Executive function and intellectual disability: innovations, methods and treatment

2021 ◽  
Author(s):  
D. J. Fidler ◽  
S. Lanfranchi
Keyword(s):  
Executive Function ◽  
Intellectual Disability

scholarly journals Lagging skills contribute to challenging behaviors in children with autism spectrum disorder without intellectual disability

Autism ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 898-906 ◽  
Author(s):  
Brenna B Maddox ◽  
Patrick Cleary ◽  
Emily S Kuschner ◽  
Judith S Miller ◽  
Anna Chelsea Armour ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Emotion Regulation ◽  
Executive Function ◽  
Intellectual Disability ◽  
Social Skills ◽  
Challenging Behaviors ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Environmental Demands

Many children with autism spectrum disorder display challenging behaviors. These behaviors are not limited to those with cognitive and/or language impairments. The Collaborative and Proactive Solutions framework proposes that challenging behaviors result from an incompatibility between environmental demands and a child’s “lagging skills.” The primary Collaborative and Proactive Solutions lagging skills—executive function, emotion regulation, language, and social skills—are often areas of weakness for individuals with autism spectrum disorder. The purpose of this study was to evaluate whether these lagging skills are associated with challenging behaviors in youth with autism spectrum disorder without intellectual disability. Parents of 182 youth with autism spectrum disorder (6–15 years) completed measures of their children’s challenging behaviors, executive function, language, emotion regulation, and social skills. We tested whether the Collaborative and Proactive Solutions lagging skills predicted challenging behaviors using multiple linear regression. The Collaborative and Proactive Solutions lagging skills explained significant variance in participants’ challenging behaviors. The Depression (emotion regulation), Inhibit (executive function), and Sameness (executive function) scales emerged as significant predictors. Impairments in emotion regulation and executive function may contribute substantially to aggressive and oppositional behaviors in school-age youth with autism spectrum disorder without intellectual disability. Treatment for challenging behaviors in this group may consider targeting the incompatibility between environmental demands and a child’s lagging skills.

Adding the missing voice: How self-report of autistic youth self-report on an executive functioning rating scale compares to parent report and that of youth with attention deficit hyperactivity disorder or neurotypical development

Autism ◽  
2021 ◽  
pp. 136236132110291
Author(s):  
Lauren Kenworthy ◽  
Alyssa Verbalis ◽  
Julia Bascom ◽  
Sharon daVanport ◽  
John F Strang ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Executive Function ◽  
Intellectual Disability ◽  
Executive Functions ◽  
Attention Deficit ◽  
Parent Report ◽  
Self Report ◽  
Youth Self Report ◽  
Hyperactivity Disorder ◽  
Autistic People

Executive functions are related to key outcomes. Studies of autistic youth self-report of other nonsocial traits indicate that their insights into their own functioning and internal experiences provide important information that is not captured by their parents’ report, but youth self-report of executive function has not been researched in autism. We investigate self- and parent-report on the Behavior Rating Inventory of Executive Function-2 in 197 autistic youth without intellectual disability, including the magnitude and profile of problems reported across subdomains of executive function. We also compare autistic self-report to that of 114 youth with attention deficit hyperactivity disorder and 197 neurotypical youth. We find that autistic youth report significant executive function challenges in comparison to neurotypical youth and a distinctive profile of challenges in comparison to attention deficit hyperactivity disorder youth. Parents and their autistic children diverge regarding the severity of the youth’s executive function difficulties, but both emphasize flexibility problems within their profile of executive function challenges. Intraclass correlation coefficients between parent and youth ratings were moderate to poor in the autistic group, indicating that autistic youth report adds important information beyond that captured by their parents’ report. These data elevate the importance of asking autistic youth directly about their own executive function. Lay abstract 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.

scholarly journals Validation of the NIH Toolbox Cognitive Battery in intellectual disability

