Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development

Executive functioning (EF) is an overarching term that refers to neuropsychological processes that enable physical, cognitive, and emotional self-control. Deficits in EF are often present in neurodevelopmental disorders, but examinations of the specificity of EF deficits and direct comparisons across disorders are rare. The current study investigated EF in 7- to 12-year-old children with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) and typical development using a comprehensive battery of measures assessing EF, including response inhibition, working memory, cognitive flexibility, planning, fluency and vigilance. The ADHD group exhibited deficits in vigilance, inhibition and working memory relative to the typical group; however, they did not consistently demonstrate problems on the remaining EF measures. Children with ASD showed significant deficits in vigilance compared with the typical group, and significant differences in response inhibition, cognitive flexibility/switching, and working memory compared with both groups. These results lend support for previous findings that show children with autism demonstrate generalized and profound impairment in EF. In addition, the observed deficits in vigilance and inhibitory control suggest that a significant number of children with ASD present with cognitive profiles consistent with ADHD.

[1]  Joseph Biederman,et al.  Neurobiology of attention-deficit hyperactivity disorder , 1998, Biological Psychiatry.

[2]  David L. Strayer,et al.  Inhibitory Function in Nonretarded Children with Autism , 1997, Journal of autism and developmental disorders.

[3]  E. Youngstrom,et al.  The latent structure of attention-deficit/hyperactivity disorder in a clinic-referred sample. , 2007, Neuropsychology.

[4]  N. Alessi,et al.  ADHD and PDD. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[5]  Stewart H Mostofsky,et al.  Smaller prefrontal and premotor volumes in boys with attention-deficit/hyperactivity disorder , 2002, Biological Psychiatry.

[6]  Hj Norussis,et al.  SPSS for Windows , 1993 .

[7]  M Davies,et al.  The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): description, acceptability, prevalence rates, and performance in the MECA Study. Methods for the Epidemiology of Child and Adolescent Mental Disorders Study. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[8]  S. Baron-Cohen,et al.  Autism: a window onto the development of the social and the analytic brain. , 2005, Annual review of neuroscience.

[9]  C. Francks,et al.  A genomewide scan for loci involved in attention-deficit/hyperactivity disorder. , 2002, American journal of human genetics.

[10]  A. Azizian,et al.  Psychiatric Symptoms in Preschool Children with PDD and Clinic and Comparison Samples , 2004, Journal of autism and developmental disorders.

[11]  R. Barkley.  Issues in the diagnosis of attention-deficit/hyperactivity disorder in children , 2003, Brain and Development.

[12]  Larry J. Seidman,et al.  Functional MRI in attention-deficit hyperactivity disorder: Evidence for hypofrontality , 2005, Brain and Development.

[13]  L. E. Arnold,et al.  Atomoxetine for hyperactivity in autism spectrum disorders: placebo-controlled crossover pilot trial. , 2006, Journal of the American Academy of Child and Adolescent Psychiatry.

[14]  B. Corbett,et al.  Autism and Attention Deficit Hyperactivity Disorder: Assessing Attention and Response Control with the Integrated Visual and Auditory Continuous Performance Test , 2006, Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence.

[15]  F. Castellanos,et al.  Characterizing cognition in ADHD: beyond executive dysfunction , 2006, Trends in Cognitive Sciences.

[16]  P. Maruff,et al.  Attention Deficit Hyperactivity Disorder, Combined Type: Better Executive Function Performance With Longer-Term Psychostimulant Medication , 2003, The Australian and New Zealand journal of psychiatry.

[17]  M. C. Goldberg,et al.  Language, Social, and Executive Functions in High Functioning Autism: A Continuum of Performance , 2005, Journal of autism and developmental disorders.

[18]  Edmund J. S. Sonuga-Barke,et al.  Causal Models of Attention-Deficit/Hyperactivity Disorder: From Common Simple Deficits to Multiple Developmental Pathways , 2005, Biological Psychiatry.

[19]  B. Astor,et al.  Subtle Executive Impairment in Children with Autism and Children with ADHD , 2005, Journal of autism and developmental disorders.

[20]  K. Matthews,et al.  Neuropsychological functioning in stimulant-naive boys with hyperkinetic disorder , 2005, Psychological Medicine.

[21]  Suzanne E. Welcome,et al.  Cortical abnormalities in children and adolescents with attention-deficit hyperactivity disorder , 2003, The Lancet.

[22]  Eric Courchesne,et al.  Localized enlargement of the frontal cortex in early autism , 2005, Biological Psychiatry.

[23]  B. Pennington,et al.  Executive function deficits in high-functioning autistic individuals: relationship to theory of mind. , 1991, Journal of child psychology and psychiatry, and allied disciplines.

[24]  Jaap Oosterlaan,et al.  How specific is a deficit of executive functioning for Attention-Deficit/Hyperactivity Disorder? , 2002, Behavioural Brain Research.

[25]  M. Denckla,et al.  Biological Correlates of Learning and Attention: What Is Relevant to Learning Disability and Attention‐Deficit Hyperactivity Disorder? , 1996, Journal of developmental and behavioral pediatrics : JDBP.

[26]  Ruth A. Carper,et al.  Inverse correlation between frontal lobe and cerebellum sizes in children with autism. , 2000, Brain : a journal of neurology.

[27]  S. Goldstein,et al.  The Comorbidity of Pervasive Developmental Disorder and Attention Deficit Hyperactivity Disorder: Results of a Retrospective Chart Review , 2004, Journal of autism and developmental disorders.

[28]  S. Ozonoff,et al.  Brief Report: Specific Executive Function Profiles in Three Neurodevelopmental Disorders , 1999, Journal of autism and developmental disorders.

[29]  D. Stuss,et al.  Neuropsychological studies of the frontal lobes. , 1984, Psychological bulletin.

