Identifying Child Correlates of Parent-Reported Executive Functioning Impairments in Preschool-Aged Children with Autism Spectrum Disorder: An Examination of both Early and Concurrent Child Characteristics

While executive functioning (EF) impairments are common among school-aged children and adolescents with Autism Spectrum Disorder (ASD), less is known about the emergence of EF in preschool-aged children with ASD. An additional gap in the literature is the dearth of studies that examine all four of the core domains of EF (i.e., working memory, inhibition, shifting, and planning), making it difficult to fully characterize EF in this younger population. The present study aimed to describe the rates of parent-reported EF impairment in preschool-aged children with ASD, as measured using the BRIEF-P, and identify early and concurrent child correlates that are associated with each core domain of EF among young children (mean = 52 months) with ASD. Using data that was collected from a larger ASD study, early developmental characteristics (i.e., fine motor skills, language skills, and parent-reported temperament characteristics) and autism symptoms (i.e., parent-reported symptoms and ADOS severity) were assessed in toddlerhood and again in the preschool period. Analyses controlled for child’s age, nonverbal developmental quotient (NVDQ), and attention skills. Results indicated that children in this sample demonstrated greater EF impairments than would be expected for their chronological age. In addition, early and concurrent correlates were found to be associated with specific domains of EF. Notably, the specific correlates differed when assessed earlier in toddlerhood and later in the preschool period. In toddlerhood, autism symptoms were associated with lower EF in the preschool period; early parent-reported repetitive behavior was correlated with worse performance across the four EF domains of working memory, inhibition, shifting, and planning, and early autism severity, represented by ADOS severity scores, was associated with lower working memory and planning skills during preschool. In the preschool period, temperament characteristics (i.e., lower effortful control, higher negative affectivity, and lower surgency) were correlated with the four EF domains. Concurrent autism symptoms were also associated with EF; parent-reported impairments in social interactions was associated with lower working memory, planning, and shifting, and parent-reported repetitive behavior was correlated with lower scores of concurrent shifting. Clinical implications and future directions are discussed