Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder

Area of Science:

• Neuroscience
• Developmental Psychology
• Child Psychiatry

Background:

• Executive function (EF) deficits are common in both autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD).
• Limited research has clarified the unique versus shared nature of these EF impairments in children diagnosed with ADHD versus ASD.
• Understanding these differences is crucial for accurate diagnosis and effective intervention strategies.

Purpose of the Study:

• To critically review the existing literature on executive function profiles in children with ASD and ADHD.
• To identify limitations in current research, including diagnostic, measurement, and third-variable considerations.
• To provide recommendations for future research to better delineate unique and shared EF deficits.

Main Methods:

• Systematic review of current scientific literature.
• Critical analysis of diagnostic criteria, neuropsychological testing, and informant-rated scales.
• Consideration of co-occurrence of ASD and ADHD symptoms and within-disorder heterogeneity.

Main Results:

• Current understanding of EF profiles in ASD and ADHD is significantly limited.
• Most studies fail to account for co-occurring conditions and symptom overlap.
• Traditional neuropsychological tests and scales often lack specificity and construct validity for EF assessment.
• Children with ADHD and/or ASD generally exhibit moderate impairments across a wide range of neuropsychological tests compared to neurotypical children.

Conclusions:

• The extent to which EF difficulties are unique or shared between ASD and ADHD remains largely unknown.
• Significant methodological limitations hinder definitive conclusions about specific EF subcomponent impairments.
• Future research must address co-occurrence, employ more specific measures, and account for heterogeneity to advance understanding.