Goal-Directed Action Control in Children with Autism

Background: Repetitive behavior is a key characteristic of autism spectrum disorders (ASD) which has been related to disfunctions in the fronto-striatal circuitry.  This repetitive behavior is also seen as a reflextion of more general inflexible behaviour, but studies trying to measure this inflexibility with cognitive control lab tasks often failed. Therefore, cognitive control might not be a sufficient way to understand the observed behavior as it might be related to the balance of different cognitive systems.

Objectives: The aim of the present study was to investigate the hypothesis that this abnormal behavioral repetition results from a tendency to over-rely on habits at the expense of flexible, goal-directed action.

Methods: To this end, we tested 25 children with ASD and 25 age- and gender-matched typically developing controls (between 8-12 years) on an instrumental task. Initially, children learned to press keys to different pictorial stimuli in order to gain valuable outcomes (i.e., stimulus-response-outcome). Subsequently, in the critical “slips-of-action” test stage, some of these outcomes were no longer valuable, and children were asked to refrain from key pressing when they were shown stimuli that signaled the availability of those outcomes, while continuing to respond for the still-valuable outcomes. A baseline test, in which responding could be based on stimulus- as opposed to outcome-value, was included to control for general task characteristics. We also tested whether task performance was correlated with parent reports on repetitive behavior in the children.

Results: Importantly, we found no evidence for a disruption in the balance between goal-directed and habitual behavioral control in ASD. Children with ASD learned equally well as controls, and were not impaired at flexibly adjusting their behavior to devaluation of the outcomes. Moreover, taskperformance did not related to repetitive behavior in daily life. However, exploratory analyses revealed that the subset of ASD children who were not taking medication in our study did in fact show a general impairment across the slips-of-action and the baseline tests, relative to ASD children on medication and to controls.

Conclusions: In contrast with earlier studies, in the current study the children with ASD did not differ from controls in the way they learned stimulus-response-outcome associations. Moreover, the balance between goal-directed and habitual behavioral control did not seem to be disrupted while for example in patients with obsessive compulsive disorder such a disbalance was observed. These findings will be discussed in the context of potential deficits in ASD in goal-directed action and in cognitive control more generally.

Goal-directed action control in children with autism

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