SLPNarrative ReviewSeminars in speech and language2019

A Review of Language, Executive Function, and Intervention in Autism Spectrum Disorder.

Laura Friedman, Audra Sterling

PMID 31311054

WHAT IT FOUND

Executive function deficits in autism are inconsistent and often depend on whether the task requires language.

Social communication interventions improved executive function, while executive function interventions improved social skills. Clinicians should assess language and executive function together.

Key findings

01Executive function performance in autism varies by task type; deficits are more likely to appear in tasks requiring verbal responses than in visually based tasks.

02Interventions targeting social communication improved executive function, and interventions targeting executive function improved social skills, suggesting these domains are interconnected.

03Group matching criteria significantly influence results; studies matching for language ability often find no executive function differences between autistic children and peers, whereas age or IQ matching yields inconsistent differences.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The review highlights significant variability in findings across studies due to differences in participant ages, diagnostic severity, and comparison groups. Many studies did not control for language ability when assessing executive function, making it difficult to isolate executive deficits from linguistic difficulties. The directionality of the relationship between language and executive function remains unclear due to the cross-sectional nature of many cited studies. Intervention studies often relied on teacher or parent reports, which may be biased if raters knew the treatment assignment.

The easy way to misread this

Do not assume that every individual with autism has a core executive function deficit. Performance on these tasks is heavily influenced by language ability and the specific demands of the test. A poor score on a verbal executive function task may reflect a language difficulty rather than an executive function problem.

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