics from 24 individual tasks. No differences in EF were found between individuals diagnosed with ASD and ADHD. Individuals diagnosed with ASD and ADHD exhibited worse performance in attention, flexibility, visuospatial abilities, working memory, processing speed, and response inhibition than typically developing individuals. Groups did not differ in planning abilities.

CONCLUSION

Children and adolescents with ASD and ADHD have similar EF profiles. Further research is needed to determine if comorbidity accounts for the commonality in executive dysfunction between each disorder.

Measuring intelligence in Autism and ADHD: Measurement invariance of the-Binet 5th edition and impact of subtest scatter on abbreviated IQ accuracy

Scatter and heterogeneity in cognitive profiles is thought to be common in autism spectrum disorder (ASD), which may indicate differences in the construct of IQ. However, less research has investigated IQ scatter in attention-deficit/hyperactivity disorder (ADHD). Scatter is also thought to negatively impact the predictive validity of IQ summary scores, although there is research refuting this notion. Abbreviated IQ tests, such as the Stanford-Binet fifth edition (SB-5) abbreviated battery IQ (ABIQ), may be especially susceptible to the influence of scatter. We tested the measurement invariance of the SB-5 as well as the predictive validity of the ABIQ in predicting FSIQ in 1679 youth (21% female) ages 2-16 years with a clinical diagnosis of ASD or ADHD. Results indicated the SB-5 is measuring IQ the same way in ASD and ADHD. There were no differences between diagnostic groups in scatter between ABIQ (i.e., routing) subtests. Additionally, scatter was not related to dimensional autistic traits. Higher degree of scatter was associated with poorer predictive validity of the ABIQ and a higher likelihood of overestimating FSIQ, regardless of diagnosis. Overall, we found more similarities than differences between the ASD and ADHD groups. Our results show that the SB-5 ABIQ is generally a strong predictor of FSIQ in youth with neurodevelopmental disorders. However, the use of the SB-5 ABIQ in research and clinical applications, without consideration of scatter on routing subtests, is potentially problematic.

Effortful and effortless training of executive functions improve brain multiple demand system activities differently: an activation likelihood estimation meta-analysis of functional neuroimaging studies

Both effortful and effortless training have been shown to be effective in enhancing individuals' executive functions. Effortful training improves domain-specific EFs, while effortless training improves domain-general EFs. Furthermore, effortful training has significantly higher training effects on EFs than effortless training. The neural mechanism underlying these different effects remained unclear. The present study conducted meta-analysis on neuroimaging studies to explore the changes of brain activations induced by effortful and effortless training. The results showed that effortful training induced greater activation in superior frontal gyrus, while effortless training induced greater activation in middle frontal gyrus, precuneus and cuneus. The brain regions of MD system enhanced by effortful training were more associated with core cognitive functions underlying EFs, while those enhanced by effortless training were more correlated with language functions. In addition, the significant clusters induced by effortful training had more overlaps with the MD system than effortless training. These results provided us with possibility to discuss the different behavioral results brought by effortful and effortless training.

Effect of Cognitive Training Programs Based on Computer Systems on Executive Functions in Children With ADHD: A Systematic Review

BACKGROUND

The purpose of this systematic review is to synthesize the existing literature reporting the effects of computerized cognitive trainings on the executive functions of children with ADHD.

METHOD

A systematic review was carried out following the PRISMA statement; the primary sources used were five electronic databases (Scopus, Science Direct, Pubmed, Springer, Taylor & Francis).

RESULTS

20 articles met the eligibility criteria, data on the training characteristics and the effects on executive functions were extracted, followed by an analysis of bias and the methodological quality of the studies. The results of the studies were widely heterogeneous, largely associated with the variety of training programs and the measurement instruments used. The most studied executive functions were working memory and inhibitory control. Some of the studies reported that the intervention led to significant effects on working memory and attention (N = 7), and improvements in inhibitory control (N = 5) and planning (N = 4) were also reported. At the same time, others did not report the effects of the intervention on these processes. The assessment of the quality of the evidence showed important risk biases among the reviewed studies.

CONCLUSION

Some training based on computer systems showed positive effects on the executive functions of working memory, attention, and inhibitory control in children with ADHD. However, other training sessions did not show significant effects. In general, the evidence shows mixed results, a high diversity of measurement instruments, and high risks of bias between the studies. Therefore, the evidence has not been consistent about the general benefits of computerized training on the executive functions of children with ADHD.

Sex as a Moderator Between Parent Ratings of Executive Dysfunction and Social Difficulties in Children and Adolescents with Autism Spectrum Disorder

Girls and boys might differ in autistic symptoms and associated cognitive difficulties such as executive function (EF). We investigated sex differences in the relationship between parent rated EF and autistic symptoms in 116 children and adolescents (25 girls) aged 5-19 years with an intelligence quotient above 70 and an autism spectrum disorder (ASD) diagnosis. They were rated with the behavior rating inventory of executive function (BRIEF) and the autism diagnostic interview revised (ADI-R). We found a positive association between EF and the ADI-R domains of reciprocal social interaction (p < 0.001) and communication (p = 0.001) in girls, while these relationships were small and non-significant in boys. Our results provide a greater understanding of the sex-specific characteristics of children and adolescents with ASD.

Executive Functions in a Population of Individuals with CHARGE Syndrome: Findings from Performance-Based and Rating Scale Measures According to a 3-Factor Model

PURPOSE

To identify possible predictors of executive functions of individuals with CHARGE syndrome, as these will be important targets for interventions.

METHODS

A population-based cross-sectional study investigating the executive functions of a representative sample of 35 Norwegians with CHARGE syndrome divided into two subgroups to handle their inherent heterogeneity. Both performance-based measures and rating scale findings were included and organized according to the 3-factor model of Miyake and colleagues.

RESULTS

Both measures showed comprehensive executive dysfunctions within the population, which were largely unrelated to deafblindness. Working memory stood out as a strength within the executive domain and the only factor presenting results within the normal range. Verbal working memory was a particular cognitive resource for participants with deafblindness, and, unlike those without deafblindness, unrelated to sensorimotor functions.

CONCLUSIONS

Individuals with CHARGE syndrome appear to be at risk for underdeveloped executive functions due to neurogenetic and environmental factors. Performance-based measures and ratings from caregivers gave unique and complementary knowledge and implied the need of both when investigating executive functioning in CHARGE syndrome. Participants with deafblindness presented strong verbal working memory despite their auditory impairments, indicating effective compensatory mechanisms The results also indicated an untapped cognitive potential in both subgroups. Because of their relatively advanced working memory significantly correlating with global cognition, the environment should assume equal learning potential of individuals with CHARGE syndrome regardless of their degree of sensory impairments.

