The Development of EF and Its Relationships with Social Function and Behavior Problem in the Children with High-Functioning Autism Spectrum Disorder

Background: Individuals with autism spectrum disorder (ASD) have diverse deficits in executive and social functioning. This is difficult to identify the core impairments that cause their problems.

Objectives: The study aimed to examine different domains of executive functions (EF) with heterogeneity of high-functioning ASD (HFASD) in relations to their symptom severity, adaptive behavior and social problems.

Methods: seventy-four 7- to-10-year-old HFASD and 44 typically developing (TD) controls were measured three domains of EF tasks: working memory (i.e., Leiter-R and subtest of WISC-III), inhibition(i.e., subtest of NEPSY-III and Flanker task) and flexibility abilities (i.e., subtest of NEPSY-III). Parent-reported were also assessed for children’s executive functions and self-regulations (BRIEF), social communication (i.e., SRS, RBS-R, SCQ) and adaptive behavior (i.e., CBCL, VABS).

Results: HFASD group had worse performance on all EF tasks compared to TD group, particularly for inhibition tasks, showed the largest group differences. When intelligence was considered, the HFASD with non-intelligence (non-IG-HFASD, 70<FIQ<115) were weak in inhibition and flexibility abilities than TD group. However, these comparisons were not obviously observed between HFASD with high-intelligence (IG-HFASD, FIQ>115) and TD groups. In addition, there are respective impairments on inventory-based EF scales in the IG-HFASD and Non-IG-HFASD participants. Regression analysis revealed the problems of inhibition and shift abilities can predict restricted and repetitive symptoms as well as internalizing (e.g. anxiety) and externalizing symptom (e.g. attack).

Conclusions: Children with HFASD having better inhibition abilities are likely to have more disturbance of internalizing problems. The specific patterns of deficits in execute functions related to social behavior can be observed for HFASD with and without high-intelligence. The results highlight the uniqueness and universality of executive functions interpret heterogeneity in the cognitive profiles of children with HFASD, implying the possibilities for early intervention.