Executive Function Skills in School-Age Children With Autism Spectrum Disorder: Association With Language Abilities

Abstract

Purpose This article reviews research on executive function (EF) skills in children with autism spectrum disorder (ASD) and the relation between EF and language abilities. The current study assessed EF using nonverbal tasks of inhibition, shifting, and updating of working memory (WM) in school-age children with ASD. It also evaluated the association between children's receptive and expressive language abilities and EF performance. Method In this study, we sought to address variables that have contributed to inconsistencies in this area of research—including task issues, group comparisons, and participant heterogeneity. EF abilities in children with ASD ( n = 48) were compared to typically developing controls ( n = 71) matched on age, as well as when statistically controlling for group differences in nonverbal cognition, socioeconomic status, and social communication abilities. Six nonverbal EF tasks were administered—2 each to evaluate inhibition, shifting, and WM. Language abilities were assessed via a standardized language measure. Language–EF associations were examined for the ASD group as a whole and subdivided by language status. Results Children with ASD exhibited significant deficits in all components of EF compared to age-mates and showed particular difficulty with shifting after accounting for group differences in nonverbal cognition. Controlling for social communication—a core deficit in ASD—eliminated group differences in EF performance. A modest association was observed between language (especially comprehension) and EF skills, with some evidence of different patterns between children on the autism spectrum with and without language impairment. Conclusions There is a need for future research to examine the direction of influence between EF and language. It would be beneficial for EF interventions with children with ASD to consider language outcomes and, conversely, to examine whether specific language training facilitates aspects of executive control in children on the autism spectrum. Presentation Video https://doi.org/10.23641/asha.7298144