Sensory Gating in Neurodevelopmental Disorders: A Scoping Review

This review aimed to explore the current understanding of sensory gating in neurodevelopmental disorders as a possible transdiagnostic mechanism. We applied methods according to the Joanna Briggs Institute Manual for Evidence Synthesis, following the population, concept, and context scoping review eligibility criteria. Using a comprehensive search strategy in five relevant research databases (Medline, EMBASE, CINAHL, PsychInfo, and Scopus), we searched for relevant peer-reviewed, primary research articles and unpublished data. Two independent reviewers screened the titles and abstracts, full-texts, and completed data extraction. We identified a total of 81 relevant articles and used descriptive analyses to summarize the characteristics and outcomes of all identified studies. Literature regarding sensory gating was most common in autistic populations with relatively fewer studies examining attention-deficit/hyperactivity disorder, tic disorders, and childhood-onset fluency disorder (COFD). The methods to assess sensory gating varied widely both within and between groups and included measures such as habituation, prepulse inhibition, affect-modulated inhibition, medication and other intervention trials. Most consistently, when participants complete questionnaires about their sensory experiences, those who have neurodevelopmental disorders report differences in their sensory gating. Affect-modulated inhibition appears to be discrepant between samples with and without neurodevelopmental disorder diagnoses. Habituation was the most commonly reported phenomenon and many differences in habituation have been found in autistic individuals and individuals with tic disorders whereas concerns with inhibition seemed more common in COFD. Overall, the evidence is inconsistent within and between disorders suggesting there is still much to learn about sensory gating in neurodevelopmental disorders.

Physical Activity Interventions for Improving Cognitive Functions in Children With Autism Spectrum Disorder: Protocol for a Network Meta-Analysis of Randomized Controlled Trials

BACKGROUND

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects millions of children worldwide, with a current prevalence of approximately 1 in 54 children in the United States. Although the precise mechanisms underlying ASD remain unclear, research has shown that early intervention can have a significant impact on cognitive development and outcomes in children with ASD. Physical activity interventions have emerged as a promising intervention for children with ASD, but the efficacy of different types of interventions remains unclear.

OBJECTIVE

This study protocol aims to update the knowledge on extant literature and explore the efficacy of physical activity intervention strategies on cognitive functions in children with ASD.

METHODS

A systematic review and network meta-analysis (NMA) will be conducted following the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols for Network Meta-Analyses) statement. A total of 9 bibliographic databases (APA PsycInfo, CENTRAL, Dimensions, ERIC, MEDLINE Complete, PubMed, Scopus, SPORTDiscus, and Web of Science) will be systematically searched to screen eligible articles based on a series of inclusion and exclusion criteria. A study will be considered for inclusion if it is not classified as a systematic review with or without meta-analysis, was published from inception to present, includes children aged 0 to 12 years with ASD, quantitively measures cognitive outcomes, and examines treatment comprising at least 1 physical activity intervention strategy. The internal validity and quality of evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation framework. Statistical analyses will be performed in the RStudio software (version 3.6; RStudio Inc) with the BUGSnet package and the Comprehensive Meta-Analysis software (version 3.3; Biostat Inc). The results of our NMA will be illustrated through network diagrams accompanied by geometry and league tables. Further, to rank the interventions based on their efficacy, we will use the surface under the cumulative ranking curve.

RESULTS

Our preliminary search identified 3778 potentially relevant studies. The screening of the studies based on the inclusion and exclusion criteria is ongoing, and we anticipate that the final number of eligible studies will be in the range of 30 to 50.

CONCLUSIONS

This study will provide a comprehensive review of the literature on physical activity interventions for children with ASD and will use NMA to compare the efficacy of different types of interventions on cognitive outcomes. Our findings will have important implications for clinical practice and future research in this area and will contribute to the growing body of evidence supporting the use of physical activity interventions as a key component of early intervention for children with ASD.

TRIAL REGISTRATION

PROSPERO CRD42021279054; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279054.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/40383.

The Interplay between Socioeconomic Status, Parenting and Temperament Predicts Inhibitory Control at Two Years of Age

This paper investigates the interplay between environmental factors (socioeconomic status (SES) and parenting) and temperament in the development of inhibitory control (IC) at 2 years of age. We administered to toddlers (n = 59) a delay of gratification task which measures IC in the context of self-regulation. Parents reported their toddlers' temperament, parenting strategies, and SES. We hypothesized that poorer IC would be associated with more reactive temperament, less effortful control, lower SES and inconsistent/coercive parenting practices. Finally, we explored the interaction between temperament, parenting and SES. We found that both coercive parenting and low-SES were negatively correlated to IC at the age of 2 years. Temperamental reactivity was unrelated to IC, whereas temperamental effortful control (EC) was positively associated with IC. Results revealed a moderation effect of EC on the influence of coercive parenting and SES in toddlers' IC. Toddlers from lower SES backgrounds and with lower EC were more affected by inconsistent/coercive parenting practices and showed the poorest IC. In contrast, toddlers exhibiting high and average levels of EC seemed to be protected from the detrimental effect of low-SES and inconsistent/coercive parenting on IC. These results suggest that strengthening toddlers' EC and improving parents' parenting skills might be especially relevant for the development of IC in the context of self-regulation, particularly by preventing self-regulatory problems in children from socioeconomically deprived environments. Future studies with larger samples, focusing on populations from severe socioeconomically deprived environments, or intervention studies will be needed in order to confirm and expand our findings.

Moving Together: Social Motor Synchrony in Autistic Peer Partners Depends on Partner and Activity Type

Some suggest autistic people display impaired Interpersonal Synchrony. However, partners of different neurotypes can struggle to connect and empathise with one another. We used Motion Energy Analysis to examine Social Motor Synchrony (SMS) in familiar partners of the same neurotype: pairs of autistic and of neurotypical children. Partners played two shared tablet activities, one to support collaboration by facilitating engagement and other-awareness (Connect), and one with no additional design features to facilitate collaboration (Colours). The neurotypical group showed similar SMS to the autistic group in Colours but lower SMS in Connect. The autistic group displayed similar levels of SMS in each activity. Autistic children can synchronise to a similar, or greater, degree than neurotypical children when the social context and type of task are considered.

