International Meeting for Autism Research (May 7 - 9, 2009): Executive Functioning in Children with ASDs Who Have Achieved Optimal Outcomes

Thursday, May 7, 2009

Northwest Hall (Chicago Hilton)

3:30 PM

E. Troyb , Psychology, University of Connecticut, Storrs, CT

M. Rosenthal , Psychology, University of Connecticut, Storrs, CT

K. Tyson , Psychology, University of Connecticut, Storrs, CT

M. Helt , Psychology, University of Connecticut, Storrs, CT

I. M. Eigsti , Psychology, University of Connecticut, Storrs, CT

L. Naigles , Developmental Psychology, University of Connecticut, Storrs, CT

M. Barton , Department of Psychology, University of Connecticut, Storrs, CT

D. Fein , Psychology, University of Connecticut, Storrs, CT

Background: Since Lovaas (1987) first reported that children with Autism Spectrum Disorders (ASD) can achieve favorable outcomes following early intensive, behavioral intervention, few studies have investigated “recovery” from ASD. In addition, research examining the residual impairments in cognitive functioning of children with ASD who achieve optimal outcomes has been scarce.

Objectives: This study examines the executive functioning of a small group of children who received an ASD diagnosis before age 5, but no longer meet criteria for an ASD diagnosis at the time of testing. This study refers to this group as optimal outcome children.

Methods: Nineteen children with optimal outcomes (OO, M(age) =12.6), have been matched on their age, sex, Full Scale IQ, Verbal IQ and Nonverbal IQ, with 13 high functioning children with a current ASD diagnosis (HFA, M(age) = 13.1), and 23 typically-developing peers (TD, M(age) = 13.4). The groups were compared on performance on the D-KEFS Tower of London, Color-Word Interference and Verbal Fluency subtests. In addition, 10 of the 19 OO children were also compared to nine HFA children and 22 TD peers, on parental responses on the Behavior Rating Inventory of Executive Function (BRIEF).

Results: Performance on the subtests of the D-KEFS did not differ significantly between the three groups and all were within the average range. On the BRIEF, OO children performed in the average range on all subscales. They showed less impairment than HFA children in working memory (M(OO)=53.0, M(HFA)=64.4, p=.02), as well as in their ability to shift easily between activities (M(OO)=50.9, M(HFA)=72.6, p<.01), regulate emotional reactions (M(OO)=47.3, M(HFA)=63.2, p <.01) and self-monitor (M(OO)=51.3, M(HFA)=65.8, p<.01). However, OO children had more difficulty than their TD peers in their abilities to inhibit impulses (M(OO)=53.9, M(TD)=44.0, p=.02), shift easily between activities (M(OO)=50.9, M(TD)=41.9, p=.02), regulate emotional reactions (M(OO)=47.3, M(TD)=41.4, p=.03), initiate activities (M(OO)=53.2, M(TD)=41.8, p=.02) and self-monitor (M(OO)=51.3, M(TD)=43.5, p=.04). They also showed greater impairments than TD peers in working memory (M(OO)=53.0, M(TD)=42.9, p=.01), planning and organization (M(OO)=52.8, M(TD)=44.1, p=.02). These differences, however, were due to the superior performance of the TD group.

Conclusions: Preliminary evidence suggests that the executive functioning of OO children and HFA children is similar to that of their TD peers under optimal testing conditions. Differences in parental responses on the BRIEF suggest that in everyday situations, IQ-matched TD children were particularly good at executive skills, commensurate with their above average IQ's, while OO children scored below the TD peers, but solidly in the average range. Scores of the HFA children were at-risk for most index scores of the BRIEF, and fell in the clinically significant range for their ability to transition between activities.

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