Executive Function: Cognition and Behaviour in Adults with Autism Spectrum Disorders (ASD).
Kate Johnston, Kim Murray, Debbie Spain and 2 others
PMID 31281952WHAT IT FOUND
Adults with autism scored lower than matched controls on planning, verbal fluency and flexibility, and took longer on tasks.
Some showed no impairment, and reported everyday difficulties did not match test scores or autism symptoms.
Key findings
01Adults with ASD had lower scores than matched controls on planning, verbal fluency and flexibility, and took longer to complete tasks.
0235% of adults with ASD were in the clinically impaired range on a generativity task and 24% on a response initiation task, but more than one-third were not impaired on any task.
03Self- and informant-reported everyday executive difficulties were higher in adults with ASD, but did not align with test performance, task speed, or autism symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a comparison of two groups at one assessment, so it cannot show that executive function problems cause everyday difficulties. The ASD sample came from a specialist diagnostic service, and a large amount of DEX data was missing for administrative reasons, so the behavioural findings may not represent all adults with ASD. The study used broad clinical tests, so it cannot identify a precise pattern of executive function impairment. Adults with anxiety, mood, personality or obsessive-compulsive diagnoses were included, while ADHD was excluded, so the results apply to ASD without ADHD but not necessarily to ASD with common co-occurring conditions. There was no formal sample size calculation.
The easy way to misread this
Do not conclude that adults with ASD have a uniform executive function disorder. Some were not clinically impaired on any task, and reported everyday executive difficulties did not match test scores, task speed or autism symptoms.