Formal Thought Disorder and Executive Functioning in Children and Adolescents with Autism Spectrum Disorder: Old Leads and New Avenues

Formal thought disorder (FTD) is a disruption in the flow of thought and a common feature in psychotic disorders and autism spectrum disorder (ASD). Executive dysfunction has often been associated with FTD, yet for ASD convincing evidence is lacking. This study investigated FTD and three core executive functions in 50 young children and adolescents with high-functioning ASD and 56 matched controls. Higher overall levels of FTD marked ASD compared to controls. Furthermore, in ASD decreased performance on verbal working memory was correlated with increased FTD ratings and explained a significant amount of variance of objective and subjective FTD. Verbal working memory is currently the most promising target executive function for understanding the development of idiosyncratic thought disorders in ASD.     

Étude des profils cognitifs chez les apparentés de personnes avec autisme : hypothèse d’un manque de flexibilité cognitive ?

This study investigated whether first-degree relatives of individuals with autism spectrum disorders (ASD) demonstrate a specific profile of performance on the three cognitive domains studied in the disorders: executive function, central coherence and theory of mind. Parents and siblings of the children with ASD showed poorer performances on all tests, than control, (p > 0.02); furthermore, lack of cognitive flexibility emerged as a potential marker in ASD families, suggesting that this aspect should be further study, as playing a potential role in cognitive theories of autism.     

Adults with autism spectrum disorders and ADHD neuropsychological aspects

The purpose of the present study was to assess which types of neuropsychological deficits appear to be most commonly associated with autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD) in adults. The effect of the combination of ASD with ADHD (ASD/ADHD) was also studied. One hundred and sixty-one adult individuals (≥18 years of age) were included in the study. None had full scale IQ less than 71. The neuropsychological investigations included measures of intellectual ability, learning and memory, attention/executive function and theory of mind. The three diagnostic groups showed reduced performance in most cognitive domains. However, within these domains differentiating distinct features could be seen. The dysfunctions of the ASD/ADHD group cannot be seen as a summary of the dysfunctions found in the ASD and ADHD groups. The ADHD seemed to have the most severe neuropsychological impairments of the three groups. No domain-specific deficit typical of any of the diagnostic groups was found.     

Event-based prospective memory in children with autism spectrum disorder: The role of executive function

The present study investigated event-based prospective memory (PM) and its cognitive correlates in children with autism spectrum disorder (ASD) compared to age- and ability-matched typically developing (TD) peers. Participants included 25 children with ASD, 25 age-matched TD peers, and 28 ability-matched TD peers. Participants completed one PM task, and several executive functioning tasks assessing working memory (Block Recall Task), inhibitory control (Stroop Task), and cognitive flexibility (Dimensional Change Card Sorting Task). Results indicated that children with ASD had significantly lower scores on the PM task than children in the TD groups. Additionally, PM performance of children with ASD was significantly predicted by their nonverbal IQ, whereas PM performance of TD children was significantly predicted by their inhibitory control. These results provide evidence for the PM deficit in children with ASD and the effect of cognitive functioning, rather than a specific aspect of executive function, on the development of PM.     

Evaluation of Planning Dysfunction in Attention Deficit Hyperactivity Disorder and Autistic Spectrum Disorders Using the Zoo Map Task

Attention-Deficit-Hyperactivity-Disorders (ADHD) and Autistic-Spectrum-Disorders (ASD) share overlapping clinical and cognitive features that may confuse the diagnosis. Evaluation of executive problems and planning dysfunction may aid the clinical diagnostic process and help disentangle the neurobiological process underlying these conditions. This study evaluates the planning function problems in 80 male children and adolescents diagnosed with ADHD and 23 male children and adolescents with ASD using the Zoo Map Task; both groups were comparable in terms of age and IQ. The relationship between planning function and other executive functions is also assessed. In comparison to the ADHD groups, ASD children presented more errors in the open-ended tasks; these planning function problems seem to be mediated by processing speed and motor coordination, however it does not seem to be mediated by other executive function problems, including attention, working memory or response inhibition. In the time for planning, an interaction between the specific subgroups and working memory components was observed. ADHD and ASD present with different patterns of planning function, even when other components of executive function are taken into account; clinical and educational implications are discussed.     

Anxiety problems in young people with autism spectrum disorder: a case series

It is now well established that the prevalence of mental health difficulties in individuals with autism spectrum disorders (ASD) is considerably higher than in the general population. With recent estimates of the prevalence of autism spectrum disorders being as high as one percent, increasing numbers of children and young people are presenting to local and specialist services with mental health problems in addition to a diagnosis of ASD. Many families report that the impact of the mental health problems can be as or more impairing than the autism spectrum difficulties themselves. Clinical services are frequently called upon to treat these difficulties; however, there is limited evidence for the effectiveness of treatments in this population. This paper reports a case series of children and adolescents with ASD and an anxiety disorder who were treated with a standard cognitive behaviour therapy (CBT) rationale adapted to take account of the neuropsychological features of ASD. Common features of the presentation of the disorders and also treatment processes are discussed.     

