The Mediating Role of Executive Functioning in Problems Behaviors in Autism Spectrum Disorder
Objectives: This study examines the relationship between EF, as measured by the NIH-Toolbox Cognition Battery (NIH-TCB), and problem behaviors, as measured by the Aberrant Behavior Checklist (ABC).
Methods: Children with ASD, ages 3-17, years and typically developing (TD) children matched on age are currently being recruited. Data from 143 children and adolescents with ASD (mean age = 9 years; SD= 4 years) and 92 TD controls (mean age = 8 years 5 months; SD = 3 years) is included in this preliminary analysis. TD children demonstrated a significantly higher intelligent quotient (IQ) as indexed via the Stanford-Binet Intelligence Test, Fifth Edition (SB-5; TD mean IQ = 111.6; ASD mean IQ = 91.93; p=.01); therefore, the analysis controlled for IQ. Parents completed the ABC. Four separate path analyses were conducted to test the following hypothesized mediation model: Diagnostic status -> mediator variable (cognitive inhibition and flexibility) -> outcome variable (lethargy or irritability). Both direct and indirect models were tested.
Results: For lethargy, the hypothesized model mediated by cognitive inhibition and direct paths were tested for differences. Both the indirect model (mediated by cognitive inhibition) and the direct model were significant (indirect: Beta= -0.53, p=0.06; direct: Beta= 7.66, p<0.01). However, the hypothesized model mediated by cognitive flexibility was non-significant (indirect: Beta= -0.05, p=0.18). In the case of irritability, the hypothesized model mediated by either cognitive flexibility or inhibition presented non-significant results (p=.40, p=.10, respectively).
Conclusions: These preliminary findings replicate previously observed pathways between cognitive inhibition and problem behaviors (lethargy) in children, while extending these findings to children with ASD using performance-based measures. These findings suggest that interventions targeting EF deficits in cognitive inhibition may also mediate lethargic problem behaviors. However, other problem behaviors such as irritability may not be mediated by EF in the ASD population.