Parent-Reported Executive Functioning and Adaptive Social Skills in School-Age Children with ASD

Background: Individuals with autism spectrum disorder (ASD) present with deficits in socialization and communication. Research has also documented impaired executive functioning (EF) in this population, yet few studies have looked at the expression of specific EF deficits in the everyday social skills of children with ASD.

Objectives: This study assessed the relationship between components of EF and adaptive social skills in school-age children with ASD.

Methods: Participants were 29 children (25 males; mean age 9.4 ± 1.6 years) drawn from a larger study on the early detection of ASD, in which they were diagnosed with either Autistic Disorder or Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) at 2 and 4 years. Diagnosis was confirmed at school-age follow-up using the Autism Diagnostic Observation Schedule (ADOS), and IQ was assessed with the Differential Ability Scales, Second Edition (DAS-II) or Stanford-Binet Intelligence Scales, Fifth Edition (SB-5). EF and adaptive functioning were measured using parent reports: the Behavior Rating Inventory of Executive Function (BRIEF) and Vineland Adaptive Behavior Scales, Second Edition (VABS-II). Correlation and hierarchical regression, controlling for IQ, were used to examine the relationship between EF scales and adaptive social skills. Due to the small sample size and risk of Type I and Type II errors, a conservative cutoff of α = .01 was used for all analyses.

Results: VABS-II Socialization and Communication were negatively correlated with BRIEF Emotional Control, Inhibit (Socialization only), Monitor, Shift (Socialization only), and Working Memory (all Pearson’s r’s > .50, all p’s < .01). Results of partial correlations controlling for IQ (i.e., DAS-II General Conceptual Ability or SB-5 Brief IQ) were consistent with Pearson’s correlations, with one exception; the correlation between VABS-II Communication and BRIEF Monitor (r = -.405, p = .040) was no longer significant using our conservative cutoff. Hierarchical regressions were then run with IQ entered first, followed by each BRIEF scale entered individually in a second block. Results were consistent with partial correlation findings.

Conclusions: This study examined the relationship between parent-reported EF and adaptive social skills in school-age children with ASD. Results suggest that EF deficits are significantly related to the social and communication impairments seen in children with ASD. Specifically, BRIEF Emotional Control, Inhibit, and Shift, which assess ability to regulate behavior, exercise flexibility, and modulate emotional response, were significantly associated with VABS-II Socialization. BRIEF Monitor and Working Memory, which measure ability to assess one’s own performance and hold information in mind to complete a task, were also significantly associated with level of social skills. Further, a strong relationship between VABS-II Communication and BRIEF Emotional Control and Working Memory was found, suggesting that children with greater emotion regulation and information processing capabilities demonstrate higher language skills. These findings held when overall cognitive level was controlled. It is possible that children with limited social interaction learn fewer EF skills through instruction or modeling, but it is equally or more probable that EF deficits lead to impaired social communication skills. Thus, children with ASD may benefit from targeted EF intervention to improve everyday social behaviors.