Real-world executive functioning for autistic children in school and home settings

Abstract

Executive function challenges are commonly reported in the home setting for children with an autism spectrum disorder diagnosis (hereafter, autism), but little is known about these challenges in the school setting. A total of 337 youth (autism, N = 241 and typically developing, N = 96) were assessed using Behavior Rating Inventory of Executive Function ratings from home and school settings. Within each setting, we examined differences in specific executive function skills between diagnostic groups. Then, we examined if the autism group showed similar peak executive function impairments, associations with age, and relationships with adaptive behavior across settings. Finally, we examined inter-rater reliability. Autism and typically developing groups differed on all Behavior Rating Inventory of Executive Function scales in both settings. The Shift scale was the peak impairment in the autism group in both settings. There was also an effect of age on executive function impairment in both settings, and executive function ratings in both settings significantly predicted individual adaptive behavior domains. Inter-rater correlations for autistic participants were similar to inter-rater reliability correlations from the Behavior Rating Inventory of Executive Function standardization sample. This study shows that autistic children experience similar but not identical real-world executive function challenges across school and home settings and that supports may vary by setting. Lay abstract Executive functioning skills are important for children to be able to control thoughts, emotions, and actions, and for their ability to adapt to different settings. Previous studies have found that autistic children have difficulty with executive functioning, but most of these studies took place in the home setting. Executive functioning skills in autistic children have not yet been fully examined in the school setting. This is a knowledge gap that needs to be addressed because the school setting is potentially one of the most demanding in terms of executive functioning and is a setting where executive function interventions are already being used for autistic children. In order to learn more about executive functioning for autistic children in the school setting, this study compared ratings of executive function from autistic children’s caregivers and school professionals. The study found that autistic children experience similar but not identical executive function challenges across school and home settings and that supports may differ in each setting. Having information about differences in executive functioning challenges and supports for autistic children across settings can help lead to development of supports that are tailored to each setting.

Effects of the Early Phase of COVID-19 on the Autistic Community in Sweden: A Qualitative Multi-Informant Study Linking to ICF

“…Students and employed participants reported having to themselves seek out support, self-initiate work, transition from work to leisure and between activities, sorting through general written information, planning and structuring work, and staying motivated throughout the day to a larger extent during the pandemic. Self-management functions may be particularly challenging for the general autism community [45] and many may need pedagogical support in everyday settings (including home-, school-, and work environments) relating to these challenges [7][8][9]. It is therefore not surprising that our participants found these particular demands caused distress and other negative outcomes.…”

“…The distinctive diagnostic features and functional impairments are associated with a preference for highly predictable environments [3]. Conversely, change, unpredictability, and uncertainty are circumstances under which autistic individuals may respond with significant emotional and behavioral distress [7][8][9][10][11][12]. Moreover, caregivers of autistic children experience higher levels of stress than other groups of parents during pre-pandemic conditions [13] relating to the lifelong needs of their child, parents' pivotal role in advocacy, care coordination and provision, as well as typically variable access to targeted formal support [14].…”

Moulding environmental contexts to optimise neurodiverse executive function performance and development: A goodness‐of‐fit account

“…Teacher‐reported sensory processing issues predict lower scores on EF performance measures among autistic children (Pastor‐Cerezuela et al, 2020). It is perhaps not surprising then that although EF difficulties are observed in both the home and school setting for autistic children, researchers have found evidence for a widening gap with age in actualised EF ability between autistic and neurotypical groups in the school setting, but not the home setting (Tschida & Yerys, 2022). Further, research indicates that autistic children have more variable observer‐reported EF scores across home and school settings compared with neurotypical samples (Tschida & Yerys, 2022), while teachers report greater EF difficulties for children with ADHD compared with their parents (Mares et al, 2007; Soriano‐Ferrer et al, 2014), indicating that neurodivergent children's EF performance is more vulnerable to poor environmental fit, and/or that they are more likely to experience differences in the degree of environmental fit between home and school compared with neurotypical peers.…”

Executive Functions in Children and Adolescents with Autism Spectrum Disorder in Family and School Environment

“…There is more information on the possible dysfunction at the EF level in people with autism in the domestic context than in the educational environment [10], denoting that the perception of teachers and parents suggests that they tend to underestimate the EF [6,11].…”