Hot and Cool Executive Function and Theory of Mind in Children and Adolescents with Autism Spectrum Disorder: Cross Sectional Developmental Trajectories

Background:

Research on the development of Executive Function (EF) has indicated that the emergence of EF occurs in the early years of life, followed by critical changes throughout the preschool era. There is significant evidence suggesting that it continues to develop at least during the adolescence, protracted to the development of the prefrontal cortex. Despite research supporting separate domains of cool and hot EF, traditionally, the development of EF in ASD has been investigated mainly using tasks tapping only the “cool”-purely cognitive- aspects of EF. Thus, minimal is known about the developmental trajectories of “hot”-affective EF processes and whether cool and hot EF follow a similar developmental pathway in ASD. Finally, although the development of cool EF and its links to Theory of Mind (ToM) have been widely examined, understanding of the development of hot EF and its relation to ToM in ASD is very limited.

Objectives:

The present study sought to examine the age-related changes in both cool and hot EF of ASD participants from middle childhood to adolescence, shedding more light on the hot-cool EF organisation. It also explored the interrelation between the developmental trajectories of cool & hot EF and ToM in ASD.

Methods:

The current study employed a cross-sectional developmental trajectories approach to compare the hot and cool EF profiles as well as ToM, relative to chronological age between children and adolescents with ASD and typically developing peers. 170 participants (91 controls and 79 with ASD) between 7 and 16 years old were assessed on measures tapping cool EF (working memory, inhibition, planning), hot EF (affective decision making, delay discounting) and ToM (emotion understanding, false no false belief knowledge).

Results:

Results demonstrated that the developmental trajectories of selective cool EF (working memory, planning) differed significantly as a function of age (age-related changes) in participants with ASD relative to typically developing participants. Cool EF inhibition followed the same developmental pattern as in the control group (improvements with age) while for the hot EF, both ASD and control groups presented no significant changes across younger and older participants. Gains were also reported in both ToM measures for both groups. Developmental trajectories of cool and hot EF skills were related to ToM developmental trajectory in ASD.

Conclusions:

Theoretical implications are discussed as the examination of the developmental trajectories of the EF cognitive processes and their effect on social cognition such as ToM could contribute to our better understanding of the phenotypes of children and adolescents with ASD. These findings highlight the need to assess both hot and cool EF developmental trajectories in clinical practice as they may aid in enhancing diagnosis or better informed intervention programs.