Relationship of Executive Functioning Deficits and Life Outcome in Intellectually Able Adults with ASD

Background:  

Intellectually able persons with high-functioning autism spectrum disorders (ASD) often have difficulty with independent living and successful transition into adulthood. In addition to the social deficits of ASD, many experience deficits in executive functioning which may impede adaptive functioning, goal attainment, employment success, independent living, and achieving educational goals.

The Barkley Deficits in Executive Functioning Scale (BDEFS-LF) is a self-report assessment used to evaluate adults ages 18 to 81, and measures type and extent of EF deficits. Because it incorporates a long-term view of a person’s executive functioning, the BDEFS-LF may be helpful for understanding where specific areas of difficulty correlate with life functioning.

Objectives:  

This study is designed to investigate relationships between executive functioning deficits and life outcomes in intellectually-able adults who meet DSM-IV/DSM-5 criteria for ASD. A primary objective of this study is to provide evidence of BDEFS-LF score patterns linked to life outcome for intellectually able adults with ASD which can then be used for clinical application.

Methods:  

Data were collected from archival records of intellectually able adults who qualify for a DSM-IV or DSM-5 diagnosis of Autism Spectrum Disorder (Asperger’s Type) from an outpatient clinic which specializes in diagnosing ASD in adults. There were 43 participants with DSM-IV/DSM-5 ASD (40% F). Distribution of ages was 37% in the 18 -25 year-old category, 42% age 25-39, 20% over the age of 39. Specific records studied include scores from BDEFS-LF categories of self-management to time, organization and problem solving, self-restraint, self-motivation, and self-regulation. Independent variables were: Relationship Status, Education, Employment, and Residence.

Results:  

Standard linear regression was conducted to determine the accuracy of the independent variables (BDEFS-LF scores for self-management to time, organization and problem solving, self-restraint, self-motivation, and self-regulation) in predicting the dependent variables of relationship status, education, employment, and place of residence. 

Regression results indicate that the overall model significantly predicts current marital status and residence. Results for marital status are (R² = .144, R2_adj = -.028, F(5, 37) = 1.244, p<.05), which accounts for 14.4% of variance. One of the four variables, self-management to time, significantly contributed to the model. The overall model also significantly predicts residence (R² = .209, R2_adj = -.102, F(5, 37) = .1.957, p<.05). This model accounts for 20.9% of variance in the dependent variable of residence. As with the results for marital status, the variable of self-management to time significantly contributed to the model. However, regression results indicate the overall model does not significantly predict employment status or level of education.

Conclusions:  

Results suggest the factor of self-management to time significantly impacts marital status and independent living for intellectually able adults with ASD. This preliminary investigation into specific executive functioning components which might benefit from clinical treatment suggests that focusing on time management skills might assist with growing skills for independence, particularly maintaining adult relationships and independent residence. Limitations include size of study and the preliminary nature of the investigation. Future directions are underway as data continues to be collected, and may include gender differentials.