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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