Children's National, USA.
Autistic Self Advocacy Network, USA.
Autism. 2022 Feb;26(2):422-433. doi: 10.1177/13623613211029117. Epub 2021 Jul 9.
Executive functions are often impaired in autistic people and relate to important outcomes such as mental health, success in school and work, and quality of life. Evaluating executive functions helps autistic people, clinicians, and families identify targets for external supports and skill building. Youth self-report of executive function has not been studied, yet we know that self-report from autistic youth is key to understanding other cognitive/behavioral phenomena in autism such as anxiety, obsessions/compulsions, sensory sensitivities, and repetitive behaviors. We investigated self- and parent-report of executive function problems in 197 autistic youth without intellectual disability (ages 11-18 years), including the magnitude and profiles of executive function problems autistic youth report across subdomains of executive function. We compared autistic self-report with that of 114 youth with attention deficit hyperactivity disorder without intellectual disability and 197 neurotypical youth. We found that autistic youth report significant executive function problems compared to neurotypical youth and a distinctive profile of challenges in comparison to attention deficit hyperactivity disorder youth. Parents and their autistic children diverged regarding the magnitude of the youth's executive function difficulties, but both identify inflexibility as the most impaired executive function subdomain. Autistic youth and their parents were somewhat more concordant in their report of executive function problems than youth with attention deficit hyperactivity disorder and their parents, but only showed moderate concordance at best. These findings elevate the importance of asking autistic youth directly about their executive functioning when engaging them in assessment and intervention, or researching executive functions in autism.
执行功能在自闭症患者中经常受损，与心理健康、学业和工作成功以及生活质量等重要结果相关。评估执行功能有助于自闭症患者、临床医生和家庭确定需要外部支持和技能培养的目标。青少年对执行功能的自我报告尚未得到研究，但我们知道，自闭症青少年的自我报告是理解自闭症中其他认知/行为现象（如焦虑、强迫症/冲动、感官敏感性和重复行为）的关键。我们调查了 197 名无智力障碍的自闭症青少年（年龄 11-18 岁）的自我报告和家长报告的执行功能问题，包括自闭症青少年在执行功能各子领域报告的执行功能问题的严重程度和特征。我们将自闭症青少年的自我报告与 114 名无智力障碍的注意缺陷多动障碍青少年和 197 名神经典型青少年进行了比较。我们发现，与神经典型青少年相比，自闭症青少年报告的执行功能问题显著，与注意缺陷多动障碍青少年相比，他们的问题特征也明显不同。家长和他们的自闭症孩子在孩子执行功能困难的严重程度上存在分歧，但都认为灵活性是最受损的执行功能子领域。自闭症青少年及其家长在报告执行功能问题方面的一致性比注意缺陷多动障碍青少年及其家长略高，但最多也只有中等一致性。这些发现强调了在对自闭症患者进行评估和干预，或研究自闭症中的执行功能时，直接询问自闭症患者有关其执行功能的重要性。