Effectiveness of exercise intervention on improving fundamental motor skills in children with autism spectrum disorder: a systematic review and meta-analysis

Background

Autism spectrum disorder (ASD) is a severe public health concern, and most of the children with ASD experience a substantial delay in FMS. This study aimed to investigate the effectiveness of exercise interventions in improving FMS in children with ASD, and provide evidence to support the scientific use of exercise interventions in practice.

Methods

We searched seven online databases (PubMed, Scopus, Web of Science, Embase, EBSCO, Clinical Trials, and The Cochrane Library) from inception to May 20, 2022. We included randomized control trials of exercise interventions for FMS in children with ASD. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database Scale. Stata 14.0 software was used for meta-analysis, forest plotting, subgroup analysis, heterogeneity analysis, and meta-regression.

Results

Thirteen studies underwent systematic review (541 participants), of which 10 underwent meta-analysis (297 participants). Overall, exercise interventions significantly improved overall FMS in children with ASD. Regarding the three categories of FMS, exercise interventions significantly improved LMS (SMD = 1.07; 95% CI 0.73 to 1.41, p < 0.001), OCS (SMD = 0.79; 95% CI 0.32 to 1.26, p = 0.001), and SS (SMD = 0.72; 95% CI 0.45 to 0.98, p < 0.0001).

Conclusion

exercise interventions can effectively improve the FMS of children with ASD. The effects on LMS are considered as large effect sizes, while the effects on OCS and SS are considered as moderate effect sizes. These findings can inform clinical practice.

Systematic review registration

https://inplasy.com/inplasy-2022-12-0013/.

Autism and Hierarchical Models of Intelligence

BACKGROUND

The Wechsler Intelligence Scale for Children (WISC) employs a hierarchical model of general intelligence in which index scores separate out different clinically-relevant aspects of intelligence; the test is designed such that index scores are statistically independent from one another within the normative sample. Whether or not the existing index scores meet the desired psychometric property of being statistically independent within autistic samples is unknown.

METHOD

We conducted a factor analysis on WISC fifth edition (WISC-V) (N = 83) and WISC fourth edition (WISC-IV) (N = 131) subtest data in children with autism. We compared the data-driven exploratory factor analysis with the manual-derived index scores, including in a typically developing (TD) WISC-IV cohort (N = 209).

RESULTS

The WISC-IV TD cohort showed the expected 1:1 relationship between empirically derived factors and manual-derived index scores. We observed less unique correlations between our data-driven factors and manualized IQ index scores in both ASD samples (WISC-IV and WISC-V). In particular, in both WISC-IV and -V, working memory (WM) influenced index scores in autistic individuals that do not load on WM in the normative sample.

CONCLUSIONS

WISC index scores do not show the desired statistical independence within autistic samples, as judged against an empirically-derived exploratory factor analysis. In particular, within the currently used WISC-V version, WM influences multiple index scores.

Reduced inferior fronto-insular-thalamic activation during failed inhibition in young adults with combined ASD and ADHD compared to typically developing and pure disorder groups

Autism spectrum disorder (ASD) often co-occurs with attention-deficit/hyperactivity disorder (ADHD) and people with these conditions have frontostriatal functional atypicality during motor inhibition. We compared the neural and neurocognitive correlates of motor inhibition and performance monitoring in young adult males with "pure" and combined presentations with age-and sex-matched typically developing controls, to explore shared or disorder-specific atypicality. Males aged 20-27 years with typical development (TD; n = 22), ASD (n = 21), combined diagnoses ASD + ADHD (n = 23), and ADHD (n = 25) were compared using a modified tracking fMRI stop-signal task that measures motor inhibition and performance monitoring while controlling for selective attention. In addition, they performed a behavioural go/no-go task outside the scanner. While groups did not differ behaviourally during successful stop trials, the ASD + ADHD group relative to other groups had underactivation in typical performance monitoring regions of bilateral anterior insula/inferior frontal gyrus, right posterior thalamus, and right middle temporal gyrus/hippocampus during failed inhibition, which was associated with increased stop-signal reaction time. In the behavioural go/no-go task, both ADHD groups, with and without ASD, had significantly lower motor inhibition performance compared to TD controls. In conclusion, only young adult males with ASD + ADHD had neurofunctional atypicality in brain regions associated with performance monitoring, while inhibition difficulties on go/no-go task performance was shared with ADHD. The suggests that young people with ASD + ADHD are most severely impaired during motor inhibition tasks compared to ASD and ADHD but do not reflect a combination of the difficulties associated with the pure disorders.

Executive function profiles of preschool children with autism spectrum disorder and attention-deficit/hyperactivity disorder: A systematic review

Background

Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are both associated with differences in Executive Functioning (EF). There is lack of clarity around the specificity or overlap of EF differences in early childhood when both disorders are first emerging.

Method

This systematic review aims to delineate preschool EF profiles by examining studies comparing the EF profiles of children with and without ASD or ADHD. Five electronic databases were systematically searched (last search in May 2022) to identify published, quantitative studies of global and specific EF (Inhibition, Shifting, Working Memory (WM), Planning and Attentional Control), comparing children aged 2-6 with a diagnosis of ASD or ADHD to peers without ASD or ADHD.

Results

Thirty-one empirical studies (10 ADHD and 21 ASD studies) met criteria for inclusion. EF profiles in preschool ASD were characterised by consistent Shifting, and, in most cases, Inhibition impairments. ADHD studies consistently reported impairments in Inhibition and Planning, and in most cases WM. Findings with regards to sustained Attention and Shifting in ADHD and WM and Planning in ASD were mixed.

Conclusions

Overall, current evidence indicates overlap but also some specificity in EF impairments in preschool ASD and ADHD. There were differences in the degree to which individual domains were impaired, with Shifting more consistently impaired in ASD, and Inhibition, WM and Planning in ADHD. Methodological issues and differences in methods of outcome measurement could potentially underlie mixed findings, as informant-based measures revealed more robust EF impairments than laboratory-based tasks.

Inhibitory deficits and symptoms of attention-deficit hyperactivity disorder: How are they related to effortful control?