Executive and Visuo-motor Function in Adolescents and Adults with Autism Spectrum Disorder

This study broadly examines executive (EF) and visuo-motor function in 30 adolescent and adult individuals with high-functioning autism spectrum disorder (ASD) in comparison to 28 controls matched for age, gender, and IQ. ASD individuals showed impaired spatial working memory, whereas planning, cognitive flexibility, and inhibition were spared. Pure movement execution during visuo-motor information processing also was intact. In contrast, execution time of reading, naming, and of visuo-motor information processing tasks including a choice component was increased in the ASD group. Results of this study are in line with previous studies reporting only minimal EF difficulties in older individuals with ASD when assessed by computerized tasks. The finding of impaired visuo-motor information processing should be accounted for in further neuropsychological studies in ASD.     

Is It a Bird? Is It a Plane? Category Use in Problem-solving in Children with Autism Spectrum Disorders

Fourteen children with autism spectrum disorders (ASD) and fourteen age-matched typically-developing (TD) controls were tested on an adapted version of the Twenty Questions Task (Mosher and Hornsby in Studies in cognitive growth. Wiley, New York, pp 86–102, 1966) to examine effects of content, executive and verbal IQ factors on category use in problem-solving (age range 8–17). Across conditions participants with ASD asked questions that focussed on smaller categories than controls. Specific group differences were observed in the handling of abstract content and response to additional working memory demands. In addition, post hoc regression analysis indicated that VIQ predicted performance in ASD but not TD participants. The implications for theories of category processing in autism are discussed.     

Spatial Cognition in Autism Spectrum Disorders: Superior,Impaired, or Just Intact?

The profile of spatial ability is of interest across autism spectrum disorders (ASD) because of reported spatial strengths in ASD and due to the recent association of Asperger’s syndrome with Nonverbal Learning Disability. Spatial functions were examined in relation to two cognitive theories in autism: the central coherence and executive function (EF) theories. Performance on spatial tasks, EFs, and global/local processing was compared in children with ASD and controls. While the ASD group had faster reaction times on the Embedded Figures task, spatial performance was intact, but not superior, on other tasks. There was no evidence for impairments in EF or in processing global/local information, therefore contradicting these two theories. The implications of these results for these two theories are discussed.     

Theory of Mind and Executive Function in Preschoolers with Typical Development Versus Intellectually Able Preschoolers with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) have difficulties in theory of mind (ToM) and executive function (EF), which may be linked because one domain (EF) affects the other (ToM). Group differences (ASD vs. typical development) were examined in both cognitive domains, as well as EF’s associations and regressions with ToM. Participants included 29 intellectually able preschoolers with ASD and 30 typical preschoolers, aged 3–6 years. EF tasks included planning and cognitive shifting measures. ToM tasks included predicting and explaining affective and location false-belief tasks. The novelty of this study lies in its in-depth examination of ToM explanation abilities in ASD alongside the role of verbal abilities (VIQ). Significant group differences emerged on most EF and ToM measures, in favor of typically developing children. Overall in the study group, EF-planning skills, EF-cognitive shifting and VIQ significantly contributed to the explained variance of ToM measures. Implications are discussed regarding the social-cognitive deficit in ASD.     

Aging with elevated autistic traits: Cognitive functioning among older adults with the broad autism phenotype

BackgroundLittle is known about the impact of aging with autism spectrum disorder (ASD) on cognition. As a first step in addressing this gap in our knowledge, the current study examined cognitive functioning among older adults with elevated, but subclinical levels of autistic traits (i.e., the Broad Autism Phenotype; BAP) compared to older adults without the BAP.MethodForty older adults (aged 60–91, M = 73 years) were recruited and classified as meeting criteria for the BAP (n = 20) or not (control older adults, COA; n = 20). Different components of executive function as well as episodic memory were measured using standardized performance-based neuropsychological assessments in addition to a self-report questionnaire of executive function difficulties.ResultsDespite no differences in age, sex ratio, educational history or IQ, the BAP group demonstrated poorer performance on measures of executive function and episodic memory compared to the COA group. The BAP group also self-reported more executive function difficulties in everyday settings. Moreover, differences in working memory and attentional shifting were maintained after accounting for the influences of IQ and both depression and anxiety symptoms.ConclusionsThese findings suggest that aging with the BAP confers additional risk to cognitive function for older adults. As the BAP forms a bridge in the continuum from typical to atypical levels of autistic traits, these findings suggest that individuals with ASD might also incur cognitive costs as they age into older adulthood.     

