Executive Functions and Symptom Severity in an Italian Sample of Intellectually Able Preschoolers with Autism Spectrum D
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ORIGINAL PAPER
Executive Functions and Symptom Severity in an Italian Sample of Intellectually Able Preschoolers with Autism Spectrum Disorder Giovanni Valeri1 · Laura Casula1 · Eleonora Napoli1 · Paolo Stievano2 · Barbara Trimarco1 · Stefano Vicari1 · Teresa Gloria Scalisi3
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract A novel battery (BAFE; Valeri et al. 2015) was used in order to assess three executive function (EF) abilities (working memory, inhibition and shifting) in a sample of 27 intellectually able preschoolers with autism spectrum disorder (ASD) compared with 27 typically developing children matched on age and nonverbal IQ. Differences in EF skills were analyzed in participants with distinct ASD symptom severity. Children with ASD performed worse than typical controls on both setshifting and inhibition, but not on visuo-spatial working memory. Additionally, children with more severe ASD symptoms showed a worse performance on inhibition than children with milder symptoms. These results confirm the presence of EF deficits and highlight a link between ASD symptoms and EF impairments in preschool age. Keywords Working memory · Inhibition · Shifting · Autism spectrum disorder · Preschoolers · Executive functions
Introduction Executive functions (EFs) are a set of higher cognitive processes able to regulate more automatic processes toward a goal, associated with the prefrontal cortex and with interconnected subcortical systems (Stuss 1992; Zelazo and Müller 2002; Diamond 2013). The EF construct contributes to the understanding of typical and atypical development, with relevant implications in clinical and educational fields (Diamond 2016). There is general agreement that three core EF processes can be identified in adulthood (Diamond 2013) as was first proposed by Miyake et al. (2000), who differentiated the following EF subdomains: updating (maintaining information in working memory and refreshing it in the presence of new information), inhibition (response inhibition and interference control) and shifting (or switching, the ability * Barbara Trimarco [email protected] 1
Department of Neuroscience, Child Neuropsychiatric Unit, Bambino Gesù Children’s Hospital, Piazza Sant’Onofrio 4, 00165 Rome, Italy
2
Azienda Sanitaria Locale ROMA 2, Rome, Italy
3
Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
to shift attention between two tasks). However, even though results on 8 to 13 year-old children confirmed the threefactor model (Lehto et al. 2003), it is still an open question if this model is appropriate for a child population. In fact Lee et al. (2013) showed that many confirmatory factor analytic studies on the EF structure in children failed to find evidence for differentiation into the three Miyake et al.’s factors. Hughes et al. (2010) found that inhibitory control, working memory and planning tapped a single underlying cognitive construct in 4 and 6 year-old children, but the result may have been due to
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