Hot and Cool Executive Function in Children with Autism Spectrum Disorder and Schizotypal Traits

Background: Schizotypal traits are notably prevalent among children diagnosed with Autism spectrum disorder (ASD). Both conditions commonly exhibit impairments in executive functions (EF), which encompass cool and hot processes. The observed deficits in these EF domains across ASD and schizotypy underscore a compelling need to investigate how their co-occurrence impacts EF. Methods: This study investigated the impact of co-occurring autistic and schizotypal traits on EF in 63 children diagnosed with ASD, aged 7 to 12 years. Participants were assessed using the Autism Diagnostic Observation Schedule-2 (ADOS-2), the Melbourne Assessment of Schizotypy in Kids (MASK), and a battery of hot and cool EF tests. Results: Correlational analyses revealed a significant association between MASK score and working memory, as well as between ADOS scores and various cool EF components (i.e., working memory, inhibition and planning). Hierarchical regression analyses showed that the interaction between ADOS and MASK scores significantly predicted performance on hot EF (i.e., affective decision-making), but not on cool EF tasks. Conclusions: These findings suggest that the co-occurrence of ASD and schizotypal traits may have differential effects on cool and hot EF domains. Understanding how the combination of autistic and schizotypal traits affects cognitive processes may inform tailored interventions and support strategies for individuals presenting with these traits.