Repetitive Behaviors and Executive Functions in Children with High Functioning Autism Spectrum Disorders

Background: Repetitive, restricted and stereotyped types of behavior are a core feature of Autism Spectrum Disorders (ASDs) and are necessary for their diagnosis. Previous research has reported a distinct profile of executive functions in a group of young adults with a subset of High Functioning ASDs, and specifically in non-verbally mediated cognitive flexibility. The relationship between executive functions and repetitive behaviors has previously been examined in adults with ASDs, but has not distinguished between verbally and non-verbally mediated cognitive flexibility or looked at the relationship in children on the high-functioning end of the spectrum. It has been suggested that both impairment in executive functions and the presence of repetitive behaviors contributes to the social interaction deficits seen in this population. 

Objectives: The current study examines the relationship between cognitive flexibility and repetitive, stereotyped behavior patterns in children with high-functioning ASDs to explore the underlying cause of the poor social interaction skills that are so debilitating to individuals with this disorder. 

Methods: Participants included 25 children ages 8-12 with Asperger Syndrome, High-Functioning Autism, or Pervasive-Developmental Disorder Not-Otherwise-Specified, whose diagnosis was based on the Autism Diagnostic Instrument-Revised (ADI-R) and 25 age- and gender-matched typically developing controls. Participants with scores lower than 85 on the Verbal and Performance IQ on the Wechsler Abbreviated Scale of Intelligence were excluded. Cognitive flexibility was assessed using the Trail-making, Verbal Fluency, and Design Fluency tasks of the Delis-Kaplan Executive Function System (D-KEFS) whereas repetitive behaviors were evaluated using the ADI-R and the Yale Special Interests Survey (YSIS). 

Results: Bivariate correlations revealed no statistically significant associations between circumscribed interests or repetitive behavior and performance-based measures of verbally or non-verbally mediated cognitive flexibility of the D-KEFS.  

Conclusions: Preliminary findings suggest that there is no significant relationship between cognitive flexibility and areas of repetitive behaviors based on a small sample of children with high-functioning ASDs. This finding is in contrast to the positive relationship previously observed in adults with ASDs who ranged in cognitive functioning. The current findings may be a result of variations in methodology, a more limited range of cognitive functioning, or the younger developmental stage of the current sample group. Future investigations should aim to clarify this relationship in children across the entirety of the spectrum.