Neurology ◽  
2020 ◽  
Vol 94 (12) ◽  
pp. e1229-e1240 ◽  
Author(s):  
Rebecca H. Shields ◽  
Aaron J. Kaat ◽  
Forrest J. McKenzie ◽  
Andrea Drayton ◽  
Stephanie M. Sansone ◽  
...  
Keyword(s):  
Executive Function ◽  
Intellectual Disability ◽  
Convergent Validity ◽  
Fragile X ◽  
Outcome Measurement ◽  
Receptive Language ◽  
Cognitive Outcome ◽  
Language Deficit ◽  
Mental Age ◽  
Feasibility Test

ObjectiveTo advance the science of cognitive outcome measurement for individuals with intellectual disability (ID), we established administration guidelines and evaluated the psychometric properties of the NIH-Toolbox Cognitive Battery (NIHTB-CB) for use in clinical research.MethodsWe assessed feasibility, test-retest reliability, and convergent validity of the NIHTB-CB (measuring executive function, processing speed, memory, and language) by assessing 242 individuals with fragile X syndrome (FXS), Down syndrome (DS), and other ID, ages 6 through 25 years, with retesting completed after 1 month. To facilitate accessibility and measurement accuracy, we developed accommodations and standard assessment guidelines, documented in an e-manual. Finally, we assessed the sensitivity of the battery to expected syndrome-specific cognitive phenotypes.ResultsAbove a mental age of 5.0 years, all tests had excellent feasibility. More varied feasibility across tests was seen between mental ages of 3 and 4 years. Reliability and convergent validity ranged from moderate to strong. Each test and the Crystallized and Fluid Composite scores correlated moderately to strongly with IQ, and the Crystallized Composite had modest correlations with adaptive behavior. The NIHTB-CB showed known-groups validity by detecting expected executive function deficits in FXS and a receptive language deficit in DS.ConclusionThe NIHTB-CB is a reliable and valid test battery for children and young adults with ID with a mental age of ≈5 years and above. Adaptations for very low-functioning or younger children with ID are needed for some subtests to expand the developmental range of the battery. Studies examining sensitivity to developmental and treatment changes are now warranted.

Investigation of the Clinical Utility of the BRIEF2 in Youth With and Without Intellectual Disability

2020 ◽  
Vol 26 (10) ◽  
pp. 1036-1044
Author(s):  
Y. Shishido ◽  
E.M. Mahone ◽  
L.A. Jacobson
Keyword(s):  
Executive Function ◽  
Intellectual Disability ◽  
Clinical Utility ◽  
Comparison Group ◽  
Behavior Rating ◽  
Behavioral Regulation ◽  
Self Monitoring ◽  
Structural Differences ◽  
Behavior Rating Inventory ◽  
Per Se

AbstractObjective:Executive function (EF) difficulties are commonly found in youth with intellectual disability (ID). Given mixed results from studies using performance-based EF measures, the EF profile has not been well characterized for this population. No published work has examined the clinical utility of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) in distinguishing EF in ID. We hypothesized that the BRIEF2 would show greater elevations in youth with ID compared to the Average IQ comparison group.Methods:Participants included a large sample of 504 youth (157 in ID group; aged 8–18 years) referred for (neuro)psychological evaluation (2015–2019) and identified as meeting criteria for either ID or Average IQ comparison group.Results:Significant elevations were found across BRIEF2 indices and scales. Only mild elevations were noted in selective cognitive regulation scales within the Average IQ group. Groups differed significantly across all EF dimensions, with greater differences observed in behavioral regulation (Self-Monitoring, Inhibition), Shift, and Working Memory. An elevated but less variable pattern of index scores was noted in ID, while the overall pattern of scaled scores appeared similar between groups.Conclusions:The less variable and consistently elevated profile may suggest fewer EF dimensions in individuals with ID than the model proposed in the test manual. Similar profiles between groups may reflect differences in severity, rather than differences in constructs measured by the EF factors, per se. Additional examination is needed to confirm potential structural differences in EF for youth with ID as measured by BRIEF2, with a clinical implication for greater efficiency of EF assessment in this population.