Noradrenergic moderation of working memory impairments in adults with autism spectrum disorder

In addition to having difficulties with social communications, individuals with an autism spectrum disorder (ASD) often also experience impairment in higher-order, executive skills. The present study examined the effects of pharmacological modulation of the norepinephrine system on the severity of such impairments. A sample of 14 high-functioning adults with ASD and a demographically-matched comparison group of 13 typically developing individuals participated. An AX continuous performance test (AX-CPT) was used to evaluate working memory and inhibitory control. AX-CPT performance was assessed following administration of a single dose of propranolol (a beta adrenergic antagonist) and following placebo (sugar pill) administration. Individuals with ASD performed more poorly than non-ASD individuals in the working memory condition (BX trials). Importantly, administration of propranolol attenuated this impairment, with the ASD group performing significantly better in the propranolol condition than the placebo condition. Working memory performance of the non-ASD group was unaffected by propranolol/placebo administration. No group or medication effects were observed for the inhibition condition (AY trials). The present findings suggest that norepinephrine may play a role in some, but not necessarily all, cognitive impairments associated with ASD. Additional research is needed to fully understand whether this role is primarily causal or compensatory in nature.     

Broad Cognitive Profile in Children and Adolescents with HF-ASD and in Their Siblings: Widespread Underperformance and its Clinical and Adaptive Correlates

Despite evidence supporting the presence of cognitive deficits in children and adolescents with high-functioning autism spectrum disorder (HF-ASD), the nature of these deficits and their clinical and adaptive correlates remain unclear. Moreover, there are few cognitive studies of ASD siblings as a high risk population. We compared 50 children and adolescents with HF-ASD, 22 unaffected siblings of the HF-ASD sample and 34 community controls using an extensive neuropsychological battery. Planning, cognitive flexibility, verbal and working memory, visual local–global processing and emotion recognition are impaired in HF-ASD. Worse cognitive performance, especially in verbal and working memory, was significantly correlated with more severe symptoms and poorer adaptive functioning, also when controlling for intelligence quotient. Results in siblings may suggest an intermediate profile.     

La mémoire autobiographique et le self dans les troubles du spectre autistique sans déficience intellectuelle (TSASDI) à l’âge adulte

Introduction

Autism spectrum disorder combines deficits in socio-communication, restricted, repetitive patterns but also disorders of self and cognitive impairments. Among them, people with ASD have autobiographical memory deficits as shown by several recent studies. Autobiographical memory is a critical function supporting socialization but it represents also an important support for the self as illustrated by the model of Self Memory System put forward by Conway. This cognitive model describes the reciprocal relationships between autobiographical memory and self and then provides a relevant theoretical framework to explore disorders of self by examining autobiographical memory deficits.

Fonctionnement de la mémoire chez les sujets avec autisme

Introduction

Autism is an early developmental disorder with cognitive impairments that leads to learning and social integration disabilities. The characterization of memory functions in individuals with autism has been the subject of numerous investigations, with widely varying conclusions. The notable differences between these studies can be attributed to variations in the age, intelligence and level of severity of the participants with autism.

Literature findings

The purpose of our review of the recent literature is to describe the memory function of individuals with autism. Some of the different memory subtypes are intact, others are impaired. Short-term memory (digit span) is not impaired while working memory is impaired in some of its components, but the findings are inconsistent. More recent studies demonstrate reduced spatial working memory abilities in autism and extend previous findings by demonstrating that these deficits are significant when tasks impose heavier demands on working memory. Episodic long-term memory, as measured by free recall, cued recall or recognition tasks, is intact, but participants with autism perform significantly less well than controls as the complexity of the verbal or visual material to be recalled increases. Source or contextual memory involves a variety of characteristics specifying the conditions under which specific items or facts are acquired: it has been investigated in individuals with autism with different methods. Deficits in source memory for temporal information have been found, but there were no reality monitoring deficits. Recent findings indicate that the nature of source memory confusion in autism does not appear to reflect a generalized deficit in attaching context to memories, but rather is dependant on the specific to-be-remembered information that involves social aspects of context. The self-reference effect is missing, with individuals with autism recalling events performed by themselves less well than the events performed by a peer, suggesting they have difficulties in relation to processes involving the self. Studies involving assessment of subjective states of awareness during recognition show less conscious recollection and more feelings of familiarity. Recent investigations are consistent in demonstrating memory impairments related to the failure of subjects with autism to use organizing strategies or meaning to support memory, an effect which grows with the increasing complexity of the material. Memory deficits in autism may be related more to retrieval and less to encoding, as deficit in source memory in participants with autism is largely eliminated when source was supported at test.

