OTCase-ControlAutism : the international journal of research and practice2022

Real-world executive functioning for autistic children in school and home settings.

Jessica E Tschida, Benjamin E Yerys

PMID 34465230

WHAT IT FOUND

Autistic children were rated as having greater everyday executive function difficulties at school and at home, especially shifting between activities.

Age-related differences appeared mainly in school, and ratings tracked adaptive behavior in the same setting.

Key findings

01Teacher and parent ratings showed greater executive function impairment for autistic children than for typically developing children in both school and home settings.

02Within the autism group, shifting was rated as more impaired than the other executive function scales in both school and home settings.

03Executive function ratings added information about adaptive behavior in the same setting for autistic children.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The sample was overrepresented by non-Hispanic white males, so findings may not apply equally to girls or children from other backgrounds. Age effects were based on different children at one time, not the same children followed over time. Some children did not have a school questionnaire, especially those with lower IQ, so the school sample may not represent all autistic children. The school adaptive behavior sample was smaller than the school executive function sample. The study used adult ratings only and did not include performance-based or neural measures of executive function. Information about raters, classroom type, and other school reference points was limited. Co-occurring conditions other than ADHD, such as anxiety or depression, were not examined. Autism diagnostic criteria and the shifting scale may overlap, which could inflate the shift finding.

Declared interests

The supplied metadata lists NIH and non-U.S. government research support. No author conflict-of-interest declaration is included in the supplied text.

The easy way to misread this

Do not conclude that treating executive function will improve adaptive behavior or school functioning. The study compared adult ratings at one time and did not test an intervention.

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