Abstract
This article reviews research on executive function (EF) skills in children with autism spectrum disorder (ASD) and the relation between EF and language abilities. The current study assessed EF using nonverbal tasks of inhibition, shifting, and updating of working memory (WM) in school-age children with ASD. It also evaluated the association between children's receptive and expressive language abilities and EF performance. In this study, we sought to address variables that have contributed to inconsistencies in this area of research-including task issues, group comparisons, and participant heterogeneity. EF abilities in children with ASD (n = 48) were compared to typically developing controls (n = 71) matched on age, as well as when statistically controlling for group differences in nonverbal cognition, socioeconomic status, and social communication abilities. Six nonverbal EF tasks were administered-2 each to evaluate inhibition, shifting, and WM. Language abilities were assessed via a standardized language measure. Language-EF associations were examined for the ASD group as a whole and subdivided by language status. Children with ASD exhibited significant deficits in all components of EF compared to age-mates and showed particular difficulty with shifting after accounting for group differences in nonverbal cognition. Controlling for social communication-a core deficit in ASD-eliminated group differences in EF performance. A modest association was observed between language (especially comprehension) and EF skills, with some evidence of different patterns between children on the autism spectrum with and without language impairment. There is a need for future research to examine the direction of influence between EF and language. It would be beneficial for EF interventions with children with ASD to consider language outcomes and, conversely, to examine whether specific language training facilitates aspects of executive control in children on the autism spectrum. https://doi.org/10.23641/asha.7298144.
Highlights
Our findings indicate that social communication was the covariate that eliminated group differences across all EF measures
This study provided a global assessment of core EF skills in children with ASD and an evaluation of the overall relationship between executive control and structural language abilities as assessed by an off-line measure of language comprehension and production that is widely used in clinical settings
Results indicated that children with ASD had significant deficits in inhibition, shifting, and updating of WM relative to age-matched controls and displayed particular difficulties in shifting even after accounting for differences in nonverbal IQ. It was only after controlling for social communication abilities that group differences in EF abilities were no longer found. These findings are interpreted to suggest that the EF deficits observed in these school-age children with ASD were tied to core autism symptoms characterized by social communication rather than other factors
Summary
Children were recruited through area schools, clinics, and community centers by website postings and flyers. The TD and ASD groups were matched on chronological age, t(117) = −0.74, p = .46, but differed significantly on nonverbal IQ, t(116) = 3.03, p < .01, maternal education, t(115) = 2.03, p = .04, social communication, t(116) = −17.10, p < .01, and core language abilities, t(114) = 8.18, p < .01. ASD LI = autism spectrum disorder, language impairment (scored ≤ 81.25 on CELF-4 Core Language standard score, −1.25 SD); ASD LN = autism spectrum disorder, language normal (scored > 81.25 on CELF-4 Core Language standard score); SES = socioeconomic status; WISC-IV = Wechsler Intelligence Scale for Children–Fourth Edition; SCQ = Social Communication Questionnaire; CELF-4 = Clinical Evaluation of Language Fundamentals–Fourth Edition. That TD > ASD LI and ASD LN, p < .01, and ASD LN > ASD LI, p < .01
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