Executive Functioning Training in ASD

Background:

There is an urgent need for effective interventions for children with autism spectrum disorders (ASDs). Most intervention studies focus directly on teaching of social and communicative skills. However, as children with ASD are known to show difficulties in executive functioning (EF), training these fundamental abilities might be susceptible for success. In developmental disorders related to autism, especially attention deficit/hyperactivity disorder (AD/HD), executive function interventions have been shown to generalize to domains that were not specifically targeted during the intervention.

Objectives:

The objective is to present the first results of an ongoing randomized clinical trial regarding the efficacy of two executive function interventions for children with ASD; a working memory training (WM) and a cognitive flexibility (CogF) training.  The objective of the study is; 1) to improve the trained executive function; 2) to improve related executive functions; 3) that these functions will improve in everyday life; and 4) that this improvement will generalize to other domains, resulting in improvement in day-to-day behavior and quality of life. Currently we will focus on the influence of the two training versions on behavior in day-to-day life.

Methods:

Children with ASD (n=102, 8-12 years, IQ<80, reaching cut off scores on the SRS and ADI-R) will play an EF training computer game (randomly assigned to one of three different conditions; WM training, CogF training, or non-EF training). The training consists of 25 sessions, taking 40 minutes each, performed within 6 weeks. Each session contains two training blocks for each EF. Only the blocks of the trained EF will increase in difficulty; the other blocks will remain at a low level.

                Children will be tested on three occasions; a pretest directly before onset of the training; a posttest directly after; and a follow up test six weeks after the training is completed. In children ToM, reward sensitivity, and EF will be examined. Questionnaires concerning EF (BRIEF), reward and punishment sensitivity (BIS/BAS), social behavior (CSBQ), behavioral problems (DBD), and quality of life (PedsQL) will be administered to the parents.

Results:

Currently, 32 children finished the whole game (about 10 in each condition). First analyses of the BRIEF questionnaire revealed that especially the working memory training improved executive functioning in everyday life. For May 2012, about 50 children will be included. Hence, more robust and powerful findings can be presented.

Conclusions:

Preliminary, in the currently analyzed small number of participants, the WM training improved daily life EF in children with ASD. We will analyze the other cognitive, behavioral, and quality of life measurements.