scholarly journals Self-Regulation in Children with Intellectual Disability

2015 ◽  
Vol 16 (3-4) ◽  
Author(s):  
Haris Memisevic
Keyword(s):  
Executive Function ◽  
Intellectual Disability ◽  
Academic Success ◽  
Executive Functions ◽  
Self Regulation ◽  
Educational Institutions ◽  
Mild Intellectual Disability ◽  
Behavior Rating Inventory ◽  
Clinically Significant ◽  
Children With Intellectual Disability

Abstract. Self-regulation is an important executive function responsible for the control of emotions, behaviors and inner processes. It is related to the academic success of the children as well as to their cognitive and social development. Children with intellectual disability are reported to have significant deficits in self-regulation skills.The goal of this study was to examine self-regulation skills in children with mild intellectual disability. The additional goals were to examine self-regulation in relation to the child’s gender and to examine the relationship between age and self-regulation.. The sample for this study comprised 42 children with mild intellectual disability, aged 7 to 15. There were 22 boys and 20 girls. Self-regulation was assessed with the Behavior Rating Inventory of Executive Function (BRIEF).. The results indicated that 10 children or 23.8% had clinically significant deficit in self-regulation skills. Self-regulation skills in this sample were significantly lower as compared to the normative sample. Boys had better self-regulation skills than the girls in this sample. Self-regulation skills were improving with age for this sample of participants.. Given the fact that these skills can be improved, it is suggested that educational institutions should give more attention to the development of executive functions at school age. Educational institutions should consider incorporating the training of executive functions into their curriculums.

Normocentric biases taint cognitive neuroscience and intervention of autism

2019 ◽  
Vol 42 ◽  
Author(s):  
Laurent Mottron
Keyword(s):  
Intellectual Disability ◽  
Cognitive Neuroscience ◽  
Social Motivation ◽  
Repetitive Behaviors ◽  
Restricted Interests ◽  
Autistic People

Abstract Stepping away from a normocentric understanding of autism goes beyond questioning the supposed lack of social motivation of autistic people. It evokes subversion of the prevalence of intellectual disability even in non-verbal autism. It also challenges the perceived purposelessness of some restricted interests and repetitive behaviors, and instead interprets them as legitimate exploratory and learning-associated manifestations.

Executive Functions and Clinical and Academic Outcomes in Speech-Language Pathology Graduate Students

2020 ◽  
Vol 5 (5) ◽  
pp. 1221-1230
Author(s):  
Jane Roitsch ◽  
Kimberly A. Murphy ◽  
Anastasia M. Raymer
Keyword(s):  
Executive Function ◽  
Academic Outcomes ◽  
Graduate Program ◽  
Performance Outcomes ◽  
Future Research ◽  
Speech Language Pathology ◽  
Grade Point ◽  
Praxis Ii ◽  
Language Pathology ◽  
Preliminary Study

Purpose The purpose of this study was to investigate executive function measures as they relate to clinical and academic performance outcomes of graduate speech-language pathology students. Method An observational design incorporating correlations and stepwise multiple regressions was used to determine the strength of the relationships between clinical outcomes that occurred at various time points throughout the graduate program (clinical coursework grades throughout the program and case study paper scores at the end of the program), academic outcomes (graduate grade point average and Praxis II exam in speech-language pathology scores), and executive function (EF) scores (EF assessment scores, self-reported EF scores). Participants were 37 students (36 women, M age = 24.1) in a master's degree program in speech-language pathology at a southeastern U.S. university during the 2017–2018 academic year. Results Findings of this preliminary study indicated that a limited number of objective EF scores and self-reported EF scores were related to clinical and academic outcomes of graduate speech-language pathology students. Conclusion As results of this preliminary study suggest that EF tests may be related to clinical and academic outcomes, future research can move to study the potential role of EF measures in the graduate admissions process in clinical graduate programs such as speech-language pathology.

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