Separate studies with clinical and community-based samples have identified an association between symptoms of attention-deficit hyperactivity disorder (ADHD) and inhibitory control deficits and ADHD and weak effortful control. We tested whether differences in effortful control explained the associations between ADHD symptoms and inhibitory control deficits, controlling for conduct problems. In a community sample, parents rated ADHD symptoms, conduct problems, effortful control, surgency and negative affect in 77 4-7-year-olds (47 girls), who performed an inhibitory control task. ADHD symptoms, deficient inhibitory control and low effortful control were correlated. Controlling for conduct problems, path analysis showed the ADHD symptoms - inhibitory control link was mediated statistically by effortful control. This focuses attention on cognitive-energetic factors associated with ADHD-related executive deficits.

Here's the Story: Narrative Ability and Executive Function in Autism Spectrum Disorder

Background

Difficulties with narrative have been reported in individuals diagnosed with autism spectrum disorder (ASD), but the role of executive function on narrative ability has not been examined in ASD. In this study, we aimed to (1) examine whether narrative abilities of ASD children differed from neurotypical (NT) children who did not differ in age, sex, and IQ; and (2) investigate relations between executive function and narrative ability in ASD children.

Method

Narratives were elicited from 64 ASD children and 26 NT children using a wordless picture book and coded to derive several aspects of narrative ability such as propositions, evaluative devices, and self-repairs. Executive functions (specifically, inhibition and working memory) were measured using both experimenter-administered assessment and parent-report measures.

Results

Compared to NT children, ASD children produced fewer propositions but did not differ in their use of evaluative devices and self-repairs during narrative production. Greater inhibitory challenges related to more self-repairs involving repetition of story elements, whereas working memory did not relate to any of the measures of narrative ability among ASD children.

Conclusions

This study revealed that narratives by verbally fluent ASD children were shorter and less complex than those by NT children but did not differ in the specific features of narratives. Furthermore, although ASD children did not make more self-repairs than NT children, difficulty with inhibition was related to more self-repairs, indicating more dysfluent narrative production in ASD children, which has implications for intervention.

The Effect of Meditation-Based Mind-Body Interventions on Symptoms and Executive Function in People With ADHD: A Meta-Analysis of Randomized Controlled Trials

OBJECTIVE

This study aims to perform a systematic review and meta-analysis of the effect of MBIs (Mindfulness, Tai Chi, Yoga, and Qigong) on symptoms and executive function (EF) in ADHD.

METHOD

PubMed, Web of Science, the Cochrane Library, PsycINFO, CINAHL, Embase, and CNKI databases were searched to collect randomized controlled trials (RCTs) on the effects of MBIs on symptoms and EF in ADHD. Data extraction and methodological quality evaluation were conducted by two researchers, and a meta-analysis was conducted by Stata SE.

RESULTS

The pooled meta-analyses of MBIs revealed a positive and small effect on inattention (g = -0.26), hyperactivity/impulsivity (g = -0.19), and EF (g = -0.35).

CONCLUSION

Results suggest that MBIs have a significant improvement relative to the control condition. Although some results show that symptoms are affected by age, interventions, and total time of moderators, while EF is not affected by age and measurement, it needs to be supported by more research evidence. (J. of Att. Dis. XXXX; XX(X) XX-XX).

IAmHero: Preliminary Findings of an Experimental Study to Evaluate the Statistical Significance of an Intervention for ADHD Conducted through the Use of Serious Games in Virtual Reality

The use of new technologies, such as virtual reality (VR), represents a promising strategy in the rehabilitation of subjects with attention-deficit/hyperactivity disorder (ADHD). We present the results obtained by administering the IAmHero tool through VR to a cohort of subjects with ADHD between 5 and 12 years of age. The trial time was approximately 6 months. In order to assess the beneficial effects of the treatment, standardised tests assessing both ADHD symptoms and executive functions (e.g., Conners-3 scales) were administered both before and at the end of the sessions. Improvements were observed at the end of treatment in both ADHD symptoms (especially in the hyperactivity/impulsivity domain) and executive functions. One of the strengths of the VR approach is related above all to the acceptability of this tool and its flexibility. Unfortunately, to date, there are still few studies on this topic; therefore, future studies are essential to expand our knowledge on the utility and benefits of these technologies in the rehabilitation field.

Effects of transcranial direct current stimulation in children and young people with psychiatric disorders: a systematic review

Transcranial direct current stimulation (tDCS) has demonstrated benefits in adults with various psychiatric disorders, but its clinical utility in children and young people (CYP) remains unclear. This PRISMA systematic review used published and ongoing studies to examine the effects of tDCS on disorder-specific symptoms, mood and neurocognition in CYP with psychiatric disorders. We searched Medline via PubMed, Embase, PsychINFO via OVID, and Clinicaltrials.gov up to December 2022. Eligible studies involved multiple session (i.e., treatment) tDCS in CYP (≤ 25 years old) with psychiatric disorders. Two independent raters assessed the eligibility of studies and extracted data using a custom-built form. Of 33 eligible studies (participant N = 517), the majority (n = 27) reported an improvement in at least one outcome measure of disorder-specific symptoms. Few studies (n = 13) examined tDCS effects on mood and/or neurocognition, but findings were mainly positive. Overall, tDCS was well tolerated with minimal side effects. Of 11 eligible ongoing studies, many are sham-controlled RCTs (n = 9) with better blinding techniques and a larger estimated participant enrolment (M = 79.7; range 15-172) than published studies. Although encouraging, the evidence to date is insufficient to firmly conclude that tDCS can improve clinical symptoms, mood, or cognition in CYP with psychiatric disorders. Ongoing studies appear of improved methodological quality; however, future studies should broaden outcome measures to more comprehensively assess the effects of tDCS and develop dosage guidance (i.e., treatment regimens).

Executive Function in Autism: Association with ADHD and ASD Symptoms

There is substantial comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), and there are well-documented executive functioning (EF) deficits in both populations. An important question concerns whether EF deficits in children with ASD are related to severity of ASD, ADHD, or both. We examined ADHD and ASD symptoms in relation to ratings of EF in the home and classroom. The sample comprised 64 children (55 males) diagnosed with ASD (mean age = 9.26 years; mean FSIQ = 92). Analyses indicated that parent and teacher ratings of EF (except Shift and Emotional Control) were consistently related to ADHD symptom severity, but not to ASD severity. Thus, functioning in the domains of Shift and Emotional control appear relatively spared, whereas performance in all other EF was impaired in relation to ADHD symptoms.

