Neuropsychological Profiles In Italian Children with Autism: a Descriptive Study Through NEPSY-II

Background: A deep investigation of the neuropsychological impairments in children with autism, may help to the identification of the  pathophysiological mechanisms associated with the disorder and to design appropriate interventions aimed to improve cognitive capacities in individuals with autism. NEPSY-II (Korkman et coll. 2007) is one of the most comprehensive instrument designed to assess neuropsychological development in preschool and school-age children. It consists of several tests divided into six content domains: Attention and Executive Functioning, Language, Memory and Learning, Social-Perception, Sensorimotor Functions and Visuospatial Processing. The advantage of the NEPSY-II is the capability to assess the primary and secondary deficits underlying impaired performance both within and across functional domains.

Objectives: To explore the neuropsycological profile of children with autism through NEPSY-II.

Methods: A sample of 22 children (mean age = 9.56 years) with DSM-IV-TR clinical diagnosis of Autistic Disorder or Autistic Disorder NOS confirmed through ADOS and ADI-R was assessed with all the tests of the Italian version of the NEPSY-II. Additional inclusion criteria were: absence of any neurological dysfunction; Wechsler Full Scale IQ greater or equal to 80. A neurotypical sample matched for age and sex was randomly selected from the Italian normative sample (Urgesi, Campanella, Fabbro, in press) for comparison of neuropsychological profiles. Statistic analyses were conducted using t-Test (p<.001 was established as significant to correct for multiple comparisons).

Results: Attention and Executive Functioning: The test of inhibition, requiring the ability to suppress automatic responses in a naming task, was impaired in children with autism. In the Animal Sorting task, the autistic sample obtained higher scores than the control one. In Visual and Auditory attentions tests, requiring selective and sustained Attention abilitites, Design Fluency and Statue there was no difference between groups. Language: Comprehension of instruction, Repetitive of nonsense word, Speeding Naming and Word Generation were similar in the two groups whilst Oromotor Sequences and Phonological Processing were impaired in the autistic sample. Memory and Learning: Memory for Designs, Memory for Faces, Memory for Names and Sentence Repetition measures didn't show significant differences between autistic and neurotypical samples. List Memory, Narrative Memory under free and cued recall, and Word List Interference were impaired in autistic sample. Sensorimotor: Autistic sample showed significant deficiency in all tasks (Fingertip Tapping, Imitating Hand Positions, Manual Motor Sequences, and Visuomotor Precision). Social-Perception: Affect Recognition was impaired. Regarding Theory-of-Mind (ToM) measures, verbal tasks were impaired whilst measures in contextual tasks were intact. Visuospatial Processing: Block Designs, Geometric Puzzle, and Picture Puzzle tests showed no statistical differences between groups. Only Design Copying was impaired in autistic sample.

Conclusions: Only Sensorimotor domain appears totally impaired in autistic children. Within other domains, some traditional deficits are confirmed. For example ToM performance appears to be more apparent in verbal tasks and not in the understanding the emotional context of emotions. These findings provide additional support for the phenotypic neuropsychological profile of individuals with autism and suggest that the NEPSY-II can contribute to the neuropsychological description of children with autism.