Executive Functioning Corresponds With Expression of Autism Features Among Preschoolers

This study examined the relationship between executive functioning (EF) and core features associated with autism in children aged 2 and 4 years. EF encompasses a set of goal-directed skills that enable organized thoughts and behavior which develop rapidly during the preschool period. To examine concurrent associations between EF and early autism expression, we analyzed whether EF performance relates to observed social communication and repetitive behaviors during parent-child interactions.

Participants included 110 autistic children aged 24 to 60 months diagnosed with autism. Developmental and cognitive abilities were assessed using the Mullen Scales of Early Learning. Social communication and repetitive behaviors associated with autism were coded from 10-minute free play parent-child videos using the Brief Observation of Social Communication Change (BOSCC), yielding total social communication, restricted/repetitive behaviors scores, and overall total scores. An EF score was derived from a test battery that included measurements of set-shifting, working memory, inhibition, and delay. Regression analyses were conducted to assess EF's contribution to autism expression, controlling for cognitive ability.

For 2-year-olds, EF was not related to observed autism behaviors after controlling for cognition. Conversely, for 4-year-olds, EF related to overall behaviors associated with autism observed during parent-child interactions.

Findings of an association between EF and autism-related behaviors observed in parent-child interactions by preschool at age 4 but not in toddlerhood at age 2 highlight potential developmental differences in the relation between EF and autism-related behaviors. Longitudinal and experimental research is needed to establish directionality and malleability of EF and autism-related behaviors.