[30]  L. Henriksen,et al.  Focal cerebral hypoperfusion in children with dysphasia and/or attention deficit disorder. , 1984, Archives of neurology.

[31]  Joseph Biederman,et al.  Diagnostic efficiency of neuropsychological test scores for discriminating boys with and without attention deficit-hyperactivity disorder. , 2000, Journal of consulting and clinical psychology.

[32]  Claire Hughes,et al.  Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: Examining profiles across domains and ages , 2006, Brain and Cognition.

[33]  E. Courchesne,et al.  Atypical patterns of cerebral motor activation in autism: a functional magnetic resonance study , 2001, Biological Psychiatry.

[34]  J. Smoller,et al.  Molecular Genetics of Attention-Deficit/Hyperactivity Disorder , 2005, Biological Psychiatry.

[35]  D. Zafeiriou,et al.  Childhood autism and associated comorbidities , 2007, Brain and Development.

[36]  C. Francks,et al.  A genomewide scan for attention-deficit/hyperactivity disorder in an extended sample: suggestive linkage on 17p11. , 2003, American journal of human genetics.

[37]  P. Maruff,et al.  Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children , 1999, Psychological Medicine.

[38]  J. Epstein,et al.  Conners Rating Scales-Revised. , 1999 .

[39]  A R Damasio,et al.  A neurological model for childhood autism. , 1978, Archives of neurology.

[40]  B. Birmaher,et al.  Use of methylphenidate in the treatment of children with autistic disorder , 1995, Journal of autism and developmental disorders.

[41]  Jack M. Gorman,et al.  A Guide to Treatments That Work , 2007 .

[42]  Herbert Roeyers,et al.  How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? , 2004, Journal of child psychology and psychiatry, and allied disciplines.

[43]  K. Matthews,et al.  The Neuropsychological Effects of Chronic Methylphenidate on Drug-Naive Boys with Attention-Deficit/Hyperactivity Disorder , 2007, Biological Psychiatry.

[44]  B. Pennington,et al.  Validity of the Executive Function Theory of Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review , 2005, Biological Psychiatry.

[45]  J. Suckling,et al.  Mapping the brain in autism. A voxel-based MRI study of volumetric differences and intercorrelations in autism. , 2004, Brain : a journal of neurology.

[46]  Herbert Roeyers,et al.  The relationship of working memory, inhibition, and response variability in child psychopathology , 2006, Journal of Neuroscience Methods.

[47]  Ruth A. Carper,et al.  Unusual brain growth patterns in early life in patients with autistic disorder , 2001, Neurology.

[48]  A. Couteur,et al.  Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders , 1994, Journal of autism and developmental disorders.

[49]  J. Russell.  Autism as an executive disorder , 1997 .

[50]  R. Barkley,et al.  Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report , 1992, Journal of abnormal child psychology.

[51]  Brian Toone,et al.  Task-specific hypoactivation in prefrontal and temporoparietal brain regions during motor inhibition and task switching in medication-naive children and adolescents with attention deficit hyperactivity disorder. , 2006, The American journal of psychiatry.

[52]  K. Matthews,et al.  Acute neuropsychological effects of methylphenidate in stimulant drug-naïve boys with ADHD II--broader executive and non-executive domains. , 2006, Journal of child psychology and psychiatry, and allied disciplines.

[53]  C. Gillberg,et al.  The comorbidity of ADHD in the general population of Swedish school-age children. , 2001, Journal of child psychology and psychiatry, and allied disciplines.

[54]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[55]  E. Hill.  Executive dysfunction in autism , 2004, Trends in Cognitive Sciences.

[56]  Russell A. Barkley,et al.  ADHD and The Nature of Self-Control , 1997, Journal of Cognitive Psychotherapy.

[57]  G. Dawson,et al.  Performance on Cambridge Neuropsychological Test Automated Battery Subtests Sensitive to Frontal Lobe Function in People with Autistic Disorder: Evidence from the Collaborative Programs of Excellence in Autism Network , 2004, Journal of autism and developmental disorders.

[58]  Godfrey D Pearlson,et al.  MRI parcellation of the frontal lobe in boys with attention deficit hyperactivity disorder or Tourette syndrome , 2002, Psychiatry Research: Neuroimaging.

[59]  Joel T. Nigg,et al.  Causal Heterogeneity in Attention-Deficit/Hyperactivity Disorder: Do We Need Neuropsychologically Impaired Subtypes? , 2005, Biological Psychiatry.

[60]  C. McDougle,et al.  A naturalistic retrospective analysis of psychostimulants in pervasive developmental disorders. , 2004, Journal of child and adolescent psychopharmacology.

[61]  H. Geurts,et al.  The top and the bottom of ADHD: a neuropsychological perspective , 2003, Neuroscience & Biobehavioral Reviews.

[62]  Bruce F. Pennington,et al.  Assessing frontal lobe functioning in children: Views from developmental psychology , 1988 .

[63]  B. Pennington,et al.  Executive functions and developmental psychopathology. , 1996, Journal of child psychology and psychiatry, and allied disciplines.

[64]  R. Cantor,et al.  Toward localizing genes underlying cerebral asymmetry and mental health , 2005, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[65]  J. Constantino,et al.  Autistic traits in a population-based ADHD twin sample. , 2007, Journal of child psychology and psychiatry, and allied disciplines.

[66]  J. Russell,et al.  Evidence for executive dysfunction in autism , 1994, Neuropsychologia.

[67]  C. McDougle,et al.  Open-label atomoxetine for attention-deficit/ hyperactivity disorder symptoms associated with high-functioning pervasive developmental disorders. , 2006, Journal of child and adolescent psychopharmacology.

[68]  M. Lezak.  Neuropsychological assessment, 3rd ed. , 1995 .