Reactance, Decisional Procrastination, and Hesitation: A Latent Class Analysis of Clutter Behavior

During the 2019-2020 global pandemic, mandated time at home suggested engagement in personal projects, such as home decluttering. Clutter (an overabundance of possessions) may impede one's quality of life by interfering with space livability and social connections and prompting negative affect and financial problems. The present study explored action-state orientation, psychological reactance, and decisional procrastination with 227 American adults (M age = 49.9 years old). A latent class analysis tested for differences in cognition across groups. Results supported that persons who struggle with clutter reflect clusters or "classes" given their self-reported cognitive processes, with hesitant and indecisive participants experiencing greater negative impacts of clutter than action-oriented and decisive participants. Our findings suggested improving the decision-making and goal-directed capacities of those struggling with clutter may be effective as preventive and/or interventive strategies. Future research might consider when hesitation to initiate challenging tasks and indecision emerge in the decluttering timeline and how those who are prone to these cognitions may be supported in managing their personal possessions.

Catecholaminergic and cholinergic neuromodulation in autism spectrum disorder: A comparison to attention-deficit hyperactivity disorder

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder characterized by social impairments and restricted, repetitive behaviors. Treatment of ASD is notoriously difficult and might benefit from identification of underlying mechanisms that overlap with those disturbed in other developmental disorders, for which treatment options are more obvious. One example of the latter is attention-deficit hyperactivity disorder (ADHD), given the efficacy of especially stimulants in treatment of ADHD. Deficiencies in catecholaminergic systems [dopamine (DA), norepinephrine (NE)] in ADHD are obvious targets for stimulant treatment. Recent findings suggest that dysfunction in catecholaminergic systems may also be a factor in at least a subgroup of ASD. In this review we scrutinize the evidence for catecholaminergic mechanisms underlying ASD symptoms, and also include in this analysis a third classic ascending arousing system, the acetylcholinergic (ACh) network. We complement this with a comprehensive review of DA-, NE-, and ACh-targeted interventions in ASD, and an exploratory search for potential treatment-response predictors (biomarkers) in ASD, genetically or otherwise. Based on this review and analysis we propose that (1) stimulant treatment may be a viable option for an ASD subcategory, possibly defined by genetic subtyping; (2) cerebellar dysfunction is pronounced for a relatively small ADHD subgroup but much more common in ASD and in both cases may point toward NE- or ACh-directed intervention; (3) deficiency of the cortical salience network is sizable in subgroups of both disorders, and biomarkers such as eye blink rate and pupillometric data may predict the efficacy of targeting this underlying deficiency via DA, NE, or ACh in both ASD and ADHD.

Comparative effectiveness of various physical exercise interventions on executive functions and related symptoms in children and adolescents with attention deficit hyperactivity disorder: A systematic review and network meta-analysis

Background

Physical exercise has been recommended as an important nonpharmacological therapeutic strategy for managing attention deficit hyperactivity disorder (ADHD). We conducted a network meta-analysis (NMA) to assess the comparative impact of different physical exercise modalities on enhancing executive functions (EFs) and alleviating symptoms in children and adolescents with ADHD.

Methods

We searched Web of Science, PubMed, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycINFO, CNKI, and clinical trials databases from inception to October 20, 2022. Randomized controlled trials (RCTs) and quasi-experimental studies investigating physical exercise for ADHD-related symptoms of hyperactivity/impulsivity and inattention, and executive functions were included. The frequentist random-effect NMA method was applied to pool the results.

Results

A total of 59 studies (including 39 RCTs, 5 quasi-RCTs, and 15 self-controlled trials) published between 1983 and 2022 were incorporated into the systematic review, of which 44 studies with 1757 participants were eligible for meta-analysis. All types of physical exercise were effective in improving EFs (SMD = 1.15, 95% CI: 0.83 to 1.46), and open-skill activities which require participants to react in a dynamically changing and externally paced environment induced the most incredible benefits for executive functions (SUCRA = 98.0%, SMD = 1.96, and 95% CI: 1.15 to 2.77). Subgroup analyses for EFs revealed varied findings that open-skill activities were the most promising physical exercise type for improving inhibitory control (SUCRA = 99.1%, SMD = 1.94, and 95% CI: 1.24 to 2.64), and closed-skill activities dominated by aerobic exercises had a slightly higher probability of being the most promising physical exercise intervention for working memory (SUCRA = 75.9%, SMD = 1.21, and 95% CI: -0.22 to 2.65), and multicomponent physical exercise tended to be the most effective in cognitive flexibility (SUCRA = 70.3%, SMD = 1.44, and 95% CI: -0.19 to 3.07). Regarding ADHD-related symptoms, closed-skill activities dominated by aerobic exercises might be more advantageous for hyperactivity/impulsivity (SUCRA = 72.5%, SMD = -1.60, and 95% CI: -3.02 to -0.19) and inattention (SUCRA = 96.3%, SMD = -1.51, and 95% CI: -2.33 to -0.69) improvement.

Conclusion

Physical exercise can significantly help to alleviate the symptoms of ADHD and improve executive functions in children and adolescents with ADHD. Most of all, to promote adherence to treatment, they should be encouraged to perform the physical exercises that they enjoy most.

Tactile sensory processing as a precursor of executive attention: Toward early detection of attention impairments and neurodevelopmental disorders

Recent studies in developmental neuroscience tend to show the existence of neural attention networks from birth. Their construction is based on the first sensory experiences that allow us to learn the patterns of the world surrounding us and preserve our limited attentional resources. Touch is the first sensory modality to develop, although it is still little studied in developmental psychology in contrast to distal modalities such as audition or vision. Atypical tactile sensory processing at an early age could predict later attention dysfunction, both of them being part of the symptomatology of neurodevelopmental disorders (NDD). We review the state of knowledge on tactile sensory processing and its links with attention, executive attention (EA) in particular, and propose that abnormal tactile sensory processing at an early age could provide markers of EA dysfunctions, contributing to the early detection of NDD. This article is categorized under: Psychology > Attention.

