Longitudinal Examination of Everyday Executive Functioning in Children With ASD: Relations With Social, Emotional, and Behavioral Functioning Over Time.

Vanessa M Vogan,Rachel C Leung,Margot J Taylor,Rhonda Martinussen,Mary Lou Smith,Kristina Safar

doi:10.3389/fpsyg.2018.01774

Abstract

Executive functioning (EF) deficits are well-documented in Autism Spectrum Disorder (ASD), yet little is known about the longitudinal trajectory of “everyday” EF and links to social, emotional and behavioral outcomes in ASD. This study examined the profile of everyday EF utilizing parent-reported measures over 2 years, and explored whether prior estimates of EF were related to later co-morbid psychopathology and social functioning in 39 children with ASD and 34 typically developing (TD) children (ages 7–14 years). According to parent reports, children with ASD had impaired scores of EF in all domains at both time points, and showed no significant improvement across 2 years, compared to controls. Regression analyses showed that prior estimates of behavior regulation difficulties at time 1 uniquely predicted later emotional (i.e., symptoms of anxiety/depression) and behavioral (i.e., oppositionality/aggressiveness) problems in children with ASD 2 years later. Furthermore, an improvement of metacognitive skills predicted a reduction of social difficulties over 2 years in ASD. These results imply that EF may be a potential target of intervention for preventing and reducing co-morbid psychopathology and promoting social competence in youth with ASD. Furthermore, the findings that EF related to behavior is more critical for later emotional and behavioral functioning, whereas EF related to cognition is more critical for social functioning, indicates that it may be beneficial to tailor treatment. Future studies investigating the effectiveness of EF-based interventions in improving the cognitive, psychological and social outcomes in ASD are of high priority.

Highlights

In addition to social-communicative deficits and repetitive/restricted behaviors and interests, individuals with Autism Spectrum Disorder (ASD) often have executive functioning (EF) impairments (Hill, 2004; Russo et al, 2007; Kenworthy et al, 2008; Bramham et al, 2009; Gardiner et al, 2017)
As abilities on laboratory tasks may differ from real-world observations, the current study focused on parent-reported EF measures using the Behavior Rating Inventory of Executive Functioning (BRIEF; Gioia et al, 2000), which captures daily scenarios of EF in individuals with ASD
To examine whether initial age at baseline (T1) affected the change in EF over 2 years, we controlled for age and found no significant Time × Age interaction on any scales or indices of the BRIEF, indicating that effects of time were not impacted by initial age of the participants

Summary

Introduction

In addition to social-communicative deficits and repetitive/restricted behaviors and interests, individuals with Autism Spectrum Disorder (ASD) often have executive functioning (EF) impairments (Hill, 2004; Russo et al, 2007; Kenworthy et al, 2008; Bramham et al, 2009; Gardiner et al, 2017). Impairments of EF in ASD are correlated with symptom presentation (Lopez et al, 2005; Hill and Bird, 2006; Kenworthy et al, 2009; Reed et al, 2013), adaptive behavior problems (Gilotty et al, 2002; Pugliese et al, 2016), social competence (Pellicano, 2010; Leung et al, 2016; Torske et al, 2016), academic success and psychiatric comorbidities (Lawson et al, 2015), and are associated with greater dependence and poor outcomes in adulthood (Hume et al, 2009). One crucial question is how the EF profile manifests over time in ASD and its impact on developmental outcomes

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Conclusion