Adding the missing voice: How self-report of autistic youth self-report on an executive functioning rating scale compares to parent report and that of youth with attention deficit hyperactivity disorder or neurotypical development.
Lauren Kenworthy, Alyssa Verbalis, Julia Bascom and 9 others
PMID 34238038WHAT IT FOUND
Autistic youth self-report executive function problems that match their parents' overall pattern but are consistently less severe.
Their own reports identify flexibility as a primary struggle, validating the use of self-report alongside parent forms to capture the patient's perspective.
Key findings
01Autistic youth reported significantly more executive function problems than neurotypical peers and a distinct profile compared to youth with ADHD, specifically noting greater issues with self-monitoring, flexibility, and emotional control.
02While parents and autistic youth agreed on the pattern of difficulties, parents consistently reported a higher magnitude of problems, with 64% of parents identifying clinically elevated global executive function issues compared to 41% of the youth themselves.
03Concordance between parent and self-report was moderate for the autistic group, which was significantly stronger than the poor concordance seen in the ADHD group, suggesting autistic youth do not have uniquely impaired insight into their own executive functioning.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study excluded autistic youth with an IQ below 70, so the findings do not apply to this population. Participants were recruited from different sources (clinical referrals and intervention studies), which may introduce bias. The neurotypical group was matched for age and gender but IQ and ADHD symptom data were not available for comparison. The study did not include performance-based measures of executive function, relying solely on questionnaire reports.
Declared interests
One author, Lauren Kenworthy, receives financial compensation for the use of the BRIEF and BRIEF-2 assessment tools.
The easy way to misread this
Do not assume that a discrepancy between parent and child report indicates a lack of insight in the autistic child. The study found that parent-child agreement was actually stronger in the autistic group than in the ADHD group, and the differences in severity ratings likely reflect different contexts of observation rather than impaired self-awareness.