Findings of a Multidisciplinary Assessment of Children Referred for Possible Neurodevelopmental Disorders: Insights from a Retrospective Chart Review Study

Children with ASD have a wide spectrum of functional deficits in multiple neurodevelopmental domains. A multidisciplinary team assessment (MDT) is required to assess those deficits to help construct a multimodal intervention plan. This is a retrospective chart review of the assessment for children who were referred for an assessment of potential neurodevelopmental disorders. We reviewed 221 participants' charts from January 2019 to January 2020. The mean age of the children was 7.95 ± 3.69, while the mean age of the fathers and mothers was 37.31 ± 8.57 and 31.95 ± 6.93, respectively. Consanguinity was as high as 37.9% for the referred children with developmental delay who were first-degree related, and 13.2% of the parents were second-degree relatives. Approximately 26.6% of children had a family history of mental illness in first-degree relatives. ASD was the most commonly reported diagnosis post-assessment, and ADHD was the most common reported comorbidity at 64.3% and 88.5%, respectively. The MDT findings showed that 58% of children required moderate or higher assistance with toileting, 79.2% were unable to answer yes/no questions, and 86.8% were unable to understand "wh" questions. Only 26% of the nonverbal children had average IQ testing results, and 31% of verbal children did. In conclusion, the mean age of the children when assessed was above that recommended for early screening and intervention. An increased paternal and maternal age was noticeable. Consanguinity and a family history of mental disorders in first-degree relatives were high, attesting to a possible genetic risk.

No need to choose: Independent regulation of cognitive stability and flexibility challenges the stability-flexibility trade-off

Adaptive behavior requires the ability to focus on a current task and protect it from distraction (cognitive stability), as well as the ability to rapidly switch to another task in light of changing circumstances (cognitive flexibility). Cognitive stability and flexibility have been conceptualized as opposite endpoints on a stability-flexibility trade-off continuum, implying an obligatory reciprocity between the two: Greater flexibility necessitates less stability, and vice versa. Surprisingly, rigorous empirical tests of this critical assumption are lacking. Here, we acquired simultaneous measurements of cognitive stability (congruency effects) and flexibility (switch costs) on the same stimuli within the same task while independently varying contextual demands on these functions with block-wise manipulations of the proportion of incongruent trials and task switches, respectively. If cognitive stability and flexibility are reciprocal, increases in flexibility in response to higher switch rates should lead to commensurate decreases in stability, and increases in stability in response to more frequent incongruent trials should result in decreased flexibility. Across three experiments, using classic cued task-switching (Experiments 1 and 3) and attentional set-shifting (Experiment 2) protocols, we found robust evidence against an obligatory stability-flexibility trade-off. Although we observed the expected contextual adaptation of stability and flexibility to changing demands, strategic adjustments in stability had little influence on flexibility, and vice versa. These results refute the long-held assumption of a stability-flexibility trade-off, documenting instead that the cognitive processes mediating these functions can be regulated independently-it is possible to be both stable and flexible at the same time. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

BOAM: A Visual, Explanatory Diagnostic and Psychoeducation System Used in Collaboration with Families-Feasibility and Acceptability for Children Who Are Non-Responsive to Treatment as Usual

Many children referred to mental health services have neurodevelopmental problems, which are not always recognized because the resulting emotional and behavioral problems dominate diagnosis and treatment. BOAM (Basic needs, Order, Autonomy and Meaning) is a new diagnostic system consisting of imaginative models that explain the complexity of symptoms and underlying neuropsychological problems in a simple way. It is designed to be used in a transparent, collaborative process with families, so that family members can better understand the nature of mental health problems, thus increasing self-knowledge and mutual understanding. In this study, the feasibility of the BOAM diagnostic trajectory and subsequent treatment informed by this trajectory are evaluated clinically in 34 children who have not responded to or relapsed after treatment as usual (TAU). Parents completed questionnaires pre-test, post-test and at a 3-month follow-up. The treatment drop-out rate was 2.9%. Post-test, parents rated the BOAM trajectory positively. The questionnaires (measuring child psychopathology, attention, executive functioning, family functioning, partner relationships and parenting stress) demonstrated sensitivity to change, and therefore, seems appropriate for a future effectiveness study. A limitation was the high percentage of missing measurements both post-test (41%) and at the follow-up (41%). The BOAM diagnostic trajectory and subsequent treatment may be a feasible alternative for children who do not respond to or relapse after TAU.

Brief report: Free-living physical activity levels and cognitive control in multi-problem young adults

Previous studies indicate a positive association between physical activity and cognitive control in sedentary but healthy adults, yet not much is known about physical activity levels in multi-problem young adults. We examined the level of self-reported free-living physical activity (i.e., MET minutes per week) in an ecologically valid sample of young adults facing multiple problems, including unemployment, lack of education, frequent substance use, and history of delinquency. We compared cognitive control with an age- and sex-matched control sample. Additionally, the association between physical activity and cognitive control (i.e., response inhibition, error processing, interference effect) in the multi-problem group was examined. Physical activity and cognitive control were measured with the International Physical Activity Questionnaire-Long Form and three cognitive control experiments (i.e., Flanker, Go/NoGo, Stroop), respectively. With M = 4428 Metabolic Equivalents (METs), our multi-problem sample (n = 63) showed physical activity levels similar to the age- and sex-matched control sample from the general population (n = 62). The multi-problem young adults also showed impaired cognitive control indexed as decreased response inhibition and decreased Flanker correctness effect compared to their peers. We could not find an association between self-reported physical activity and cognitive control in the multi-problem sample. Due to the small sample size, results should be interpreted with caution. However, future dose-response studies could still use these results to further examine if within-individual increased physical activity may possibly lead to improved cognitive control in (already relatively active) multi-problem young adults.

Working Memory Training in Youth With Autism, Fragile X, and Intellectual Disability: A Pilot Study

This pilot study sought to identify potential markers of improvement from pre-post treatment in response to computerized working memory (WM) training for youth (ages 8-18) with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) in a single arm, pre-post design. Participants included 26 children with ASD and 18 with comorbid ASD and fragile X syndrome (ASD+FXS). Analyses were adjusted for age and IQ. The ASD group demonstrated greater improvement on WM training relative to the ASD+FXS group. Participants improved on WM and far transfer outcomes, however, there were no significant group differences in improvement except for repetitive behavior. Higher hyperactivity/impulsivity ratings predicted lower performance on visuospatial WM. Findings suggest cognitive training may be beneficial for youth with ASD and ID, warranting further exploration.

Prenatal organophosphorus pesticide exposure and executive function in preschool-aged children in the Norwegian Mother, Father and Child Cohort Study (MoBa)

INTRODUCTION

Prenatal exposure to organophosphorus pesticides (OPPs) has been associated with neurodevelopmental deficits in children, however evidence linking OPPs with specific cognitive mechanisms, such as executive function (EF), is limited.

OBJECTIVE

This study aims to evaluate the association between prenatal exposure to OPPs with multiple measures of EF in preschool-aged children, while considering the role of variant alleles in OPP metabolism genes.

