Thursday, December 9, 2010

Executive Dysfunction and ASD

Research evidence suggests that deficits in executive function are an important feature of ASD. Executive function is a broad term used to describe the higher-order cognitive processes such as response initiation and selection, working memory, planning and strategy formation, cognitive flexibility,  inhibition of response, self-monitoring and self-regulation. It is generally acknowledged that the frontal brain system (including frontal lobes) is responsible for these functions. Executive functions include the many of the skills required to prepare for and execute complex behavior, such as planning, inhibition, organization, self-monitoring, cognitive flexibility, and set-shifting. Markers of executive dysfunction in include difficulty in initiating action, planning ahead, inhibiting inappropriate responses, transitioning, and poor self-monitoring. Poor performance monitoring and self-regulation may be associated with the core features of ASD such as a lack of social reciprocity and intense emotional responses to change (e.g., meltdowns). 
We should note, however, that executive function deficits are not experienced by all individuals on the autism spectrum nor are they specific to ASD. Several childhood disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD) and Obsessive-Compulsive Disorder share deficits in executive function.  Nevertheless, executive dysfunction is likely to have an adverse impact on many areas of everyday life and affect adaptability in several domains (personal, social and communication). An assessment of executive function can add important information about the child’s strengths and weaknesses and assist with intervention planning. For example, the Behavioral Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000), a parent- or teacher-rated questionnaire for children ages 5 to 18 years of age, can be used to assess executive functioning in children with ASD and may be included in a comprehensive assessment battery. 
Further information on assessment and intervention is available from
Gioia, G. A., Isquith, P. K., Guy, S. C, & Kenworthy, L. (2000). Behavior rating inventory of executive function. Lutz, FL: Psychological Assessment Resources.
© Lee A. Wilkinson, PhD

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  • Attwood, T. (2006). The complete guide to Asperger’s syndrome. London: Jessica Kingsley Publishers.
  • Baker, J. (2008). No More Meltdowns: Positive Strategies for Managing and Preventing Out-Of-Control Behavior. Arlington, TX: Future Horizons.
  • Baron-Cohen, S. (2008). Autism and Asperger syndrome: The facts. New York: Oxford.
  • Bashe, P. R., & Kirby, B. L. (2005). The OASIS guide to Asperger syndrome: Advice, support, insight, and inspiration. New York: Crown Publishing.
  • Bellini, S. (2006). Building Social Relationships: A Systematic Approach to Teaching Social Interaction Skills to Children and Adolescents with Autism Spectrum Disorders and Other Social Difficulties. Shawnee Mission, KS: Autism Asperger Publishing Company.
  • Gaus, V. L. (2007). Cognitive-behavioral therapy for adult Asperger syndrome. New York: Guilford.
  • Klin, A., Volkmar, F. R. & Sparrow, S. S. (Eds.). (2000). Asperger’s syndrome. New York: The Guilford Press.
  • Koegel, R. L., & Koegel, L. K. (2006). Pivotal response treatments for autism: Communication, social, and academic development. Baltimore, MD: Paul H. Brookes Publishing.
  • National Research Council (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. C. Lord & J. P. McGee (Eds). Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.
  • Ozonoff, S., Dawson, G., & McPartland, J. (2002). A parent’s guide to Asperger syndrome and high-functioning autism: How to meet the challenges and help your child to thrive. New York: Guilford Press.
  • Stone, W. L. (2006). Does my child have autism? A parent’s guide to early detection and intervention in autism spectrum disorders. San Francisco, CA: Jossey Bass.
  • Twachtman-Cullen, D., & Twachtman-Reilly, J. (2003). How Well Does Your Child's IEP Measure Up? Quality Indicators for Effective Service Delivery. London: Jessica Kingsley Publishers.
  • Volkmar, F. R., Paul, R., Klin, A., & Cohen, D. (Eds.) (2005). Handbook of autism and pervasive developmental disorders (3rd. ed.) (Vols. 1 & 2). Hoboken, NJ: John Wiley & Sons.
  • Wilkinson, L. A. (2010). A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools. London: Jessica Kingsley Publishers.

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