Skip to main content

Advertisement

Log in

Relationship Between Executive Functioning and Symptoms of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in 6–8 Year Old Children

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

This study examined relationships between executive functioning (EF) and ADHD/ASD symptoms in 339 6–8 year-old children to characterise EF profiles associated with ADHD and ADHD + ASD. ADHD status was assessed using screening surveys and diagnostic interviews. ASD symptoms were measured using the Social Communication Questionnaire, and children completed assessments of EF. We found the EF profile of children with ADHD + ASD did not differ from ADHD-alone and that lower-order cognitive skills contributed significantly to EF. Dimensionally, ASD and inattention symptoms were differentially associated with EF, whereas hyperactivity symptoms were unrelated to EF. Differences between categorical and dimensional findings suggest it is important to use both diagnostic and symptom based approaches in clinical settings when assessing these children’s functional abilities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Data on these children’s EF in relation to ASD status have not previously been reported.

References

  • Anagnostou, E., & Taylor, M. J. (2011). Review of neuroimaging in autism spectrum disorders: What have we learned and where we go from here. Molecular Autism, 2(1), 4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Anderson, P. (2002). Assessment and development of executive function (EF) during childhood. Child Neuropsychology, 8(2), 71–82.

    Article  PubMed  Google Scholar 

  • Australian Bureau of Statistics. (2013). Census of population and housing: Socio-economic indexes for areas (SEIFA), Australia—Data only. Retrieved August 21, 2015, from http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2033.0.55.0012011?OpenDocument

  • Bink, M., van Boxtel, G. J. M., Popma, A., Bongers, I. L., Denissen, A. J. M., & van Nieuwenhuizen, C. (2015). EEG theta and beta power spectra in adolescents with ADHD versus adolescents with ASD + ADHD. European Child and Adolescent Psychiatry, 24(8), 873–886.

    Article  PubMed  Google Scholar 

  • Bradshaw, J. L., & Sheppard, D. M. (2000). The neurodevelopmental frontostriatal disorders: Evolutionary adaptiveness and anomalous lateralization. Brain and Language, 73(2), 297–320.

    Article  PubMed  Google Scholar 

  • Brassett-Harknett, A., & Butler, N. (2007). Attention-deficit/hyperactivity disorder: An overview of the etiology and a review of the literature relating to the correlates and lifecourse outcomes for men and women. Clinical Psychology Review, 27(2), 188–210.

    Article  PubMed  Google Scholar 

  • Bühler, E., Bachmann, C., Goyert, H., Heinzel-Gutenbrunner, M., & Kamp-Becker, I. (2011). Differential diagnosis of autism spectrum disorder and attention deficit hyperactivity disorder by means of inhibitory control and “theory of mind”. Journal of Autism and Developmental Disorders, 41, 1718–1726.

    Article  PubMed  Google Scholar 

  • Conners, C. (2008). Conners (3rd ed.). Toronto: Multi-health systems.

    Google Scholar 

  • Dennis, M., Francis, D. J., Cirino, P. T., Barnes, M. A., & Fletcher, J. M. (2009). Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15(3), 331–343.

    Article  PubMed  PubMed Central  Google Scholar 

  • Di Martino, A., Zuo, X. N., Kelly, C., Grzadzinski, R., Mennes, M., Schvarcz, A., et al. (2013). Shared and distinct intrinsic functional network centrality in autism and attention-deficit/hyperactivity disorder. Biological Psychiatry, 74(8), 623–632.

    Article  PubMed  PubMed Central  Google Scholar 

  • Efron, D., Sciberras, E., Anderson, V., Hazell, P., Ukoumunne, O. C., Jongeling, B., et al. (2014). Functional status in children with ADHD at age 6–8: A controlled community study. Pediatrics, 134(4), e992–e1000.

    Article  PubMed  Google Scholar 

  • Gargaro, B. A., Rinehart, N. J., Bradshaw, J. L., Tonge, B. J., & Sheppard, D. M. (2011). Autism and ADHD: How far have we come in the comorbidity debate? Neuroscience and Biobehavioral Reviews, 35, 1081–1088.

    Article  PubMed  Google Scholar 

  • Geurts, H. M., Verté, S., Oosterlaan, J., Roeyers, H., & Sergeant, J. (2004). How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? Journal of Child Psychology and Psychiatry and Allied Disciplines, 45(4), 836–854.

    Article  Google Scholar 

  • Goldberg, M. C., Mostofsky, S. H., Cutting, L. E., Mahone, E. M., Astor, B. C., Denckla, M. B., et al. (2005). Subtle executive impairment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35(3), 279–293.

    Article  PubMed  Google Scholar 

  • Happé, F., Booth, R., Charlton, R., & Hughes, C. (2006). Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: Examining profiles across domains and ages. Brain and Cognition, 61, 25–39.

    Article  PubMed  Google Scholar 

  • Howell, D. (2002). Statistical methods for psychology (5th ed.). Belmont, CA: Duxbury Press.