METHODS

We included 262 children with preschool attention-deficit/hyperactivity disorder (ADHD), and 78 typically developing children, from the Preschool ADHD substudy of the Norwegian, Mother, Father, and Child Cohort Study. Participants who gave birth between 2004 and 2008 were invited to participate in an on-site clinical assessment when the child was approximately 3.5 years; measurements of EF included parent and teacher rating on Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P), and three performance-based assessments. We measured OPP metabolites in maternal urines collected at ∼17 weeks' gestation to calculate total dimethyl- (ΣDMP) and diethyl phosphate (ΣDEP) metabolite concentrations. We estimated multivariable adjusted β's and 95% confidence intervals (CIs) corresponding to a change in z-score per unit increase in log-ΣDMP/DEP. We further characterized gene-OPP interactions for maternal variants in PON1 (Q192R, M55L), CYP1A2 (1548T > C), CYP1A1 (IntG > A) and CYP2A6 (-47A > C).

RESULTS

Prenatal OPP metabolite concentrations were associated with worse parent and teacher ratings of emotional control, inhibition, and working memory. A one log-∑DMP increase was associated with poorer teacher ratings of EF on the BRIEF-P (e.g. emotional control domain: β = 0.55, 95% CI: 0.35, 0.74), when weighted to account for sampling procedures. We found less consistent associations with performance-based EF assessments. We found some evidence of modification for PON1 Q192R and CYP2A6 -47A > C. Association with other variants were inconsistent.

CONCLUSIONS

Biomarkers of prenatal OPP exposure were associated with more adverse teacher and parent ratings of EF in preschool-aged children.

Emotion control training enhances reappraisal success among individuals with reported ADHD symptoms

Previous research indicates that training individuals to recruit cognitive control before exposure to negative pictures can facilitate the propensity to use reappraisal and reappraisal success. Individuals with attention deficit hyperactivity disorder (ADHD) experience difficulties in cognitive control and emotion regulation, so they may especially benefit from such training. Individuals reporting high ADHD symptoms and controls were randomly assigned to one of two training conditions. In the high emotion control (H-EC) training condition, negative pictures were typically preceded by a stimulus that recruits cognitive control. In contrast, in the low emotion control (L-EC) training condition, negative pictures were typically preceded by a stimulus that does not recruit cognitive control. Participants were then asked to recall an adverse personal event and to reappraise the event. As predicted, instructed reappraisal was more effective in reducing negative mood in the H-EC training compared to the L-EC training. Furthermore, compared to controls, individuals with reported ADHD symptoms showed a greater propensity to use reappraisal after writing the event and a more considerable reduction in event significance and negativity following the instructed reappraisal assignment. We argue that employing cognitive control over emotional information has a causal role in reappraisal use and success among individuals with ADHD symptoms.

Age-Related Variance in Performance versus Ratings of Attention and Impulse Regulation in Children: Implications for the Assessment of ADHD

Executive function task (EF) deficits are hypothesized to underlie difficulties with self-regulation. However, tasks assessing EF impairments have only been weakly correlated with rating scales that index self-regulation difficulties. A community sample of children and youth aged between 8 and 20 years old were assessed longitudinally. Growth curve analyses and correlations were conducted to better understand how these two types of measures relate to one another across development, as well as the impact of age-related variance. EF was assessed using the Stroop Task and Trail Making test and behavioral ratings of self-regulation were captured using the SWAN scale. EF task performance improved steeply until age 14–15, whereas the SWAN Scale showed small age-related decreases. EF task performance was moderately correlated with age among 8–13-year-olds and to a lesser extent among 14–20-year-olds. SWAN scores were not significantly related to age in either group. Correlations were similar in an ADHD “at-risk” subgroup. EF task performance and parent ratings of attention regulation have different developmental trajectories, which may partly explain why correlations are low to modest in these samples. In particular, age-related variance is an important methodological consideration with significant implications for the assessment of self-regulation in children and youth with ADHD.

A framework for characterizing heterogeneity in neurodevelopmental data using latent profile analysis in a sample of children with ADHD

BACKGROUND

Heterogeneity in neurodevelopmental disorders, and attention deficit hyperactivity disorder (ADHD) in particular, is increasingly identified as a barrier to identifying biomarkers and developing standards for clinical care. Clustering analytic methods have previously been used across a variety of data types with the goal of identifying meaningful subgroups of individuals with ADHD. However, these analyses have often relied on algorithmic approaches which assume no error in group membership and have not made associations between patterns of behavioral, neurocognitive, and genetic indicators. More sophisticated latent classification models are often not utilized in neurodevelopmental research due to the difficulty of working with these models in small sample sizes.

METHODS

In the current study, we propose a framework for evaluating mixture models in sample sizes typical of neurodevelopmental research. We describe a combination of qualitative and quantitative model fit evaluation procedures. We test our framework using latent profile analysis (LPA) in a case study of 120 children with and without ADHD, starting with well-understood neuropsychological indicators, and building toward integration of electroencephalogram (EEG) measures.

RESULTS

We identified a stable five-class LPA model using seven neuropsychological indicators. Although we were not able to identify a stable multimethod indicator model, we did successfully extrapolate results of the neuropsychological model to identify distinct patterns of resting EEG power across five frequency bands.

CONCLUSIONS

Our approach, which emphasizes theoretical as well as empirical evaluation of mixture models, could make these models more accessible to clinical researchers and may be a useful approach to parsing heterogeneity in neurodevelopmental disorders.

