Assessment and Treatment of Executive Function Impairments in Autism Spectrum Disorder: An Update

Empirical evidence for executive function (EF) impairments in autism spectrum disorder (ASD) was first established more than 30 years ago. In the interim, a large literature has emerged that supports a profile of relatively intact and impaired (e.g., flexibility) EF subdomains in ASD. We pick up where our last review (Kenworthy, Yerys, Anthony, & Wallace, 2008; Neuropsychology Review) left off by examining both laboratory-based and ecologically valid EF assessment findings in ASD, how the presence of comorbid attention deficit hyperactivity disorder (ADHD) symptoms and/or diagnosis affects EF in ASD, and a newly emerging evidence base for intervention studies targeting EF impairments in ASD. The evidence to date suggests that laboratory-based EF findings remain more mixed than those based on ecologically valid assessment of EF (which more consistently reveal EF deficits in ASD), nevertheless, the latter requires more study. Findings also suggest that subgrouping ASD based on ADHD symptomatology might clarify heretofore mixed findings, particularly in terms of inhibitory control deficits. Finally, EF is proving to be a viable treatment target in ASD, although much more work is needed in this area.