Mapping neurodevelopmental diversity in executive function

Abstract

AbstractExecutive functions can be conceptualised as either a set of higher-order cognitive skills that enable us to engage in flexible thinking and regulate our thoughts and behaviours, or as the ability to integrate knowledge, beliefs, and values when applying cognitive control in everyday situations. These two perspectives map onto the ways in which executive function is measured in childhood – using either structured laboratory tasks or ratings of everyday behaviours. Differences in executive functioning are associated with neurodevelopmental differences, but evidence for associations between specific profiles of executive function and specific neurodevelopmental conditions is mixed. In this study, we adopt a data-driven approach to identify common profiles of executive function in a transdiagnostic sample of 566 neurodivergent children, using both performance and rating-based measures of executive function. Three profiles of executive function were identified: one had consistent difficulties across both types of assessments, while the other two had inconsistent profiles of predominantly rating- or predominantly task-based difficulties. Children with these different profiles had differences in academic achievement and mental health outcomes and could further be differentiated from a comparison group of neurotypical children on both shared and profile-unique patterns of neural white matter organisation. Importantly, children’s executive function profiles were not directly related to diagnostic categories or to dimensions of neurodiversity associated with specific diagnoses (e.g., hyperactivity, inattention, social communication). These findings support the idea that there are separate domains of executive function and that the two types of assessment tapping these functions are dissociable and provide non-redundant information related to neurodevelopmental differences. These findings advance our understanding of executive function profiles in neurodivergent populations and their relationship to behavioural outcomes and neural variation.