    Google Scholar 

  • Kochhar, P., Batty, M. J., Liddle, E. B., Groom, M. J., Scerif, G., Liddle, P. F., et al. (2011). Autistic spectrum disorder traits in children with attention deficit hyperactivity disorder. Child: Care, Health and Development, 37(1), 103–110.

    Google Scholar 

  • Lim, L., Chantiluke, K., Cubillo, A. I., Smith, A. B., Simmons, A., Mehta, M. A., et al. (2015). Disorder-specific grey matter deficits in attention deficit hyperactivity disorder relative to autism spectrum disorder. Psychological Medicine, 45(05), 965–976.

    Article  PubMed  Google Scholar 

  • Manly, T., Robertson, I. H., Anderson, V., & Nimmo-Smith, I. (1999). The test of everyday attention for children (TEA-Ch)—Manual. Suffolk: Thames Valley Test Company.

    Google Scholar 

  • Matsuura, N., Ishitobi, M., Arai, S., Kawamura, K., Asano, M., Inohara, K., et al. (2014). Distinguishing between autism spectrum disorder and attention deficit hyperactivity disorder by using behavioral checklists, cognitive assessments, and neuropsychological test battery. Asian Journal of Psychiatry, 12, 50–57.

    Article  PubMed  Google Scholar 

  • Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latent variable analysis. Cognitive Psychology, 41(1), 49–100.

    Article  PubMed  Google Scholar 

  • Pennington, B. F., & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry and Allied Disciplines, 37(1), 51–87.

    Article  Google Scholar 

  • Perneger, T. V. (1998). What’s wrong with Bonferroni adjustments. BMJ, 316(7139), 1236–1238.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pietrzak, R. H., Mollica, C. M., Maruff, P., & Snyder, P. J. (2006). Cognitive effects of immediate-release methylphenidate in children with attention-deficit/hyperactivity disorder. Neuroscience and Biobehavioral Reviews, 30(8), 1225–1245.

    Article  PubMed  Google Scholar 

  • Reiersen, A. M. (2011). Links between autism spectrum disorder and ADHD symptom trajectories: important findings and unanswered questions. Journal of the American Academy of Child and Adolescent Psychiatry, 50(9), 857–859.

    Article  PubMed  Google Scholar 

  • Reiersen, A. M., Constantino, J. N., Volk, H. E., & Todd, R. D. (2007). Autistic traits in a population-based ADHD twin sample. Journal of Child Psychology and Psychiatry and Allied Disciplines, 48(5), 464–472.

    Article  Google Scholar 

  • Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire-WPS (SCQ-WPS). Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Sciberras, E., Efron, D., Schilpzand, E. J., Anderson, V., Jongeling, B., Hazell, P., et al. (2013). The Children’s Attention Project: A community-based longitudinal study of children with ADHD and non-ADHD controls. BMC Psychiatry, 13, 18.

    Article  PubMed  PubMed Central  Google Scholar 

  • Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A., & Butcher, B. (2010). Executive functioning in children with asperger syndrome, ADHD-combined type, ADHD-predominately inattentive type, and controls. Journal of Autism and Developmental Disorders, 40(8), 1017–1027.

    Article  PubMed  Google Scholar 

  • Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 28–38.

    Article  PubMed  Google Scholar 

  • Shaywitz, B. A., Fletcher, J. M., & Shaywitz, S. E. (1995). Defining and classifying learning disabilities and attention-deficit/hyperactivity disorder. Journal of Child Neurology, 10(Suppl 1), S50–S57.

    Article  PubMed  Google Scholar 

  • Sinzig, J., Morsch, D., Bruning, N., Schmidt, M. H., & Lehmkuhl, G. (2008). Inhibition, flexibility, working memory and planning in autism spectrum disorders with and without comorbid ADHD-symptoms. Child and Adolescent Psychiatry and Mental Health, 2(1), 4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sonuga-Barke, E. J. S. (2005). Causal models of attention-deficit/hyperactivity disorder: From common simple deficits to multiple developmental pathways. Biological Psychiatry, 57(11), 1231–1238.

    Article  PubMed  Google Scholar 

  • Spencer-Smith, M., & Anderson, V. (2009). Healthy and abnormal development of the prefrontal cortex. Developmental Neurorehabilitation, 12(5), 279–297.

    Article  PubMed  Google Scholar 

  • St Pourcain, B., Mandy, W. P., Heron, J., Golding, J., Smith, G. D., & Skuse, D. H. (2011). Links between co-occurring social-communication and hyperactive-inattentive trait trajectories. Journal of the American Academy of Child and Adolescent Psychiatry, 50(9), 892–902.e5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stanfield, A. C., McIntosh, A. M., Spencer, M. D., Philip, R., Gaur, S., & Lawrie, S. M. (2008). Towards a neuroanatomy of autism: A systematic review and meta-analysis of structural magnetic resonance imaging studies. European Psychiatry, 23(4), 289–299.

    Article  PubMed  Google Scholar 

  • Takeuchi, A., Ogino, T., Hanafusa, K., Morooka, T., Oka, M., Yorifuji, T., et al. (2013). Inhibitory function and working memory in attention defcit/hyperactivity disorder and pervasive developmental disorders: Does a continuous cognitive gradient explain ADHD and PDD traits? Acta Medica Okayama, 67(5), 293–303.

