Sunday, December 29, 2013

Executive Functions in Autism

By Lee Wilkinson from
Research evidence suggests that deficits in executive function (EF) are an important feature of autism spectrum disorder (ASD). Executive function is a broad term used to describe the higher-order cognitive processes such as response initiation and selection, working memory, planning and strategy formation, cognitive flexibility, inhibition of response, self-monitoring and self-regulation. It is generally acknowledged that these higher order processes are associated with the prefrontal cortex, which is necessary for regulating and controlling behavior. Executive functions include the many of the skills required to prepare for and execute complex behavior, such as planning, inhibition, organization, self-monitoring, cognitive flexibility, and set-shifting. Markers of executive dysfunction may include difficulty initiating action, planning ahead, inhibiting inappropriate responses, transitioning, switching flexibly between response sets, and poor self-monitoring. Indeed, poor performance monitoring and self-regulation may be associated with the core features of ASD such as a lack of social reciprocity, perseverative responses, and intense emotional responses to change (e.g., meltdowns). Moreover, school success depends on mastery of basic EF skills, including remembering and following instructions, completing tasks independently and smoothly transitioning between tasks, and inhibiting inappropriate behaviors. Consequently, EF plays an important role in the acquisition of knowledge and social skills; the better children are at focusing and refocusing their attention, holding information in mind and manipulating it (i.e., working memory), resisting distraction, and adapting flexibly to change, the more positive the social, adaptive, and academic outcomes.

It is important to note, however, that executive function deficits are not experienced by all individuals on the autism spectrum nor do they appear to play a primary causal role in ASD. Nevertheless, executive dysfunction places a child at-risk and is likely to have an adverse impact on many areas of everyday life and affect adaptability in several domains (personal, social and communication). Consequently, an assessment of executive function can add important information about the child’s strengths and weaknesses and assist with intervention/treatment planning. Although not inclusive, the following measures may be included in a comprehensive developmental assessment battery for ASD.

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