Relationship between executive function and autism symptoms in preschoolers with autism spectrum disorder

Executive dysfunction and other symptomatology could have links in preschoolers with autism spectrum disorder (ASD). This study contains three objectives: to explore the difference in executive function between preschoolers with ASD and typically developing individuals (TD), to investigate correlations between executive function and multiple domains of autism symptoms in preschoolers with ASD, and to examine the impact of executive function on symptoms of autism. Participants of this study included preschoolers (4-6 years) with ASD (24 boys, 20 girls) according to DSM-5-TR criteria and TD (24 boys, 20 girls). BRIEF-P (Behavior Rating Inventory of Executive Function-Preschool Version) and CASD-C (Checklist for Autism Spectrum Disorder-Chinese Version) were used as measurement tools. Data were analyzed using MANOVA, ANOVA, Pearson correlations, and simple regression. For the results, the study found results of executive function were significantly lower in preschoolers with ASD than in preschoolers without ASD; the greater the executive dysfunction, the greater the autistic symptomatology, and executive dysfunction predicted 57 % of the variability of autism symptoms. In conclusion, preschoolers with ASD had more executive dysfunction than those without ASD. Based on our findings, the study recommends incorporating executive function into clinical assessment programs to understand how executive function is related to autism symptoms.

Inhibitory abilities in girls and boys: More similarities or differences?

This brief review examined the literature from 1990 to June 2020 on sex differences in inhibitory abilities from early childhood to adolescence, primarily in individuals with typical development (TD) and individuals with atypical development. The 38 articles included (28 on individuals with TD, eight on the attention deficit hyperactivity disorder [ADHD] population, and two on individuals with autism spectrum disorder [ASD]) suggest that the cognitive demand of the task is important, together with contextual factors that may interact with the development of inhibitory ability, for revealing differences between the sexes. The literature has neglected the multicomponential nature of inhibitory abilities, and the emphasis has consequently been placed on response inhibition (vs. other components). The implication of the impurity problem has also been considered. The findings on children and adolescents with ADHD or ASD-even for outcomes that are not conclusive-imply that there is no evidence for a difference in inhibitory abilities between males and females. The literature proposes an asynchrony in the development of inhibitory abilities that may explain what is found in typically developing girls who perform more highly than boys on more demanding tasks.

Inhibitory Control in Autism Spectrum Disorders: Meta-analyses on Indirect and Direct Measures

This manuscript aimed to advance our understanding of inhibitory control (IC) in autism spectrum disorders (ASD), adopting a meta-analytic multilevel approach. The first meta-analysis, on 164 studies adopting direct measures, indicated a significant small-to-medium (g = 0.484) deficit in the group with ASD (n = 5140) compared with controls (n = 6075). Similar effect sizes between response inhibition and interference control were found, but they were differentially affected by intellectual functioning and age. The second meta-analysis, on 24 studies using indirect measures, revealed a large deficit (g = 1.334) in the group with ASD (n = 985) compared with controls (n = 1300). Presentation format, intellectual functioning, and age were significant moderators. The effect of comorbidity with ADHD was not statistically significant. Implications are discussed for IC research and practice in autism.

Is cognitive inflexibility a missing link? The role of cognitive inflexibility, alexithymia and intolerance of uncertainty in externalising and internalising behaviours in young people with autism spectrum disorder

BACKGROUND

Internalising (anxiety and low mood) and externalising (aggressive or outburst behaviours, and irritability) difficulties are very common in autism spectrum disorder (ASD) across the life span, relatively stable over time and often associated with poorer quality of life. Understanding the cognitive mechanisms underlying internalising and externalising difficulties in ASD is essential for developing targeted supports and interventions. In the present study, we investigated established and less-researched cognitive factors hypothesised to contribute to internalising and/or externalising difficulties in ASD, namely cognitive inflexibility (CI), intolerance of uncertainty (IU) and alexithymia. Based on previous models and clinical experience, we hypothesised that IU would lead to internalising symptoms, with alexithymia contributing to this pathway, and that CI would have a direct effect on externalising behaviours and may indirectly contribute to internalising symptoms via increasing IU.

METHODS

Our sample consisted of 95 5- to 18-year-olds presenting to a specialist neurodevelopmental clinic and receiving a diagnosis of ASD. Parents/caregivers completed questionnaires assessing ASD symptomatology, internalising and externalising difficulties, CI, IU and alexithymia. Structural equation modelling was used to examine the hypothesised pathways and relationships between the main variables of interest.

RESULTS

Cognitive Inflexibility played a significant direct role in the pathway from ASD symptoms to externalising symptoms in ASD, and indirect role via IU in the pathway to internalising problems. Relationships between alexithymia and both internalising and externalising symptoms were weaker, with alexithymia predicting internalising difficulties via IU only.

CONCLUSIONS

The finding of a direct pathway from CI to externalising behaviours is novel, as is the indirect role of CI in internalising symptomatology. Of the three cognitive mechanisms examined, only CI significantly predicted externalising symptoms. Possible implications for interventions and supports targeting these cognitive processes in ASD are discussed.