Clinical autism subscales have common genetic liabilities that are heritable, pleiotropic, and generalizable to the general population

The complexity of autism's phenotypic spectra is well-known, yet most genetic research uses case-control status as the target trait. It is undetermined if autistic symptom domain severity underlying this heterogeneity is heritable and pleiotropic with other psychiatric and behavior traits in the same manner as autism case-control status. In N = 6064 autistic children in the SPARK cohort, we investigated the common genetic properties of twelve subscales from three clinical autism instruments measuring autistic traits: the Social Communication Questionnaire (SCQ), the Repetitive Behavior Scale-Revised (RBS-R), and the Developmental Coordination Disorder Questionnaire (DCDQ). Educational attainment polygenic scores (PGS) were significantly negatively correlated with eleven subscales, while ADHD and major depression PGS were positively correlated with ten and eight of the autism subscales, respectively. Loneliness and neuroticism PGS were also positively correlated with many subscales. Significant PGS by sex interactions were found-surprisingly, the autism case-control PGS was negatively correlated in females and had no strong correlation in males. SNP-heritability of the DCDQ subscales ranged from 0.04 to 0.08, RBS-R subscales ranged from 0.09 to 0.24, and SCQ subscales ranged from 0 to 0.12. GWAS in SPARK followed by estimation of polygenic scores (PGS) in the typically-developing ABCD cohort (N = 5285), revealed significant associations of RBS-R subscale PGS with autism-related behavioral traits, with several subscale PGS more strongly correlated than the autism case-control PGS. Overall, our analyses suggest that the clinical autism subscale traits show variability in SNP-heritability, PGS associations, and significant PGS by sex interactions, underscoring the heterogeneity in autistic traits at a genetic level. Furthermore, of the three instruments investigated, the RBS-R shows the greatest evidence of genetic signal in both (1) autistic samples (greater heritability) and (2) general population samples (strongest PGS associations).

Neural Correlates of Executive Functioning in Anorexia Nervosa and Obsessive-Compulsive Disorder

Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are commonly reported to co-occur and present with overlapping symptomatology. Executive functioning difficulties have been implicated in both mental health conditions. However, studies directly comparing these functions in AN and OCD are extremely limited. This review provides a synthesis of behavioral and neuroimaging research examining executive functioning in AN and OCD to bridge this gap in knowledge. We outline the similarities and differences in behavioral and neuroimaging findings between AN and OCD, focusing on set shifting, working memory, response inhibition, and response monitoring. This review aims to facilitate understanding of transdiagnostic correlates of executive functioning and highlights important considerations for future research. We also discuss the importance of examining both behavioral and neural markers when studying transdiagnostic correlates of executive functions.

College as a Developmental Context for Emerging Adulthood in Autism: A Systematic Review of What We Know and Where We Go from Here

Autistic individuals often struggle to successfully navigate emerging adulthood (EA). College is an increasingly common context in which individuals learn and hone the necessary skills for adulthood. The goal of this paper is to systematically review and assess the existing research on college as a context of EA development in autistic individuals, particularly in terms of understanding whether and how this context might be critically different for those who are typically developing or developing with other disabilities. Our findings indicate that ASD college students report feeling prepared academically, but exhibit weaknesses in daily living and social skills. Interventions largely focus on social skills, and rarely evaluate outcomes relevant to college success or longer-term emerging adulthood independence. We conclude with hypotheses and recommendations for future work that are essential for understanding and supporting ASD students as they navigate potentially unique challenges in college and their transition to independence during EA.

Beyond group differences: Exploring the preliminary signals of target engagement of an executive function training for autistic children

Understanding both for whom and how interventions work is a crucial next step in providing personalized care to children with autism spectrum disorder (ASD). Autistic children present with heterogeneity both within core ASD criteria and with respect to co‐occurring mental health challenges, which may affect their ability to benefit from intervention. In a secondary data analysis of a randomized control trial evaluating an executive function (EF) training with 70 7‐ to 11‐year‐old autistic children, we explored: (1) whether co‐occurring attention‐deficit/hyperactivity disorder (ADHD) features or anxiety features at baseline moderated the extent to which children benefited from the EF training. In other words, we asked, “For whom is training effective?” We also explored: (2) the extent to which changes in a brain‐based measure of target engagement predicted the clinical outcomes of the EF training. This is a step towards asking, “How is training effective?” We found that EF training improved behavioral inhibition only for children with clinically significant co‐occurring ADHD features. Anxiety features, while prevalent, did not moderate EF training efficacy. Finally, for the EF training group only, there was a significant correlation between pre‐to‐post change in an EEG‐based measure of target engagement, N2 incongruent amplitude during a flanker task, and change in repetitive behaviors, a behavioral outcome that was reported in the parent RCT to have improved with training compared to waitlist control. This study provides preliminary evidence that EF training may differentially affect subgroups of autistic children and that changes at the neural level may precede changes in behavior.

Adding the missing voice: How self-report of autistic youth self-report on an executive functioning rating scale compares to parent report and that of youth with attention deficit hyperactivity disorder or neurotypical development

LAY ABSTRACT

Executive functions are often impaired in autistic people and relate to important outcomes such as mental health, success in school and work, and quality of life. Evaluating executive functions helps autistic people, clinicians, and families identify targets for external supports and skill building. Youth self-report of executive function has not been studied, yet we know that self-report from autistic youth is key to understanding other cognitive/behavioral phenomena in autism such as anxiety, obsessions/compulsions, sensory sensitivities, and repetitive behaviors. We investigated self- and parent-report of executive function problems in 197 autistic youth without intellectual disability (ages 11-18 years), including the magnitude and profiles of executive function problems autistic youth report across subdomains of executive function. We compared autistic self-report with that of 114 youth with attention deficit hyperactivity disorder without intellectual disability and 197 neurotypical youth. We found that autistic youth report significant executive function problems compared to neurotypical youth and a distinctive profile of challenges in comparison to attention deficit hyperactivity disorder youth. Parents and their autistic children diverged regarding the magnitude of the youth's executive function difficulties, but both identify inflexibility as the most impaired executive function subdomain. Autistic youth and their parents were somewhat more concordant in their report of executive function problems than youth with attention deficit hyperactivity disorder and their parents, but only showed moderate concordance at best. These findings elevate the importance of asking autistic youth directly about their executive functioning when engaging them in assessment and intervention, or researching executive functions in autism.

Indices of Heart Rate Variability and Performance During a Response-Conflict Task Are Differently Associated With ADHD and Autism

We investigated autonomic arousal, attention and response conflict, in ADHD and autism. Heart rate variability (HRV), and behavioral/electrophysiological indices of performance, were recorded during a task with low and high levels of response conflict in 78 children/adolescents (7-15 years old) with ADHD, autism, comorbid ADHD+autism, or neurotypical. ANOVA models were used to investigate effects of ADHD and autism, while a mediation model was tested to clarify the relationship between ADHD and slower performance. Slower and less accurate performance characterized ADHD and autism; however, atypical electrophysiological indices differently characterized these conditions. The relationship between ADHD and slower task performance was mediated by reduced HRV in response to the cue stimulus. Autonomic hypo-arousal and difficulties in mobilizing energetic resources in response to sensory information (associated with ADHD), and atypical electrophysiological indices of information processing (associated with autism), might negatively affect cognitive performance in those with ADHD+autism.