    PubMed  Google Scholar 

  • Tye, C., Asherson, P., Ashwood, K. L., Azadi, B., Bolton, P., & McLoughlin, G. (2014). Attention and inhibition in children with ASD, ADHD and co-morbid ASD + ADHD: an event-related potential study. Psychological Medicine, 44, 1101–1116.

    Article  Google Scholar 

  • van der Meer, J. M. J., Lappenschaar, M. G. A., Hartman, C. A., Greven, C. U., Buitelaar, J. K., & Rommelse, N. N. J. (2014). Homogeneous Combinations of ASD-ADHD Traits and Their Cognitive and Behavioral Correlates in a Population-Based Sample. Journal of Attention Disorders. doi:10.1177/1087054714533194.

    PubMed  Google Scholar 

  • van der Meer, J. M. J., Oerlemans, A. M., van Steijn, D. J., Lappenschaar, M. G. A., de Sonneville, L. M. J., Buitelaar, J. K., et al. (2012). Are autism spectrum disorder and attention-deficit/hyperactivity disorder different manifestations of one overarching disorder? Cognitive and symptom evidence from a clinical and population-based sample. Journal of the American Academy of Child and Adolescent Psychiatry, 51(11), 1160–1172.e3.

    Article  PubMed  Google Scholar 

  • Walsh, K. (1988). Neuropsychology: A clinical approach. Edinburgh: Churchill Livinstone.

    Google Scholar 

  • Wechsler, D. (1999). Wechsler abbreviated scale of intelligence. San Antonio, TX: Harcourt Assessment Inc.

    Google Scholar 

  • Wechsler, D. (2003). Wechsler intelligence scale for children–Fourth Edition (WISC-IV). San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Wei, T., Chesnut, S. R., Barnard-Brak, L., & Richman, D. (2015). Psychometric Analysis of the Social Communication Questionnaire using an item-response theory framework: Implications for the use of the lifetime and current forms. Journal of Psychopathology and Behavioral Assessment, 37(3), 469–480.

    Article  Google Scholar 

  • Welsh, M. C., & Pennington, B. F. (1988). Assessing frontal lobe functioning in children: Views from developmental psychology. Developmental Neuropsychology, 4(3), 199–230.

    Article  Google Scholar 

  • Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biological Psychiatry, 57(11), 1336–1346.

    Article  PubMed  Google Scholar 

  • Yerys, B. E., Wallace, G. L., Sokoloff, J. L., Shook, D. A., James, J. D., & Kenworthy, L. (2009). Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders. Autism Research: Official Journal of the International Society for Autism Research, 2(6), 322–333.

    Google Scholar 

Download references

Acknowledgments

We would like to acknowledge all research staff, students and interns who contributed to data collection for this project. We would also like to thank the families, teachers and schools that have participated in the project.

Authors’ Contributions

RN performed the statistical analysis, participated in the interpretation of data, and drafted the manuscript; JG assisted with the statistical analysis, interpretation of data and drafting the manuscript; ES participated in the design and coordination of the study, interpretation of data and drafting the manuscript; PH participated in the design of the study and revised the manuscript critically for important intellectual content; VA participated in the design of the study, interpretation of data, and drafting the manuscript. All authors read and approved the final manuscript.

Funding

The study received funding from the National Health and Medical Research Council of Australia (NHMRC Project Grant #1008522) and internal funding from the Murdoch Childrens Research Institute. RN’s research is supported by Murdoch Children Research Institute (MCRI). JG is funded by a Monash University Australian Postgraduate Scholarship (APA; 2012–2015). ES is funded by an NHMRC Early Career Fellowship in Population Health 1037159 (2012–2015) and an NHMRC Career Development Fellowship 1110688 (2016–2019). VA is funded by an NHMRC Senior Practitioner Fellowship 607333 (2010–2014). Research at the MCRI is supported by the Victorian Government’s Operational Infrastructure Program. The sponsors, had no role in study design; the collection, analysis and interpretation of data; writing of the report; or the decision to submit the article for publication.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Emma Sciberras.

Ethics declarations

Conflict of interest

VA declares a financial disclosure and conflict of interest associated with the Test of Everyday Attention for Children (TEA-Ch), as she receives royalties from Pearson Publishing. All other authors declare that they have no conflict of interest.

Ethical Approval

Ethical approval was granted by the Human Research Ethics Committees of the Royal Children’s Hospital (#31056) and the Victorian Department of Education and Early Childhood Development (#2011_001095). All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all participants and ethical approval was granted by the Human Research Ethics Committees of the Royal Children’s Hospital (#31056) and the Victorian Department of Education and Early Childhood Development (#2011_001095).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Neely, R.J., Green, J.L., Sciberras, E. et al. Relationship Between Executive Functioning and Symptoms of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in 6–8 Year Old Children. J Autism Dev Disord 46, 3270–3280 (2016). https://doi.org/10.1007/s10803-016-2874-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-016-2874-6

Keywords

Navigation