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Language and Executive Function As Predictors for Concurrent and Future Academic and Social Outcomes in Cognitively-Able Kindergarteners with ASD
Objectives: To (1) examine the development of academic/social outcomes in cognitively-able children with ASD throughout kindergarten; (2) observe how school-entry EF and language predict these outcomes.
Methods: Participants included 54 cognitively-able children with ASD at kindergarten-entry (M=62.3 months; SD=4.8). Kindergarten-exit evaluations were completed for 36 participants (M=71.4; SD=3.9). EF was assessed based on innovative, tablet-based tasks, “EF-Touch” (Willoughby et al., 2010), targeting inhibitory control (“Spatial Conflict Arrows”; SCA), working memory (“Pick the Picture”; PTP), and attention shifting (“Something’s the Same”; STS). The Woodcock-Johnson III tests of achievement (WJ; Woodcock et al., 2001) was used to measure academic achievement in reading (passage comprehension [PC], letter-word identification [LW]) and math (math fluency [MF], applied problems [AP]). Social outcomes were assessed using the Brief Observation of Social Communication Change (BOSCC; Grzadzinski et al., 2016). Kindergarten-entry ASD symptom severity, cognitive skills (NVIQ), and language were assessed with the Autism Diagnostic Observation Schedule-2 (ADOS-2; Lord et al., 2012), the Differential Ability Scale (DAS; Elliott, 2007), and the Children’s Communication Checklist-2 (CCC-2; Bishop, 1998), respectively. Regression analyses were conducted to examine whether EF and language significantly predicted concurrent and future academic and social outcomes.
Results: Preliminary results showed that from kindergarten-entry to -exit, children made significant improvements (p<0.05) in reading and math (WJ), and social communication (BOSCC) with moderate-to-large effect sizes (Cohen’s d=0.6-0.9). Kindergarten-entry attention shifting (STS) significantly predicted concurrent and future math performance at kindergarten-exit (AP). Working memory (PTP) significantly predicted concurrent math performance (MF). Inhibitory control (SCA) significantly predicted concurrent math performance (AP) and social communication (BOSCC). Kindergarten-entry inhibitory control (SCA) significantly predicted math performance at kindergarten-exit (AP). Phonological skills (CCC-2 Speech) significantly predicted concurrent reading (LW). Pragmatic language (CCC-2 Initiation, Interests) predicted concurrent social communication (BOSCC). Kindergarten-entry phonological and syntax skills (CCC-2 Speech, Syntax) significantly predicted reading (PC) and social communication (BOSCC) at kindergarten-exit, respectively. Predictors were significant after controlling for maternal education, gender, NVIQ, and symptom severity (p<0.05).
Conclusions: Cognitively-able children with ASD demonstrated academic and social gains throughout kindergarten. Kindergarten-entry EF and language were strong predictors of concurrent and future academic and social outcomes, above and beyond symptom severity, gender, and NVIQ. Inhibitory control, attention shifting, and working memory consistently predicted math skills, similar to past studies of TD kindergarteners (e.g., Passolunghi et al., 2012). Kindergarten-entry pragmatic language and phonological skills predicted concurrent and future reading as well as social communication. Results highlight the importance of targeting EF and language even before school-entry to maximize academic and social outcomes in children with ASD (Jones et al., 2017; Blair & Razza, 2007). Final analyses will be with a larger sample from an on-going study.