A preliminary randomized, controlled trial of executive function training for children with autism spectrum disorder.
Susan Faja, Tessa Clarkson, Rachel Gilbert and 5 others
PMID 34474598WHAT IT FOUND
10 hours of computer executive-function training plus coaching changed children's brain response during a conflict task, but did not improve lab or parent-reported executive function.
A reduction in repetitive behaviors was not a planned main result.
Key findings
01Computer training plus coaching produced a significant change in brain response to conflict trials, while waitlist children did not change.
02Computer training plus coaching did not improve lab-based executive-function tasks or parent-reported real-world executive function.
03After adjusting for baseline, the computer training plus coaching group had lower parent-reported repetitive behaviors, an exploratory outcome.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was preliminary, and multiple outcomes were examined without correction for multiple comparisons. The sample size was chosen for a preliminary efficacy study, so only large behavioral effects could be detected. Children were not selected based on executive-function impairment, which may have limited room for improvement. The control group was waitlist, not an active alternative treatment. Some EEG analyses excluded children with fewer than 10 usable trials per condition, so not all 70 children contributed to each outcome. There was no follow-up after immediate post-testing. Repetitive behaviors were an exploratory outcome, and the groups differed at baseline. Parent feedback came from 23 families, so acceptability data were limited. ASD community members were not involved in developing the research question, outcome measures, design, implementation, or interpretation.
Declared interests
The supplied article text does not state author conflicts or funding; metadata lists NIH extramural and non-U.S. government support.
The easy way to misread this
Do not read the reduction in repetitive behaviors as evidence that computer training plus coaching improves everyday executive function. The parent-reported executive function outcomes did not change, and repetitive behavior was an exploratory outcome with baseline group differences.