Discussion

The neuroanatomical basis of the specificities of memory impairment in autism is still uncertain, but it is suggested that autism involves an impairment in the conversion of limbic inputs into medial prefrontal outputs. Memory deficits found in individuals with autism may explain some of the clinical symptoms. Failure to encode all the information, especially its social aspects, may therefore contribute to dysfunction in the social, communication, and reasoning domains. Abnormal memory functioning in autism is also related to more general cognitive impairments, including executive function deficits and central coherence weakness. Evidence of the normality of certain memory capacities, at least in individuals with moderate autistic symptomatology, is encouraging for adaptive improvements in cognitive functioning.     

Verbal and Spatial Working Memory in Autism

Verbal and spatial working memory were examined in high-functioning children, adolescents, and adults with autism compared to age and cognitive-matched controls. No deficit was found in verbal working memory in the individuals with autism using an N-back letter task and standardized measures. The distinction between the N-back task and others used previously to infer a working memory deficit in autism is that this task does not involve a complex cognitive demand. Deficits were found in spatial working memory. Understanding the basis for the dissociation between intact verbal working memory and impaired spatial working memory and the breakdown that occurs in verbal working memory as information processing demands are increased will likely provide valuable insights into the neural basis of autism.     

Identifying Symbolic Relationships in Autism Spectrum Disorders: A Deficit in the Identification of Temporal Co-occurrence?

Individuals with Autism spectrum disorders (ASD) experience difficulties understanding the non-verbal cues conveyed by others that provide symbolic information about relationships between self, other, and environmental events. This study examined whether these difficulties reflect underlying problems in the identification of temporal co-occurrence, or in memorial, associative, or inference skills. The performance of a group of adolescents with ASD was compared to that of typically developing children and adolescents with learning difficulties on four tasks assessing these processes. The ASD group experienced specific difficulties when they were required to identify relationships signalled by the temporal co-occurrence of stimuli. These results are discussed in relation to theories of conceptual deduction in ASD, and a hypothesised role in social cognitive development for attention processes is outlined.     

Assessment of executive function in young children with and without ASD using parent ratings and computerized tasks of executive function

Objective: The current study investigated executive function (EF) in young children with and without autism spectrum disorder (ASD) using multiple methods of assessment. Method: Young children (M = 63.2 months) with and without ASD, matched on age, IQ, and maternal education, were assessed on computerized measures of working memory, inhibition, flexibility, and planning. Parents completed a behavior rating scale assessing children’s EF within everyday contexts. Results: There were no significant group differences on working memory, inhibition, flexibility, or planning. The mean difference on one aspect of the planning task (number of correct trials), however, approached significance and showed a medium to large effect size. There was also a significant difference between groups on the EF behavior rating scale, indicating that participants with ASD demonstrated greater executive dysfunction, as indexed by parent report. Conclusions: The results suggest that in young children with ASD, EF difficulties may only become apparent when situational demands require coordinating multiple abilities, as assessed with scales indexing children’s abilities to manage their day-to-day EF-related behavior. We suggest that multiple methods are needed to achieve a comprehensive and valid EF assessment in young children with ASD.     

Size Sequencing as a Window on Executive Control in Children with Autism and Asperger’s Syndrome

A study is reported in which size sequencing on a touch screen is used as a measure of executive control in 20 high-functioning children with Autistic Spectrum Disorders (ASD). The data show a significant and age-independent effect of the length of sequence that can be executed without errors by these children, in comparison with a chronologically age-matched group of children with normal development. Error data and reaction times are analysed and are interpreted as revealing a constraint on the prospective component of working memory in children on the autistic spectrum even when there is no change in goal or perceptual set. It is concluded that the size sequencing paradigm is an effective measure of executive difficulties associated with autism.     

Sleep disturbances in autism spectrum disorder without intellectual impairment: relationship with executive function and psychiatric symptoms

The autism spectrum disorder (ASD) is a neurodevelopmental condition, frequently accompanied by medical and psychiatric pathology. One of the most commonly found problems associated with ASD is sleep disturbances, which are estimated to affect approximately 80% of the people with ASD, not only during childhood but also in the adolescence and adult stages. Nevertheless, the relationship of these sleep difficulties with autism severity, as well as other associated impairments such as executive functioning and psychiatric disorders (eg, depression), has not yet been widely studied. The main objective of the present study was to explore the relationship between sleep disturbances, subjective measures of executive function, and psychiatric pathology in the ASD population. To reach that goal, a group of 89 participants with ASD (44 children/adolescents and 45 adults) was recruited and evaluated with self-reported measures of executive function performance and psychiatric pathology tests. Multivariate analysis showed a significant association between sleep disturbances and psychiatric symptoms in both ASD groups, with greater sleep disturbances predicting more severe psychiatric pathology. No significant association was found with executive function in any group. Limitations included a small sample size and lack of objective measures. Sleep problems seem to be associated with the severity of psychiatric pathology throughout the lifespan, increasing the chance of developing psychiatric symptoms when they were present. Improving sleep quality in ASD at all ages may result in preventing and/or decreasing psychiatric pathology in this population.